bluuebunny/crossref_metadata_2025 huggingface dataset:
Up-Regulation of the Excitatory Amino Acid Transporters EAAT1 and EAAT2 by Mammalian Target of Rapamycin
Authors: Abousaab Abeer , Uzcategui Nestor Luis , Elsir Bhaeldin , Lang Florian
Published: November 2016

Background: The excitatory amino-acid transporters EAAT1 and EAAT2 clear glutamate from the synaptic cleft and thus terminate neuronal excitation. The carriers are subject to regulation by various kinases. The EAAT3 isoform is regulated by mammalian target of rapamycin (mTOR). The present study thus explored whether mTOR influences transport by EAAT1 and/or EAAT2. Methods: cRNA encoding wild type EAAT1 (SLC1A3) or EAAT2 (SLC1A2) was injected into Xenopus oocytes without or with additional injection of cRNA encoding mTOR. Dual electrode voltage clamp was performed in order to determine electrogenic glutamate transport (IEAAT). EAAT2 protein abundance was determined utilizing chemiluminescence. Results: Appreciable IEAAT was observed in EAAT1 or EAAT2 expressing but not in water injected oocytes. IEAAT was significantly increased by coexpression of mTOR. Coexpression of mTOR increased significantly the maximal IEAAT in EAAT1 or EAAT2 expressing oocytes, without significantly modifying affinity of the carriers. Moreover, coexpression of mTOR increased significantly EAAT2 protein abundance in the cell membrane. Conclusions: The kinase mTOR up-regulates the excitatory amino acid transporters EAAT1 and EAAT2.
Knockdown of Radixin Suppresses Gastric Cancer Metastasis In Vitro by Up-Regulation of E-Cadherin via NF-κB/Snail Pathway
Authors: Zhu Yu-Wen , Yan Jun-Kai , Li Juan-Juan , Ou Yang-Ming , Yang Qing
Published: November 2016

Background/Aims: Radixin has recently been shown to correlate with the metastasis of gastric cancer, but the pathogenesis is elusive. Adhesion proteins contribute to the regulation of metastasis, and thus this study sought to investigate the role of radixin in the migration, invasion and adhesion of gastric cancer cells, as well as its interaction with adhesion proteins in vitro. Methods: Radixin stable knockdown human gastric carcinoma SGC-7901 cells were constructed. Alterations in the migration, invasion and adhesion ability were examined by matrigel-coated plate and transwell assays. The expression pattern of adhesion proteins, including E-cadherin, β-catenin and claudin-1, was determined by quantitative real-time PCR and western blot. Possible involvement of NF-κB/snail pathway was also evaluated. Results: Stable knockdown of radixin significantly suppressed migration and invasion, but enhanced adhesion in SGC-7901 cells. The expression of E-cadherin was manifestly increased in radixin knockdown cells, whereas the expression of β-catenin and claudin-1 was unchanged. The nuclear exclusion of NF-κB followed by conspicuous reduction of snail expression was involved in the regulation of E-cadherin expression. Conclusions: Radixin knockdown suppresses the metastasis of SGC-7901 cells in vitro by up-regulation of E-cadherin. The NF-κB/snail pathway contributes to the regulation of E-cadherin in response to depletion of radixin.
You Can't Always Get What You Want: Why Foreign-Imposed Regime Change Seldom Improves Interstate Relations
Authors: Downes Alexander B. , O'Rourke Lindsey A.
Published: November 2016

States frequently employ overt and covert foreign-imposed regime change (FIRC) to pursue their foreign policy interests. Yet there is little scholarship on the question of whether FIRCs improve relations between the states involved. In fact, most FIRCs either fail to reduce—or increase—the likelihood of militarized disputes between interveners and targets. Fundamentally, FIRC entails a principal-agent problem: foreign-imposed leaders rule over states with interests different from those of the intervener. Whereas the intervening state wants the new leader to pursue policies that reflect its interests, once in power, such leaders are focused on ensuring their political survival, a task that is often undermined by implementing the intervener's agenda. Foreign-imposed leaders who carry out the intervener's desired policies attract the ire of domestic actors. These domestic opponents can force the regime to reverse course or may even remove it from power in favor of leaders who are hostile to the intervener; in both cases, the result can be renewed conflict with the intervener. Rwanda's replacement of Mobutu Sese Seko with Laurent-Désiré Kabila in Zaire illustrates this problem.
Solution by Negotiation and Determination by Arbitration in Arab World Construction Disputes: Comparative Study between fidic Rules of 1987 and fidic Rules of 1999
Authors: Daradkeh Lafi
Published: November 2016

This article deals with dispute settlement mechanisms for construction, in particular, fidic contracts. The fidic Rules provide for a two-step process of dispute settlement. The first step, which is amiable in nature, relies on the consulting engineer under the fidic Rules of 1987 and on the Dispute Adjudication Board under the fidic Rules of 1999. In the second step, the dispute will be submitted to arbitration for a binding decision upon the request of one of the parties. This article is concerned with the first step, and offers a comparative analysis of the fidic Rules of 1987, which depend on the consulting engineer, and the fidic Rules of 1999, which depend on the Dispute Adjudication Board.
Human Weakness in Isaac of Nineveh and the Syriac Macarian Corpus: A First Investigation
Authors: Duca Valentina
Published: November 2016

This article explores some ideas of the Syriac Macarian corpus which influenced Isaac of Nineveh’s conception of what he calls ‘weakness’, a condition which, for him, indicates an original frailty inscribed in creaturality. Three concepts deriving from different Macarian writings are analysed and placed side-by-side with some reflections of Isaac: the idea of ‘weakness’ as something proper to the human condition; the relationship to negative experiences and to God in order to discover its reality; and the link between acknowledging it and humility. Through this comparison, Isaac’s debt to the ‘Syriac Macarius’ emerges. The fact that Isaac read texts coming from different authors and proper to the Syriac version—which is different from the Greek Pseudo-Macarian corpus—attributing them to the Egyptian ascetic ‘Macarius’, is underlined. This highlights Isaac’s distinctive approach to the texts and points to the necessity of studying the Syriac versions independently from their Greek originals.
Resolving Genealogical Ambiguity: Eusebius and (ps-)Ephrem on Luke 1.36
Authors: Crawford Matthew R.
Published: November 2016

The earliest formal New Testament commentary in Syriac is the so-called Commentary on the Diatessaron attributed to Ephrem. This commentary is thoroughly at home in the world of Syriac Christianity, as seen not least in the fact that it focuses on Tatian’s idiosyncratic gospel version. Nevertheless, portions of the commentary also exhibit awareness of exegetical traditions shared with contemporary Greek authors. This paper focuses on one of the more striking of these parallels, namely, (ps-)Ephrem’s treatment of Mary’s Davidic lineage and relation to Elizabeth her ‘kinswoman’. Eusebius of Caesarea had taken up this issue in his Gospel Problems and Solutions, and the author of the Syriac commentary argues for the same three points evident in Eusebius’ treatment. Hence, the Syriac commentator has likely been directly or indirectly influenced by Eusebius’ formulation of this tradition, although specifying the manner of this transmission of ideas is impossible.
The nomenclatural status of the amphibian nomina published by Luuc Bauer from 1985 to 1994, with comments on the Rules of the Code concerning the techniques of printing

Authors: DUBOIS ALAIN , FRÉTEY THIERRY , OHLER ANNEMARIE
Published: November 2016

From 1985 to 1994, Luuc Bauer published 31 new amphibian nomina for taxa at various ranks, including 14 genera. The nomenclatural status of these nomina regarding their availability and validity is evaluated here: 15 of them are considered available, including four or five valid ones according to the classification chosen (one for a species and three or four for genera) and two more which could possibly become valid if in the future some phylogenetic uncertainties are resolved. Attention is called to the fact that the current Rules of the Code regarding the technique used to produce a paper-printed publication are unclear and sometimes inapplicable, when this technique cannot be unambiguously determined by looking at the printed document. It is here suggested that the Code should be modified in order to accept all documents printed on paper in several simultaneously produced identical copies, clearly issued for the purpose of providing a public and permanent scientific record, as potentially available (if the other criteria of availability are complied with), whatever the technique used for their production.
Rediscovery, extended enumeration and conservation assessment of Henckelia lyrata (Gesneriaceae) in Western Ghats, India
Authors: GEETHAKUMARY M.P. , DEEPU S. , PANDURANGAN A.G. , KUMAR E.S. SANTHOSH
Published: November 2016

The generic name Henckelia Sprengel (1817: 402) was proposed in honor of Leo F. V. Henckel von Donnersmark (1785–1861), a German administrator and passionate botanist. However, even though the genus had priority over Didymocarpus Wallich (1819: 378), in view of its wider usage the latter name was conserved (Vitek et al. 2000). Henckelia Sprengel (1817: 402) was resurrected from synonymy of Didymocarpus by Weber & Burtt (1997), separating them by an array of morphological characters, to give a more natural taxonomic unit. The genus Henckelia has about 180 species distributed from south India and Sri Lanka over Sumatra, southern Thailand, Malaya Peninsula, Borneo to the Philippines, Sulawesi and New Guinea. It accommodates most of the south Indian species formerly placed in Didymocarpus (Middleton et al. 2013). At present, 30 species are known to occur in India, of which 13 are endemic to the Western Ghats (Janeesha & Nampy 2015).
A Mass-Flux Cumulus Parameterization Scheme across Gray-Zone Resolutions
Authors: Kwon Young Cheol , Hong Song-You
Published: November 2016

A method that enables a mass-flux cumulus parameterization scheme (CPS) to work seamlessly in various model grids across CPS gray-zone resolutions is proposed. The convective cloud-base mass flux, convective inhibition, and convective detrainment in the simplified Arakawa–Schubert (SAS) scheme are modified to be functions of the convective updraft fraction. The combination of two updraft fractions is used to modulate the cloud-base mass flux; the first one depends on the horizontal grid space and the other is a function of the grid-scale and convective vertical velocity. The convective inhibition and detrainment of hydrometeors are also modified to be a function of the grid-size-dependent convective updraft fraction.

A set of sensitivity experiments with the Weather Research and Forecasting (WRF) Model is conducted for a heavy rainfall case over South Korea. The results show that the revised SAS CPS outperforms the original SAS. At 3 and 1 km, the precipitation core over South Korea is well reproduced by the experiments with the revised SAS scheme. On the contrary, the simulated precipitation is widespread in the case of the original SAS experiment and there are multiple spurious cores when the CPS is removed at those resolutions. The modified mass flux at the cloud base is found to play a major role in organizing the grid-scale precipitation at the convective core. A 1-month simulation at 3 km confirms that the revised scheme produces slightly better summer monsoonal precipitation results as compared to the typical model setup without CPS.
High‐Dose Vitamin D3 Administration Is Associated With Increases in Hemoglobin Concentrations in Mechanically Ventilated Critically Ill Adults: A Pilot Double‐Blind, Randomized, Placebo‐Controlled Trial
Authors: Smith Ellen M. , Jones Jennifer L. , Han Jenny E. , Alvarez Jessica A. , Sloan John H. , Konrad Robert J. , Zughaier Susu M. , Martin Greg S. , Ziegler Thomas R. , Tangpricha Vin
Published: November 2016

Background: Anemia and vitamin D deficiency are highly prevalent in critical illness, and vitamin D status has been associated with hemoglobin concentrations in epidemiologic studies. We examined the effect of high‐dose vitamin D therapy on hemoglobin and hepcidin concentrations in critically ill adults. Materials and Methods: Mechanically ventilated critically ill adults (N = 30) enrolled in a pilot double‐blind, randomized, placebo‐controlled trial of high‐dose vitamin D3 (D3) were included in this analysis. Participants were randomized to receive placebo, 50,000 IU D3, or 100,000 IU D3 daily for 5 days (totaling 250,000 IU D3 and 500,000 IU D3, respectively). Blood was drawn weekly throughout hospitalization for up to 4 weeks. Linear mixed‐effects models were used to assess change in hemoglobin and hepcidin concentrations by treatment group over time. Results: At enrollment, >75% of participants in all groups had plasma 25‐hydroxyvitamin D (25(OH)D) concentrations <30 ng/mL, and >85% of participants across groups were anemic. In the 500,000‐IU D3 group, hemoglobin concentrations increased significantly over time (Pgroup × time = .01) compared with placebo but did not change in the 250,000‐IU D3 group (Pgroup × time = 0.59). Hepcidin concentrations decreased acutely in the 500,000‐IU D3 group relative to placebo after 1 week (P = .007). Hepcidin did not change significantly in the 250,000‐IU D3 group. Conclusion: In these critically ill adults, treatment with 500,000 IU D3 was associated with increased hemoglobin concentrations over time and acutely reduced serum hepcidin concentrations. These findings suggest that high‐dose vitamin D may improve iron metabolism in critical illness and should be confirmed in larger studies.
Questionnaire Adapting: Little Changes Mean a Lot
Authors: Sousa Vanessa E. C. , Matson Jeffrey , Dunn Lopez Karen
Published: November 2016

Questionnaire development involves rigorous testing to ensure reliability and validity. Due to time and cost constraints of developing new questionnaires, researchers often adapt existing questionnaires to better fit the purpose of their study. However, the effect of such adaptations is unclear. We conducted cognitive interviews as a method to evaluate the understanding of original and adapted questionnaire items to be applied in a future study. The findings revealed that all subjects (a) comprehended the original and adapted items differently, (b) changed their scores after comparing the original to the adapted items, and (c) were unanimous in stating that the adapted items were easier to understand. Cognitive interviewing allowed us to assess the interpretation of adapted items in a useful and efficient manner before use in data collection.
Danggui Buxue Decoction, a Classical Formula of Traditional Chinese Medicine, Fails to Prevent Myelosuppression in Breast Cancer Patients Treated With Adjuvant Chemotherapy: A Prospective Study
Authors: Hong Jin , Chen Xiaosong , Huang Jiahui , Li Chunqing , Zhong Li , Chen Leying , Wu Jiayi , Huang Ou , He Jianrong , Zhu Li , Chen Weiguo , Li Yafen , Wan Hua , Shen Kunwei
Published: November 2016

Danggui Buxue Decoction (DBD), a classical formula of traditional Chinese medicine (TCM), has an impact on promoting hematopoiesis. The aim of our study was to determine whether DBD can prevent myelosuppression in breast cancer patients treated with adjuvant chemotherapy. We conducted a phase II randomized prospective controlled clinical study. From December 2013 to February 2015, 106 patients were enrolled and randomly assigned (1:1) to the TCM group and control group. The primary end point was incidence of grade 3-4 neutropenia. The secondary end points included incidence of grade 3-4 neutropenia in each cycle, incidence of anemia, and incidence of thrombopenia during 4 cycles. Seventeen patients withdrew from this study, and 89 patients were included in the final analysis. Incidences of grade 3-4 neutropenia during 4 cycles were 57.1% in the TCM group and 59.6% in the control group, and there was no significant difference ( P = .816). Similarly, no significant differences were observed between the 2 groups for incidence of grade 3-4 neutropenia in each cycle. While incidences of anemia were 54.8% and 66.6% for the TCM group and control group, respectively ( P = .280), incidences of thrombopenia were 11.9% for the TCM group and 4.3% for the control group ( P = .248). No significant differences were observed for the incidence of other nonhematological toxicities between the 2 groups. DBD failed to prevent myelosuppression in breast cancer patients treated with adjuvant chemotherapy. Further studies are warranted to validate the efficacy of DBD in selected patients.
Enhancement of congestion control of Constrained Application Protocol/Congestion Control/Advanced for Internet of Things environment
Authors: Lee Jung June , Kim Kyung Tae , Youn Hee Yong
Published: November 2016

With the wide spread of Internet of Things, efficient communication between the nodes is getting more important. Constrained Application Protocol was developed to accommodate the resource-constrained nodes and low-power communication links. Being an Internet protocol, Constrained Application Protocol must adhere to congestion control, primarily to keep the backbone network stable. An advanced congestion control mechanism for Constrained Application Protocol, called Congestion Control/Advanced, has also been recently developed. In this article, we propose a new round trip time–based adaptive congestion control scheme, which further improves Congestion Control/Advanced by utilizing the retransmission count in estimating the retransmission timeout value and the lower bound in round trip time variation. An experiment is conducted based on Californium Constrained Application Protocol framework and real devices, and the performance is compared with Constrained Application Protocol, Congestion Control/Advanced, and an existing scheme. It reveals that the proposed scheme significantly increases the throughput and rate of successful transactions in comparison with the other schemes. The approach of utilizing the option field of Constrained Application Protocol enables the proposed scheme to be implemented without any conflict with the existing protocol and extra overhead.
Radial shortening osteotomy for treatment of Lichtman Stage IIIA Kienböck disease
Authors: Luegmair M. , Goehtz F. , Kalb K. , Cip J. , van Schoonhoven J.
Published: November 2016

We carried out a retrospective study to analyse the long-term outcome of 36 patients after radial shortening osteotomy for treatment of Lichtman Stage IIIA Kienböck disease at a mean follow-up of 12.1 years (range 5.4–17.5). At review, seven wrists had progressed to Stage IIIB, eight wrists to Stage IV and 21 remained in Stage IIIA. Motion and grip strength were significantly improved. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score at review was 12 points (range 0–52), and patient satisfaction was high. Apart from plate removals in 14 patients and one wrist denervation, no subsequent surgical procedures were done. Radial shortening yields good long-term clinical results, but does not prevent radiographic progression of disease in some patients.

Level of evidence: Therapeutic IV
How I evaluate and treat thrombocytopenia in the intensive care unit patient
Authors: Greinacher Andreas , Selleng Sixten
Published: November 2016

Multiple causes (pseudothrombocytopenia, hemodilution, increased consumption, decreased production, increased sequestration, and immune-mediated destruction of platelets) alone or in combination make thrombocytopenia very common in intensive care unit (ICU) patients. Persisting thrombocytopenia in critically ill patients is associated with, but not causative of, increased mortality. Identification of the underlying cause is key for management decisions in individual patients. While platelet transfusion might be indicated in patients with impaired platelet production or increased platelet destruction, it could be deleterious in patients with increased intravascular platelet activation. Sepsis and trauma are the most common causes of thrombocytopenia in the ICU. In these patients, treatment of the underlying disease will also increase platelet counts. Heparin-induced thrombocytopenia requires alternative anticoagulation at a therapeutic dose and immune thrombocytopenia immunomodulatory treatment. Thrombocytopenia with symptomatic bleeding at or above World Health Organization grade 2 or planned invasive procedures are established indications for platelet transfusions, while the evidence for a benefit of prophylactic platelet transfusions is weak and controversial. If the platelet count does not increase after transfusion of 2 fresh ABO blood group–identical platelet concentrates (therapeutic units), ongoing platelet consumption and high-titer anti-HLA class I antibodies should be considered. The latter requires transfusion of HLA-compatible platelet concentrates.
Disease gene prioritization by integrating tissue-specific molecular networks using a robust multi-network model
Authors: Ni Jingchao , Koyuturk Mehmet , Tong Hanghang , Haines Jonathan , Xu Rong , Zhang Xiang
Published: November 2016

Background

Accurately prioritizing candidate disease genes is an important and challenging problem. Various network-based methods have been developed to predict potential disease genes by utilizing the disease similarity network and molecular networks such as protein interaction or gene co-expression networks. Although successful, a common limitation of the existing methods is that they assume all diseases share the same molecular network and a single generic molecular network is used to predict candidate genes for all diseases. However, different diseases tend to manifest in different tissues, and the molecular networks in different tissues are usually different. An ideal method should be able to incorporate tissue-specific molecular networks for different diseases.

Results

In this paper, we develop a robust and flexible method to integrate tissue-specific molecular networks for disease gene prioritization. Our method allows each disease to have its own tissue-specific network(s). We formulate the problem of candidate gene prioritization as an optimization problem based on network propagation. When there are multiple tissue-specific networks available for a disease, our method can automatically infer the relative importance of each tissue-specific network. Thus it is robust to the noisy and incomplete network data. To solve the optimization problem, we develop fast algorithms which have linear time complexities in the number of nodes in the molecular networks. We also provide rigorous theoretical foundations for our algorithms in terms of their optimality and convergence properties. Extensive experimental results show that our method can significantly improve the accuracy of candidate gene prioritization compared with the state-of-the-art methods.

Conclusions

In our experiments, we compare our methods with 7 popular network-based disease gene prioritization algorithms on diseases from Online Mendelian Inheritance in Man (OMIM) database. The experimental results demonstrate that our methods recover true associations more accurately than other methods in terms of AUC values, and the performance differences are significant (with paired t-test p-values less than 0.05). This validates the importance to integrate tissue-specific molecular networks for studying disease gene prioritization and show the superiority of our network models and ranking algorithms toward this purpose. The source code and datasets are available at http://nijingchao.github.io/CRstar/.
libFLASM: a software library for fixed-length approximate string matching
Authors: Ayad Lorraine A. K. , Pissis Solon P. , Retha Ahmad
Published: November 2016

Background

Approximate string matching is the problem of finding all factors of a given text that are at a distance at most k from a given pattern. Fixed-length approximate string matching is the problem of finding all factors of a text of length n that are at a distance at most k from any factor of length ℓ of a pattern of length m. There exist bit-vector techniques to solve the fixed-length approximate string matching problem in time $\mathcal {O}(m\lceil \ell /w \rceil n)$
O
(
m
⌈
ℓ
/
w
⌉
n
)
and space $\mathcal {O}(m\lceil \ell /w\rceil)$
O
(
m
⌈
ℓ
/
w
⌉
)
under the edit and Hamming distance models, where w is the size of the computer word; as such these techniques are independent of the distance threshold k or the alphabet size. Fixed-length approximate string matching is a generalisation of approximate string matching and, hence, has numerous direct applications in computational molecular biology and elsewhere.

Results

We present and make available , a free open-source software library for solving fixed-length approximate string matching under both the edit and the Hamming distance models. Moreover we describe how fixed-length approximate string matching is applied to solve real problems by incorporating into established applications for multiple circular sequence alignment as well as single and structured motif extraction. Specifically, we describe how it can be used to improve the accuracy of multiple circular sequence alignment in terms of the inferred likelihood-based phylogenies; and we also describe how it is used to efficiently find motifs in molecular sequences representing regulatory or functional regions. The comparison of the performance of the library to other algorithms show how it is competitive, especially with increasing distance thresholds.

Conclusions

Fixed-length approximate string matching is a generalisation of the classic approximate string matching problem. We present , a free open-source software library for solving fixed-length approximate string matching. The extensive experimental results presented here suggest that other applications could benefit from using , and thus further maintenance and development of is desirable.
Phenomenology, Physiognomy, and the “Radio Voice”
Authors: Kane Brian
Published: November 2016

The publication of Current of Music affords a reassessment of Theodor W. Adorno's years at the Princeton Radio Research Project. Although his encounter with the culture industry was made vivid and palpable during these years, this article reads Current of Music as a prolongation of his earlier concerns with a critique of Husserlian phenomenology and an analysis of Wagnerian phantasmagoria. I argue that Adorno's method for radio research is phenomenological, modified to accommodate dialectics. This modified phenomenology, renamed “physiognomy,” aims to expose phantasmagoria, the occultation of the means of production, masked in Husserlian phenomenology by its static categories and reductions. Given the prominent role of physiognomy as a form of social critique in Adorno's later writings, Current of Music offers a unique opportunity to see the concept at work in its earliest formation.
High resolution microscopy reveals the nuclear shape of budding yeast during cell cycle and in various biological states
Authors: Wang Renjie , Kamgoue Alain , Normand Christophe , Léger-Silvestre Isabelle , Mangeat Thomas , Gadal Olivier
Published: November 2016

How spatial organization of the genome depends on nuclear shape is unknown, mostly because accurate nuclear size and shape measurement is technically challenging. In large cell populations of the yeast Saccharomyces cerevisiae, we assessed the geometry (size and shape) of nuclei in three dimensions with a resolution of 30 nm. We improved an automated fluorescence localization method by implementing a post-acquisition correction of the spherical microscopic aberration along the z-axis, to detect the three dimensional (3D) positions of nuclear pore complexes (NPCs) in the nuclear envelope. Here, we used a method called NucQuant to accurately estimate the geometry of nuclei in 3D throughout the cell cycle. To increase the robustness of the statistics, we aggregated thousands of detected NPCs from a cell population in a single representation using the nucleolus or the spindle pole body (SPB) as references to align nuclei along the same axis. We could detect asymmetric changes of the nucleus associated with modification of nucleolar size. Stereotypical modification of the nucleus toward the nucleolus further confirmed the asymmetric properties of the nuclear envelope.
Hubungan Spektrum Klinis Infeksi Dengue dengan Kadar Seng dan Feritin Serum
Authors: Ruslianti Vindy , Chairulfatah Alex , Rachmadi Dedi
Published: November 2016

Latar belakang. Sindrom syok dengue (SSD) merupakan masalah kesehatan dengan morbiditas dan mortalitas tinggi. Infeksi dengue dapat menyebabkan badai sitokin dan produksi berlebih MMP-2 dan MMP-9, yaitu suatu enzim yang tergantung seng. Sitokin ini akan menyebabkan peningkatan feritin sebagai reaktan fase akut, sedangkan produksi berlebih MMP-2 dan MMP-9 menjadi salah satu penyebab kebocoran plasma.Tujuan. Menganalisis hubungan spektrum klinis infeksi dengue dengan kadar seng dan feritin serum pada anak.Metode. Penelitian cross-sectional dilaksanakan dari Januari 2012 sampai Mei 2012 melibatkan 39 anak laki-laki dan 42 anak perempuan. Dilakukan pemeriksaan kadar seng serum dengan metode atomic absorption spectroscopy (AAS) dan feritin serum dengan metode electrochemiluminescense immunoasssay (ECLIA). Uji statistik dengan ANOVA dan uji korelasi Spearman. Kemaknaan ditentukan berdasarkan nilai p<0,05.Hasil. Kadar seng serum rendah pada 53 (65%) anak. Rerata kadar seng serum pada demam dengue (DD), demam berdarah dengue (DBD) dan SSD adalah 68,2 μg/dL (SB 15,3), 64,8 μg/dL (SB 15,6) dan 59,2 μg/dL (SB 15,0) (p=0,09), sedangkan kadar feritin tinggi pada 79 (98%) anak dengan rerata 1158,9 ng/mL (SB 1766,8), 3048,2 ng/mL (SB 2566,2), 6891 ng/mL (SB 9822) (p<0,001). Terdapat hubungan kuat dan bermakna antara derajat berat penyakit dengan kadar feritin (p<0,001; r=0,635), tetapi tidak terdapat hubungan dengan kadar seng serum (p=0,043; r=-0,225).Kesimpulan. Spektrum klinis infeksi dengue berhubungan kuat dengan kadar feritin yang tinggi dan memiliki hubungan dengan kadar seng serum rendah.
Hubungan Kadar Serum Metabolit Nitrit Oksida dan Gangguan Fungsi Ginjal pada Sepsis
Authors: Mandei Jose M. , Chandra Ronald , Wilar Rocky , Runtunuwu Ari L. , Manoppo, Jeanette I. Ch. , Umboh Adrian
Published: November 2016

Latar belakang. Sepsis adalah respons sistemik terhadap infeksi dengan salah satu komplikasinya berupa gagal organ ginjal. Peran nitrit oksida (NO) sebagai mediator yang terlibat dalam mekanisme gagal organ ginjal kasus sepsis masih bersifat kontroversi.Tujuan. Mengevaluasi hubungan antara kadar serum NO dan gangguan fungsi ginjal pada sepsis anak.Metode. Desain penelitian potong lintang secara konsekutif dilaksanakan sejak bulan Juni sampai November 2012 dengan sampel anak usia satu bulan sampai lima tahun yang didiagnosis sepsis. Pemeriksaan kadar serum kreatinin mencerminkan fungsi ginjal dan kadar serum metabolit NO (nitrat dan nitrit) mencerminkan kadar NO endogen. Uji korelasi menggunakan uji korelasi Spearman, dinyatakan bermakna apabila p<0,05. Data diolah menggunakan piranti lunak SPSS 19.00Hasil. Diperoleh 40 subjek dengan median usia 8,5 bulan (2 sampai 70 bulan) dan 22 di antaranya anak laki-laki. Kadar metabolit NO ditemukan berhubungan dengan kadar serum kreatinin (rs=0,33; p=0,041).Kesimpulan. Terdapat hubungan antara peningkatan kadar serum NO dan terjadinya gangguan fungsi ginjal pada anak dengan sepsis.
Gambaran Klinis Fixed Drug Eruption pada Anak di Rumah Sakit Cipto Mangunkusumo
Authors: Susilawati Afaf , Akib Arwin AP. , Satari Hindra Irawan
Published: November 2016

Latar belakang. Erupsi obat pada kulit merupakan manifestasi terbanyak dari reaksi simpang obat. Fixed drug eruption (FDE) merupakan salah satu erupsi obat pada kulit yang sering ditemukan, tetapi angka prevalensnya sangat bervariasi. Walaupun gejala yang timbul bukan merupakan gejala yang fatal, FDE bisa menimbulkan masalah kosmetik yang berlangsung kronik. Gejala yang ringan dan ketidaktahuan dokter menyebabkan kasus FDE tidak banyak dilaporkan.Tujuan. Mengetahui proporsi FDE dibandingkan alergi obat yang bermanifestasi di kulit lainnya, serta profil pasien FDE yang meliputi profil usia, jenis kelamin, atopi, manifestasi klinis, predileksi lesi, dan obat yang terkait.Metode. Penelitian deskriptif dengan mengambil data rekam medik di RS. Cipto Mangunkusumo selama sepuluh tahun (Januari 2000-Desember 2009). Subjek diambil berdasarkan keterangan kode diagnosis alergi obat. Subjek dengan diagnosis FDE diambil data-data demografis, klinis, dan riwayat penggunaan obat sebelum munculnya gejala klinis FDE.Hasil. Dari 142 subjek dengan alergi obat, 96 didapatkan rekam medis yang lengkap. Diagnosis FDE terdapat pada 56 subjek. Proporsi yang sama didapatkan antara laki-laki dan perempuan dengan kelompok usia terbanyak pada usia di atas 5 tahun. Riwayat atopi didapatkan pada 32% subjek. Semua subjek menunjukkan awitan kurang dari 24 jam. Manifestasi klinis yang muncul berupa lesi hiperpigmentasi, lesi lebih dari satu di daerah wajah, bibir, ekstremitas atas, ekstremitas bawah, genitalia, dan badan. Terdapat 5 subjek dengan lesi berbentuk bula, dan 8 subjek dengan erosi kulit. Satu subjek harus dilakukan sistostomi karena nekrosis di mukosa penis. Kotrimoksasol merupakan obat tersering terkait dengan FDE selain parasetamol, amoksisilin, tetrasiklin, dimenhidrinat.Kesimpulan. Proporsi FDE ditemukan 58% dengan umur terbanyak di atas 5 tahun, dan perbandingan yang sama antara lelaki dan perempuan. Lesi hiperpigmentasi merupakan bentuk kelainan kulit yang paling sering ditemukan dan muncul paling sering di bibir. Kotrimoksasol merupakan obat tersering yang dikaitkan dengan FDE.
Faktor Risiko Trauma Lahir
Authors: Widiyati MM. Tri , Wibowo Setya Wandita Tunjung , Haksari Ekawaty Lutfia
Published: November 2016

Latar belakang. Kemajuan di bidang pelayanan obstetri berhasil menurunkan kejadian trauma lahir. Namun, trauma lahir masih merupakan salah satu penyebab morbiditas dan mortalitas pada neonatal. Banyak faktor risiko yang berperan dalam trauma lahir.Tujuan. Mengetahui faktor risiko trauma lahir.Metode. Penelitian kasus-kontrol di bangsal Perinatal Rumah Sakit Dr Sardjito, Yogyakarta, mulai Januari 2004 sampai Desember 2008. Kriteria inklusi adalah semua neonatus dengan trauma lahir dan kriteria eksklusi adalah jika ada anomali kongenital dan data medis tidak lengkap. Kontrol adalah neonatus tanpa trauma lahir. Kasus adalah semua neonatus dengan trauma lahir, dan keduanya memenuhi kriteria inklusi dan eksklusi. Data dikumpulkan dari rekam medis yang berkaitan dengan data ibu, bayi, dan faktor risiko yang diduga berhubungan dengan trauma lahir.Hasil. Di antara 6678 neonatus, 47 mengalami trauma lahir, yaitu trauma kepala 27 (57%), trauma tulang 13(28%), saraf perifer 10(21,3%), saraf pusat 7(14,8%), dan 3 lainnya (6%). Faktor risiko trauma lahir adalah paritas (OR 1,3;CI95%=0,5-3,4; p=0,625), umur kehamilan (OR 1,5;95%CI=0,2-9,6; p=1,00), berat lahir (OR 1,4;95%CI=0,3-6,5; p=0,100), lingkar kepala (OR 1,5;95%CI=0,4-5,0; p=0,76), malpresentasi (OR 3,6;95%CI=0,4-30,3;p=0,244), presentasi bokong (OR 3,9;95%CI=1,0-14,8; p=0,049), presentasi muka (OR 2,0;95%CI=1,7-2,5; p=1,00), vakum ekstraksi (OR 10,1;95%CI=1,2-88,3; p=0,037), versi ekstraksi (OR 3,1;95%CI=0,3-31,3; p=0,62), penyulit persalinan (OR 11,4;95%CI=2,2-60,2; p=0,004), letak lintang (OR 1,0;95%CI=0,2-5,2; p=1,000), dan seksio kaisaria (OR 0,4;95%CI=0,1-0,8; p=0,017).Kesimpulan. Faktor risiko trauma lahir adalah presentasi bokong, persalinan dengan penyulit dan vakum ekstraksi, sedangkan kelainan presentasi tidak berhubungan dengan trauma lahir. Seksio kaisaria merupakan faktor protektif terhadap terjadinya trauma lahir.
Faktor yang Memengaruhi Pemberian ASI Eksklusif pada Bayi Cukup Bulan yang Dilakukan Inisiasi Menyusu Dini (IMD)
Authors: Fahriani Reni , Rohsiswatmo Rinawati , Hendarto Aryono
Published: November 2016

Latar belakang. Air susu ibu merupakan nutrisi ideal untuk bayi. World Health Organization (WHO) menganjurkan pemberian ASI eksklusif hingga 6 bulan. Data Survey Demografi dan Kesehatan Indonesia (SDKI) tahun 2003 dan 2007 menunjukkan angka ASI eksklusif di Indonesia cenderung turun. Beberapa penelitian menunjukkan terdapat beberapa faktor yang memengaruhi pemberian ASI eksklusif.Tujuan. Mengetahui proposi ASI eksklusif pada bayi yang dilakukan IMD, dan mengetahui faktor-faktor yang memengaruhinya.Metode. Penelitian potong lintang analitik dengan pengumpulan data melalui wawancara pada bulan Juni-September 2012. Subjek penelitian adalah ibu yang memiliki anak berusia 0-6 bulan yang datang ke Poliklinik Anak RS St. Carolus Jakarta. Analisis statistik dengan uji Kai kuadrat dan regresi logistik.Hasil. Dilakukan penelitian pada 120 subjek. Proporsi ASI eksklusif 75%, sebagian besar merupakan primipara (56,7%). Kelahiran secara spontan 65,8%. Subjek yang memiliki tingkat pendidikan tinggi 73,3% dan 59,2% merupakan ibu bekerja. Subjek yang termasuk ke dalam status sosial ekonomi tinggi 45%, sisanya berada di sosial ekonomi rendah (4,2%), dan menengah (50,8%). Sebagian besar subjek (73,3%) telah memperoleh konseling ASI. Faktor yang paling bermakna memengaruhi ASI eksklusif berturut-turut, yaitu faktor psikis ibu, dukungan keluarga, pengetahuan tentang ASI eksklusif, dan konseling ASI.Kesimpulan. Proporsi ASI eksklusif pada bayi cukup bulan yang dilakukan IMD di RS St Carolus adalah 75%. Faktor yang terbukti memengaruhi pemberian ASI eksklsusif adalah faktor psikis ibu (keyakinan ibu terhadap produksi ASI), dukungan keluarga, pengetahuan ibu yang benar tentang ASI eksklusif, dan konseling ASI.
Hubungan Hipertirotropinemia Terhadap Tingkat dan Aspek Kecerdasan Anak TK di Desa Seloharjo Kecamatan Pundong, Bantul, Yogyakarta
Authors: Hapsari Indri , Patria S.Yudha , Gamayanti IL.
Published: November 2016

Latar belakang. Hipertirotropinemia (peningkatan TSH) menunjukkan adanya insufisiensi saturasi reseptor T3 di otak dan potensial berisiko defisiensi dalam perkembangan kecerdasan. Semakin muda anak mengalami defisiensi hormon tiroid maka semakin berat terhadap gangguan kecerdasan. Hormon tiroid dirangsang sekresinya oleh TSH (Thyroid stimulating hormone). Hipertirotropinemia digunakan sebagai penapis pertama dalam deteksi gangguan tiroid.Tujuan. Mengetahui adanya hubungan hipertirotropinemia dengan tingkat dan aspek kecerdasan anak taman kanak-kanak (TK) di Desa Seloharjo, Kecamatan Pundong, Bantul, Yogyakarta.Metode. Rancangan penelitian potong lintang dengan jumlah subjek 51 anak dari dua TK di Desa Seloharjo selama bulan Desember 2010. Desa Seloharjo dipilih karena termasuk daerah endemik GAKI, sumber data lengkap, dan bisa dijangkau. Penilaian dilakukan terhadap kadar tetes darah TSH (dengan ELISA) dan tingkat kecerdasan serta aspek (dengan Stanford-Binet). Analisis dengan uji kai-kuadrat dan uji regresi logistik.Hasil. Terdapat 39,2% responden termasuk hipertirotropinemia dengan rerata TSH 5,59 μUI/mL. Intelligency Quotient poin di bawah rata-rata 25,5% dengan rerata 96,8 poin. Anak hipertirotropinemia dengan IQ di bawah rata-rata 6 orang (30%) dengan rerata TSH 7,63 μUI/ml (kenaikan 1,38 kali) dan rerata IQ 81 poin. Tidak didapatkan hubungan bermakna antara kadar TSH dengan tingkat kecerdasan (p=0,553, RP=1,469, 95%IK 0,4-5,254) dan enam aspek kecerdasan (p>0,05). Hasil uji regresi logistik menunjukkan variabel lain tidak memengaruhi tingkat kecerdasan, sedangkan untuk aspek penalaran aritmatika terbukti dipengaruhi oleh adanya anggota keluarga yang gondok (p=0,045, RP 8,448, IK95% 1,050-67,977).Kesimpulan. Hipertirotropinemia tidak terbukti memengaruhi tingkat dan aspek kecerdasan anak TK.
Kejadian Demam dan Kadar IL-10 Serum Pasca Imunisasi DTwP/HepB Ketiga pada Bayi yang Mendapat dan Tidak Mendapat ASI Eksklusif
Authors: Firdaus Andri , Chairulfatah Alex , Setiabudiawan Budi
Published: November 2016

Latar belakang. Dilaporkan bayi yang mendapat ASI eksklusif lebih jarang mengalami demam pasca imunisasi. Berbagai faktor yang berperan diantaranya adalah IL-10 yang banyak ditemukan dalam ASI.Tujuan. Membandingkan kejadian demam dan kadar IL-10 serum pasca imunisasi DTwP/HepB ketiga antara bayi yang mendapat dan tidak mendapat ASI eksklusif.Metode. Penelitian potong lintang dilaksanakan dari September–Desember 2012 melibatkan 70 bayi usia 4–6 bulan yang menerima imunisasi DTwP/HepB ketiga. Pengukuran suhu tubuh dilakukan sebelum, 30 menit, 6 jam, 12 jam, dan 24 jam pasca imunisasi atau saat demam dilakukan oleh ibu yang telah dilatih. Kadar IL-10 serum diperiksa dengan metode enzyme-linked immunosorbent assay (ELISA). Analisis statistik dilakukan dengan uji chi-kuadrat Pearson dan Mann-Whitney.Hasil. Delapan dari 35 bayi yang mendapat ASI eksklusif (23%) dan 32 dari 35 bayi yang tidak mendapat ASI eksklusif (91%) mengalami demam pasca imunisasi (p<0,001; RP 0,25). Demam pasca imunisasi timbul lebih cepat pada bayi yang tidak mendapat ASI eksklusif. Dari 24 bayi yang mengalami demam dalam 3 jam pasca imunisasi , 22 bayi (92%) tidak mendapat ASI eksklusif dan 2 bayi (8%) mendapat ASI eksklusif (p<0,001). Rata-rata suhu pada bayi yang mendapat ASI eksklusif 37,8 oC, sedangkan yang tidak mendapat ASI eksklusif 38,1 oC (p=0,033). Kadar IL-10 serum rata-rata bayi yang tidak mengalami demam pasca imunisasi 3,25 pg/mL, sedangkan yang mengalami demam 1,71 pg/mL (p<0,001). Kadar IL-10 serum rata-rata bayi yang mendapat ASI eksklusif 3,6 pg/mL, sedangkan yang tidak mendapat ASI eksklusif 1,1 pg/mL (p<0,001).Kesimpulan. Kemungkinan kejadian demam pasca imunisasi pada bayi yang tidak mendapat ASI eksklusif adalah 4 kali lebih tinggi dibandingkan bayi yang mendapat ASI eksklusif. Bayi yang tidak mendapat ASI eksklusif lebih cepat mengalami demam dengan suhu yang lebih tinggi. Bayi yang tidak mendapat ASI eksklusif mempunyai kadar IL-10 serum yang rendah daripada bayi yang mendapat ASI eksklusif.
Hubungan Kadar Cardiac Troponin T (cTnT) sebagai Penanda Jejas Miokardium dengan Derajat Pneumonia pada Anak
Authors: Erimarisya Meida , Nataprawira Heda Melinda , Sekarwana Nanan
Published: November 2016

Latar belakang. Hipoksemia berhubungan erat dengan pneumonia dan akan bertambah berat seiring bertambah beratnya pneumonia. Hipoksemia merupakan satu dari beberapa mekanisme yang menyebabkan komplikasi/penyulit kardiovaskular pada pneumonia. Cardiac troponin T (cTnT) telah digunakan secara luas sebagai penanda yang sensitif dan spesifik dalam deteksi kerusakan/jejas pada miokardium.Tujuan. Menganalisis hubungan kadar cTnT sebagai penanda jejas miokardium dengan derajat pneumonia.Metode. Penelitian cross-sectional dilaksanakan dari April-Juni 2013, dilibatkan 38 anak usia 2-60 bulan dengan diagnosis pneumonia dan dibagi dalam 2 kelompok, yaitu pneumonia dan pneumonia berat. Kadar cTnT serum dan pemeriksaan EKG dilakukan pada sedikitnya 72 jam awitan sesak. Analisis statistik dilakukan dengan uji Chi-kuadrat dan Mann-WhitneyHasil. Kelompok pneumonia terdiri dari 17 subjek dan pneumonia berat 21 subjek. Rerata kadar cTnT masing-masing kelompok 10,33 pg/dL dan 17,51 pg/dL (p=0,037). Proporsi subjek dengan kadar cTnT >10pg/mL dalam kelompok pneumonia berat berbeda bermakna dibandingkan kelompok pneumonia (p=0,009). Kelainan gambaran EKG ditemukan pada 8 dari 20 subjek dengan kadar cTnT >10pg/mL berupa gangguan irama, pemanjangan interval PR atau QT dan perubahan aksis jantung dan hipertrofi ventrikel kananKesimpulan. Kadar cTnT berhubungan dengan derajat pneumonia. Peningkatan kadar cTnT menunjukkan kerusakan/ jejas non-iskemik pada miokardium.
Pengaruh Pemberian Vitamin C terhadap Perubahan Kadar Total Antioksidan Serum pada Penderita Tuberkulosis Paru Anak
Authors: Zakiyyah Eki Rakhmah , Gurnida Dida A , Kartasasmita Cissy B
Published: November 2016

Latar belakang. Pada penderita tuberkulosis (TB) paru, terjadi peningkatan Reactive Oxygen Species (ROS) yang menyebabkan kebutuhan antioksidan meningkat sehingga terjadi penurunan kadar antioksidan serum. Pemberian vitamin C dapat meningkatkan kadar total antioksidan serum.Tujuan. Mengetahui pengaruh vitamin C terhadap kadar total antioksidan serum pada penderita TB paru.Metode. Penelitian uji klinis samar tunggal acak terkontrol dilaksanakan bulan April-Juli 2013. Tigapuluh orang penderita TB paru yang baru didiagnosis dilibatkan, berusia 1-14 tahun. Penelitian dilakukan di poli anak Rumah Sakit Dr. Hasan Sadikin Bandung dan RSUD Cibabat, Dibagi 2 kelompok, yaitu mendapat vitamin C dan plasebo, dilakukan selama 2 minggu. Pemeriksaan kadar total antioksidan serum dilakukan sebelum dan sesudah pemberian vitamin C dan plasebo. Perhitungan statistik dengan analisis varian two-way ANOVA digunakan untuk menganalisis perubahan kadar total antioksidan serum berdasarkan waktu (faktor A), pengaruh perlakuan (faktor B), dan interaksi di antara keduanya.Hasil. Subjek terdiri dari 22 anak laki-laki dan 8 perempuan. Tidak terdapat perbedaan bermakna pada usia, jenis kelamin, berat badan, tinggi badan, status gizi, dan asupan gizi pada kedua kelompok. Terdapat perbedaan bermakna pada perubahan kadar total antioksidan serum berdasarkan waktu (p=0,01) dan interaksi antara perubahan kadar total antioksidan serum berdasarkan waktu dengan perlakuan (p=0,01).Kesimpulan. Penelitian ini menunjukkan pemberian vitamin C bermanfaat dalam meningkatkan kadar total antioksidan serum pada penderita TB paru
Audit Tata laksana Meningitis Bakterialis pada Anak di RSUP Dr. Sardjito
Authors: Yuda I Putu Ardika , Sunartini Sunartini , Nurani Neti
Published: November 2016

Latar belakang. Angka kematian dan disabilitas pasien meningitis bakterialis masih cukup tinggi serta berhubungan dengan kualitas pelayanan. Audit medis perlu dilakukan sebagai salah satu upaya meningkatkan patient safety.Tujuan. Mengetahui kesesuaian antara praktik tata laksana meningitis bakterialis pada anak yang dirawat di bangsal anak RSUP Dr. Sardjito dengan pedoman pelayanan medis berdasarkan standar pelayanan medis (SPM) RSUP Dr. Sardjito 2005 dan (Pedoman Pelayanan Medis) PPM IDAI 2010.Metode. Audit retrospektif dengan menggunakan pedoman audit berdasarkan SPM RSUP Dr. Sardjito tahun 2005 dan PPM IDAI tahun 2010. Subjek penelitian adalah anak usia 1 bulan-18 tahun dengan diagnosis meningitis bakterialis yang dirawat di bangsal anak RSUP Dr. Sardjito pada 1 Januari 2011 sampai dengan 31 Mei 2013.Hasil. Terdapat 114 anak dengan diagnosis meningitis bakterialis. Rata-rata lama waktu penanganan di UGD adalah 89 menit dengan median 78 menit. Median lama waktu dilakukannya pungsi lumbal sejak pasien masuk adalah 4,5 jam (rata-rata 13,9 jam, rentang interkuartil 2,3–18,2 jam). Enampuluh dua pasien (54,4%; 95%CI: 49,7-59, 1%) yang mendapatkan antibiotik dosis intrakranial dalam waktu 6 jam sejak pasien masuk. Namun, defisiensi ini tidak terbukti memengaruhi outcome kematian (OR: 0,7; 95%CI: 0,18-3,0; p=0,480) maupun terjadinya sekuel (OR: 1,1; 95%CI: 0,4-2,5; p=0,839). Pemeriksaan uji fungsi pendengaran dengan Brainstem Evoked Respons Audiometri (BERA) hanya dilakukan pada 26/63 (41,3%; 95%CI: 29,1-53,5%) pasien.Kesimpulan. Belum semua kasus tata laksana meningitis bakterialis memenuhi standar mutu sesuai pedoman. Perlu diadakan pelatihan atau workshop tata laksana meningitis bakterialis pada anak di RSUP Dr. Sardjito.