bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunology Pedagogical Psychology of Pesantren Kindergarten: Multicase Study at Pesantren Kindergarten in Yogyakarta
Authors: Suyadi S
Published: July 2019

Normatively, children's education is the responsibility of the family. But when families experience disharmony, even broken home, children's education prone to be abandoned. When a modern school has not been able to maximally accommodate broken home children, Early Childhood Pondok Pesantren/pontren becomes the best alternative choice. The purpose of this research is to find the best alternative education for broken home children in the modern era. This research was conducted throughout 2017 at Early Childhood Pesantren Baiquniyah Yogyakarta. This research was using the qualitative approach, while data collection techniques were observations, interviews, and documentation; data analysis was done in descriptive, interpretative, and comparative. The results show that Baiquniyah Early Childhood Pontren Yogyakarta can be the best alternative choice. This is because the Baiquniyah Early Childhood Pontren Yogyakarta is able to bring the children closer to their parents psychologically, even when they are biologically separated. This condition has implications for the increase of pedagogical immunity, in which children are not easy to stress and depression, thus comfortable in studying at pesantren.

 
Tauhid Hakimiyyah Verses in Ibn 'Ashur's Interpretation
Authors: Munthe Saifuddin Herlambang
Published: July 2019

This paper discusses Ibn ‘Ashur’s interpretation of the verses which serve as the basis of the Tauhid Hakimiyyah concept. Despitebeing an expert in Islamic law, Ibn ‘Ashur did not perceive the Tauhid Hakimiyyah verses as a basis for the necessity to apply Shari’a law at the level of government. Perhaps the thought of “hakimiyyatullah” had not developed in the time of Ibn ‘Ashur. Another reason, Ibn ‘Ashur used a linguistic-sociological contextual approach when interpreting the verses claimed to be the basis of the Tauhid Hakimiyyah concept. With this approach, Ibn ‘Ashur did not use the Tauhid Hakimiyyah verse to judge the behavior of the Muslims because in fact these verses were revealed to explain the behavior of the polytheists who opposed Islamic da’wah.
Developing the Character of Learning Community at Madrasah Tsanawiyah in Bantul Yogyakarta: Islamic Education in Nusantara Perspective
Authors: Kamilati Nurul , Sutrisno S , Sumardi Yosaphat
Published: July 2019

This research aims to promote the development of the character of  learning community at Madrasah Tsanawiyah of Bantul Regency Yogyakarta, and two problems posed to be addressed: why the character of community learning pattern does not realize as it has been expected,  and how does the development of the character of learning community  at MTs of Bantul look like? The research uses the Research and Development model that is consisted of four stages: exploration, development, tests, and dissemination. The data were collected by means of observatiosn, interviews, questionaire, and review of documentation. The results show: (1) the character of learning community  at the MTs in Bantul Regency has not been fully established because the teachers were not active in preparing their lesson study, and they did not benefit from it. Also, they were too busy in fulfilling their obligations as teachers; (2) the development of the character of learning  community at MTs in Bantul could be implemented through Classroom Action Research-based lesson study plans which are consisted of five stages: consolidation of lesson study concepts, explanation of Classroom Action Research as a form of scientific publication, planning, implementation of action, and reflection.
Females Fall More From Heights But Males Survive Less Among A Geriatric Population: Insights From An American Level 1 Trauma Center
Authors: El-Menyar Ayman , Tilley Elizabeth , Al-Thani Hassan , Latifi Rifat
Published: July 2019

Background: Approximately one third of subjects ≥65 year old and half of subjects ≥80 years old sustain a fall injury each year. We aimed to study the outcomes of fall from a height (FFH) among older adults. We hypothesized that in an elderly population, fall-related injury and mortality are the same in both genders.
Methods: A retrospective analysis was conducted between January 2012 and December 2016 in patients who sustained fall injury at age of at least 60 years and were admitted into a Level 1 Trauma center. Patients were divided into 3 groups: Gp-I: 60-69, Gp-II: 70-79 and Gp-III: ≥80 years old. Data were analyzed and compared using Chi-square, one-way analysis of variance (ANOVA) and logistic regression analysis tests.
Results: Forty-three percent (3665/8528) of adult trauma patients had FFH and 59.5% (2181) were ≥ 60 years old and 52% were women. The risk of fall increased with age with an Odd ratio (OR) 1.52 for age 70-79 and an OR 3.40 for ≥80.
Females fell 1.2 times more (age-adjusted OR 1.24; 95% CI 1.05-1.45) and 47% of ≥80 years old suffered FFH. Two-thirds of FFH occurred at a height ≤1 meter. Injury severity (ISS, NISS and GCS) were worse in Gp-II, lower extremities max Abbreviated Injury score (max AIS) was higher in Gp-III. Overall mortality was 8.7% (Gp-I 3.6% vs. 11.3% in Gp-II and 14% in Gp- III). Males showed higher mortality than females in the entire age groups (Gp-I: 4.6% vs 1%, Gp-II: 12.9% vs 4.2% and Gp-III: 17.3% vs 6.9% respectively). On multivariate analysis, shock index (OR 3.80; 95% CI 1.27-11.33) and male gender (OR 2.70; 95% CI 1.69-4.16) were independent predictors of mortality.
Conclusions: Fall from a height is more common in older adult female patients, but male patients have worse outcomes. Preventive measures for falls at home still are needed for the older adults of both genders.
Happiness inequality in young adults: a nationwide cross sectional study from Iran
Authors: Montazeri Ali , Tavousi Mahmoud , Haeri-Mehrizi Aliasghar , Sadighi Jila , Farzadi Faranak , Maftoon Farzaneh , Aeenparast Afsoon , Mozaffari Ramin
Published: July 2019

Objective
The correlation between happiness and health is well established. This study aimed to measure happiness and its correlates among a sample of young adults in Iran. As such a national cross sectional study was conducted and the Oxford Happiness Questionnaire (OHQ) was administered to measure happiness. We performed logistic regression analysis to examine the relationship between happiness and independent variables.
Results
In all 14292 young adults (7702 female and 6590 male) were completed the questionnaire. The mean happiness score for the study sample was 4.09 (SD = 0.57) out of 6; indicative of a condition that is named as ‘rather happy; pretty happy’. The results obtained from multiple logistic regression analysis showed insignificant association between happiness, age, gender, and education whereas the association between happiness and income [OR for poor/very poor= 1.69, 95% CI: 1.51-1.90] and employment status [OR for unemployed = 1.88, 95% CI: 1.53-2.32] was significant. In addition separate analyses for men and women showed that income and employment still were significant for men but for women only income was significant.
Increment of plasma glucose by exogenous glucagon is associated with present and future renal function in type 2 diabetes: a retrospective study from glucagon stimulation test.
Authors: Takada Yasutaka , Fujita Yukihiro , Bessho Ryoichi , Sato Mao , Abe Tomoe , Yanagimachi Tsuyoshi , Sakagami Hidemitsu , Abiko Atsuko , Takiyama Yumi , Ota Tsuguhito , Haneda Masakazu
Published: July 2019

Background: Glucagon stimulation test (GST) is often employed to assess the insulin reserve of the pancreatic beta cells in diabetic subjects. The clinical significance of the increment of plasma glucose (Δglucose) by exogenous glucagon during GST has not been elucidated. We investigated the relationship between Δglucose and clinical parameters including the liver and renal function in type 2 diabetic subjects, since we hypothesized that Δglucose is associated with the liver and renal function reflecting the capacity for gluconeogenesis in the organs.
Methods: A total of 209 subjects with type 2 diabetes who underwent GST during admission were included in this cross-sectional study. We defined the difference between plasma glucose at fasting and 6 min after intravenous injection of 1 mg glucagon as Δglucose. We assessed correlations between Δglucose and clinical parameters such as diabetic duration, BMI, HbA1c, beta cell function, serum free fatty acids (FFA) which is known to stimulate gluconeogenesis, liver function, the indices of liver function, renal function, and urinary albumin excretion (UAE).
Results: In correlation analysis, Δglucose positively correlated to FFA and estimated glomerular filtration rate (eGFR), but inversely to serum creatinine and cystatin C, although Δglucose showed no correlation with both liver function and the indices of residual liver function. Multiple regression analysis revealed that Δglucose was an independent determinant for the eGFR after 1 year, equally BMI, HbA1c, serum lipids, and UAE, which are known as the predictors for the development of chronic kidney disease.
Conclusion: Our results suggest that Δglucose during GST might be related to gluconeogenesis in the kidney and could be the determinant of future renal function in type 2 diabetes.
Antithrombin III Predicts Acute Kidney Injury in Septic Elderly Patients
Authors: Xie Yun , Tian Rui , Jin Wei , Xie Hui , Du Jiang , Zhou Zhigang , Wang Ruilan
Published: July 2019

Background

The elderly are the primary age group of acute kidney injury (AKI). The predictive value of Antithrombin III (ATIII) level in preventing AKI among septic elderly patients has not been studied. The purpose of this study was to evaluate the value of ATIII in predicting AKI nondevelopment and prognosis in septic elderly patients under ICU settings.

Materials and methods

This is a retrospective study enrolling 107 elderly patients with sepsis who were admitted to ICUs from October 2015 to March 2018. Assessment of renal function was performed daily by measuring serum creatinine level and urine output. The ATIII level was obtained within the first 48 hours of the diagnosis of sepsis (ATIII1).

Results

Among all enrolled patients, 29 (27.1%) developed AKI. The ATIII level was a predictor of AKI nondevelopment (AUC-ROC =0.729, and sensitivity 0.700and specificity0.714). The ATIII/Cr ratio was also a predictor of AKI nondevelopment (AUC-ROC =0.971, and sensitivity 0.900and specificity1).The accuracy of ATIII and ATIII/Cr in predicting survival was intermediate, with AUC-ROC of 0.681 and 0.804 repectively, sensitivity ranging between 0.802 and 0.596, and specificity between 0.542 and 0.875. The ATIII level demonstrated excellent ability in predicting AKI nondevelopment in septic elderly patients in ICUs. Patients were divided into low ATIII group and high ATIII group using 66.95 or 55.7 as cutoff value. In comparison, ICU stay was significantly lower in the high ATIII group(p=0.020 and 0.049, repectively. Off mechanical ventilation time, off CRRT time, and survival time were significantly higher in high ATIII group(p=0.049,0.048,0.014 using 66.95 as cutoff and 0.041,0.036,0.021 using 55.7 as cutoff).

Conclusion

This study suggests that ATIII predicts acute kidney injury in septic elderly patients. Lower ATIII predicts worse prognosis .
Randomised, double-blind, placebo controlled multi-centre study to assess the efficacy, tolerability and safety of Enterosgel® in the treatment of Irritable Bowel Syndrome with Diarrhoea (IBS-D) in adults
Authors: Kemppinen Anu , Howell Carol , Allgar Victoria , Dodd Matthew , Gregson John , Knowles Charles , McLaughlin John , Pandya Preeti , Whorwell Peter , Markaryan Elena , Yiannakou Yan
Published: July 2019

Background

Irritable Bowel Syndrome (IBS) with diarrhoea (IBS-D) is a common and chronic condition that can significantly impair quality of life. The emergence of new drugs for IBS-D has been slow and there is a need for new treatments, including drug-free treatments, which are easy to use and suitable for different patient groups. Currently available drug-free treatments include Enterosgel®, an intestinal adsorbent approved for use in IBS-D and acute diarrhoea and available over-the-counter in the UK and 30 countries worldwide. The aim of this randomised, double-blind, placebo-controlled multi-centre study is to test the efficacy and safety of Enterosgel® compared to placebo in symptomatic treatment in IBS-D.

Methods and design

430 participants with IBS-D will be recruited from approximately 30 primary and secondary care sites in England. Participants meeting the required abdominal pain and stool consistency criteria over a 2-week screening period, will be randomly allocated to receive blinded treatment (Enterosgel® or placebo) for 8 weeks. This will be followed by an 8-week open-label treatment phase with Enterosgel®. Participants will be allowed to adjust their daily dosage during both phases based on their symptoms. Participants will then return to standard care and those who responded to treatment will receive a follow-up call 8 weeks later. Co-medication with loperamide will be permitted and use recorded. The primary outcome measure is the percentage of participants defined as responders for abdominal pain and stool consistency during at least 4 weeks in the 8-week blinded phase. Secondary outcome measures include stool frequency, stool consistency, abdominal pain, bloating, urgency, adequate relief, questionnaire scores and rescue medication use. Exploratory outcomes will be assessed in subsets of participants including qualitative and quantitative data on faecal microorganisms and biomarkers, and gut-related measurements from magnetic resonance imaging data.

Discussion

This is the first large scale randomised controlled trial investigating Enterosgel® in IBS-D. A study design with blinded phase followed by an open-label phase was chosen to encourage participation and study completion. Demonstrating that Enterosgel® is effective and safe in IBS-D could encourage adoption by patients and healthcare professionals and foster future clinical trials assessing its use in related conditions.
Effectiveness of Checklist based Box system Interventions (CBBSI) versus routine care on improving utilization of Maternal Health Service in North West, Ethiopia: Cluster Randomized Controlled Trial
Authors: Belete Netsanet , Gerbaba Mulusew , Tura Gurmesa
Published: July 2019

Background -

Maternal mortality is still high in Ethiopia. Antenatal care, use of skilled delivery and postnatal care are key maternal health care services that can significantly reduce maternal mortality. However, in low and middle income countries including Ethiopia, utilization of these key services are not enough to deliver the recommended preventive, promotive and curative services. The aim of this study is to examine the effectiveness of checklist based box system interventions on improving maternal health service utilization.

Methods -

A community level cluster-randomized controlled trial will be conducted to compare the effectiveness of checklist based box system interventions over the routine standard of care. The intervention will use health extension program and provided by health extension workers and midwives, using a special type of health education scheduling and service utilization monitoring boxes, placed at health posts and health centers respectively. For this, 1,200 pregnant mothers, below 16 weeks of gestation, will be recruited from 30 clusters. Suspected pregnant mothers will be identified through a community survey and linked to the nearby health center. In a two weeks base, review of dropouts will be conducted at each intervention health center. Then intervention health posts (supervised by intervention health center) will be communicated for each dropout. Then, health extension workers will provide health education, using a person-centered manual prepared for this purpose. Data will be collected using ODK-Collect and analyzed using STATA version 13.0. Data will be analyzed by intention to treat analysis. Risk ration will be computed at cluster level and the summary will be compared using t-test. Outcomes between intervention and control groups will be compared with random effects logistic regression models.

Discussion -

The authors of this study expect that, the study will generate evidence on the effectiveness of checklist based box system interventions on improving utilization of maternal health care service, that are strong enough to inform policies in the country.
Evaluation of the Influenza Sentinel Surveillance System in the Democratic Republic of Congo, 2012-2015
Authors: Babakazo Pelagie Diambalula , Kabamba-Tshilobo Joelle , Wemakoy Emile Okitolonda , Lubula Léopold , Manya Léonie Kitoko , Ilunga Benoit Kebela , Disasuani Wally , Nkwembe Edith , Kavunga-Membo Hugo , Changachanga Jean-Claude , Muhemedi Saleh , Tamfum Jean-Jacques Muyembe , Tempia Stefano
Published: July 2019

Background

The World Health Organization recommends periodic evaluations of influenza surveillance systems to identify areas for improvement and provide evidence of data reliability for policymaking. However, data about the performance of established influenza surveillance systems are limited in Africa, including in the Democratic Republic of Congo (DRC).

Methods

We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza sentinel surveillance system (ISSS) in DRC during 2012-2015. The performance of the system was evaluated using eight surveillance attributes: (i) data quality and completeness for key variables, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability and (viii) utility. For each attribute, specific indicators were developed and described using quantitative and qualitative methods. Scores for each indicator were as follows: <60% weak performance; 60-79% moderate performance; ≥80% good performance.

Results

During 2012-2015, we enrolled and tested 4,339 patients with influenza-like illness (ILI) and 2,869 patients with severe acute respiratory illness (SARI) from 11 sentinel sites situated in 5 of 11 provinces. Influenza viruses were detected in 446 (10.3%) samples from patients with ILI and in 151 (5.5%) samples from patients with SARI with higher detection during December-May. Data quality and completeness was >90% for all evaluated indicators. Other strengths of the system were timeliness, representativeness, simplicity, stability and utility that scored >70% each. Flexibility and acceptability had moderate to week performance. It was reported that the ISSS contributed to: (i) a better understanding of the epidemiology, circulating patterns and proportional contribution of influenza virus among patients with ILI or SARI; (ii) acquisition of new key competences related to influenza surveillance and diagnosis; and (iii) continuous education of surveillance staff and clinicians at sentinel sites about influenza. However, due to limited resources no actions were undertaken to mitigate the impact of seasonal influenza epidemics.

Conclusions

The system performed overall satisfactorily and provided reliable and timely data about influenza circulation in DRC. The simplicity of the system contributed to its stability. A better use of the available data could be made to inform and promote prevention interventions especially among the most vulnerable groups.
Cysteine-cysteine chemokine receptor 5 (CCR5) profile of HIV-infected subjects attending University of Calabar Teaching Hospital, Calabar, Southern Nigeria
Authors: Ekere Ekerette Friday , Useh Monday F. , Okoroiwu Henshaw Uchechi , Mirabeau Tatfeng Youtchou
Published: July 2019

Background

Cysteine-cysteine chemokine receptor 5 is the main HIV co-receptor involved in the virus and cell-to-cell spread. A variant of the CCR5 gene known as CCR5-Δ32 which is a product of 32 base pair deletion in the gene plays critical role in the infection and progression to AIDS. The study was done to determine the CCR5 genotype of HIV-infected subjects attending University of Calabar Teaching Hospital, Calabar.

Methods

A total of 100 subjects attending HIV clinic, University of Calabar Teaching Hospital were purposively recruited for this study. DNA was extracted from each sample using the quick gDNA miniprep DNA extraction kit. Polymerase chain reaction was used in amplification of CCR5 gene in each DNA in a 9700 ABI Thermo cycler and then resolved on 4% agarose gel electrophoresis.

Result

Out of the 100 samples assessed, 100 (100%) were homozygous for the CCR5 wild type gene (CCR5-wt), while none (0%) was homozygous for the CCR5-Δ32 (mutant type), and heterozygosity was not observed.

Conclusion

This study observed absence of CCR5-Δ32 deletion gene among the studied subjects in Calabar. This implies lack of genetic advantage in HIV infection and possible rapid progression towards AIDS if other precautions are not checked.
Intra-abdominal infections: the role of different classifications on the selection of the best antibiotic treatment
Authors: Nunes João Silva , Cardoso Teresa Maria Costa
Published: July 2019

Background

Intra-abdominal infections (IAIs) represent a most frequent gastrointestinal emergency and serious cause of morbimortality. A full classification including all facets of IAIs does not exist. Two classifications are used to subdivide IAIs: uncomplicated or complicated, considering infection extent; and community-acquired, healthcare-associated or hospital-acquired, regarding place of acquisition. Adequacy of initial empirical antibiotic therapy prescribed is an essential need. Inadequate antibiotic therapy is associated with treatment failure and increased mortality. This study was designed to determine accuracy of different classifications of IAIs to identify infections by pathogens sensitive to current treatment guidelines helping in selection of best antibiotic therapy.

Methods

Retrospective cohort study including all adult patients discharged from hospital with diagnosis of IAI between 1st of January and 31st of October, 2016. All variables potentially associated with pre-defined outcomes: infection by a pathogen sensitive to non-pseudomonal cephalosporin or ciprofloxacin plus metronidazol (ATB 1, primary outcome), sensitive to piperacillin-tazobactam (ATB 2) and hospital mortality (secondary outcomes) were studied through logistic regression. Accuracy of the models was assessed by area under receiver operating characteristics (AUROC) curve and calibration was tested using Hosmer-Lemeshow goodness-of-fit test.

Results

Of 1804 patients screened 154 met inclusion criteria. Sensitivity to ATB 1 was independently associated with male gender (adjusted OR=2.612) and previous invasive procedures in last year (adjusted OR=0.424) (AUROC curve=0,65). Sensitivity to ATB 2 was independently associated with liver disease (adjusted OR=3.580) and post-operative infections (adjusted OR=2.944) (AUROC curve=0.604). Hospital mortality was independently associated with age≥70 (adjusted OR=4.677), solid tumor (adjusted OR=3.127) and sensitivity to non-pseudomonal cephalosporin or ciprofloxacin plus metronidazole (adjusted OR=0.368).
Accuracy of pre-existing classifications to identify infection by a pathogen sensitive to ATB 1 was 0.59 considering place of acquisition, 0.61 infection extent and 0.57 local of infection, for ATB 2 it was 0.66, 0.50 and 0.57, respectively.

Conclusion

None of existent classifications had a good discriminative power to identify IAIs caused by pathogens sensitive to current antibiotic treatment recommendations. A new classification including patients individual characteristics like those included in current model might have a higher potential to distinguish IAIs by resistant pathogens allowing a better choice of empiric antibiotic therapy.
Stakeholders’ recommendations for implementing HIV self-testing and secondary distribution of HIV self-testing for male partners of Option B+ clients in Haiti as an assisted partner service strategy: a qualitative study
Authors: Conserve Donaldson Fadael , Michel Jacob , Demes Joseph Emmanuel Adrien , Chéry Jean Marxcime , Balan Jean-Gabriel , Choko Augustine , François Kesner , Puttkammer Nancy
Published: July 2019

Background

Despite significant public health efforts, HIV testing remains low among men in Haiti. HIV self-testing (HIVST), which allows people to test in private, is an effective strategy for increasing HIV testing among men. Secondary distribution of HIVST to male partners of women living with HIV (WLWH) is one promising assisted partner services strategy to address the low HIV testing rate among men in Haiti. However, little research has been conducted on how to implement HIVST in the Caribbean. The purpose of this study was to assess stakeholders’ perspectives towards HIVST and to obtain their recommendations for how to implementing HIVST in Haiti to reach male partners of Option B+ clients.

Methods

Sixteen key informant interviews and nine focus groups with 44 healthcare workers (HCWs), 31 Option B+ clients, and 13 men were carried out in Haiti. Key informants were representatives of the Ministry of Health and of a non-governmental agency involved in HIV partner services. HCWs included program leads and staff members from the HIV care and treatment program, the Option B+ program, the community health service program, and the HIV counseling and testing services from 2 hospitals.

Results

Perceived HIVST advantages included an increase in the number of people who would learn their HIV status and start treatment. Perceived disadvantages were lack of support to ensure self-testers initiate treatment, uncertainty about male partner’s reaction, risk of violence towards a woman by a man after having received an HIVST kit from her, and the inability of a woman to counsel a man in case his self-test result is positive. Recommendations for implementing HIVST and secondary distribution of HIVST included coupling HIVST distribution with public information, education, and communication through media and social marketing; relying on community health workers to mediate the use of HIVST and ensure linkage to care; and piloting HIVST programs on a small scale.

Conclusions

HIVST is an appropriate and feasible HIV prevention strategy for men and women. Our findings indicate that more research is needed to determine and pilot how best to implement HIVST and secondary distribution of HIVST by Option B+ clients in Haiti.
Burden of viral hepatitis caused by specific aetiologies in China, 1990-2016: findings from the GBD 2016
Authors: Li Man , Wang Zhuo-qun , Zhang Lu , Zheng Hao , Zhou Mai-geng , Liu Dian-wu
Published: July 2019

Purpose

The aim of this study is to quantify the burden caused by viral hepatitis in China from 1990 to 2016. Methods: Data from the GBD 2016 study were extracted to calculate incidence, prevalence and disability-adjusted life years (DALYs). Trends in DALYs were assessed in 33 provinces/regions. Results: From 1990 to 2016, the total incidence of hepatitis decreased by 88.5%. However, the prevalence of hepatitis (counts in thousands), increased by 37.6% from 153,856 (95% UI: 136,047-172,319) in 1990 to 211,721 (95% UI: 179,776-240,981) in 2016, with age-standardized prevalence rates changing slightly. The number and age-standardized prevalence rates increased by 35.9% and 1.6% for hepatitis B and by 81.8% and 30.4% for hepatitis C, respectively. Guangxi, Guangdong and Hainan had the highest age-standardized prevalence rates (≥16,500 per 100,000). Tibet, Qinghai and Gansu had the highest age-standardized DALYs rates (≥40 per 100,000). The largest absolute number of DALYs was observed in the 15-49 year age group in 2016. The highest rate of DALYs occurred in males aged 50-69 years and in females aged ≧70 years. Conclusion: The incidence and DALYs of viral hepatitis decreased dramatically from 1990 to 2016. However, the prevalence still remains at a high level, which may result in heavy burdens in the future.
Comparison of weight-based versus standard dosing of tranexamic acid for blood loss and transfusion amount in knee arthroplasty without tourniquet
Authors: guler olcay , Çarkçı Engin , Çerci Mehmet Halis , Gümüşsuyu Gürkan , Öztürk Çağatay
Published: July 2019

Backgruond

To compare weight-based versus standard dosing of intravenous (IV) tranexamic acid for blood loss and transfusion amount in total knee arthroplasty (TNA) without tourniquet.

Methods

A total of 99 patients who underwent TNA with the diagnosis of primary osteoarthritis were enrolled in this retrospective case-control study. Patients were divided into two groups according to the application of tranexamic acid. Group 1 (weight-based dosing): 10 mg/kg IV TA 30 min before the skin incision, and 10 mg/kg, at postoperative 30 min, and 3 h. Group 2 (standard dosing): 1 g of IV TA 30 min before skin incision, and 1 g at postoperative 30 min and 3 h. Hemoglobin levels, before, and 1, and 2 days after the operation, postoperative amount of decrease in hemoglobin levels, and amount of erythrocyte transfusion were recorded. Two scoring systems Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS) were applied in the evaluation of TNA results preoperatively, and at 1., 3., 6., and 12. months, postoperatively.

Results

Both groups did not differ from each other by means of age (p=0.127), gender (p=0.528), BMI (p=0.782), operating sides (p=0.544), existing comorbidities (p=0.987), preoperative hemoglobin level (p=0.718), the amount of hemoglobin reduction (p=0.769), and the amount of erythrocytes transfused (p=0.913). In both study groups, hemoglobin levels in male patients dropped significantly more deeply than female patients. Also, in both study groups, hemoglobin levels were significantly lower in patients with comorbid illnesses. A statistically significant difference was not detected between Groups 1 and 2 in terms of pre- and postoperative WOMAC scores, KSS knee scores, and KSS function scores.

Conclusion

Our study showed that weight-based and standard dosing of IV tranexamic acid treatments were similar in efficacy and safety. Both treatments reduce blood loss and the need for transfusion. Also, there was no significant difference in terms of reliability between the two groups.
Changes in Bone Mineral Density Following Conventional Oral Phosphonate Treatment of Hypophosphatemic Osteomalacia: a case-control study
Authors: Guo Yue , Wu Xian-Ping , Zhou Ying-Hui , Tang Chen-Yi , Wang Min , Mo Zhao-Hui , Tang Jun , Shepherd John A , Ng Bennett K , Fan Bo , Feng Yun-Zhi , Zhou Hou-De
Published: July 2019

Background: There are limited clinical studies aimed at solving the problem of the efficiency of conventional treatment with oral phosphate and calcitriol in adults with hypophosphatemic osteomalacia (HO). In addition, there still had no good non-hazardous markers to evaluate the severity of bone loss of osteomalacia before and after treatment. Therefore, the purpose of this study was to assess the efficacy of conventional treatment with a self-blended phosphate supplementation and calcitriol on patients with HO and whether bone mineral density (BMD) can helpful for monitoring the efficacy.
Methods: 21 HO patients and 105 healthy controls were enrolled. HO patients with calcium and calcitriol were divided into three phosphate treatment groups: Patients in group A (n=3) received continuous phosphate supplementation, patients in group B (n=5) received intermittent phosphate supplementation and patients in group C (n=3) received no phosphate supplementation. 11 of 21 HO patients were recalled for detection of BMD of the lumbar spine (L1–L4), femoral neck, and total left hip three years after the treatment.
Results: The average initial serum phosphorus level of the patient group was approximately 50% lower than that of the control group. Lower BMD was significantly observed in the HO group than the control group at the lumbar spine and total hip. Continuous treatment with the phosphate supplement could increase BMD in the lumbar spine and total hip by 33.4–52.3% and the femoral neck increased by 43.2–79.3% compared with baseline, and the effect appears to be continued once treatment is discontinued.
Conclusions: These findings suggest that conventional therapy can improve bone mineral defects in patients with HO, especially in the femoral neck. Detection of BMD in HO patients is a good tool to assess the extent of bone defects and the therapeutic effect.
Reducing Barriers to Post-9/11 Veterans’ Use of Programs and Services as They Transition to Civilian Life
Authors: Morgan Nicole R. , Aronson Keith R. , Perkins Daniel F. , Bleser Julia A. , Davenport Katie , Vogt Dawne , Copeland Laurel A. , Finley Erin P. , Gilman Cynthia L.
Published: July 2019

Background - Numerous programs exist to support veterans in their transitions to civilian life. Programs are offered by a host of governmental and non-governmental stakeholders. Veterans report encountering many barriers to program participation. This was the first study to identify barrier reduction strategies offered by programs that post-9/11 veterans report using, determine which strategies veterans use and value, and to examine veteran characteristics that impact their odds of using programs that offer barrier reduction strategies.

Method - This study reflects findings from the first wave of data collection of The Veterans Metrics Initiative, a longitudinal study examining the military-to-civilian reintegration of post-9/11 veterans. Veterans were asked to indicate which programs they had used. The websites of these programs were coded for the barrier reduction components. Veterans also indicated which barrier reduction components they found most helpful in meeting their reintegration goals.

Results - Of 9,566 veterans who participated in Wave 1 data collection, 84% reported using a program that offered at least one barrier reduction component. Barrier reduction components included tangible supports (e.g., scholarships, cash), increased access to programs, decreased stigma, and encouraged motivation to change. Although only 4% of programs that were used by veterans focused on helping them obtain Veterans Administration benefits, nearly 60% of veterans reported that this component was helpful in reaching their goals. Access assistance to other resources and supports was also reported as a helpful barrier reduction component. For instance, approximately 20% of veterans nominated programs that offered transportation. The study also found evidence of a misalignment between the kinds of barrier reduction components veterans valued and those which programs offered. Veterans from the most junior enlisted ranks, who are at most risk, were less likely than those from other ranks to use barrier reduction components.

Conclusions – Despite the evidence that barrier reduction components enhance access to programs and contribute to program sustainability, many programs used by post-9/11 veterans do not offer them. There is also a misalignment between the barrier reduction strategies veterans value and the strategies offered by programs. Veteran serving organizations should increasingly implement barrier reduction strategies that veterans value.
Interaction between COX-1 and COX-2 increases susceptibility to ischemic stroke in a Chinese population
Authors: Zhao Lei , Fang Jinghuan , Zhou Muke , Zhou Jie , Yu Lihua , Chen Ning , He Li
Published: July 2019

Background

Mutations of cyclooxygenase gene (COX gene) may increase the susceptibility of ischemic stroke. We investigated five variants (rs5788, rs1330344, rs3842788, rs20417, and rs689466) of two COX genes to explain the association between these polymorphisms and ischemic stroke risk determine whether gene–gene interaction between these genes increase the susceptibility of ischemic stroke or its subtypes.

Methods

A total of 1981 study subjects (1078 cases and 903 control subjects) were recruited. The interaction of multiple factors was investigated using Multifactor Dimensionality Reduction and additive effect of single nucleotide polymorphisms on ischemic stroke or its subtypes were analyzed by multiple factor logistic regression.

Results

At COX-1(rs1330344), AA genotype carriers had a lower susceptibility of ischemic stroke (OR=0.657, 95%CI= 0.437-0.988, P = 0.044), and A allele carriers had a lower susceptibility of ischemic stroke (OR=0.812, 95%CI= 0.657-0.978, P = 0.029). At COX-1(rs3842788), AA genotype carriers had a higher susceptibility of ischemic stroke (OR =5.203, 95% CI=1.519-5.159, P =0.016). At COX-2 (rs689466), AA genotype carriers had a higher susceptibility of large-artery atherosclerosis (OR =1.404, 95% CI=1.019-1.934, P =0.038). COX-1(rs1330344, rs3842788) and COX-2 rs689466 interacted in SVO, but had no additive effect with ischemic stroke or its subtypes.

Conclusions

At rs1330344, AA genotype may reduce the susceptibility of ischemic stroke. At rs3842788, AA genotype may increase the susceptibility of ischemic stroke. At rs689466, AA genotype may increase the susceptibility of large-artery atherosclerosis (LAA). COX-1(rs1330344, rs3842788) and COX-2 rs689466 interacted in small vessel occlusion (SVO), but had no additive effect with ischemic stroke or its subtypes.
Changing face of Candida colonization pattern in pediatric patients with hematological malignancy during repeated hospitalizations, results of a prospective observational study (2016-2017) in Shiraz, Iran
Authors: Hamzavi Sedigheh , Amanati Ali , Badiee Parisa , Kadivar Mohammad Rahim , Jafarian Hadis , Ghasemi Fatemeh , Haghpanah Sezaneh , Dehghani Mansooreh , Baghani Abbas Norouzian
Published: July 2019

Background: Surveillance of current changes in the epidemiology of Invasive Fungal Diseases (IFDs) as an important component of the antifungal stewardship programs (ASP), requires careful regular monitoring, especially in high-risk settings such as oncology centers. This study aimed to examine Candida colonization status and corresponding current changes in children with malignancy during repeated admissions and also investigate the possible epidemiological shifts after the implementation of ASP.

Methods: In this prospective observational study, all eligible patients younger than 18 years were recruited during 2016-2017 at Amir Medical Oncology Center (AMOC) in Shiraz, Iran. Totally, 136 patients were enrolled and 482 samples were collected from different sites (oral/nasal discharges, urine and stool). Weekly regular sampling was carried out during hospitalization. Candida colonization status and epidemiological changes were monitored during repeated admissions. Samples were cultivated on Sabouraud Dextrose agar medium and identified by Polymerase Chain Reaction -Restriction Fragment Length Polymorphism (PCR-RFLP).

Results: Estimated Candida colonization incidence was 59.9% (82/136) in our patients. Candida colonization was found to be higher in oral cavity and rectum than that in nasal cavity. Among those long-term follow ups and repetitive hospitalizations, a significant number of patients exhibited changes in their colonization patterns (37.7%). Candida colonization did not reveal any significant relationship with age, sex, oncologic diseases and degree of neutropenia. C. albicans (72.0%) was found as the most common Candida species in colonized patients, followed by C. krusei, C. kefyr, C. glabrata and C. parapsilosis.

Conclusion: Given the high incidence of Candida infections in children with cancers, close monitoring of epidemiologic changes is essential for judicious management, based on local surveillance data and improvement of overall quality of care in high risk patients.

Key Words: Candida Albicans, Fungal Colonization, Pediatric Leukemia
Peripheral T cell lymphoma after chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS): A case report
Authors: Liu Xiao-hang , Jin Fan , Zhang Meng , Liu Mei-xi , Wang Tao , Pan Bo-ju , Zhang Lu
Published: July 2019

Background

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is an inflammatory disorder in the central nervous system (CNS) with distinct clinical, radiological, and pathological characteristics. The pathophysiology of CLIPPERS still remains unclear. Because a few cases about lymphoma mimicking the manifestations of CLIPPERS were reported and the prognosis of lymphoma is much worse, early identification of lymphoma is very important.

Case presentation

A 31-year-old woman was admitted with 3 months’ history of diplopia, dizziness, gait ataxia and right facial numbness. The diagnosis of CLIPPERS was established based on the finding of punctate enhancing lesions in the cerebellum, thalamus, pons, medulla, and midbrain region in magnetic resonance imaging (MRI), together with the favorable clinical and radiological responses to corticosteroids. However, she was diagnosed as peripheral T cell lymphoma, not otherwise specified (PTCL-NOS) by the pulmonary nodular and the skin biopsy almost 10 years later, and she got complete remission within 1 year after chemotherapy.

Conclusion

We report the first case of CLIPPERS developing PTCL-NOS. This case proposes that when brain biopsy was difficult to achieve, biopsies in extra-cerebral lesions under the assisting examination of positron emission tomography-computed tomography (PET-CT) can be helpful in further identification.
“Bitlis Hava Kirliliği Emisyon Envanteri ve Sağlık Etkilerinin Çoklu Lineer Regresyonla Tahmini
Authors: AVŞAR Edip
Published: July 2019

Doğal Afetler ve Çevre Dergisi’nde yayınlanan "Bitlis Hava
Kirliliği Emisyon Envanteri ve Sağlık Etkilerinin Çoklu Lineer Regresyonla
Tahmini” isimli yayında (Ocak 2019, 5(1): 1-10) Bitlis’te 2015 yılında yakılan
yakıt miktarından hareketle; SOx, NOx, PM10 ve
CO parametreleri için kütlesel debiler hesaplanmıştır. Ayrıca Bitlis’te
2012-2015 yılları arasında mevcut hastanelere solunum yoluyla ilgili başvuran
hasta sayıları elde edilmiştir. Hasta sayıları ve emisyon verileri kullanılarak
2015 yılı hasta sayıları tahmin edilmiş ve hesaplanan hasta sayısı ile elde
edilen hasta sayısı arasında yüksek korelasyon görüldüğü belirtilmiştir.
Çalışmada çok önemli hatalar mevcuttur. Hesaplamaya esas alınan kömür miktarı
ve hesaplanan emisyon faktörlerinin bazıları hatalı olup bu nedenle elde edilen
emisyon envanteri tamamen yanlıştır. Bu durumda elde edilen korelasyon değeri
de tamamen rastlantısaldır. Bu makaleden faydalanacak okuyucuların bu hataları
görmesi açısından yapılan tespitler değerlendirme olarak çalışmada verilmiştir.
Önértékelő kérdőív fejlesztése a kollaboratív problémamegoldó képességet leíró modellek egyikének validálására
Authors: Pásztor-Kovács Anita , Pásztor Attila , Molnár Gyöngyvér
Published: July 2019

Jelen tanulmány a csoportban történő problémamegoldó képesség kollaboratív komponensét vizsgáló önértékelő kérdőív kialakításának folyamatát, továbbá kipróbálásának eredményeit mutatja be. A kérdőív fejlesztése kettős célt szolgált. Egyrészt egy olyan, a kollaboratív problémamegoldó képességet leíró elméleti modellek egyikére épülő mérőeszközt kívántunk kialakítani, amely egyén szintjén nyújt átfogó (és nem egyetlen esetre reflektáló) visszacsatolást a tanulók kollaboratív képességeiről, másrészt célunk volt a kollaboratív problémamegoldó képesség struktúrájának mélyebb megismerése, az elméleti modellek egyikének empirikus tesztelése, validálása. A kérdőívet az Assessment & Teaching of 21st Century Skills projekt elméleti modelljének kollaboratív komponensére építettük. Összesen 36 tételt fejlesztettünk a három fő képesség, ezen belül a kilenc részképesség vizsgálatára. A tanulók ötfokú skála segítségével értékelték, hogy mennyire jellemző rájuk egy adott állítás. A kérdőív működését online nagymintás adatfelvétel keretein belül teszteltük nyolcadik évfolyamos tanulók körében (N=871) az eDia rendszeren keresztül. Megerősítő faktoranalízist alkalmazva elemeztük, hogy kimutatható-e az elméleti modell változókészletünk mögött. Az alacsony faktorsúlyú tételek szelektálása után az új, 17 tételes redukált skála megfelelő illeszkedést mutatott a háromdimenziós modellel (χ2=386,06 df=116; p<0,01; CFI=0,918; TLI=0,904; RMSEA=0,052), azaz a három fő képességet (részvétel, nézőpontátvétel, szociális szabályozás) egyértelműen kimutattuk a kollaboratív komponens mögött. A 17 tételes rövidített skála (Cronbach-α=0,91) és annak három alskálája (Cronbach-α=0,70–0,85) megfelelő szintű reliabilitás mutatóval rendelkezett, a kérdőív tehát kellő megbízhatósággal ad becslést a diákok kollaboratív képességeinek fejlettségi szintjéről.
Psychological Capital and Business Success of Chinese, Minangnese, and Javanese Entrepreneurs
Authors: Andri Nofri , Ronauli Puji Tania , Riyanti Benedicta P. Dwi
Published: July 2019

Psychological capital (Psycap) is a condition of positive psychology (hope, efficacy, resilience, and optimism), which facilitates entrepreneurs to survive in running and reach success in their business. This research was intended to obtain the overviews of psycap and business success of Chinese, Minangnese, and Javanese entrepreneurs. There was a total of 207 entrepreneurs involved as respondents. There were two instruments used in this study: the Psychological Capital Scale and the Balanced Scorecard. Data analysis method applied to measure psychological capital  was a descriptive statistic. The result showed that Javanese entrepreneurs  had a very high level of psychological capital, while both Chinese and  Minangnese entrepreneurs hold on the same high degree. Meanwhile, the  data analysis regarding the successfulness of business showed that most  of the Javanese entrepreneurs reached a high level of success, Chinese entrepreneurs were average, and Minangnese entrepreneurs were low.
Impact of Corporate Governance on Corporate Sustainable Growth
Authors: Mukherjee Tutun , Sen Som Sankar
Published: July 2019

It is believed that good corporate governance practices assist  significantly in uplifting corporate performance, and brings in business  success and sustainability. This study aims to shed light on the impact  of corporate governance practices on corporate sustainable growth in  India. A sample size of leading 139 non-financial companies listed in  NSE for five years has been used in this study. Using longitudinal data  analysis, the findings of the study suggest that Board Size (BS) and the  Board Independence (B-IND) exercise strong influence in explaining  the Corporate Sustainable Growth in India after controlling the effect  of Leverage (LEV).
Model of Corporate Value Improvement Through Investment Opportunity in Manufacturing Company Sector
Authors: Faozi Imam , Ghoniyah Nunung
Published: July 2019

This study aims to analyze the significance of the direct and indirect effect of  institutional ownership (INST), profitability (ROI), funding policy (DER), and  dividend policy (Tobin’s Q) through investment opportunity (MV/BVE). The  research data used 21 samples of manufacturing companies listed on the  Indonesia Stock Exchange (IDX) during the 2012-2016 period. Data analysis  used path analysis with the help of EViews 9 and Sobel test to know the effect of  investment opportunity as an intervening variable. The interpretation findings  of the first line analysis model show that Profitability directly affects positively  and significantly on Corporate Value. Whereas, based on second-line analysis  model, Funding Policy and Dividend Policy indirectly have significant effects  on Corporate Value through Investment Opportunity variable. Simultaneously,  all independent variables affect 97.45% of Investment Opportunities and  amounted to 97.97% of Corporate Value through Investment Opportunities.