bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrated healthcare models for rheumatoid arthritis: A descriptive systematic review
Authors: Vodopivec Valentina , Vrijhoef Hubertus JM
Published: March 2019

Introduction

Integrated people-centred care is a modern approach for addressing healthcare issues related to demographic changes, increasing prevalence of chronic diseases, and restricted resources. By providing an overview of integrated care models for patients with rheumatoid arthritis, we aimed to offer insight into the strategies and interventions that are being used for designing and implementing integrated models of care for this patient group, and their outcomes.

Methods

We conducted a systematic literature search of peer-reviewed literature available in English and published between 2013 and 2018, using three databases: Cochrane, PubMed and EMBASE. We analysed the publications based on the Framework on integrated people-centred health services and the Triple/Quadruple Aim framework.

Results

We identified 1271 records. After screening, 50 articles met the criteria for inclusion in the review. Approaches for improving patient empowerment, engagement and experience of care were most prevalent in the identified care profiles. Similarly, frequently reported outcomes were related to improvements in patients’ experience of care and their health status. Most of the studies we reviewed did not demonstrate notable improvements from the perspective of cost-effectiveness or benefits for the healthcare workforce.

Conclusions

Our findings suggest that for rheumatoid arthritis, integrated care is in the early stages of development. Strategies focusing on patient outcomes and patient satisfaction were found to be prioritised. Future initiatives aiming to redesign rheumatology care should adopt systems thinking perspective to better address all of the building blocks of people-centred integrated care.
“Every part of me has changed”—shared lived experiences of adolescents living with cancer in Zambia
Authors: Sibulwa Sharleen , Chansa-Kabali Tamara , Hapunda Given
Published: March 2019

This study explored experiences of adolescents living with cancer, focusing on physical and psychosocial problems. Semi-structured interviews were carried out on 18 adolescents aged between 12 and 18 years. Transcripts were analyzed using thematic analysis. Results showed that the adolescents faced a lot of physical, psychological, and social problems due to cancer diagnosis, treatment, and care. In order to improve their well-being and quality of life, psychosocial interventions should be incorporated in biomedical interventions that adolescents with cancer receive. This study proposes cost-effective interventions that can be implemented in resource-restricted sub-Saharan countries like Zambia.
Learning design in a global classroom
Authors: McEwen Rhonda M
Published: March 2019

Learning design in a global classroom offers an approach to adult and higher education that is grounded in a comprehensive understanding of how God has created people to learn—one that is informed by the social and cultural context in which the learning takes place. This article introduces an approach to learning design which integrates educational theory and pedagogical strategies informed by relevant theological reflection, and explains how this curricular approach can facilitate more inclusive and transformative learning environments, particularly within intercultural contexts.
Combined lateral condyle mass and olecranon fractures: A proposed treatment algorithm and surgical technique
Authors: Lam Kai Yet , Mahadev Arjandas
Published: March 2019

Combined lateral condyle mass and olecranon fractures are infrequently seen. These cases are easily missed, and only 12 previous cases are detailed in the English medical literature. The decision for surgical fixation usually depends on the amount of displacement of the individual fractures. However, the optimal surgical approach or technique for open reduction and internal fixation has not been agreed upon. We present three original case reports and analyse them together with all other known cases in the English literature. We discuss how to avoid missing these combined fractures and propose a treatment algorithm based on the different permutations of the fracture displacement. Our detailed surgical approach (using a posterior ‘olecranon osteotomy’ approach) is also described.
Tibial Tubercle Proximalization: A Novel Technique to Lengthen the Extensor Mechanism in Skeletally Mature Patients With Lateral Habitual Patellar Dislocations
Authors: Song Guan-yang , Feng Hua , Zhang Hui , Zhang Jin , Zhang Zhi-jun
Published: March 2019

Background:

A habitual patellar dislocation (HPD) is a rare condition in skeletally mature patients, especially for those with severe quadriceps contracture. Until now, no study has reported the effectiveness of tibial tubercle proximalization to lengthen the extensor mechanism in treating severe HPDs in skeletally mature patients.

Purpose:

To describe a novel comprehensive procedure that includes tibial tubercle proximalization, extensive lateral release, tibial tubercle medialization, and medial patellofemoral ligament (MPFL) reconstruction in treating severe HPDs in skeletally mature patients and to report its early clinical outcomes.

Study Design:

Case series; Level of evidence, 4.

Methods:

From January 2014 to May 2016, a total of 43 consecutive patients (47 knees) with HPDs were surgically treated at a single institution and were retrospectively reviewed. Among them, 11 skeletally mature patients (11 knees) with severe primary HPDs underwent the index comprehensive procedure. Results of patellar tracking were recorded preoperatively and at the final follow-up. The radiological assessment included radiographs in standard anteroposterior, true lateral, and axial views and computed tomography scans at full knee extension before surgery and at the final follow-up. Subjective patellofemoral function was evaluated with the Kujala functional score before the index procedure and at the final follow-up visit.

Results:

The 11 included patients were evaluated for a mean period of 34.9 months (range, 25-46 months). The mean knee flexion angle when the patella dislocated laterally was 25° (range, 10°-30°) preoperatively. Radiologically, there was a statistically significant improvement in the congruence angle, from 73.4° ± 17.0° preoperatively to –7.1° ± 5.8° postoperatively ( P < .01) and in the lateral patellofemoral angle, from –65.6° ± 9.4° preoperatively to 6.1° ± 2.7° postoperatively ( P < .01). The mean preoperative Kujala functional score was 42.9, and the mean postoperative Kujala functional score was 95.2 ( P < .05). No patients reported a recurrence of patellar dislocation at the final follow-up visit.

Conclusion:

The novel comprehensive procedure, including tibial tubercle proximalization, extensive lateral release, tibial tubercle medialization, and MPFL reconstruction, effectively treated lateral HPDs in skeletally mature patients with severe quadriceps contracture.
Using Pressure Massage for Achilles Tendinopathy: A Single-Blind, Randomized Controlled Trial Comparing a Novel Treatment Versus an Eccentric Exercise Protocol
Authors: Stefansson Stefan H. , Brandsson Sveinbjörn , Langberg Henning , Arnason Arni
Published: March 2019

Background:

Eccentric exercises are the only conservative treatment that has shown good clinical results in studies of Achilles tendinopathy (AT), but success rates vary, indicating the need for alternative treatments. Soft tissue treatments are widely used for AT, but strong scientific evidence is lacking to support those treatments.

Purpose/Hypotheses:

This study aimed to determine whether pressure massage to the calf muscles is a useful treatment for AT and to compare this treatment versus an eccentric exercise protocol. Our first hypothesis was that pressure massage treatment is equivalent or superior to eccentric exercises with regard to pain reduction time (ie, pain would be reduced more quickly with pressure massage). The second hypothesis was that pressure massage is equivalent or superior to eccentric exercises with regard to function of the calf muscles.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

A total of 60 patients with AT were randomized into 3 groups: group 1 underwent an eccentric exercise protocol, group 2 underwent pressure massage, and group 3 underwent pressure massage and the eccentric exercise protocol. Patients were evaluated with the Icelandic version of the Victorian Institute of Sports Assessment–Achilles questionnaire (VISA-A-IS), an algometer to test the pressure pain threshold (PPT) of the Achilles tendon, tests for ankle range of motion (ROM), and real-time ultrasonographic (US) scanning of tendon thickness and degree of neovascularization. Measurements for VISA-A-IS, PPT, and ROM were taken at 0, 4, 8, 12, and 24 weeks. US scan measurements were taken at 0, 12, and 24 weeks. Mixed-model analysis of variance was used for statistical analysis.

Results:

All groups improved when evaluated with VISA-A-IS scores ( P < .0001). The pressure massage group improved significantly more than the eccentric exercise group at week 4, which was the only between-group difference. Ankle ROM increased significantly over time (ROM bent knee P = .006 and ROM straight knee P = .034), but no significant difference was found between groups. No significant difference was found in evaluations of PPT or US scan measurements.

Conclusion:

Pressure massage is a useful treatment for Achilles tendinopathy. Compared with eccentric exercise treatment, pressure massage gives similar results. Combining the treatments did not improve the outcome.
Using Nominal Group Technique to Identify Key Attributes of Oncology Treatments for a Discrete Choice Experiment
Authors: Somers Camilla , Chimonas Susan , McIntosh Emma , Kaltenboeck Anna , Briggs Andrew , Bach Peter
Published: March 2019

Background. Responding to rising oncology therapy costs, multiple value frameworks are emerging. However, input from economists in their design and conceptualization has been limited, and no existing framework has been developed using preference weightings as legitimate indicators of value. This article outlines use of the nominal group technique to identify valued treatment attributes (such as treatment inconvenience) and contextual considerations (such as current life expectancy) to inform the design of a discrete choice experiment to develop a preference weighted value framework for future decision makers. Methods. Three focus groups were conducted in 2017 with cancer patients, oncology physicians, and nurses. Using the nominal group technique, participants identified and prioritized cancer therapy treatment and delivery attributes as well as contextual issues considered when choosing treatment options. Results. Focus groups with patients ( n = 8), physicians ( n = 6), and nurses ( n = 10) identified 30 treatment attributes and contextual considerations. Therapy health gains was the first priority across all groups. Treatment burden/inconvenience to patients and their families and quality of evidence were prioritized treatment attributes alongside preferences for resource use and cost (to patients and society) attributes. The groups also demonstrated that contextual considerations when choosing treatment varied across the stakeholders. Patients prioritized existence of alternative treatments and oncologist/center reputation while nurses focused on administration harms, communication, and treatment innovation. The physicians did not prioritize any contextual issues in their top rankings. Conclusions. The study demonstrates that beyond health gains, there are treatment attributes and contextual considerations that are highly prioritized across stakeholder groups. These represent important candidates for inclusion in a discrete choice experiment seeking to provide weighted preferences for a value framework for oncology treatment that goes beyond health outcomes.
National Deliverance through Culture or of Culture? T. C. Chao on Christianity and Chinese Culture
Authors: Sun Zexi (Jesse)
Published: March 2019

This article traces the theological evolution in the thought of T. C. Chao regarding national deliverance as it related to Chinese culture. Although Chao never wavered on the significance of Christianity in national reconstruction, his position on the relationship between Chinese culture and Christianity shows significant theological reorientation. In his earlier works Chao tried to clothe Christianity with a Chinese fabric, emphasizing the immanence of the faith by making it culturally relevant to his compatriots. Later, “caught by truth” in a Japanese prison, Chao instead turned to Christian transcendence as the necessary corrective for the challenges and crises in Chinese culture and society.
Acetylcholine and cholinergic receptors
Authors: Brown David A.
Published: March 2019

This review provides a distillate of the advances in knowledge about the neurotransmitter functions of acetylcholine over the 50-year period between 1967 and 2017, together with incremental information about the cognate nicotinic and muscarinic acetylcholine receptors, and some brief comments on possible advances in the near future. The text is supplemented by a timelines figure indicating the dates of some key advances in knowledge about acetylcholine receptors and a box-figure providing a snapshot of selected papers about acetylcholine published in the year 1967.
Subclonal STAT3 mutations solidify clonal dominance
Authors: Kerr Cassandra M. , Clemente Michael J. , Chomczynski Peter W. , Przychodzen Bartlomiej , Nagata Yasunobu , Adema Vera , Visconte Valeria , Lichtin Alan E. , Mustjoki Satu , Radivoyevitch Tomas , Sekeres Mikkael A. , Maciejewski Jaroslaw P.
Published: March 2019

T large granular lymphocyte leukemia (T-LGLL) is a clonal lymphoproliferative disorder that can arise in the context of pathologic or physiologic cytotoxic T-cell (CTL) responses. STAT3 mutations are often absent in typical T-LGLL, suggesting that in a significant fraction of patients, antigen-driven expansion alone can maintain LGL clone persistence. We set out to determine the relationship between activating STAT3 hits and CTL clonal selection at presentation and in response to therapy. Thus, a group of patients with T-LGLL were serially subjected to deep next-generation sequencing (NGS) of the T-cell receptor (TCR) Vβ complementarity-determining region 3 (CDR3) and STAT3 to recapitulate clonal hierarchy and dynamics. The results of this complex analysis demonstrate that STAT3 mutations produce either a sweeping or linear subclone within a monoclonal CTL population either early or during the course of disease. Therapy can extinguish a LGL clone, silence it, or adapt mechanisms to escape elimination. LGL clones can persist on elimination of STAT3 subclones, and alternate STAT3-negative CTL clones can replace therapy-sensitive CTL clones. LGL clones can evolve and are fueled by a nonextinguished antigenic drive. STAT3 mutations can accelerate this process or render CTL clones semiautonomous and not reliant on physiologic stimulation.
Exosomes derived from umbilical cord mesenchymal stem cells reduce microglia-mediated neuroinflammation in perinatal brain injury
Authors: Thomi Gierin , Surbek Daniel , Haesler Valérie , Joerger-Messerli Marianne , Schoeberlein Andreina
Published: March 2019

Background

Preterm newborns are at high risk of developing neurodevelopmental deficits caused by neuroinflammation leading to perinatal brain injury. Human Wharton’s jelly mesenchymal stem cells (hWJ-MSC) derived from the umbilical cord have been suggested to reduce neuroinflammation, in part through the release of extracellular vesicle-like exosomes. Here, we studied whether exosomes derived from hWJ-MSC have anti-inflammatory effects on microglia-mediated neuroinflammation in perinatal brain injury.

Methods

Using ultracentrifugation, we isolated exosomes from hWJ-MSC culture supernatants. In an in vitro model of neuroinflammation, we stimulated immortalized BV-2 microglia and primary mixed glial cells with lipopolysaccharide (LPS) in the presence or absence of exosomes. In vivo, we introduced brain damage in 3-day-old rat pups and treated them intranasally with hWJ-MSC-derived exosomes.

Results

hWJ-MSC-derived exosomes dampened the LPS-induced expression of inflammation-related genes by BV-2 microglia and primary mixed glial cells. The secretion of pro-inflammatory cytokines by LPS-stimulated primary mixed glial was inhibited by exosomes as well. Exosomes interfered within the Toll-like receptor 4 signaling of BV-2 microglia, as they prevented the degradation of the NFκB inhibitor IκBα and the phosphorylation of molecules of the mitogen-activated protein kinase family in response to LPS stimulation. Finally, intranasally administered exosomes reached the brain and reduced microglia-mediated neuroinflammation in rats with perinatal brain injury.

Conclusions

Our data suggest that the administration of hWJ-MSC-derived exosomes represents a promising therapy to prevent and treat perinatal brain injury.
Chronic otitis media is initiated by a bulla cavitation defect in the FBXO11 mouse model
Authors: del-Pozo Jorge , MacIntyre Neil , Azar Ali , Glover James , Milne Elspeth , Cheeseman Michael
Published: March 2019

Auditory bulla cavitation defects are a cause of otitis media, but the normal cellular pattern of bulla mesenchyme regression and its failure are not well understood. In mice, neural-crest-derived mesenchyme occupies the bulla from embryonic day 17.5 (E17.5) to postnatal day 11 (P11) and then regresses to form the adult air-filled bulla cavity. We report that bulla mesenchyme is bordered by a single layer of non-ciliated epithelium characterized by interdigitating cells with desmosome cell junctions and a basal lamina, and by Bpifa1 gene expression and laminin staining of the basal lamina. At P11-P12, the mesenchyme shrinks: mesenchyme-associated epithelium shortens, and mesenchymal cells and extracellular matrix collagen fibrils condense, culminating in the formation of cochlea promontory mucosa bordered by compact non-ciliated epithelial cells. FBXO11 is a candidate disease gene in human chronic otitis media with effusion and we report that a bulla cavitation defect initiates the pathogenesis of otitis media in the established mouse model Jeff (Fbxo11Jf/+). Persistent mesenchyme in Fbxo11Jf/+ bullae has limited mesenchymal cell condensation, fibrosis and hyperplasia of the mesenchyme-associated epithelium. Subsequent modification forms fibrous adhesions that link the mucosa and the tympanic membrane, and this is accompanied by dystrophic mineralization and accumulation of serous effusion in the bulla cavity. Mouse models of bulla cavitation defects are important because their study in humans is limited to post-mortem samples. This work indicates new diagnostic criteria for this otitis media aetiology in humans, and the prospects of studying the molecular mechanisms of murine bulla cavitation in organ culture.
Iodine load reduction in dual-energy spectral CT portal venography with low energy images combined with adaptive statistical iterative reconstruction
Authors: Han Dong , Chen Xiaoxia , Lei Yuxin , Ma Chunling , Zhou Jieli , Xiao Yingcong , Yu Yong
Published: March 2019

Objective:

To study the application of using low energy images combined with adaptive statistical iterative reconstruction (ASiR) in dual-energy spectral CT portal venography (CTPV) to reduce iodine load.

Methods:

41 patients for CTPV were prospectively and randomly divided into two groups. Group A ( n = 21) used conventional 120 kVp scanning protocol with contrast dose at 0.6 gI/kg while group B ( n = 20) used dual-energy spectral imaging with reduced contrast dose at 0.3 gI/kg. The 120 kVp images in Group A and 50 keV images in Group B were reconstructed with 40% ASiR. The contrast-to-noise ratio of portal vein was calculated. The image quality and the numbers of intrahepatic portal vein branches were evaluated by two experienced radiologists using a 5-point scoring system.

Results:

Group B reduced iodine load by 52% compared to Group A (17.21 ± 3.30 gI vs 35.80 ± 6.18 gI, p < 0.001). All images in both groups were acceptable for diagnosis. CT values and standard deviations in portal veins of Group B were higher than Group A (all p < 0.05); There were no statistical differences in contrast-to-noise ratio, image quality score and the number of observed portal vein branches between the two groups (all p > 0.05), and the two observers had excellent agreement in image quality assessment (all κ > 0.75).

Conclusion:

The use of 50 keV images in dual-energy spectral CTPV with ASiR reduces total iodine load by 52% while maintaining good image quality.

Advances in knowledge:

Spectral CT images combined with ASiR can be used in low contrast dose CTPV portal venography to maintain image quality and reduce contrast dose.
De algumas categorias teórico-metodológico-jurídicas: um diálogo pós-disciplinar
Authors: Cunha Paulo Ferreira da
Published: March 2019

Este é um ensaio jushumanista pós-disciplinar, bebendo longinquamente na metodologia dos ensaios de Montaigne e Bacon e na pós-disciplinaridade de Gonçal Mayos e em sua escola. Este estudo pretende trazer à superfície elementos de Teoria e Metodologia do Direito nem sempre apercebidos e sublinhados, numa ótica perspetivista e crítica. Além disso, passa em revista questões, como a Aporia, o Tempo e o Modo, o problema da Teoria e vários tipos de abordagens metodológicas. Este é mais um levantamento para fazer pensar do que para doutrinar e fornecer dogmas pré-fabricados.
Whole genome sequence and genome-wide distributed single nucleotide polymorphisms (SNPs) of the Black Bengal goat
Authors: Mollah Md. Bazlur Rahman , Bhuiyan Md. Shamsul Alam , Khandoker M.A.M. Yahia , Jalil Md. Abdul , Deb Gautam Kumar , Choudhury Md. Panir , Desha Nure Hasni
Published: March 2019

The Black Bengal goat (BBG) is a dwarf sized heritage goat (Capra hircus) breed from Bangladesh, and is well known for its high fertility, excellent meat and skin quality. Here we present the first whole genome sequence and genome-wide distributed single nucleotide polymorphisms (SNPs) of the BBG. A total of 833,469,900 raw reads consisting of 125,020,485,000 bases were obtained by sequencing one male BBG sample. The reads were aligned to the San Clemente and the Yunnan black goat genome which resulted in 98.65% (properly paired, 94.81%) and 98.50% (properly paired, 97.10%) of the reads aligning, respectively. Notably, the estimated sequencing coverages were 48.22X and 44.28X compared to published San Clemente and the Yunnan black goat genomes respectively. On the other hand, a total of 9,497,875 high quality SNPs (Q ≥ 20) along with 1,023,359 indels, and 8,746,849 high quality SNPs along with 842,706 indels were identified in BBG against the San Clemente and Yunnan black goat genomes respectively. The dataset is publicly available from NCBI BioSample (SAMN10391846), Sequence Read Archive (SRR8182317, SRR8549413 and SRR8549904), with BioProject ID PRJNA504436. These data might be useful genomic resources in conducting genome wide association studies, identification of quantitative trait loci (QTLs) and functional genomic analysis of the Black Bengal goat.
A systematic review of the agreement of recall, home-based records, facility records, BCG scar, and serology for ascertaining vaccination status in low and middle-income countries
Authors: Dansereau Emily , Brown David , Stashko Lena , Danovaro-Holliday M. Carolina
Published: March 2019

Background: Household survey data are frequently used to estimate vaccination coverage - a key indicator for monitoring and guiding immunization programs - in low and middle-income countries. Surveys typically rely on documented evidence from home-based records (HBR) and/or maternal recall to determine a child’s vaccination history, and may also include health facility sources, BCG scars, and/or serological data. However, there is no gold standard source for vaccination history and the accuracy of existing sources has been called into question.

Methods and Findings: We conducted a systematic review of peer-reviewed literature published January 1, 1957 through December 11, 2017 that compared vaccination status at the child-level from at least two sources of vaccination history. 27 articles met inclusion criteria. The percentage point difference in coverage estimates varied substantially when comparing caregiver recall to HBRs (median: +1, range: -43 to +17), to health facility records (median: +5, range: -29 to +34) and to serology (median: -20, range: -32 to +2). Ranges were also wide comparing HBRs to facility-based records (median: +17, range: -61 to +21) and to serology (median: +2, range: -38 to +36). Across 10 studies comparing recall to HBRs, Kappa values exceeded 0.60 in 45% of comparisons; across 7 studies comparing recall to facility-based records, Kappa never reached 0.60. Agreement varied depending on study setting, coverage level, antigen type, number of doses, and child age.

Conclusions: Recall and HBR provide relatively concordant vaccination histories in some settings, but both have poor agreement with facility-based records and serology. Long-term, improving clinical decision making and vaccination coverage estimates will depend on strengthening administrative systems and record keeping practices. Short-term, there must be greater recognition of imperfections across available vaccination history sources and explicit clarity regarding survey goals and the level of precision, potential biases, and associated resources needed to achieve these goals.
Basics of special pedagogy and psychology
Authors: Азбукина Елена , Azbukina Elena , Михайлова Елена , Mihaylova Elena
Published: March 2019

This textbook discusses the formation of national systems of special education, foreign and domestic experience in this area, especially the organization of the educational process in the training of persons with disabilities and special educational needs, the basics of didactics of special pedagogy
The textbook is addressed to students of higher and secondary educational institutions, students of faculties of advanced training and retraining, teachers, parents.
It includes thematic content, test materials and tasks for independent work of students, dictionary of basic concepts and terms.
Consumer Response to Chapter 11 Bankruptcy: Negative Demand Spillover to Competitors
Authors: Ozturk O. Cem , Chintagunta Pradeep K. , Venkataraman Sriram
Published: March 2019

We empirically study the effect of Chrysler’s Chapter 11 bankruptcy filing on the quantity sold by its competitors in the U.S. auto industry.
Dynamic Credit-Collections Optimization
Authors: Chehrazi Naveed , Glynn Peter W. , Weber Thomas A.
Published: March 2019

Based on a dynamic model of the stochastic repayment behavior exhibited by delinquent credit-card accounts in the form of a self-exciting point process, a bank can control the arrival intensity of repayments using costly account-treatment actions. A semi-analytic solution to the corresponding stochastic optimal control problem is obtained using a recursive approach. For a linear cost of treatment effort, the optimal policy in the two-dimensional (intensity, balance) space is described by the frontier of a convex action region. The unique optimal policy significantly reduces a bank’s loss given default and concentrates the collection effort onto the best possible actions at the best possible times so as to minimize the sum of the expected discounted outstanding balance and the discounted cost of the collection effort, thus maximizing the net value of any given delinquent credit-card account.

This paper was accepted by Noah Gans, stochastic models and simulation.
Cotton Yield Estimation from UAV-Based Plant Height
Authors: Feng Aijing , Zhang Meina , Sudduth Kenneth A. , Vories Earl D. , Zhou Jianfeng
Published: March 2019

Abstract.

Accurate estimation of crop yield before harvest, especially in early growth stages, is important for farmers and researchers to optimize field management and evaluate crop performance. However, existing in-field methods for estimating crop yield are not efficient. The goal of this research was to evaluate the performance of a UAV-based remote sensing system with a low-cost RGB camera to estimate cotton yield based on plant height. The UAV system acquired images at 50 m above ground level over a cotton field at the first flower growth stage. Waypoints and flight speed were selected to allow >70% image overlap in both forward and side directions. Images were processed to develop a geo-referenced orthomosaic image and a digital elevation model (DEM) of the field that was used to extract plant height by calculating the difference in elevation between the crop canopy and bare soil surface. Twelve ground reference points with known height were deployed in the field to validate the UAV-based height measurement. Geo-referenced yield data were aligned to the plant height map based on GPS and image features. Correlation analysis between yield and plant height was conducted row-by-row with and without row registration. Pearson correlation coefficients between yield and plant height with row registration for all individual rows were in the range of 0.66 to 0.96 and were higher than those without row registration (0.54 to 0.95). A linear regression model using plant height was able to estimate yield with root mean square error of 550 kg ha-1 and mean absolute error of 420 kg ha-1. Locations with low yield were analyzed to identify the potential reasons, and it was found that water stress and coarse soil texture, as indicated by low soil apparent electricity conductivity (ECa), might contribute to the low yield. The findings indicate that the UAV-based remote sensing system equipped with a low-cost digital camera was potentially able to monitor plant growth status and estimate cotton yield with acceptable errors. Keywords: Cotton, Geo-registration, Plant height, UAV-based remote sensing, Yield estimation.
Does the Development of Syntax Comprehension Show a Premature Asymptote Among Persons With Down Syndrome?A Cross-Sectional Analysis
Authors: Facon Bruno , Magis David
Published: March 2019

Uncertainty persists regarding the post-childhood trajectory of syntactic acquisition of persons with Down syndrome (DS). In some studies, asymptote is reached in the early teens, whereas others find syntax continuing to develop at least into early adulthood. This study addressed the issue using a cross-sectional approach. Receptive syntax and vocabulary were tested in 62 children, adolescents and young adults with DS matched on chronological age and cognitive level with 62 participants with intellectual disability (ID) of undifferentiated etiology. On both tests there were significant effects of chronological age and diagnosis, but the chronological age × diagnosis interactions were nonsignificant. We concluded that comprehension of vocabulary and syntax does not asymptote prematurely in individuals with DS relative to those with other forms of ID.
Family Quality of Life and Its Correlates Among Parents of Children and Adults With Intellectual Disability
Authors: Boehm Thomas L. , Carter Erik W.
Published: March 2019

All families, including those impacted by disability, desire and deserve opportunities for high quality of life. This study focused on family quality of life (FQOL) among 529 parents with children or adults with intellectual disability (ID). Parents reported moderate to high levels of FQOL satisfaction, with some variability across domains. We conducted hierarchical linear regression analyses to examine associations among FQOL and: (1) individual and family demographic factors, (2) religiosity/spirituality factors, and (3) relationship factors. Findings highlighted the significance of both informal (i.e., family, friends) and formal (i.e., professional) social relationships, as well as the relevance of spirituality/religiosity, as factors contributing to FQOL. We offer recommendations for research and practice aimed at enhancing FQOL of parents with children and adults who have ID.
An Emerging Model for Semi-Independent Living for Persons With Intellectual and Developmental Disabilities
Authors: Atack Lynda , Verseghy Judy , Maher Janet , Herie Marilyn , Poirier Matthew , MacNeil Frances , Grimley Michelle
Published: March 2019

Limited housing choices constrain autonomy and the opportunity to reach social potential for persons with intellectual and development disabilities (IDD). This project implemented and evaluated “Friendly Housemates,” a complex social model where persons with IDD shared housing with students. The purpose was to enable persons with IDD to engage in independent living within a secure, supportive environment. A qualitative study using in-depth, longitudinal interviews was conducted with persons with IDD, their student housemates, families and community agency staff; the data were analyzed inductively. Although the households encountered challenges, the results were encouraging and suggest the model has potential as a transitional housing option for people with IDD. Numerous recommendations were generated for policy and practice.
Faktor Prognosis Sindrom Syok Dengue pada Anak
Authors: Satari Hindra Irawan , Mardani Rossy Agus , Gunardi Hartono
Published: March 2019

Latar belakang. Manifestasi klinis yang bervariasi, patogenesis yang kompleks, dan perbedaan serotipe virus membuat sulit memprediksi perjalanan penyakit dengue. Banyak penelitian yang telah dilakukan tentang faktor prognosis terjadinya sindrom syok dengue (SSD), tetapi semuanya menggunakan pedoman World Health Organization (WHO) tahun 1997. Tujuan. Penelitian ini bertujuan mengetahui faktor-faktor prognosis terjadinya SSD berdasarkan pedoman WHO tahun 2011.Metode. Studi retrospektif menggunakan data rekam medik pasien anak usia 0 sampai <18 tahun dengan diagnosis demam berdarah dengue (DBD), SSD dan expanded dengue syndrome (EDS) yang memenuhi kriteria WHO tahun 2011 di RSCM dari Januari 2013 sampai Desember 2016. Variabel independen, yaitu jenis kelamin, usia, status gizi, infeksi dengue sekunder, leukopenia, nyeri abdomen, perdarahan gastrointestinal, hepatomegali dan kebocoran plasma. Syok merupakan variabel dependen. Analisis multivariat menggunakan analisis regresi logistik. Hasil. Subyek yang memenuhi kriteria penelitian 145 pasien, 52 (35,8%) di antaranya mengalami SSD. Lima dari 52 pasien SSD mengalami syok selama perawatan di rumah sakit. Analisis bivariat yang menghasilkan faktor-faktor signifikan di antaranya, malnutrisi, gizi lebih dan obesitas, perdarahan gastrointestinal, hemokonsentrasi, asites, leukosit ≥5.000 mm3, ensefalopati, peningkatan enzim hati dan overload. Hasil analisis multivariat menunjukkan variabel hemokonsentrasi dan peningkatan enzim hati merupakan faktor prognosis SSD. Kesimpulan. Hemokonsentrasi dan peningkatan enzim hati merupakan faktor prognosis terjadinya SSD.
Hubungan Kadar Serum Kuprum dengan Fungsi Fagositosis Neutrofil pada Anak Leukema Limfositik Akut
Authors: Pinilih Astri , Sudarmanto Bambang
Published: March 2019

Latar belakang. Leukemia merupakan keganasan sel darah yang berasal dari sumsum tulang. Defek kualitatif neutrofil seperti kelainan kemotaksis, fagositosis dan migrasi neutrofil terjadi pada leukemia. Kuprum adalah mikronutrien yang berperan dalam fungsi neutrofil dan makrofag. Penurunan jumlah neutrofil dan gangguan fungsi neutrofil dikaitkan dengan defisiensi kuprum.Tujuan. Mengetahui hubungan kadar serum kuprum dengan fungsi fagositosis neutrofil pada anak leukemia limfositik akut.Metode. Penelitian observasional analitik dengan metode potong lintang pada 25 anak leukemia limfositik akut usia 1 – 10 tahun di RSUP Dr. Kariadi Semarang. Kadar serum kuprum dan indeks fungsi fagositosis diukur dan dianalisis dengan menggunakan korelasi Pearson.Hasil. Dua puluh lima anak yang memenuhi kriteria, terdiri dari 18 lelaki (72%) dan 7 perempuan (28%). Status gizi terdiri dari status gizi baik 12 anak (48%) dan malnutrisi 13 anak (52%). Fase kemoterapi terbanyak adalah induksi dan konsolidasi pada 17 anak (68%). Rerata kadar serum kuprum normal yaitu 1254,8 (464,77) µg/L. Rerata indeks fagositosis neutrofil menurun yaitu 53,08 (20)%. Tidak terdapat hubungan kadar serum kuprum dengan fungsi fagositosis neutrofil pada anak leukemia limfositik akut (p=0,364)Kesimpulan. Rerata indeks fagositosis neutrofil rendah pada anak leukemia limfositik akut dibandingkan nilai normal. Rerata kadar serum kuprum normal pada anak leukemia limfositik akut. Tidak terdapat hubungan kadar serum kuprum dengan fungsi fagositosis neutrofil pada anak leukemia limfositik akut.
Variabilitas Pola Perdarahan Anak Hemofilia A yang Mendapat Terapi On-demand di Rumah Sakit Cipto Mangunkusumo
Authors: Chozie Novie Amelia , Evitasari Yuniasti , Setyanto Darmawan Budi
Published: March 2019

Latar belakang. Gejala perdarahan pada hemofilia A bergantung pada kadar faktor VIII, namun pada kadar faktor koagulasi yang sama dapat terjadi perbedaan karakteristik dan luaran klinis. Tujuan. Mengidentifikasi pola perdarahan, terapi dan komplikasi pada anak hemofilia A. Metode. Penelitian kohort retrospektif pada anak ≤18 tahun di RSCM. Data diambil dari rekam medis (Januari 2014 – Juni 2016) meliputi data usia awitan perdarahan sendi, usia saat diagnosis, kekerapan perdarahan, lokasi perdarahan, penggunaan faktor VIII, dan komplikasi yang dialami. Hasil. Terdapat 109 anak lelaki terdiri dari 2,8% hemofilia A ringan, 27,5% hemofilia A sedang, dan 69,7% hemofilia A berat. Perdarahan tersering ditemukan pada sendi (60,6%) terutama pada lutut (37,2%). Dibandingkan hemofilia A ringan dan sedang, anak hemofilia A berat menunjukkan usia awitan perdarahan sendi lebih dini (median 12,5 (4-120) bulan), kekerapan perdarahan sendi lebih sering (median 8 (1-44) kali/tahun), dan menggunakan konsentrat faktor VIII lebih banyak (median 712 (131-1913) IU/kg/tahun). Komplikasi terbanyak adalah artropati dan sinovitis kronik (46,8%) serta inhibitor faktor VIII (7,3%). Terdapat 9 dari 71 (12,6)% subjek hemofilia A berat menunjukkan karakteristik klinis lebih ringan. Kesimpulan. Pola perdarahan pada anak hemofilia A sesuai kadar faktor VIII, tetapi pada hemofilia A berat terdapat variabilitas subjek dengan gejala klinis lebih ringan.
Pemberian Steroid untuk Meningkatkan Bilirubin Clearance pada Pasien dengan Atresia Bilier Pasca Prosedur Kasai
Authors: Oswari Hanifah , Lidvihurin Afina Syarah
Published: March 2019

Latar belakang. Insidensi atresia bilier di dunia berkisar antara 5-37 kasus/100.000 kelahiran hidup. Setelah prosedur Kasai, bilirubin clearance hanya tercapai 50%. Pemberian steroid diharapkan dapat mengurangi inflamasi, tetapi keuntungan penggunaan steroid belum dapat dibuktikan. Oleh karena itu, dilakukan laporan kasus berbasis bukti untuk menilai bilirubin clearance setelah pemberian steroid pada pasien dengan atresia bilier pasca prosedur Kasai.Tujuan. Mengetahui efektivitas pemberian steroid untuk meningkatkan bilirubin clearance pada pasien atresia bilier pasca prosesur Kasai.Metode. Pencarian studi dilakukan melalui penelusuran tiga pangkalan data ilmiah, yaitu PubMed, Scopus, dan Cochrane. Setelah dilakukan penapisan judul dan abstrak, didapatkan 3 studi yang akan ditelaah secara kritis meliputi validitas, kepentingan, dan kemamputerapan menggunakan Oxford Center of Evidenced-Based Medicine 2011.Hasil. Telaah kritis dilakukan pada 3 studi dan didapatkan hasil yang valid, penting, dan mampu diterapkan. Ketiga studi tersebut menjukkan pemberian steroid dosis sedang-tinggi efektif dalam meningkatkan bilirubin clearance pada pasien atresia bilier pasca prosedur Kasai dibandingkan dengan plasebo atau terapi nonsteroid, terutama pada anak yang berusia kurang dari 70 hari saat prosedur Kasai dilakukan. Pemberian steroid dapat meningkatkan bilirubin clearance setelah follow up jangka pendek (≤1 tahun).Kesimpulan. Pemberian steroid dosis sedang-tinggi efektif dalam meningkatkan bilirubin clearance pada pasien atresia bilier pasca prosedur Kasai yang berusia kurang dari 70 hari saat prosedur dilakukan.
Faktor Risiko Obstructive Sleep Apnea pada Anak Sindrom Down​
Authors: Suryani Dewi Kartika , Supriyatno Bambang , Karyanti Mulya Rahma , Munasir Zakiudin , Pardede Sudung O. , Muktiarti Dina
Published: March 2019

Latar belakang. Sindrom Down merupakan kelainan kromosom tersering. Anak dengan sindrom Down (SD) di berbagai negara memiliki beberapa faktor risiko terhadap OSA dengan prevalensii antara 30%-60%, dibandingkan 0,7%-2% pada populasi umum. Hingga saat ini belum ada data mengenai OSA pada anak sindrom Down di Indonesia. Tujuan. Mengidentifikasi prevalensi OSA pada anak sindrom Down dan menganalisis hubungan antara habitual snoring, obesitas, penyakit alergi di saluran napas, hipertrofi tonsil, dan hipertrofi adenoid sebagai faktor risiko OSA pada anak sindrom Down. Metode. Penelitian potong lintang dilakukan pada anak sindrom Down berusia 3-18 tahun yang tergabung dalam Yayasan POTADS. Penelitian dilakukan di Poliklinik Respirologi IKA FKUI RSCM dari bulan Juli 2016 hingga Juli 2017. Penegakan diagnosis OSA menggunakan nilai batas AHI≥3 pada pemeriksaan poligrafi. Faktor- risiko yang dianggap berpengaruh dianalisis secara multivariat. Hasil. Penelitian dilakukan terhadap 42 subjek dengan hasil prevalensi OSA pada anak dengan SD 61,9%. Sebesar 42,9% merupakan OSA derajat ringan, 14,3% OSA sedang, dan 4,8% OSA berat. Pada analisis multivariat didapatkan faktor risiko yang bermakna yaitu habitual snoring (p=0,022 dan PR 8,85; IK 1,37-57) dan hipertrofi adenoid (p=0,006 dan PR 12,93; IK 2,09-79). Kesimpulan. Prevalensi OSA pada anak sindrom Down sebesar 61,9%. Faktor risiko yang bermakna yaitu habitual snoring dan hipertrofi adenoid.
Methodological approaches to the use of the Register of children with juvenile arthritis at the level of specialized medical care
Authors: Malievsky V. A. , Malievsky O. A. , Akhmetshin R. Z. , Gareeva G. R. , Zhukov S. C. , Pervushina E. P. , Nuriakhmetova A. J. , Nurgalieva L. R. , Khasanova A. A.
Published: March 2019

Juvenile arthritis (JA) is a disease of unknown etiology that begins before the age of 16 years and lasts for at least 6 weeks. The main objective of most existing international registers of children with JA is assessment various aspects of the efficacy and safety of biologics in comparison with methotrexate. The results of the analysis of the effectiveness of registers as a tool for long-term monitoring of the disease and medical care for children with JA are not presented in the available literature. The aim of the study is to develop methodological approaches to maintaining the Register of children with JA and algorithms of actions of medical personnel on the basis of the experience of the Republican Children's Clinical Hospital (Ufa). This work is a retro- and prospective observational study. The Register included children under the age of 18 years with an established diagnosis of JA, who were admitted to the cardio-rheumatologic department of Republican Children's Clinical Hospital (Ufa). In this paper, we used the All-Russian register of children with JA, developed by «Aston Consulting» and «Norbit» (official partner of Microsoft) on the basis of the technological platform Microsoft Dynamics CRM 5.0. In total, the Register included information about 426 children with JA. The average age of children during the analysis of the register data was 10.9±4.3 years, and in the onset of the disease – 4.7±3.7 years. According to the results of the analysis, the tasks, areas of responsibility and scope of action for each subject of medical care (rheumatologist of rheumatology hospital and office, head of department, chief freelance specialist of the Ministry of Health) and the corresponding tools of the Register were determined. A clear algorithm of actions of specialists depending on the task will optimize the work with the register of patients, reduce the time required to enter and receive information and, at the same time, provide the possibility of the most complete and effective use of the Register in optimizing medical care for children with JA.
Changes of cytokine profile measures during the treatment of rheumatoid arthritis with rituximab biosimilar (Acellbia, BIOCAD) and the original drug (MabThera, F. Hoffmann-La Roche Ltd., Switzerland)
Authors: Avdeeva A. S. , Artyukhov A. S. , Dashinimaeva E. B. , Cherkasova M. V. , Nasonov E. L.
Published: March 2019

The aimof the investigation was to study the changes of cytokine profile parameters in patients with rheumatoid arthritis (RA) 12 and 24 weeks after initiation of therapy with rituximab (RTM) biosimilar at a total dose of 1200 mg, in comparison with the original drugMaterial and methods.The study included 54 patients with a reliable diagnosis of RA. Depending on the therapy, all patients were divided into two groups: 34 patients received the original RTM (group 1) and 20 patients – biosimilar (group 2) in a total dose of 1200 mg according to the standard scheme. The concentration of 27 cytokines in blood serum was determined by multiplex xMAP technology on the analyzer Bio-Plex Array System (BIO-RAD, USA).Results and discussion.The use of the original drug has been accompanied by reliable and significant reduction (over 30%) by 24 weeks of treatment levels of proinflammatory [interleukin (IL) 1â, IL2, IL6, IL12, IL15, interferon ã (IFN-ã), tumor necrosis factor á (TNF-á)], IL1 receptor antagonist (IL1ra), IL5, IL9, IL10, IL13 cytokines, growth factors (IL7, granulocyte-macrophage colony stimulating factor, fibroblast growth factor) and chemokines (monocyte chemoattractant protein 1 – MCP1). During the treatment with Acellbia a rapid and marked reduction in the concentration of practically the whole range of investigated parameters already 12–24 weeks after the first infusion was achieved. After 24 weeks a decrease in the concentration IL1â, IL1ra, IL2, IL4, IL5, IL6, IL7, IL8, IL9, IL10, IL12, IL13, IL15, IL17, eotaxin, granulocyte colony-stimulating factor, IFN-ã, IFN-ã-induced protein 10, MCP1, macrophage inflammation protein 1â, TNF-á, vascular endothelial growth factor was recorded (p<0.05).Conclusion.Analysis of the effectiveness of two infusions of RTM biosimilar Acellbia («BIOCAD», Russia) 24 weeks after the start of therapy shows its ability to cause a decrease of levels of proinflammatory cytokines, chemokines and growth factors in the blood serum. Changes of the cytokine profile during the therapy with Acellbia are not significantly different from that during the treatment with the original drug.
Psychological stress and rheumatoid arthritis – interference of pathogenetic mechanisms
Authors: Tuaeva N. O. , Nosyrev A. E. , Renaudineau Y. , Arleevskaya M. I.
Published: March 2019

Molecular mechanisms of development of normal and pathological neuroendocrine and immune adaptive response to psychological (mental) stress are analyzed considering its possible provoking role in the development of rheumatoid arthritis (RA). A detailed analysis reveals the synergism of mechanisms that provoke the development of pathological anti-stress adaptive response and RA. It is possible that in persons at risk of developing RA minimal and unobtrusive for the individual stressful situations, periodically provoking prolonged production of pro-inflammatory cytokines, can, finally, lead to the development of rheumatic disease.