bluuebunny/crossref_metadata_2025 huggingface dataset:
PENGARUH PENDAPATAN DAN SUKU BUNGA TERHADAP KEPUTUSAN PENGAMBILAN KPR PADA PT BANK TABUNGAN NEGARA (PERSERO) TBK CABANG PRABUMULIH
Authors: Sukmawati Emi
Published: February 2020

This study is entitled "The Effect of Income and Interest Rates on the Decision of Taking Mortgages at PT Bank Tabungan Negara (Persero) Tbk Prabumulih Branch". The main problem in this research is how much income and interest rates influence the decision to take KPR at PT Bank Tabungan Negara (Persero) Tbk Prabumulih Branch. Determination of the sample in this study is to use the accidental sampling method, namely random sampling. The number of samples studied were 100 respondents who worked, both as private employees, BUMN employees, and Civil Servants (PNS) who were classified based on the income they received per month. The analytical method used is multiple linear regression with hypothesis testing using the F test, t test, and the coefficient of determination (R2). The results of this study concluded that income and interest rates influence the decision to take a mortgage at PT. Bank Tabungan Negara (Persero) Tbk Branch Prabumulih of 46.8%. Researchers give advice, companies engaged in housing should really pay attention to what factors are very influential in determining the buyer's decision to take a mortgage so that companies avoid unwanted problems, such as bad loans
Benchmarking and improving sugar recovery from final molasses
Authors: Broadfoot Ross
Published: February 2020

The sucrose loss in final molasses in raw sugar manufacture is the largest loss. One factor that typically limits the extent of sucrose recovery from final molasses is that cooling crystallizers are high capital and maintenance cost items. The target purity of the final molasses is the commonly used benchmark to assess the effectiveness of exhaustion of final molasses. However, this benchmark does not relate to an actual loss of sucrose. A benchmark that calculates the Target Sucrose Loss (TSL) in molasses for the factory is proposed. Factories would aim to maintain the sucrose loss in final molasses to within 1 unit of the TSL. A close approach to the target purity is still required as part of the drive to achieve this result. An advantage of the TSL is that it considers the influence of the quantity of soluble impurities in the cane supply on the actual sucrose loss in molasses. Data from Australian factories are presented to demonstrate the application of the TSL. Several factors affecting the exhaustion of final molasses are discussed, including the effects of Cmassecuite purity, crystallizer station performance and shear rate on the massecuite within the crystallizers. Some Australian factories have recently refurbished horizontal, rotating coil crystallizers with designs incorporating fixed cooling elements and rotating paddles to provide high shear rate conditions and overcome maintenance issues associated with the coil design. Experience shows that the fixed-element design is an economical way to provide strong exhaustion performance.
Snow cover and its variability in the Polish Sudetes Mts. and the Sudetic Foreland
Authors: Urban Grzegorz
Published: February 2020

The paper presents the snow cover characteristics in the vertical profile of the Polish Sudetes Mountains and their foreland during the period of 1965/66–2007/08. The analysis was based on the number of days with snow cover ≥ 1 cm and its depth in a month, winter season (December–February) and entire year (season). Data was collected at 20 weather stations operated by the Institute of Meteorology and Water Management. The maximum depth of snow cover in the foreland and lower parts of the Sudetes Mountains was recorded in January, in higher parts of the mountains in mid-February or in March. On the average, the maximum depth of the snow cover varied from ca. 15÷25 cm in the foreland zone and lower slopes up to 120÷150 cm in the upper slopes and mountain tops. During the multi-annual period of 1951/52–2007/08, the maximum depth of snow cover showed a small decreasing trend, statistically insignificant at the 0.05 level, in 4 representative stations in the vertical profile of the Sudetes Mountains.
Protestant cemeteries in Czechia: a necrogeographical perspective
Authors: Nešpor Zdeněk R.
Published: February 2020

The article introduces the field of necrogeography to Czech social geography and provides information on existing (nationwide) data sources. The author takes the issue of Protestant confessional cemeteries as an example, briefly outlines the history of these special types of burial fields (established principally from the end of the 18th century until approximately the mid-20th century), and provides a historical geographical analysis of their regional distribution in the Czech Lands. The article proves the impact of religious and geographical factors on the emergence (and eventual demise) of non-Catholic Christian confessional cemeteries and, at the same time, the research unveiled a number of important research questions to be addressed by Czech necrogeography in the future.
OPEN-SOURCE WEB GIS FRAMEWORK IN MONITORING URBAN LAND USE PLANNING: PARTICIPATORY SOLUTIONS FOR DEVELOPING COUNTRIES
Authors: SEJATI Anang Wahyu , BUCHORI Imam , RUDIARTO Iwan , SILVER Christopher , SULISTYO Kartiko
Published: February 2020

This paper presents a Web GIS application development framework through an open-source software which aims to provide reliable open data services, required for policymaking in urban land use planning. The geodatabase model is comprehensively developed. It displayed a user interface using QGIS, MapServer, and Pmapper, with open source tools with PHP MapScript programming languages and integrated DB-SQL, to generate a complete digital map service with information on urban land use policy. The results of this Web GIS development can be publicly used with spatial databases suitable for public consumption, and as decision support systems for stakeholders, especially in the policy of urban land use planning. Thus, this application can serve as a model for land-use monitoring systems based upon the principle of information disclosure toward smart city and smart governance.
TOWARDS GREEN RESILIENT CITIES IN EASTERN EUROPEAN UNION COUNTRIES
Authors: BĂNICĂ Alexandru , ISTRATE Marinela , MUNTELE Ionel
Published: February 2020

Investing in green facilities is a process of urban renewal that can transform cities by enhancing the quality of life, strengthening the local economy and reducing environmental impact. Nevertheless, greener cities are not a guarantee for improved adaptive capacity when facing current local or global challenges. In this context, we have taken into account a series of sample cities from Central and Eastern European Union. Using the green cities typology proposed by the European Environment Agency, the present approach studies the statistical relationship between indicators of green infrastructure and different proxies for the resilience capacity and performance. The results distinguish between different types of green cities, indicating which are more resilient and, respectively, which are less resilient. The statistical relationship between the indicators shows that green infrastructures are developed in new urban areas, while the natural areas diminish the flood risk and air pollution and make cities more attractive; however, in older and higher density cities, the green is sacrificed for other uses that are considered more profitable. The conclusions highlight the contradictory characteristics in the territorial distributions of cities in relation to their green infrastructure and resilience features. The present assessment contributes to promoting an integrated vision that could be used in urban planning and in more coherent strategies for sustainable cities.
Kontribusi Layanan Penguasaan Konten dalam Meningkatkan Sikap Empati Siswa
Authors: Fitriyanti Evi , Solihatun Solihatun , Ardianti Tanti
Published: February 2020

This study aims to reveal how much the contribution of Content Satisfaction Services (PKO) in increasing students' empathy attitudes at SMK Taruna Bhakti Depok. This research uses a quantitative method with a descriptive correlational analysis approach that aims to find out how much influence between the research variables. This research variable consists of two, namely Content Mastery Service (PKO) (X) is an independent variable and Student Empathy Attitude (Y) is a dependent variable. Through PKO services provided to students in a classical format it is expected to help students have something useful to meet their needs and overcome the problems they face, especially in increasing students' empathy. The results showed that there was a contribution to the content mastery service (PKO) in significantly increasing students' empathy attitudes.
Conocimientos sobre bioseguridad en estudiantes de medicina de una universidad privada de Chiclayo, Perú, 2018
Authors: Cabrera-Abarca Alejandro , Leyva-Gonzales Christy Maribel , Pérez-Pérez Percy Fabrizio , López-López Elmer , Yacarini-Martínez Antero Enrique
Published: February 2020

Objetivo. Describir el conocimiento sobre medidas de bioseguridad para el manejo de residuos biocontaminados en estudiantes de primer año de Medicina Humana una universidad de Chiclayo, Perú, durante octubre de 2018. Material y métodos. Estudio descriptivo transversal, para lo cual se aplicó un cuestionario estructurado basado en el Protocolo de Bioseguridad de los Laboratorios tipo I. Resultados. Se estudió 185 estudiantes. La población se caracterizó el predominio de las mujeres (78,5%). El 30,2% y  el 82,4 % de estudiantes desconocían la información básica con respecto a los pictogramas de seguridad y la forma correcta de eliminación de residuos, respectivamente. Mientras que el 99,4 % y 95,4 % conocían sobre la indumentaria correcta y el lavado de manos. Los 99,0 % de estudiantes de Morfofisiología II respondieron correctamente el ítem sobre lavado de manos. Conclusiones. Una proporción importante de estudiantes de Medicina de la USAT desconoce los pictogramas de seguridad y la eliminación de residuos sólidos, pero conocen la indumentaria y lavado de manos correctos.
Review Sistematik: Model Pemulihan Penderita Gangguan Jiwa Berat Berbasis Komunitas
Authors: Lestari Retno , Yusuf Ah , Hargono Rachmat , Setyawan Febri Endra Budi
Published: February 2020

People with severe mental illness have complex disabilities affecting mental functions, daily activities, and social life, thus they need help from others in carrying out daily functional activities. Optimizing the recovery of severe mental illness requires a holistic approach and integration between mental health services and supportive communities so that sufferers can interact with others, have a positive self-concept, and improve their well-being. This study aims to describe a community-based model of recovery for people with severe mental illness. Several literature studies were obtained from 50 reference sources through Science Direct, Google Scholar, Proquest Health and Medical Complete, Proquest Nursing, and Allied Health Sources from 2009 to 2019. Results explain that the community provides an adequate support system in improving the care of people with severe mental illness. Support systems in the community involve social and physical aspects as well as the economic infrastructure through employment opportunities or financial support and a decent living. The interaction between community members and people with severe mental illness could be a positive thing in strengthening the motivation of people with severe mental illness to recover and be able to do their activities independently. The recovery process of severe mental illness requires strong motivation and commitment from the sufferer, the family, all society members, community mental health service team, and related policymakers. It can be concluded that people with severe mental illness need support from various parties in terms of future life planning, identifying strengths and weaknesses that they have, and recognizing multiple obstacles and support so that they recover and live independently.
Improving the Praxis of Conversation Club Leaders in a Community of Practice: A Case study in a Self-Access Centre
Authors: Sigala Villa Pamela , Ruiz-Guerrero Adelina , Zurutuza Roaro Laura María
Published: February 2020

The role that a conversation club plays in the improvement of foreign language proficiency of its users in a self-access centre varies according to the strategies a conversation club leader applies. This paper reports the changes made by conversation club leaders (CCLs), who formed a community of practice (CoP) under the methodology of Knowledge Management (KM) to become aware of the effective and non-effective practices they employed through recording themselves, sharing their experiences, listening to each other, and analyzing their performance. A total of six conversation club leaders participated in the case study that took place in 2016. The outcome was a series of strategies generated by the CCLs and shared with all new CCLs in the self-access centre.
The Use of Kalman Filter Techniques for Ship Track Estimation
Authors: Assaf Mansour H. , Voicu Groza , Petriu Emil M.
Published: February 2020

Unscented Kalman Filter (UKF) is a technique used in non-linear applications and dynamic systems identification (e.g. tracking marine vessels and ships) that require state and parameter estimation. This paper studies Kalman Filter (KF) based techniques for tracking ships using Global Positioning System (GPS) data. The present work proposes to exploit information from GPS sensors in order to track a ship in real-time. The absence and presence problem of a ship is handled by a applying KF theory to analyze GPS coordinates and compare current marine vessel routes to previously recorded ones. To study tracking performance, the system was implemented in C++ and simulation results demonstrate the feasibility and high accuracy of the proposed tracking method
Pengaruh Program Diskon Terhadap Keputusan Pembelian
Authors: Fadillah Adil , Syarif Rini
Published: February 2020

In the implementation of products marketing, a company is usually bound to use marketing concept of product, price, place, and promotion to achieve marketing goal. Promotion supports marketing activities in order that the marketing programs will be able to proceed as expected.

The purpose of this study is to determine which types of discount programs implemented by the company, to find out the factors influencing purchase decision by consumers, and to know the effect of discount program on purchasing decision at PT Ramayana Bogor Trade Mall. Data analysis technique used by the author is statistical analysis , i.e. simple linear regression analysis, simple linear correlation coefficient, and hypothesis test. Based on the analysis, it’s gotten simple linear regression equaty. Contant 30,451 states that if there is no discount program, the purchasing decision will be 30,451. Coefficient regression 0,148 states that any additional increase/decrease in discount program for a unit will result an increase/decrease of dependent variable (Y) as high as 0,148, with constant as high as 30,451.

The correlation between discount variable and purchasing decision variable counted by using correlation coefficient is o,161 or 1,6%. This shows that there is a very low correlation between discount program and purchasing decision. Based on hypothesis test,  t-statistics obtained from  t-table is 1,695, while t-table is 1,645. Therefore, t-statistics > t-table (1,695 > 1,645 at α = 0,05), with the result that Ho is refused and H1 is accepted. Thereby discount program influences purchasing decision insignificantly. Significance level of correlation coefficient yields figure 0,110. Because of probability is above 0,05, the correlation between discount program and purchasing decision is not significant. It’s found out that r-square coefficient is 0,026 or 2,6%, the rest is 97,4%, due to other causes which are not observed by the author. It shows that there is low correlation between discount variable and purchasing decision. Based on this analysis it can be concluded that discount program has no significant correlation toward purchasing decision.

 

Keywords:discount program; purchasing decision
Distinguishing Delirium from Dementia
Authors: Everhart D. Erik , Mulkey Malissa , Hardin Sonya , Olson Daiwai , Munro Cindy
Published: February 2020

Distinguishing between delirium and dementia is essential for understanding the underlying mechanisms which direct a nurse to the best interventions. However, delirium and dementia are conditions that are at times difficult to differentiate even for experienced clinicians. While the similarities can make distinguishing between the two disorders challenging, there are distinct differences. Therefore, this article describes similarities and differences in the characteristics of each condition to assist clinicians in accurate detection and identification.
MANAGING CONSENSUS BY MULTI-STAGE OPTIMIZATION MODELS WITH LINGUISTIC PREFERENCE ORDERINGS AND DOUBLE HIERARCHY LINGUISTIC PREFERENCES
Authors: Gou Xunjie , Xu Zeshui , Zhou Wei
Published: February 2020

Preference ordering structures are useful and popular tools to represent experts’ preferences in the decision making process. In the existing preference orderings, they lack the research on the precise relationship between any two adjacent alternatives in the preference orderings, and the decision making methods are unreasonable. To overcome these issues, this paper establishes a novel concept of linguistic preference ordering (LPO) in which the ordering of alternatives and the relationships between two adjacent alternatives should be fused well, and develops two transformation models to transform each LPO into the corresponding double hierarchy linguistic preference relation with complete consistency. Additionally, to fully respect the experts’ expression habits and provide more refined solutions to experts, this paper establishes a multi-stage consensus optimization model by considering the suggested preferences represented in both the continuous scale and the discrete scale, and develops a multi-stage interactive consensus reaching algorithm to deal with multi-expert decision making problem with LPOs. Furthermore, some numerical examples are presented to illustrate the developed methods and models. Finally, some comparative analyses between the proposed methods and models and some existing methods have been made to show the advantages of the proposed methods and models.
Distribution Functions of Energetic Particles Experiencing Compound Subdiffusion
Authors: Shalchi A. , Arendt V.
Published: February 2020

There are indications that the perpendicular transport of energetic particles is sometimes subdiffusive for intermediate timescales. This corresponds to a scenario where particles follow diffusive magnetic field lines while they also move diffusively in the parallel direction. This type of transport should occur at times after the ballistic regime but before the particles experience the transverse complexity of the turbulence. In this article we present a detailed analytical investigation of distribution functions of particles experiencing compound subdiffusion. Simple approximations of particle distributions are derived which can easily be used in applications. We also compare our findings with test-particle simulations performed for slab turbulence corresponding to the case of vanishing transverse turbulence structure.
hammurabi X: Simulating Galactic Synchrotron Emission with Random Magnetic Fields
Authors: Wang Jiaxin , Jaffe Tess R. , Enßlin Torsten A. , Ullio Piero , Ghosh Shamik , Santos Larissa
Published: February 2020

We present version X of the hammurabi package, the HEALPix-based numeric simulator for Galactic polarized emission. Improving on its earlier design, we have fully renewed the framework with modern C++ standards and features. Multithreading support has been built in to meet the growing computational workload in future research. For the first time, we present precision profiles of the hammurabi line-of-sight integral kernel with multilayer HEALPix shells. In addition to fundamental improvements, this report focuses on simulating polarized synchrotron emission with Gaussian random magnetic fields. Two fast methods are proposed for realizing divergence-free random magnetic fields either on the Galactic scale where field alignment and strength modulation are imposed, or on a local scale where more physically motivated models like a parameterized magnetohydrodynamic (MHD) turbulence can be applied. As an example application, we discuss the phenomenological implications of Gaussian random magnetic fields for high Galactic latitude synchrotron foregrounds. In this, we numerically find B/E polarization-mode ratios lower than unity based on Gaussian realizations of either MHD turbulent spectra or in spatially aligned magnetic fields.
Evaluation of acoustic pattern recognition of nightingale (Luscinia megarhynchos) recordings by citizens
Authors: Stehle Marcel , Lasseck Mario , Khorramshahi Omid , Sturm Ulrike
Published: February 2020

Acoustic pattern recognition methods introduce new perspectives for species identification, biodiversity monitoring and data validation in citizen science but are rarely evaluated in real world scenarios. In this case study we analysed the performance of a machine learning algorithm for automated bird identification to reliably identify common nightingales (Luscinia megarhynchos) in field recordings taken by users of the smartphone app Naturblick. We found that the performance of the automated identification tool was overall robust in our selected recordings. Although most of the recordings had a relatively low confidence score, a large proportion of the recordings were identified correctly.
The jumping mechanism of flea beetles (Coleoptera, Chrysomelidae, Alticini), its application to bionics and preliminary design for a robotic jumping leg
Authors: Ruan Yongying , Konstantinov Alexander S. , Shi Guanya , Tao Yi , Li You , Johnson Andrew J. , Luo Xiaozhu , Zhang Xinying , Zhang Mengna , Wu Jianing , Li Wenzhu , Ge Siqin , Yang Xingke
Published: February 2020

Flea beetles (Coleoptera, Chrysomelidae, Galerucinae, Alticini) are a hyperdiverse group of organisms with approximately 9900 species worldwide. In addition to walking as most insects do, nearly all the species of flea beetles have an ability to jump and this ability is commonly understood as one of the key adaptations responsible for its diversity. Our investigation of flea beetle jumping is based on high-speed filming, micro-CT scans and 3D reconstructions, and provides a mechanical description of the jump. We reveal that the flea beetle jumping mechanism is a catapult in nature and is enabled by a small structure in the hind femur called an ‘elastic plate’ which powers the explosive jump and protects other structures from potential injury. The explosive catapult jump of flea beetles involves a unique ‘high-efficiency mechanism’ and ‘positive feedback mechanism’. As this catapult mechanism could inspire the design of bionic jumping limbs, we provide a preliminary design for a robotic jumping leg, which could be a resource for the bionics industry.
Systematics and Taxonomy of Tonatia saurophila Koopman & Williams, 1951 (Chiroptera, Phyllostomidae)
Authors: Basantes Mateo , Tinoco Nicolás , Velazco Paúl M. , Hofmann Melinda J. , Rodríguez-Posada Miguel E. , Camacho M. Alejandra
Published: February 2020

The Stripe-headed Round-eared bat, Tonatia saurophila, includes three subspecies: Tonatia saurophila saurophila (known only from subfossil records in Jamaica), Tonatia saurophila bakeri (distributed from southeastern Mexico to northern Colombia, Venezuela west and north of the Cordillera de Mérida, and northwestern Ecuador), and Tonatia saurophila maresi (distributed in Venezuela east and south of the Cordillera de Mérida, the Guianas, Trinidad and Tobago, northeastern Brazil, and along the upper Amazon basin in Colombia, Ecuador, Peru, and Bolivia). The last two subspecies are an attractive example to test predictions about the historical role of the Andes in mammalian diversification. Based on morphological descriptions, morphometric analyses, and phylogenetic reconstruction using the mitochondrial gene Cyt-b and the nuclear exon RAG2, this study evaluates the intraspecific relationships within Tonatia saurophila and the taxonomic status of the taxon. The three subspecies of T. saurophila are recognizable as full species: Tonatia bakeri, Tonatia maresi, and Tonatia saurophila. The latter is restricted to its type locality and possibly is extinct. Tonatia bakeri, in addition to being larger than T. maresi, is morphologically distinguishable by possessing an acute apex at the posterior edge of the skull, a well-developed clinoid process, and relatively robust mandibular condyles, and by lacking a diastema between the canine and the first lower premolar. The genetic distance between T. bakeri and T. maresi is 7.65%.
Circulating Ficolin-2 and Ficolin-3 Form Heterocomplexes
Authors: Jarlhelt Ida , Pilely Katrine , Clausen Jytte Bryde , Skjoedt Mikkel-Ole , Bayarri-Olmos Rafael , Garred Peter
Published: February 2020

The complement system constitutes an important part of the innate immune system. The collectins and the ficolins are soluble pattern recognition molecules that contribute to complement activation via the lectin pathway. During previous experiments with ficolin-2 and ficolin-3, we have observed that the molecules may interact. We therefore hypothesized the existence of stable ficolin-2/-3 heterocomplexes. We could demonstrate ficolin-2/-3 heterocomplexes in normal human serum and plasma by ELISA using Abs specific for ficolin-2 and ficolin-3. The formation of heteromeric protein complexes were validated by coimmunoprecipitation and Western blot analysis. When recombinant ficolin-2 and recombinant ficolin-3 were mixed, no complexes were formed. However, when coexpressing ficolin-2 and ficolin-3 in Chinese hamster ovary cells, we could detect ficolin-2/-3 heterocomplexes in the supernatant. Furthermore, we measured concentration of the ficolin-2/-3 heterocomplexes in arbitrary units in 94 healthy individuals. We also established the relationship between the concentrations of ficolin-2, ficolin-3, and the ficolin-2/-3 heterocomplexes. We observed that the concentration of the ficolin-2/-3 heterocomplex correlated significantly with ficolin-2 (ρ: 0.24, p < 0.018) and ficolin-3 concentrations (ρ: 0.46, p < 0.0001). In conclusion, we describe a novel protein complex between ficolin-2 and ficolin-3 present in serum and plasma, which might be of additional biological relevance apart from the native ficolin-2 and ficolin-3 molecules.
Macrophage Migration and Phagocytosis Are Controlled by Kindlin-3's Link to the Cytoskeleton
Authors: Liu Huan , Zhu Liang , Dudiki Tejasvi , Gabanic Benjamin , Good Logan , Podrez Eugene A. , Cherepanova Olga A. , Qin Jun , Byzova Tatiana V.
Published: February 2020

Major myeloid cell functions from adhesion to migration and phagocytosis are mediated by integrin adhesion complexes, also known as adhesome. The presence of a direct integrin binding partner Kindlin-3 is crucial for these functions, and its lack causes severe immunodeficiency in humans. However, how Kindlin-3 is incorporated into the adhesome and how its function is regulated is poorly understood. In this study, using nuclear magnetic resonance spectroscopy, we show that Kindlin-3 directly interacts with paxillin (PXN) and leupaxin (LPXN) via G43/L47 within its F0 domain. Surprisingly, disruption of Kindlin-3–PXN/LPXN interactions in Raw 264.7 macrophages promoted cell spreading and polarization, resulting in upregulation of both general cell motility and directed cell migration, which is in a drastic contrast to the consequences of Kindlin-3 knockout. Moreover, disruption of Kindlin-3–PXN/LPXN binding promoted the transition from mesenchymal to amoeboid mode of movement as well as augmented phagocytosis. Thus, these novel links between Kindlin-3 and key adhesome members PXN/LPXN limit myeloid cell motility and phagocytosis, thereby providing an important immune regulatory mechanism.
Table of Contents Vol 19, No 1 & 2 (2019)
Authors: Office Editorial
Published: February 2020

No abstract available.
Table of Contents Vol 78, No 1 (2019)
Authors: Office Editorial
Published: February 2020

No abstract available.
Entamoeba histolytica: A surprising coexistence with adenocarcinoma – Never brush aside brushings for biopsy
Authors: Goel Palvi , Tyagi Ruchita , Kaur Gursheen , Garg Bhavna , Selhi Pavneet Kaur , Kaur Harpreet , Mehta Varun , Sood Neena
Published: February 2020

Entamoeba histolytica has been rarely reported as superadded infection over carcinomatous growth on rectal brushings. We present a case of 68-year-old male who presented with abdominal pain and bleeding per rectum who was found to have an ulceroproliferative growth on sigmoidoscopy. Rectal brushings revealed coexistence of E. histolytica with malignant cells of adenocarcinoma. No organism was detected on biopsy of the tumor, which also showed adenocarcinoma, because of possible surface colonization of the tumor by Entamoeba. This case highlights the role of rectal brushings in detecting superadded infection in a case where both brushings and biopsy were performed. It is always important to report infection superadded on malignancies for optimum management of the patients.
Earlier and higher rates of cytomegalovirus infection in pediatric liver transplant recipients as compared to adults: An observational study
Authors: Verma Yogita , Gupta Ekta , Kumar Niteen , Hasnain Nadeem , Bhadoria Ajeet Singh , Pamecha Viniyendra , Khanna Rajeev
Published: February 2020

AIM: To study and compare the incidence and time of occurrence of cytomegalovirus (CMV) infection in the posttransplant period in adult and pediatric liver transplant recipients.

MATERIALS AND METHODS: Consecutive live donor liver transplant recipients not on CMV prophylaxis, were prospectively enrolled from March 2012 to September 2015 and followed up for 1 year post transplant to look for CMV infection. For analysis, patients were divided into pediatric (up to 18 years) and adult (>18 years) age groups.

RESULTS: The study population of 146 patients consisted of 132 adult and 14 pediatric patients. Overall CMV infection posttransplant was seen in 54/146 (36.98%) patients, and 16/54 (29.6%) patients developed CMV disease. Post-transplant CMV infection rate was significantly higher in pediatric patients(10/14 [71.4%]) as compared to adults (44/132 [33.4%]) (P = 0.004). Among adults, CMV infection was seen in 22 (50%) patients in the 1st month, 13 (29.5%) patients in the 2nd month, 5 (11.4%) patients in the 3rd month, 2 (4.5%) patients in the 4th month, and 1 (2.3%) patient each in the 5th and 6th month. However, in pediatric patients, all the patients having CMV infection had it in the 1st-month posttransplant (P = 0.003). The median time of occurrence of CMV infection was 11.5 (7.75–19.00) days in pediatric patients versus 30 (18.5–54.5) days in adult patients (P = 0.001).

CONCLUSIONS: The results of this study show a clear difference in the incidence and timeline of posttransplant CMV infection in pediatric patients as compared to adults.
Revisiting renal amyloidosis with clinicopathological characteristics, grading, and scoring: A single-institutional experience
Authors: Kalle Abhiram , Gudipati Archana , Raju Sree Bhushan , Kalidindi Karthik , Guditi Swarnalatha , Taduri Gangadhar , Uppin Megha S.
Published: February 2020

INTRODUCTION: Kidney involvement is a major cause of mortality in systemic amyloidosis. Glomerulus is the most common site of deposition in renal amyloidosis, and nephrotic syndrome is the most common presentation. Distinction between AA and AL is done using immunofluorescence (IF) and immunohistochemistry (IHC). Renal biopsy helps in diagnosis and also predicting the clinical course by applying scoring and grading to the biopsy findings.

MATERIALS AND METHODS: The study includes all cases of biopsy-proven renal amyloidosis from January 2008 to May 2017. Light microscopic analysis; Congo red with polarization; IF; IHC for Amyloid A, kappa, and lambda; and bone marrow evaluation were done. Classification of glomerular amyloid deposition and scoring and grading are done as per the guidelines of Sen S et al.

RESULTS: There are 40 cases of biopsy-proven renal amyloidosis with 12 primary and 23 secondary cases. Mean age at presentation was 42.5 years. Edema was the most common presenting feature. Secondary amyloidosis cases were predominant. Tuberculosis was the most common secondary cause. Multiple myeloma was detected in four primary cases. Grading of renal biopsy features showed a good correlation with the class of glomerular involvement.

CONCLUSION: Clinical history, IF, and IHC are essential in amyloid typing. Grading helps provide a subtle guide regarding the severity of disease in the background of a wide range of morphological features and biochemical values. Typing of amyloid is also essential for choosing the appropriate treatment.
Well differentiated papillary mesothelioma of abdomen- a rare case with diagnostic dilemma
Authors: Saha Aniruddha , Mandal Palash Kumar , Manna Anupam , Khan Kalyan , Pal Subrata
Published: February 2020

Well-differentiated papillary mesothelioma is a rare tumor occurring predominantly in the peritoneum of young women, a few with history of asbestos exposure. A 28-year-old woman presented with ascites and pain abdomen. Ultrasonography and computed tomography scan of the abdomen revealed a mass in the retroperitoneum measuring 15 cm × 12 cm. Histopathological examination along with immunohistochemistry (IHC) confirmed it to be a papillary mesothelioma in the peritoneum. It is difficult to differentiate from more common malignant mesothelioma and papillary adenocarcinoma, which also have poorer prognosis. The difficulty can be resolved by clinico-radiological correlation along with histopathological examination and IHC.
Asymptomatic thyroid dysfunction in human immunodeficiency virus-1-infected subjects
Authors: Emokpae Mathias Abiodun , Akinnuoye Imwonghomwen Mercy
Published: February 2020

BACKGROUND: Thyroid hormone abnormalities have been reported elsewhere in human immunodeficiency virus-1 (HIV-1)-infected individuals, but such studies in Nigerians are scarce in literature.

OBJECTIVE: To evaluate thyroid function in HIV-1-infected individuals and to correlate thyroid function parameters with cluster of differentiation (CD4+) cell count.

MATERIALS AND METHODS: Total thyroxine (T4), total triiodothyronine (T3), thyroid-stimulating hormone (TSH), and CD4+ were estimated in 100 HIV-1-positive individuals on highly active antiretroviral therapy (HAART), 100 HIV-1-positive HAART naïve, and 100 HIV-1-negative controls. The mean values were compared between the groups, and CD4+ cell count was correlated with measured thyroid hormones.

RESULTS: Thyroid function abnormalities were seen in 52 HIV-1-positive individuals on HAART and 56 individuals without HAART treatment. The pattern of thyroid hormone abnormalities is similar in both groups. Among the individuals on HAART, 10 had subclinical hypothyroid, 42 sick euthyroid, and 48 had normal thyroid hormones levels. Similarly, among those without HAART therapy, seven had subclinical hypothyroid, 49 sick euthyroid, and 44 had normal thyroid hormones levels. The HIV-1-positive individuals had significantly lower (P < 0.001) CD4+ cell count, TSH (P < 0.05), T3 (P < 0.01), and T4 (P < 0.001) when compared with controls. On the other hand, HIV-1-positive individuals on HAART had significantly higher (P < 0.01) CD4+ cell count and lower (P< 0.05) T4 levels than the HAART naïve group. CD4+ correlated positively with T4 in HIV-1-positive individuals on HAART (r = 0.26; P = 0.016) and HAART naïve (r = 0.218; P = 0.038). There was no significant correlation between CD4+ and measured thyroid hormones in the control individuals.

CONCLUSION: Asymptomatic thyroid hormone abnormalities are common in HIV-infected individuals, and these abnormalities are independent of whether the individuals were on HAART or without HAART treatment.
Aggressive angiomyxoma in pregnancy: A rare and commonly misdiagnosed entity
Authors: Malukani Kamal , Varma Amit V. , Choudhary Devashish , Dosi Shilpi
Published: February 2020

Aggressive angiomyxoma (AAM) is an uncommon mesenchymal tumor that predominantly involves the pelvis and perineum of young females. It is often clinically mistaken for more common superficial lesions such as vaginal cysts, labial cysts, and lipomas. A review of the medical literature reveals very few cases of AAM reported in pregnancy. We describe a rare case of AAM in pregnancy, clinically misdiagnosed as prolapsed cervical fibroid.
Cluster of differentiation 4+ T-cell counts and human immunodeficiency virus-1 viral load in patients coinfected with hepatitis B virus and hepatitis C virus
Authors: Gupta Sakshee , Malhotra Bharti , Tiwari Jitendra Kumar , Khandelwal Prabhu Dayal , Maheshwari Rakesh Kumar
Published: February 2020

BACKGROUND: Coinfections of human immunodeficiency virus (HIV) with hepatitis viruses may affect the progress of disease and response to therapy.

OBJECTIVES: To study the incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfections in HIV–positive patients and their influence on HIV–1 viral load and cluster of differentiation 4+ (CD4+) T–cell counts.

MATERIALS AND METHODS: This pilot study was done on 179 HIV–positive patients attending antiretroviral therapy (ART) centre. Their blood samples were tested for HIV-1 viral load, CD4+ T–cell counts, hepatitis B surface antigen, anti–HCV antibodies, HBV DNA and HCV RNA polymerase chain reaction.

RESULTS: Among the 179 patients, 7.82% (14/179) were coinfected with HBV and 4.46% (8/179) with HCV. Median CD4+ T–cell count of HIV monoinfected patients was 200 cells/µl and viral load was 1.67 log10 copies/µl. Median CD4+ T–cell counts of 193 cells/µl for HBV (P = 0.230) and 197 cells/µl for HCV (P = 0.610) coinfected patients were similar to that of HIV monoinfected patients. Viral load was higher in both HBV and HCV infected patients but statistically significant only for HCV (P = 0.017). Increase in CD4+ T–cell counts and decrease in HIV–1 viral load in coinfected patients on 2 years of ART were lower than that in HIV monoinfected patients.

CONCLUSION: HBV/HCV coinfected HIV patients had similar CD4+ T–cell counts as in HIV monoinfected patients, higher HIV viral load both in chemo–naive patients and in those on ART as compared to HIV monoinfected patients. However, this study needs to be done on a large scale to assess the impact of coinfection on CD4 count and HIV viral load with proper follow–up of patients every 6 months till at least 2 years.
Evaluation of mean monocyte volume in septicemia caused by Salmonella species
Authors: Kumar Dilip , Sudha Madhusoodanan , Tarai Bansidhar , Das Poonam
Published: February 2020

OBJECTIVE: The objective was to study the significance of volume, conductivity, and scatter (VCS) parameters of monocytes in Salmonella infection.

MATERIALS AND METHODS: We selected peripheral blood samples of 52 patients whose blood culture was positive for Salmonella species (Salmonella typhi and Salmonella paratyphi A) and analyzed VCS parameters by subjecting them to differential count in hematology analyzer LH750 (Beckman Coulter). Out of these, we studied VCS parameters of monocytes in Salmonella infection and compared with two control groups (control 1: other infections and control 2: normal subjects).

RESULTS: Mean monocyte volume (MMV), standard deviation (SD) of MMV, and SD of mean channel monocyte conductivity were found to be significantly increased in Salmonella infection (P < 0.05) when compared with both controls. We propose a cutoff value of 185 for MMV with sensitivity and specificity of 80% and 73%, respectively, to predict Salmonella infection.

CONCLUSIONS: MMV can be a useful tool for predicting Salmonella infection under appropriate clinical settings.
Catheter associated urinary tract infections due to Trichosporon asahii
Authors: Urs Tejashree Anantharaj , Kadiyala Visakha , Deepak Saundarya , M. Krishna Karthik
Published: February 2020

Urinary tract infections (UTIs) caused by fungi, frequently associated with medical devices, have increased and caused great morbidity and mortality among hospitalized patients. Difficulties on different species identification as well as the lack of standardized sensitivity tests in vitro, contribute to the limited information available on epidemiology, diagnosis, and therapeutics of Trichosporon infections. There are only sporadic reports of UTI caused by Trichosporon asahii reported from India. We report six cases of UTI caused by T. asahii in severely ill patients in a tertiary care setup. Among six positive T. asahii UTI, four were found in female patients with a mean age of 60 years. We observed that all patients were on indwelling urinary catheter, broad-spectrum antibiotics, and with other comorbid conditions. With regard to the antifungal susceptibility testing, all the isolates were resistant to amphotericin B and sensitive to voriconazole. Majority of them were sensitive to Itraconazole, half of them were sensitive to fluconazole. The ubiquity and biofilm formation poses difficulty in establishing pathogenicity and delineating environmental or nosocomial infections. Risk factors such as use of antibiotics, indwelling catheter, and comorbidities such as hypertension, diabetes, anemia, and chronic kidney disease predispose for the development of UTI by T. asahii. Isolation of the same yeast in three consecutive urine samples with significant counts, along with significant number of pus cells establishes T. asahii as an etiological agent of UTI. Furthermore, the clearance of the fungus from the urinary tract with the recovery of the patient following catheter removal and antifungal therapy further confirms T. asahii as the cause of UTI.
Extracellular hydrolytic enzyme activities of the different Candida spp. isolated from the blood of the Intensive Care Unit-admitted patients
Authors: Pandey Nidhi , Gupta Munesh Kumar , Tilak Ragini
Published: February 2020

BACKGROUND: Candida spp. secretes various extracellular hydrolytic enzymes. These enzymes are the important virulence factor for the pathogenesis of Candida. We assessed four different enzymatic activities of Candida isolates obtained from bloodstream infections.

MATERIALS AND METHODS: We isolated 79 strains of different Candida species from the blood of the Intensive Care Unit-admitted patients. Species were identified by conventional methods including culture characteristic, germ tube, sugar assimilation, and Dalmau's culture technique. Phospholipase, proteinase, hemolysin, and esterase enzymatic activities were determined by the Plate method.

RESULTS: Non albicans candida were the most common isolates from the blood of the ICU admitted patient with a predominance of Candida tropicalis. Hemolytic activity was the most prominent enzyme activity followed by the proteinase activity. Candida albicans (89.86%) was the major proteinase producer, while 95.8% of C. tropicalis produced hemolysin. No esterase activity was shown by the Candida glabrata and Candida krusei.

CONCLUSION: No significant difference was observed between the two most common causative agents of candidemia: C. albicans and C. tropicalis.
Clinico-microbiological profile of healthcare associated pneumonia in critically ill patients at level-I trauma centre of India
Authors: Kumari Minu , Rastogi Neha , Malhotra Rajesh , Mathur Purva
Published: February 2020

INTRODUCTION: Device-associated infections constitute the majority of health-care infections in Intensive Care Units (ICUs). Trauma patients are more prone to acquire such infections; ventilator-associated pneumonia (VAP) being the most common Health care associated infections (HAI) in ICU has serious implications such as increased morbidity, prolonged hospital stay, and mortality. This study aims to compare the clinicomicrobiological profile of VAP and non-VAP trauma patients at Level I trauma center.

MATERIALS AND METHODS: A 4-year retrospective study of prospectively maintained database was conducted at Level 1 trauma center from January 2013 to December 2016. The patients were classified into two groups named VAP and non-VAP patients. VAP patients were defined according to the criteria of the Centers for Disease Control and Prevention. The data were compiled and analyzed. Statistical data were analyzed using SPSS version 21 software.

RESULTS: During the study period, 134 (13%) cases of VAP and 909 (87%) non-VAP cases were observed in our study. The total number of ventilator days for VAP patients was 5128 days, which ranged from 2 to 82 days (median 42 days). The length of hospital stay in non-VAP category ranged from 1 to 390 days (median 195.5 days). Inhospital mortality was observed in 62 (46%) patients with VAP. Three hundred and eighteen (35%) non-VAP patients had also had a fatal outcome. Gram-negative organisms, most commonly Acinetobacter spp. (13, 21%), were reported in the fatal VAP patients.

CONCLUSION AND DISCUSSION: Higher rate of mortality was observed in patients with VAP in comparison to non-VAP patients, both being on mechanical ventilation. Early recognition of VAP, implementation of proper VAP preventive bundle strategies, and stringent infection control practices are essential mandates to prevent VAP.
Antibiotic susceptibility pattern of Shigella isolates in a tertiary healthcare center
Authors: Madhavan Anitha , Balakrishnan Sobha , Vasudevapanicker Jayalakshmi
Published: February 2020

BACKGROUND AND OBJECTIVES: Shigellosis is one of the most common causes of morbidity and mortality in children in developing countries. To the best of our knowledge, there is no published data in the study area on the antimicrobial susceptibility pattern and prevalence of Shigella species among diarrheagenic cases. Therefore, a retrospective analysis was done to find the Shigella serotypes, common age group affected, and antimicrobial resistance pattern of Shigella isolates in South Kerala

METHODS: Stool samples collected from cases of dysentery and diarrhea from January 2011 to December 2016 were processed. Standard bacteriological methods were used to isolate, identify, and determine the antimicrobial susceptibility pattern of Shigella isolates. The data were analyzed using SPSS version 16.

RESULTS: Among 1585 stool samples, 48(3%) yielded Shigella . The most common serogroup isolated was Shigella sonnei (62.5%) followed by Shigella flexneri. Of 48 isolates, 44(91.6%) isolates were found to be multidrug resistant. Over the 5-year period, the isolates show 100% resistance to nalidixic acid, ciprofloxacin, and cotrimoxazole. Eight isolates were found to be resistant to ceftriaxone and cefotaxime. The presence of Extended spectrum betalactamase (ESBL) was phenotypically confirmed in five isolates.

CONCLUSION: Even though S. flexneri is the most common Shigella-causing diarrhea, S. sonnei was found to be the most important species responsible in our study. Multidrug resistance was common (91.6%) and the most common multidrug resistance profile was ampicillin-nalidixic acid-cotrimoxazole-ciprofloxacin. Regular monitoring of antibiotic susceptibility pattern including detection of beta lactamases should be done in all microbiology laboratories. Guidelines for therapy should be monitored and modified based on regional susceptibility reports.