bluuebunny/crossref_metadata_2025 huggingface dataset:
A Preliminary Implementation Framework of Building Information Modelling (BIM) in the Algerian AEC Industry
Authors: Bouguerra Khalid , Yaik-Wah Lim , Ali Kherun Nita
Published: September 2020

The construction industry is one of the most growing sectors worldwide, it plays a great role in boosting the economy. The construction sector in Algeria has recently witnessed an upward growth, due to the Algerian government’s vision to develop economic activity and boost the residential construction market. On the other hand, the Algerian construction market is suffering from the lack of efficiency; projects delay and less quality of projects delivery. It becomes very necessary to find a way to improve these inefficiencies by adopting new approaches and technologies. Building Information Modelling (BIM) is becoming a widespread and common approach in the design, construction and maintenance of building facilities as BIM reduces waste, improves construction quality and enhance collaboration among the construction stakeholders. Hence, it becomes necessary to start gradually introducing BIM to the Algerian construction industry in order to improve its productivity. This paper addresses BIM implementation in the Algerian AEC industry and proposes a preliminary framework towards its implementation. Through a questionnaire survey, we explored the BIM capabilities, BIM awareness and BIM maturity of the Algerian AEC players. Based on the questionnaire findings and literature review, this paper proposes an effective BIM implementation based on both levels of macro-adoption and micro-adoption. The framework developed is based on three main aspects comprise of technology, process and policy. This study is considered as the first implementation framework of Building information modelling in the Algerian AEC industry. The framework proposed will be used as a reference for the Algerian researchers and professionals.
The Role of Phase Change Materials for Lifetime Heating of Buildings in Cold Climatic Conditions
Authors: Kushwah Anand , Kumar Gaur Manoj , Kumar Pandit Rajindra
Published: September 2020

The study focuses on utilization of the solar insulation in buildings by means of thermal storage materials. During months of April to October, a significant part of solar gain was noticed in outer walls as well as in roof of the structure. Light weight modern construction materials have low thermal inertia so it stores less energy. The study focuses on the utilization of Phase Change Materials (PCM) for harnessing solar thermal energy for heating buildings. Various researches that show the effect of implementing PCMs in different parts of buildings like in walls, roof, windows, doors, floor etc. has been shown in the paper. The PCMs are helpful especially for those buildings which are located in cold climatic condition. Effective solutions are still required for harnessing maximum possible solar energy for heating buildings by storing heat energy by means of thermal storage materials like PCMs in hot days and to liberate it in cold night.
Level of Teacher’s Preparedness in Teaching towards Disabled Student in Vocational Special Education School/ Tahap Kesediaan Guru Mengajar Pelajar Kurang Upaya (OKU) di Sekolah Menengah Pendidikan Khas Vokasional (SMPKV)
Authors: Mohamad Rozai Nur Hidayah , Jabor Mohd Khata
Published: September 2020

The research on teacher readiness in teaching students with disabled is beneficial to teachers especially who are not exposed to the basics of Special Education knowledge. This research was conducted to identify the level of readiness of teachers from pedagogical aspect and communicating with disabled students during the learning and facilities process. The research was conducted at two Malaysian Vocational Special Education Secondary Schools. The total number of respondents involved in this research was 76 teachers. Quantitative methods are used by researchers in conducting research. Statistical Packages for Social Science Version 25.0 (SPSS 25.0) was used to analyze data for questionnaire instruments. The reliability of the questionnaire through a pilot study was 0.984 for the pedagogical aspect and 0.858 for the communication aspect. The findings show that the item has a positive and readiness in communicating. Therefore, in conclusion, the findings of this study are shown the level of teacher readiness for disabled students is high and ready.
Issue and Challenge for Vocational Teaching Quality in the Vocational College Lecturers: A Systematic Review/ Isu dan Cabaran Kualiti Penyampaian Pengajaran Bidang Vokasional dalam Kalangan Pensyarah Kolej Vokasional: Satu Ulasan Sistematik
Authors: Mohd Yusof Muhamad Hafidz , Arsat Mahyuddin , Amin Nor Fadila , Abdul Latif Adibah
Published: September 2020

Based on demand for professional labor and the growing economy, the Technical and Vocational Education (TVET) system has been transformed into a system that works to develop and equip individuals with current technical skills based on industry demand. The government has undertaken various efforts to strengthen the field of Technical and Vocational Education. Among the efforts undertaken was the transformation of the Technical and Vocational Education and Training (TVET) system. Kurikulum Standard Kolej Vokasional (KSKV) syllabus has been introduced to guide the teaching process at Vocational College. The KSKV was developed based on the latest industry requirements under the National Occupational Skill Standard (NOSS). Jabatan Pembangunan Kemahiran (JPK) is responsible for ensuring that the skills provided to students meet NOSS standards. However, there are issues and challenges faced in implementing the transformation, which is the level of knowledge and technical skills proficiency that lecturers have that is an important aspect of enabling educators to cope with growing technology. In line with the latest technological advances and industry demands, the issue that has begun among lecturers is the preparation of lecturers in terms of knowledge and technical skills related to the latest technologies updated in KSKV. This will further impact the quality of teaching delivery delivered by lecturers at Vocational College. Finally, the latest technical skills are essential to enable the teaching process delivered by the lecturers to be mastered by the students and thus produce qualified Vocational College graduates according to the latest industry employment standards.
The Influence of Distributed Leadership on Professional Learning Community among Secondary School Leaders in The State of Johore/ Pengaruh Kepimpinan Distributif Terhadap Komuniti Pembelajaran Profesional Dalam Kalangan Pemimpin Sekolah Menengah Di Negeri Johor
Authors: Syed Abdullah Syed Syahrul Zarizi
Published: September 2020

Distributed leadership is a leadership theory that emphasis on cooperation among leaders. It is practiced in schools, an institution that not only educates pupils but now serves as a professional learning community for school leaders and teachers. This study aims to investigate the influence of distributed leadership towards a professional learning community among the school leaders in Johor, Malaysia. This study uses quantitative approach and involves 27 secondary schools from six districts in Johor. Sample study is a school leader consisting of principal, senior assistant, senior teachers and head committee subjects. The respondent is a total of 358 people. Data collected using the Perception of Distributed Leadership Practices (PDLP) questionnaire by Hairon and Goh, (2015) and Professional Learning Communities Assessment-Revised (PLCA-R) by Olivier et al., (2010). Data was analyzed using SPSS Amos software version 26. Studies find all the common shared decision making have a significant influence on all the dimensions of professional learning communities. Bounded empowerment practices are found to influence only one of the dimensions of professional learning communities, namely learning and application collectively. It is hoped that this study would enhance the leadership practices of the distributive of the school leaders in the professional learning community.
Workplace Happiness and the Relationship to the Work Motivation among Primary School Teachers in Pasir Gudang District/ Kebahagiaan di Tempat Kerja dan Hubungannya terhadap Motivasi Kerja Guru Sekolah Rendah di Daerah Pasir Gudang
Authors: Ahmed Nor Elee , Hushin Hassan , Mahayadin Mahfuzah
Published: September 2020

Happiness is an element capable of motivating the daily routine of individuals, creating self-awareness, creativity and creating harmonious social relationships. Happiness at work is the key to creating positive thinking in the workforce. However, the importance of happiness at work at school is still being a discussion in Malaysia. This study examines the relationship between happiness in the workplace and work motivation among primary school teachers in Pasir Gudang, Johor. This study involved 420 primary school teachers from 20 schools as a sample of the study. This study was conducted using a questionnaire, which identified the level of teachers' happiness and the motivation of teachers in the workplace. The results of Spearman analysis of correlation show high levels of happiness in the workplace and teachers' work motivation. This study supports previous studies showing a positive relationship between happiness in the workplace and teacher work motivation.
The Difference between Placebo and Energy Drinking Consumption towards Aerobic Endurance
Authors: Zarwan Zarwan , Hardiansyah Sefri , Zalindro Ade , Maifitri Fella
Published: September 2020

An issue of this research is the aerobic endurance of students categorized low during the formation of physical conditions so that many students consume energy drinks to improve the aerobic endurance capability.  However, this is still an assumption needed to prove by giving another comparative drink (placebo). The purpose of this research is to compare the effect of placebo and energy drinks consumption to aerobic endurance capability.  It was quasi-experiment research using two types of substances: placebo consumed by experimental group (X1) and energy drinks consumed by the control group (X2). The population of this study was a group of 40 students. Samples were 36 students chosen by purposive sampling technique. Division of the group in a random way, the instrument used was Cooper run test 2.4 km. Data were analyzed using the test of different independent samples. The results of this study obtained the mean of 1.03 for the placebo group and the mean of 1.10  for the energy drink group. The statistical testobtainedtobserved0.14 ttable1.69 so that it can be concluded that the effects given by the consumption of placebo and energy drinks are not significantly different.
The Effect of Peer Teaching Methods on Results of Learning Writing Negotiation Text
Authors: Munirah Munirah , Sartika Fuput , Asnidar Anin , Yusuf Akram Budiman
Published: September 2020

This istudy iaims to idetermine the ieffect of peer teaching learningi methods on learning outcomes of negotiating text writing skills. This study is a true experimental design study aimed to idetermine the ieffect iof peer teaching learning imethods on ilearning ioutcomes of the writing ability of negotiating students in class X MA Aisyiyah Sungguminasa 2018/2019 academic year. The iresearch idesign iused was a ipretest-posttest icontrol igroup idesign. The studyipopulation iwas alliof MA Aisyiyah Sungguminasa students consisting of six classes. Samples were obtained using purposive sampling technique and selected Science iclass Xi as the experimental iclass and Social iclass X as a control iclass with the number of students respectively 24 and 29 students. The experimental class was taught using the peer teaching method, while the control class was without using the peer iteaching imethod. The iindependent variable in thisi studyi is the peer teachingi method, and the dependent variable is the learning outcome of students' negotiating writing ability. Data collection techniques used test techniques taken from the results of the posttest and observations of students' activities on the application of the method. Inferential statistical analysis results prove that the data are normally distributed and homogeneous. Hypothesis testing carried out by t-testi resulted in a t-counti of 872.5 which was then compared with a t-tablei of 2.007 or t-counti t-tablei which means that H0 iwas rejectedi and H1 was iaccepted. An alternative hypothesis (H1) is accepted if the value of it-count t-table. It can be concluded that the method of peer teaching affects the learning outcomes in the negotiation imaterial of iclass X MA Aisyiyah Sungguminasa.
Alternative Assessments: Performance Assessment, Authenticity, Portfolios and Methods of Implementing Performance Assessments / Pentaksiran Alternatif: Pentaksiran Prestasi, Autentik, Portfolio dan Kaedah Pelaksanaan Pentaksiran Prestasi
Authors: Said Nurul Akmar
Published: September 2020

Assessment is part of the teaching and learning process, aimed at improving student performance. Assessment also improves the quality of education, which enhances lifelong learning skills and performance in the educational context. Evaluation is a form of process of measuring the assessment process. It is a systematic process that involves the collection, analysis and translation of student achievement levels into the teaching objectives. Today, alternative assessments implemented in the learning system are a form of assessment that complements conventional assessment. Alternative assessments focus on student growth over time as well as the final process. And finally there are four categories of performance assessment namely response building, product evaluation, performance assessment and process focus assessment. Each category comes with examples of activities to help teachers teach and learn in the classroom
Inventory of Constructive Alignment Evaluation (ICAE) In Teacher Education Institute: A Literature / Inventori Penilaian Penjajaran Konstruktif (IPPK) Di Institut Pendidikan Guru: Satu Analisis Literatur
Authors: Md Jani Md Daud , Abdul Latif Adibah , Talib Latif Rohaya
Published: September 2020

This study was conducted for the purpose of developing an inventory which assess the implementation of constructive alignment in the teaching and learning system at the Teacher Education Institute (TEI). In this literature analysis, several concepts related to learning outcomes, teaching activities and assessment were discussed. This literature analysis also described in detail the concept of constructive alignment based on few theories and models. Besides, it was also supported by previous studies, assignments and assessments, syllabus, number of hours of student learning, factors that influenced the implementation of constructive alignment, assessment concepts, reliability, the validity and theory of measurement used as a guide and reference in the study. The development of the inventory was carried out in accordance with a basic procedure that involved 11 steps and it was divided into 3 stages, namely the actual stage of inventory development, validation and actual study. During the development stage of the inventory, the researcher divided it into 4 steps: conducting literature review, interviewing expert panels, conducting meta-analysis and producing items. Meanwhile, during the inventory validation stage, the researcher divided it into 5 steps: expert panel judgment, item review, pilot study, data analysis (reliability and validity) and final step of item review and final formatting. Then, at the actual study stage, 2 steps have been identified by conducting research on selected TEIs and analysing the data. This inventory will be used to build a profile of knowledge and practice of constructive alignment among lecturers of Teacher Education Institutes as well as a source of reference in strengthening the assessment system and teaching activities at the TEI in order to maintain the MQA Malaysian accreditation standards that require the assessment system to be based on learning outcomes (Malaysian Qualifications Agency (MQA), 2010). In addition, it is also a source of information for TEI in building the inventory to enhance the level of implementation of constructive alignment. Thus, it will help TEI in grasping the inspiration of the first shift of Malaysia Education Blueprint or PPPM in producing holistic, entrepreneur and balanced graduates.
Summative Test Items Analysis Using Classical Test Theory (CTT)/ Analisis Item Kertas Peperiksaan Sumatif Menggunakan Teori Ujian Klasik (TUK)
Authors: Saat Nor Aisyah
Published: September 2020

Item analysis is the process of examining student responses to test items individually in order to get clear picture on the quality of the item and the overall test. Teachers are encouraged to perform item analysis for each administered test in order to determine which items should be retained, modified, or discarded in the given test. This study aims to analyse items in 2 summative examination question papers by using classical test theory (CTT). The instruments used were the SPM Mathematics Trial Examination Questions 1 2019 which involved 50 students in form 5 students and the SPM Mathematics Trial Examination Question 1 2019 which involved 20 students. The SPM Mathematics Trial Examination Question paper 1 contains 40 objective questions while the SPM Mathematics Trial Examination paper 1 contains 25 subjective questions. The data obtained were analysed using Microsoft Excel software based on the formulas of item difficulty index and discrimination index. This analysis can help teachers for better understanding about the difficulty level of the items used. Finally, based on the analysis items obtained, the items were classified as good, good but improved, marginal or weak items.
Students' Perceptions towards Mathematical Softwares Based Learning / Persepsi Pelajar terhadap Pembelajaran Berasaskan Perisian Matematik
Authors: Abdullah Nor Adibah , Mukhtar Nur E'zzatul Hamizah , Amran Nurzarina
Published: September 2020

In tandem with the advancement of technology in the education field, the usage of software in Mathematics teaching and learning is prevalent among teachers to improve students’ achievement. The research was carried out to identify students’ perception towards Mathematical software based learning features and aspects of the software which help and hinder students’ learning process. This quantitative research used survey design. The questionnaire instrument used consisted of 46 items with Five Points Likert Scale of Agreement Level. This research involved 36 Form Four students who were randomly selected from seven classses in a secondary school in Selangor. Data were analysed descriptively. It was found that the students’ perception towards learning features based on Mathematical software was at moderate level. Th learning features which recorded the highest mean score are students’ autonomy with the score of 3.89 followed by interaction in software based learning with mean score of 3.62, learning structure with mean score of 3.21 and the lowest was 3.20 for delivery system feature. Students’ perception towards the aspects in Mathematical software which help the teaching and learning process namely participation in class, students’ mindset change, and test achievement shows moderate level with mean score of 3.39 whereas the aspects which hinder the Mathematical software based teaching and learning process such as the factors of time, understanding, learning practice, and computer sharing were also at moderate level with mean score of 3.40. Mathematical software based learning serves as the best and most effective teaching and learning approach as well as utilising information and communication technology (ICT) facility in line with Malaysian Education Blueprint 2013-2025.
The Emphasis on Generalization Strategies in Teaching Integral: Calculus Lesson Plans
Authors: Hashemi Nourooz , Kashefi Hamidreza , Abu Mohd Salleh
Published: September 2020

Although integral is one of the important concepts in mathematics, most students have problems learning it. A well-designed lesson plan consisting generalization and its related activities can play an important role to overcome the students’ difficulties in the learning process. In this study, generalization means going from particular to something general by looking at common things and expanding their domains of validity. The main goal of this study is to investigate the rate of using generalization by mathematics instructors in teaching of integral concepts based on lesson plans. Thus, the instructors were interviewed on what generalization means to them and to find the reasons of emphasis on generalization or lack of it in their lesson plans. Findings revealed that most instructors did not emphasise the teaching of generalization in their lesson plans. Although most of the instructors expressed that generalization can be used to extend the theorems, the interview clarified that majority of the instructors did not know about the important applications of generalization in the teaching of integral. The results demonstrated that instructors have oppressed generalization in the integral teaching process.
The Ability to Translate Arabic Vocabulary among STAM Student/ Kebolehan Menterjemah Kosa Kata Bahasa Arab dalam Kalangan Pelajar STAM
Authors: Maaruf Izzah Syakirah , Samah Rosni
Published: September 2020

Religious school students have been learning Arabic from standard one until standard six at the level of STAM examination. During these six years of learning, apperently, they can master Arabic well. However, some studies have discussed on their weaknesses. Therefore, this study was conducted to identify the students’ ability to translate in using the Arabic vocabulary that consists of nouns, verbs and cohetions among form sixth students at a religious school in Selangor. The researchers used descriptive analysis to obtain the mean. A total of 80 respondents were randomly selected to answer a set of test by translating 66 Arabic vocabularies which were selected from STAM textbook. The results of the analysis indicated that the respondents’ translation ability for nouns, verbs and cohetions is considered as weak. This study suggested that translation exercises should be conducted periodically for students in the classroom or in the co-curricular activities.
The Operation of the Halal Assurance System in the Broilers Farming Sector: A Preliminary Study/ Pengoperasian Sistem Pengurusan Jaminan Halal Di Sektor Penternakan Ayam Pedaging: Satu Kajian Awal
Authors: Ramli Mohd Hasli , Rosman Arieff Salleh , Ajmain@Jima’ain Muhammad Talhah
Published: September 2020

The demand for halal food products especially chicken meat products is increasing due to the belief in products that are based on the halal concept. The Department of Islamic Development Malaysia (JAKIM) has taken the initiative to develop the Halal Assurance System (HAS) to be implemented in the food product manufacturing industry. The main purpose of this system is to increase the level of integrity of the halal product start from raw material source to the end user. Until today, the operation of this HAS in Malaysia only been focused at the stage of raw material received to the finished product and subsequently consumer consumption. As such, HAS implementation practices are less emphasized and implemented at the top halal food chain which involves the chicken broilers farming industry. Therefore this study is to discuss and identify the necessity of HAS be implemented at broiler farming sector. The methodology used in this study is a qualitative approach through document analysis used to obtain information related to the halal assurance management system and to describe the essential aspects of HAS elements such as halal control point in broilers farming activities. The findings of this study have found that aspects of animal feed source, medications and animal welfare are most important elements in SJH's implementation on poultry breeding phase. This study also recommended the implementation of HAS not only be applied on chicken broiler farming sector but also can be implemented in others farming industries such as ruminant and other poultry animals.
Religious Discrimination among Muslim Employees/ Diskriminasi Agama Dalam Kalangan Pekerja Muslim
Authors: Hazaha Muhammad Farhan , Abdull Rahman Rabeatul Husna , Abdull Rahman Nurul Labanihuda
Published: September 2020

This study aims to examine religious discrimination against Muslim workers. There are three objectives in this study, namely to identify the level of discrimination against Islam, to identify differences in the level of discrimination against Islam between the sexes, and to identify differences in the level of discrimination against Islam between employers of different religions. Purposive sampling and snowball sampling methods were used to select a sample consisting of Muslim workers working as salesmen. A total of 132 questionnaires were analyzed from four different shopping complexes in Johor Bahru, Johor. The results of the study found that the level of religious discrimination is at a low level. In addition, researchers also found that male workers were more likely to experience religious discrimination than female workers. In terms of the religion of employers, non-Muslim employers are more likely to discriminate against religion than Muslim employers. In conclusion, in the context of this study, religious discrimination against Muslim workers is at a low level.
Systematic Literature Review:Online Social Media Interaction in Education and Employment Cluster/ Tinjauan Literatur Sistematik: Interaksi Media Sosial Atas Talian dalam Kluster Pendidikan dan Pekerjaan
Authors: Saleh Nor Shela , Rosli Mohd Shafie
Published: September 2020

The research is related to online social media interactions in education and employment clusters. The researcher has developed five objectives of the study specifically to identifying the top forms of social media in Malaysia, to identifying the tendency of Malaysians to habit social media, to identifying online interaction platforms in the employment sector, to identifying the effectiveness of social media in generating income and for educational purposes. All objectives use two methods of analysis that is critical factor analysis and quantitative analysis. All of these objectives were achieved. The results show that Malaysians are more likely to use Facebook social media and WhatsApp application in their regular lives for social, educational and career purposes. This shows that social media and interaction applications have a positive impact on society, especially for employees and students in the face of the changing world of Technology in the 21st century.
Management of incidental unruptured intracranial aneurysms
Authors: Renowden Shelley , Nelson Richard
Published: September 2020

The widespread use of MR has led to the increasingly frequent diagnosis of unruptured incidental intracranial aneurysms. Most are small (<7 mm diameter) and will never rupture. Yet, their recognition causes much anxiety, and their optimal management remains controversial. This review addresses the difficulties in managing incidental unruptured saccular intracranial aneurysms. Note that our conclusions and recommendations do not apply to symptomatic unruptured aneurysms or to fusiform, dissecting, mycotic, traumatic and paediatric aneurysms, each of which has a different natural history.
A golden probe of nonlinear Higgs dynamics
Authors: Liu Da , Low Ian , Vega-Morales Roberto
Published: September 2020

The most salient generic feature of a composite Higgs boson resides in the nonlinearity of its dynamics, which arises from degenerate vacua associated with the pseudo-Nambu–Goldstone (PNGB) nature of the Higgs boson. It has been shown that the nonlinear Higgs dynamics is universal in the IR and controlled only by a single parameter f, the decay constant of the PNGB Higgs. In this work we perform a fit, for the first time, to Wilson coefficients of $${\mathcal {O}}(p^4)$$

O
(

p
4

)

operators in the nonlinear Lagrangian using the golden H $$\rightarrow $$
→
4L decay channel. By utilizing both the “rate” information in the signal strength and the “shape” information in the fully differential spectra, we provide limits on the Goldstone decay constant f, as well as $${\mathcal {O}}(p^4)$$

O
(

p
4

)

Wilson coefficients, using Run 2 data at the LHC. In rate measurements alone, the golden channel prefers a negative $$\xi =v^2/f^2$$

ξ
=

v
2

/

f
2

corresponding to a non-compact coset structure. Including the shape information, we identify regions of parameter space where current LHC constraint on f is still weak, allowing for $$\xi \lesssim 0.5$$

ξ
≲
0.5

or $$\xi \gtrsim -0.5$$

ξ
≳
-
0.5

. We also comment on future sensitivity at the high-luminosity upgrade of the LHC which could allow for simultaneous fits to multiple Wilson coefficients.
Long‐Term Imaging Evolution and Clinical Prognosis Among Patients With Acute Penetrating Aortic Ulcers: A Retrospective Observational Study
Authors: Yang Lin , Zhang Quan‐Yu , Wang Xiao‐Zeng , Zhao Xin , Liu Xuan‐Ze , Wang Ping , Jing Quan‐min , Han Ya‐Ling
Published: September 2020

Background

Acute penetrating aortic ulcers (PAUs) are reported to dynamically evolve into different clinical outcomes ranging from regression to aortic rupture, but no practice guidelines are available in China.

Methods and Results

All 109 patients with acute PAUs were monitored clinically. At 30 days follow‐up, 31 patients (28.44%) suffered from aortic‐related adverse events, a composite of aortic‐related mortality, aortic dissection, or an enlarged ulcer. In addition, 7 (6.42%) patients had clinically related adverse events, including all‐cause mortality, cerebral stroke, nonfatal myocardial infarction, acute heart failure alone or acute exacerbation of chronic heart failure, acute renal failure, arrhythmia, and bleeding events. In the present study, the intervention criteria for the Chinese PAU population included a PAU diameter of 12.5 mm and depth of 9.5 mm. The multivariate analysis showed that an ulcer diameter >12.5 mm (hazard ratio [HR], 3.846; 95% CI, 1.561–9.476;
P
=0.003) and an ulcer depth >9.5 mm (HR, 3.359; 95% CI, 1.505–7.494;
P
=0.003) were each independent predictors of aortic‐related events.

Conclusions

Patients with acute PAUs were at high risk for aortic‐related adverse events and clinically related adverse events within 30 days after onset. Patients with an ulcer diameter >12.5 mm or an ulcer depth >9.5 mm have a higher risk for disease progression, and early intervention may be recommended.
Risks of Incident Cardiovascular Disease Associated With Concomitant Elevations in Lipoprotein(a) and Low‐Density Lipoprotein Cholesterol—The Framingham Heart Study
Authors: Afshar Mehdi , Rong Jian , Zhan Yang , Chen Hao Yu , Engert James C. , Sniderman Allan D. , Larson Martin G. , Vasan Ramachandran S. , Thanassoulis George
Published: September 2020

Background

Elevated lipoprotein(a) is a well‐established risk factor for atherosclerotic vascular disease but is not measured in routine clinical care. Screening of high lipoprotein(a) in individuals with moderate elevations of low‐density lipoprotein cholesterol (LDL‐C) may identify individuals at high risk of cardiovascular disease.

Methods and Results

We examined 2606 Framingham Offspring participants (median age, 54 years; 45% men) prospectively with a median follow‐up of 15 years (n=392 incident cardiovascular events). Individuals with higher (≥100 nmol/L) versus lower lipoprotein(a) were divided into groups based on LDL‐C <135 mg/dL versus ≥135 mg/dL. In Cox models, after adjustment for known risk factors, high lipoprotein(a) (≥100 nmol/L) and LDL‐C ≥135 mg/dL were each significant predictors of cardiovascular disease (LDL‐C ≥135 mg/dL: hazard ratio [HR], 1.34; 95% CI, 1.09–1.64;
P
=0.006; high lipoprotein (a): HR, 1.31; 95% CI, 1.03–1.66;
P
=0.026). Across the groups of high/low lipoprotein (a) and LDL‐C ≥135 mg/dL or <135 mg/dL, the absolute cardiovascular disease risks at 15 years were 22.6% (high lipoprotein(a)/LDL‐C ≥135 mg/dL, n=248), 17.3% (low lipoprotein(a)/LDL‐C ≥135 mg/dL, n=758), 12.7% (high lipoprotein(a)/LDL‐C <135 mg/dL, n=275) and 11.5% (low lipoprotein(a)/LDL‐C <135 mg/dL, n=1328, reference group). Among individuals with LDL‐C ≥135 mg/dL, those with high lipoprotein(a) had a 43% higher risk (HR, 1.43; 95% CI, 1.05–1.97;
P
=0.02). Presence of high lipoprotein(a) with moderate LDL‐C levels (135–159 mg/dL) yielded absolute risks equivalent to those with LDL‐C ≥160 mg/dL (23.5%, 95% CI, 17.4%–31.3%; and 20.7%, 95% CI, 16.8%–25.3%, respectively).

Conclusions

Concomitant elevation of LDL‐C ≥135 mg/dL and lipoprotein(a) ≥100 nmol/L is associated with a high absolute risk of incident cardiovascular disease. lipoprotein(a) measurement in individuals with moderate elevations in LDL‐C, who do not otherwise meet criteria for statins, may identify individuals at high cardiovascular risk.
Effects of a Vegetarian Diet on Cardiometabolic Risk Factors, Gut Microbiota, and Plasma Metabolome in Subjects With Ischemic Heart Disease: A Randomized, Crossover Study
Authors: Djekic Demir , Shi Lin , Brolin Harald , Carlsson Frida , Särnqvist Charlotte , Savolainen Otto , Cao Yang , Bäckhed Fredrik , Tremaroli Valentina , Landberg Rikard , Frøbert Ole
Published: September 2020

Background

A vegetarian diet (VD) may reduce future cardiovascular risk in patients with ischemic heart disease.

Methods and Results

A randomized crossover study was conducted in subjects with ischemic heart disease, assigned to 4‐week intervention periods of isocaloric VD and meat diet (MD) with individually designed diet plans, separated by a 4‐week washout period. The primary outcome was difference in oxidized low‐density lipoprotein cholesterol (LDL‐C) between diets. Secondary outcomes were differences in cardiometabolic risk factors, quality of life, gut microbiota, fecal short‐chain and branched‐chain fatty acids, and plasma metabolome. Of 150 eligible patients, 31 (21%) agreed to participate, and 27 (87%) participants completed the study. Mean oxidized LDL‐C (−2.73 U/L), total cholesterol (−5.03 mg/dL), LDL‐C (−3.87 mg/dL), and body weight (−0.67 kg) were significantly lower with the VD than with the MD. Differences between VD and MD were observed in the relative abundance of several microbe genera within the families Ruminococcaceae, Lachnospiraceae, and Akkermansiaceae. Plasma metabolites, including
l
‐carnitine, acylcarnitine metabolites, and phospholipids, differed in subjects consuming VD and MD. The effect on oxidized LDL‐C in response to the VD was associated with a baseline gut microbiota composition dominated by several genera of Ruminococcaceae.

Conclusions

The VD in conjunction with optimal medical therapy reduced levels of oxidized LDL‐C, improved cardiometabolic risk factors, and altered the relative abundance of gut microbes and plasma metabolites in patients with ischemic heart disease. Our results suggest that composition of the gut microbiota at baseline may be related to the reduction of oxidized LDL‐C observed with the VD.

Registration

URL:
https://www.clini​caltr​ials.gov
; Unique identifier: NCT02942628.
Short‐Term Changes in Albuminuria and Risk of Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus: A Post Hoc Analysis of the EMPA‐REG OUTCOME Trial
Authors: Waijer Simke W. , Xie Di , Inzucchi Silvio E. , Zinman Bernard , Koitka‐Weber Audrey , Mattheus Michaela , von Eynatten Maximillian , Inker Lesley A. , Wanner Christoph , Heerspink Hiddo J. L.
Published: September 2020

Background

Early reduction in albuminuria with an SGLT2 (sodium‐glucose cotransporter 2) inhibitor may be a positive indicator of long‐term cardiovascular and renal benefits. We assessed changes in albuminuria during the first 12 weeks of treatment and subsequent long‐term cardiovascular and renal risks associated with the SGLT2 inhibitor, empagliflozin, in the EMPA‐REG OUTCOME (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 diabetes Mellitus Patients) trial.

Methods and Results

We calculated the percentage urinary albumin creatinine ratio (UACR) change from baseline to week 12 in 6820 participants who did not experience a cardiovascular outcome (including 3‐point major cardiovascular events and cardiovascular death or hospitalization for heart failure) or renal outcome (defined as 40% decline in estimated glomerular filtration rate from baseline, estimated glomerular filtration rate <15 mL/min per 1.73 m
2
, need for continuous renal‐replacement therapy, or renal death) during the first 12 weeks. Multivariable Cox regression models were used to estimate the hazard ratio (HR) for each 30% reduction in UACR with outcomes. Empagliflozin reduced UACR by 18% (95% CI, 14–22) at week 12 compared with placebo, and increased the likelihood of a >30% reduction in UACR (odds ratio, 1.42; 95% CI, 1.27–1.58;
P
<0.001). During 3.0 years of follow‐up, 704 major cardiovascular events, 440 cardiovascular deaths/hospitalizations for heart failure, and 168 renal outcomes were observed. Each 30% decrease in UACR during the first 12 weeks was statistically significantly associated with a lower hazard for major cardiovascular events (HR, 0.96; 95% CI, 0.93–0.99;
P
=0.012), cardiovascular deaths/hospitalizations for heart failure (HR, 0.94; 95% CI, 0.91–0.98;
P
=0.003), and renal outcomes (HR, 0.83; 95% CI, 0.78–0.89;
P
<0.001).

Conclusions

Short‐term reduction in UACR was more common with empagliflozin and was statistically significantly associated with a decreased risk of long‐term cardiovascular and renal outcomes.

Registration

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01131676.
Functional bladder paraganglioma: An odd presentation of haematuria
Authors: Mataruka Gerald Tatenda , Dlamini Khayalethu , Mukendi Alain Mwamba , Blumberg Raphael , Orsar Solomon , Brits Nicholas
Published: September 2020

Introduction:

Bladder paraganglioma is a rare tumour of chromaffin cell origin. Few cases have been reported in the literature.

Case report:

A 59-year-old female with no known co-morbidities presented with catecholamine-related symptoms, haematuria, elevated blood pressures and raised urine metanephrines. A sonar and computed tomography scan confirmed a bladder mass shown to be active on iodine-131 meta-iodobenzylguanidine. Partial cystectomy was performed.

Conclusion:

Although bladder paraganglioma is rare, clinicians need to be aware of how such cases may present and the necessary work-up to confirm the diagnosis. Surgery is the treatment of choice, and long-term follow-up of these patients is necessary to detect recurrence or metastases.

Level of evidence:

4.
Household heating associated with disability in activities of daily living among Chinese middle-aged and elderly: a longitudinal study
Authors: Wang Qing , Tapia Granados Jose A.
Published: September 2020

Background

The health hazards of indoor air pollution are well-established but studies of the health effects due to pollution from heating are rare. This study investigated the association of heating and disability for activities of daily living among Chinese middle-aged and elderly.

Methods

We used two consecutive surveys in a cohort of over 17,000 adults aged 45 or older, who were interviewed first in 2011–2012 and then in 2013. In these surveys, taking advantage of random survey time, we applied a random effects logit regression model that included an interaction between pollution-producing heating fuel and a dummy variable, which measured interview time based on whether or not it was heating season.

Results

Exposure to pollution-producing heating fuel was associated with a 39.9% (OR 1.399; 95%CI 1.227–1.594) and 71.0% (OR 1.710; 95%CI 1.523–1.920) increase in the likelihood of disability in activities of daily living (DADL) and disability in instrumental activities of daily living (DIADL), respectively. In heating season between year 2011 and 2013, moving from clean heating energy for heating to pollution-producing fuel was linked with an increase in the likelihoods having DADL and DIADL, with the OR of 2.014 (95%CI 1.126–3.600) and 1.956 (95%CI 1.186–3.226), respectively. However, disability increases due to change from clean energy to pollution-producing heating energy did not appear in advantaged education respondents.

Conclusions

We found that exposure to heating by burning of coal, wood, or crop residue was associated with disability in performing daily living activities. Health policymakers should take indoor pollution due to heating into consideration as it is a major determinant of activities of daily living in elderly people; especially, such policy should focus on elderly people who have disadvantaged education.
Is nerve sparing clitoroplasty really a nerve sparing?
Authors: Dawood Waleed , Abdallah Dina , Soliman Ashraf , Khater Doaa , Elsayed Shaymaa , Omar Magdy , Badawy Haytham
Published: September 2020

Background

Surgery for clitoral reduction has been practised for over half a century. The aim of clitoral surgery is to achieve normal clitoral morphology without compromising sexual function. To achieve these purposes, many techniques were developed since Young first reported reduction clitoroplasty in 1937. As the importance of the neurovascular bundle was realized, attempts were made to preserve this structure aiming at preservation of the sensory supply to the clitoris to achieve sexual satisfaction.

Methods

The study was conducted on six patients with congenital adrenal hyperplasia, who were operated upon with reduction clitoroplasty with neurovascular bundle preservation as a part of the genital reconstruction; surgery was done by single author (first author). Whole surgically removed corporal bodies were processed. Examination of the sections was done for the presence of nerve bundles related to the anatomical location of the neurovascular bundle using S100 immunohistochemical staining.

Results

In four cases, the presence of nerve fibers in the removed part of the corpus stained by S100 was high on the dorsal surface, with the presence of large nerve fibers (score 3–4), and low on the ventral surface with the presence of small nerve fibers (score 1). In the other two cases, it was low on both surfaces (score 1).

Conclusion

Subfacial clitoroplasty technique carries an inevitable risk of nerve injury and should be replaced by the subtunical technique.

Level of evidence

IV. Type of study: case series with no comparison group.
Non-medial infectious orbital cellulitis: etiology, causative organisms, radiologic findings, management and complications
Authors: Abtahi Seyed Mohammad Bagher , Eghtedari Masoomeh , Hosseini Shahla , Shirvani Mohammad , Talebi Atefeh , Masihpoor Nasrin , Mohaghegh Sahar , Hamidianjahromi Anahid , Hosseini Mohammad
Published: September 2020

Background

Orbital cellulitis is an ophthalmic emergency, which is associated with vision-threatening adverse effects. The purpose of this study is investigating etiology, radiologic findings, management and complications of patients with non-medial orbital cellulitis.

Method

A retrospective medical record and radiologic file review of patients with infectious orbital cellulitis was performed to detect all patients with non-medial orbital cellulitis who referred to Khalili hospital from 2016 to 2019. Age, sex, origin of infection, size of collection or abscess, medical or surgical management, microbiology, first and final best-corrected visual acuity, duration of admission, and complications was recorded. Patients divided into two groups; medical management and surgical management groups and all of data compared between in this groups.

Results

Of ninety-six patients with infectious orbital cellulitis, 23 cases (14 male, 9 female) were included. Five patients (21.7%) were managed medically and 18 patients (78.3%) were managed surgically. Patients’ age range was 5–70 years old. Most common location for non-medial cellulitis was superior space (66.7% in surgical and 40% in medical group; p = 0.511). In 13 cases of surgical group (72.3%) were detected microorganisms. The mean ± SD of collection volume in medical group were 476.5 ± 290.93 mm3 and 2572.94 ± 1075.75 mm3 in surgical group (p < 0.001). Ten patients in surgical group had compressive optic neuropathy. The mean ± SD of collection volume was 3204.97 ± 879.88 mm3 in patient with compressive optic neuropathy and 1280.43 ± 880.68 mm3 in patient without compressive optic neuropathy (P < 0.001). One case complicated by subdural empyema and another case progressed to necrotizing fasciitis.

Conclusion

Non-medial orbital cellulitis is an uncommon but sight-threatening and life-threatening condition. Timely diagnosis and accurate management reduce morbidity and mortality. Combined surgery for patients with superior or supra-temporal and large non-medial abscess is recommended.
Potential causes and consequences of rapid mitochondrial genome evolution in thermoacidophilic Galdieria (Rhodophyta)
Authors: Cho Chung Hyun , Park Seung In , Ciniglia Claudia , Yang Eun Chan , Graf Louis , Bhattacharya Debashish , Yoon Hwan Su
Published: September 2020

Background

The Cyanidiophyceae is an early-diverged red algal class that thrives in extreme conditions around acidic hot springs. Although this lineage has been highlighted as a model for understanding the biology of extremophilic eukaryotes, little is known about the molecular evolution of their mitochondrial genomes (mitogenomes).

Results

To fill this knowledge gap, we sequenced five mitogenomes from representative clades of Cyanidiophyceae and identified two major groups, here referred to as Galdieria-type (G-type) and Cyanidium-type (C-type). G-type mitogenomes exhibit the following three features: (i) reduction in genome size and gene inventory, (ii) evolution of unique protein properties including charge, hydropathy, stability, amino acid composition, and protein size, and (iii) distinctive GC-content and skewness of nucleotides. Based on GC-skew-associated characteristics, we postulate that unidirectional DNA replication may have resulted in the rapid evolution of G-type mitogenomes.

Conclusions

The high divergence of G-type mitogenomes was likely driven by natural selection in the multiple extreme environments that Galdieria species inhabit combined with their highly flexible heterotrophic metabolism. We speculate that the interplay between mitogenome divergence and adaptation may help explain the dominance of Galdieria species in diverse extreme habitats.