bluuebunny/crossref_metadata_2025 huggingface dataset:
The Gene Master Regulators (GMR) Approach Provides Legitimate Targets for Personalized, Time-Sensitive Cancer Gene Therapy
Authors: Iacobas Sanda , Ede Nneka , Iacobas Dumitru
Published: June 2019

The dynamic and never exactly repeatable tumor transcriptomic profile of people affected by the same form of cancer requires a personalized and time-sensitive approach of the gene therapy. The Gene Master Regulators (GMRs) were defined as genes whose highly controlled expression by the homeostatic mechanisms commands the cell phenotype by modulating major functional pathways through expression correlation with their genes. The Gene Commanding Height (GCH), a measure that combines the expression control and expression correlation with all other genes, is used to establish the gene hierarchy in each cell phenotype. We developed the experimental protocol, the mathematical algorithm and the computer software to identify the GMRs from transcriptomic data in surgically removed tumors, biopsies or blood from cancer patients. The GMR approach is illustrated with applications to our microarray data on human kidney, thyroid and prostate cancer samples, and on thyroid, prostate and blood cancer cell lines. We proved experimentally that each patient has his/her own GMRs, that cancer nuclei and surrounding normal tissue are governed by different GMRs, and that manipulating the expression has larger consequences for genes with higher GCH. Therefore, we launch the hypothesis that silencing the GMR may selectively kill the cancer cells from a tissue.
PENETAPAN KADAR PSEUDOEPHEDRINE HCl, GUAIFENESIN DAN TRIPROLIDINE HCl SECARA SIMULTAN DALAM SEDIAAN SIRUP DENGAN METODE KCKT
Authors: Adriyani Ana , Rifai Yusnita , Yulianty Risfah
Published: June 2019

Dalam rangka mengontrol kualitas dan keamanan obat yang beredar, maka diperlukan metode analisis obat baru. Penelitian ini bertujuan untuk memperoleh metode analisis penetapan kadar campuran triprolidin HCl, pseudoephedrine HCl dan guaifenesin dalam sediaan sirup secara simultan dengan metode KCKT. Kondisi analisis KCKT menggunakan kolom C18. [Waters x bridge (4,6 x 250 mm) 5 μm], pada panjang gelombang 210 nm, kecepatan alir 0,6 ml/menit dengan fase gerak : [methanol : dapar KH2PO4 pH 3,0 (45 : 55)]. Hasil uji presisi (n=10) mempunyai kadar rata-rata dan %RSD untuk pseudoephedrine HCl, guaifenesin dan triprolidine masing masing sebesar 5,86 mg/mL (97,71%) dan 0,44%; 20,19 mg/mL (100,95%) dan 0.37%; 0,26 mg/mL (103,25%) dan 1,02% dari jumlah yang tertera pada etiket. Hasil uji akurasi berdasarkan nilai recovery untuk pseudoephedrine HCl, guaifenesin dan triprolidine mempunyai rentang masing masing 100,74 - 103,67%; 97,03 - 101,33%; 97,03 - 101,73% . Persyaratan recovery yang dapat menjamin hasil uji untuk pseudoephedrine HCl antara 95,0 -105,0% untuk guaifenesine 97,0 – 103,0% dan untuk triprolidin HCl 90,0 - 107,0%. Berdasarkan hasil penelitian ini maka dapat dapat diperoleh metode analisis penetapan kadar pseudoephedrine HCl, guaifenesin dan triprolidine HCl secara simultan dan dapat digunakan sebagai acuan dalam menganalisis sampel.
ANALISIS EFEKTIVITAS TERAPI PADA PASIEN ANEMIA GAGAL GINJAL HEMODIALISIS DI RSUP DR. WAHIDIN SUDIROHUSODO MAKASSAR
Authors: Insani Nurul , Manggau Marianti A. , Kasim Hasyim
Published: June 2019

Penelitian ini bertujuan untuk menganalisis efektivitas terapi anemia penggunaan EPO,PRC pada pasien gagal ginjal hemodialisis berdasarkan outcome terhadap parameter hematologi meliputi kadar RBC,Hgb,Hct,MCV,MCH,MCHC pasien selama rawat inap di RSUP Dr. Wahidin Sudirohusodo Makassar.Desain penelitian yang digunakan adalah penelitian prospektif dengan rancangan deskriptif. Pengambilan sampel dilakukan dengan teknik non-probability sampling dengan cara purposive sampling, yang mencapai jumlah 27 orang sampel. Data yang dianalisis secara deskriptif berupa parameter hematologi. Hasil penelitian menunjukkan terapi EPO efektif meningkatkan kadar RBC,Hgb,Hct dan MCV pada pasien anemia hemodialisis. Terapi PRC efektif meningkatkan kadar RBC,Hgb,Hct pada pasien anemia hemodialisis. Interaksi obat potensial bermakna yang terjadi antara EPO dengan obat lain yaitu antihipertensi golongan angiotensin receptor blocker.
DETEKSI Salmonella enterica serovar Typhimurium DALAM PRODUK PANGAN SIAP SAJI MENGGUNAKAN METODE PCR, MELT CURVE, DAN ANALISIS HRM
Authors: Nurhamidah Sitti , Djide Muhammad Natsir , Arfiansyah Rudi , Nainu Firzan
Published: June 2019

Metode kultur konvensional membutuhkan waktu pengerjaan yang lama, dan sumber daya laboratorium yang besar. Olehnya itu, telah dikembangkan metode berbasis DNA dalam pengujian mikrobiologi. Tujuan penelitian ini adalah untuk menentukan metode yang tepat, dari berbagai metode berbasis DNA, dalam mendeteksi Salmonella enterica serovar Typhimurium pada produk pangan siap saji. Metode yang digunakan dalam penelitian ini adalah PCR, Melt Curve, dan Analisis HRM (High Resolution Melting). Dua gen yang digunakan sebagai target analisis molekuler dalam penelitian ini adalah invA dan fliC. Pengujian dilakukan terhadap tiga jenis sampel pangan siap saji, yaitu olahan daging, olahan unggas, dan salad buah. Hasil penelitian menunjukkan bahwa metode PCR dan Melt Curve dapat mendeteksi Salmonella enterica serovar Typhimurium menggunakan primer yang mengamplifikasi sekuens spesifik pada gen fliC. Walaupun demikian, sensitivitas yang lebih baik ditunjukkan oleh metode real-time PCR dengan nilai LOD 0,5 pg. Lebih lanjut, metode analisis HRM terbukti mampu mendeteksi Salmonella enterica serovar Typhimurium dan membedakannya dari serovar Salmonella yang lain, meskipun menggunakan primer invA yang kurang spesifik.
PENETAPAN KADAR RIBOFLAVIN, PIRIDOKSIN HCl, DAN ASAM FOLAT DALAM SUSU FORMULA BAYI DENGAN KROMATOGRAFI CAIR KINERJA TINGGI (KCKT)
Authors: Pagama Nurmahida , Rifai Yusnita , Aswad Muhammad
Published: June 2019

Susu formula bayi merupakan pengganti air susu ibu yang diproduksi untuk memenuhi kebutuhan gizi bayi selama bulan-bulan pertama kehidupannya hingga pengenalan makanan pelengkap yang sesuai. Riboflavin, piridoksin HCl dan asam folat diekstraksi dari susu formula bayi dengan dapar fosfat pH 4,5 dan asetonitril yang telah diasamkan dengan asam  fosfat. Kondisi kromatografi yang digunakan: kolom Atlantis C18 4.6 x 150 mm 5 µm, fase gerak terdiri dari dapar fosfat pH 4,5 dan campuran asetonitril dengan dapar fosfat pH 4,5 (7:3), menggunakan sistem kromatografi gradien dengan laju alir 0,5 mL/menit. Riboflavin diukur pada panjang gelombang 270 nm, piridoksin HCl 290 nm dan asam folat 280 nm. Dari hasil uji linieritas diperoleh nilai r > 0.999 dan nilai VX0 kurang dari 5% yaitu berkisar antara 2.28-2.79%, dengan rentang konsentrasi larutan standar yaitu 0,05-10,00 µg/mL untuk riboflavin,  piridoksin HCl 0,03-2,00 µg/mL dan asam folat 0,01-2,00 µg/mL. Presisi yang disajikan dalam bentuk relative standard deviation (%RSD) untuk analisa riboflavin, piridoksin HCl dan asam folat berturut-turut adalah: 0,75; 3,60 dan 1,21%. Hasil evaluasi menunjukkan kadar masing-masing 10,95 µg/g untuk riboflavin, 3,97 µg/g untuk piridoksin dan 0.96 µg/g untuk asam folat.  Riboflavin, piridoksin HCl dan asam folat dapat ditetapkan kadarnya secara simultan dengan KCKT detektor UV pada kondisi analisis yang disebutkan.
IDENTIFIKASI SENYAWA MYCOSPORINE-LIKE AMINO ACIDs DARI FRAKSI ETANOL Eucheuma cottonii MENGGUNAKAN SPEKTROFOTOMETER UV
Authors: Reymon Reymon , Lallo Subehan , Manggau Marianti A
Published: June 2019

UV-A merupakan sinar UV yang berpenetrasi paling dalam pada kulit dan dapat menyebabkan kerusakan kulit hingga penuaan dini. Paparan sinar UV-A dalam waktu yang lama dapat menyebabkan kerusakan pada jaringan dermis kulit, pigmentasi dan kanker kulit. Perlindungan kulit terhadap sinar UV-A yaitu dengan menggunakan bahan anti UV-A. Senyawa yang berperan sebagai anti UV-A di alam, salah satunya Mycosporine-like Amino Acids (MAAs). Senyawa ini  terdapat dalam organisme laut seperti cyanobakteri, mikroalga dan makroalga. Eucheuma cottonii merupakan salah satu makroalga merah yang diduga mengandung MAAs. Tujuan dari penelitian ini untuk mengidentifikasi senyawa MAAs  dari fraksi etanol Eucheuma cottonii yang diperoleh dari pantai kepulauan Selayar. Sampel dicuci hingga kadar garamnya berkurang, diliofilisasi menggunakan freeze dryer dan diektraksi dengan maserasi menggunakan pelarut etanol 70%. Ekstrak cair yang diperoleh diuapkan dengan rotavapor hingga didapatkan ekstrak kering. Ekstrak kemudian difraksinasi dan diidentifikasi menggunakan spektrofotometer UV. Fraksi yang diperoleh sebanyak 6 yang kemudian diidentifikasi menggunakan spektrofotmeter UV dan FT IR. Hasil identifikasi menunjukkan jika senyawa yang terdapat pada fraksi 4 dan 6 tidak menunjukkan adanya senyawa MAAs, sedangkan fraksi 1 dan 3 terdapat senyawa pengotor sehingga tidak dapat dipastikan mengandung senyawa MAAs. Fraksi 2 dan 5 menunjukkan kemungkinan adanya senyawa MAAs. Disimpulkan bahwa fraksi etanol 2 dan 5 dari Eucheuma cottonii kemungkinan mengandung senyawa MAAs.
IDENTIFIKASI GENOTIP CTX-M PADA Escherichia coli PENGHASIL EXTENDED SPECTRUM BETA LACTAMASE (ESBL) YANG RESISTEN PADA CEPHALOSPORIN GENERASI III DI RSUP WAHIDIN SUDIROHUSODO MAKASSAR
Authors: Pratama Agus Sangka , Djide M Natsir , Massi M Nasrum
Published: June 2019

Penelitian ini bertujuan untuk mengetahui untuk mendaptkan gambaran tentang prevalensi kejadian Escherichia coli penghasil ESBL yang resisten terhadap cephalosporin generasi III pada pasien RSUP Dr. Wahidin Sudirohusodo Makassar dan prevalensi genotif CTX-M Escherichia coli penghasil ESBL yang resisten terhadap cephalosporin generasi III pada pasien RSUP Dr. Wahidin Sudirohusodo Makassar. Penelitian dilaksanakan diruang perawatab rawat inap, ruang ICU, ruang HCU, ruang PICU, ruang IGD anak, Infection Center, laboratorium patologi klinik RSUP Dr. Wahidin Sudirohusodo dan laboratorium mikrobiologi klinik RSP Universitas Hasanuddin Makassar periode Juni 2018 – Agustus 2018. Penelitian ini menggunakan desain eksperimental laboratorium dengan teknik pengambilan sampel secara consecutive sampling. Bakteri Escherichia coli diisolasi dari 50 pasien. Pengujian dilakukan meliputi uji sensitivitas antibiotika dengan mengunakan metode difusi agar Kirby-bauer dan vitek 2 compact, uji deteksi ESBL dengan metode Double Disc Synergy Test (DDST), Phenotypic Confirmatory Test dan Uji genotip CTX-M Polymerase Chain Reaction (PCR). Hasil penelitian menunjukkan uji sensitivitas antibiotika pada 50 sampel klinik (Urin, Sputum, Darah, Feses, Pus dan Jaringan) yang diuji terhadap antibiotika golongan sefalosporin generasi III yang telah mengalami resistensi sebesar 40 isolat (80%) baik pada Ceftriaxone, Cefotaxime dan Ceftazidine. Pada uji fenotip dengan metode DDST dan Vitek 2 compact ditemukan 40 sampel (80%) positif ESBL pada Antibiotika Cefotaxime+As.Klavulanat (30 ųg/10 ųg ) maupun Ceftazidine+As.Klavulanat (30 ųg/10 ųg ). Pada uji genotip CTX-M di temukan 41 sampel (82%) memiliki gen CTX-M penghasil ESBL
ANALISIS EFEKTIVITAS DAN EFEK SAMPING PENGGUNAAN ANTIHIPERTENSI PADA PASIEN GAGAL GINJAL KRONIK RAWAT INAP DI RSUP Dr. WAHIDIN SUDIROHUSODO
Authors: Paranoan Restuyani , Manggau Marianti A , Kasim Hasyim , Djide M Natsir , Lallo Subehan , Djabir Yulia Yusrini
Published: June 2019

Sebagian besar pasien penyakit ginjal stadium akhir (ESRD) yang menyebabkan hemodialisis, dapat mengalami hipertensi. Penelitian ini bertujuan untuk menganalisis efektivitas dan efek samping penggunaan antihipertensi  amlodipin tunggal dan kombinasi amlodipin dengan telmisartan,  dan kombinasi  amlodipin dengan Valsartan  pada pasien gagal ginjal kronik selama rawat inap di RSUP Dr. Wahidin Sudirohusodo Makassar. Penelitian ini dilaksanakan di ruangan rekam medik RSUP Wahidin Sudirohusodo  selama periode September sampai oktober 2018. penelitian ini merupakan  penelitian observasional noneksperimental. pengambilan data dilakukan secara retrospektif. pengambilan data berdasarkan rekam medik pasien gagal ginjal kronik  (ESRD) yang mendapat  terapi obat antihipertensi amlodipin tunggal, amlodipin kombinasi telmisartan, amlodipin kombinasi valsartan periode Januari sampai Agustus 2018. Dari hasil penelitian dengan melihat persen penurunan dan waktu penurunan tekanan darah pasien dan efek samping  maka dapat disimpulkan bahwa Kombinasi amlodipin dan telmisartan paling efektif di antara amlodipin tunggal dan amlodipin  kombinasi valsartan dalam menurunkan hipertensi pada pasien gagal ginjal kronik . Efek samping yang ditimbulkan dari kelompok amlodipin  dalah adalah  udem  sebanyak  7,14%, efek samping yang ditimbulkan dari kelompok amlodipin kombinasi Telmisartan adalah hiperkalemia sebanyak 14,28 %, dan efek samping yang ditimbulkan oleh kelompok amlodipin kombinasi valsartan adalah pusing  sebanyak 14, 28 %
PENGARUH PENGGUNAAN SEDIAAN FIXED DOSE COMBINATION (FDC) DIBANDINGKAN DENGAN TABLET LEPAS OBAT ANTI-TUBERKULOSIS TERHADAP PENINGKATAN NILAI SGPT DAN SGOT PADA PASIEN TUBERKULOSIS DI BALAI BESAR KESEHATAN PARU MASYARAKAT MAKASSAR
Authors: Munawarah Munawarah , Djide M Natsir , Santoso Arif , Wahyudin Elly , Sartini Sartini , Djabir Yulia Yusrini
Published: June 2019

Penelitian ini bertujuan untuk menganalisis pengaruh pemberian terapi Fixed Dose Combinaton (FDC) dibandingkan dengan tablet lepas Obat Anti Tuberkulosis (OAT) terhadap resiko terjadinya Drug Induced Hepatotoxicity (DIH) yang ditandai dengan peningkatan nilai SGPT dan SGOT pada penderita Tuberkulosis. Desain penelitian yang digunakan adalah penelitian observasional non eksperimen dengan rancangan deskriptif-analitik. Pengambilan sampel dilakukan dengan teknik non-probability sampling dengan cara consecutive sampling. Jumlah sampel 30 pasien, terdiri dari kelompok FDC dan kelompok tablet lepas jumlah masing-masing 17 dan 13 sampel. Dianalisis dengan uji statistik metode Mann-Whitney U. Hasil penelitian menunjukkan bahwa selisih nilai SGPT dan SGOT antara kelompok FDC dan kelompok tablet lepas menunjukkan perbedaan yang signifikan (p>0,05).
The US Census and the People’s Health: Public Health Engagement From Enslavement and “Indians Not Taxed” to Census Tracts and Health Equity (1790–2018)
Authors: Krieger Nancy
Published: June 2019

Public health professionals have long played a vital—albeit underappreciated—role in shaping, not simply using, US Census data, so as to provide the factual evidence required for good governance and health equity. Since its advent in 1790, the US Census has constituted a key political instrument, given the novel mandate of the US Constitution to allocate political representation via a national decennial census. US Census approaches to categorizing and enumerating people and places have profound implications for every branch and level of government and the resources and representation accorded across and within US states. Using a health equity lens to consider how public health has featured in each generation’s political battles waged over and with census data, this essay considers three illustrations of public health’s engagement with the enduring ramifications of three foundational elements of the US Census: its treatment of slavery, Indigenous populations, and the politics of place. This history underscores how public health has major stakes in the values and vision for governance that produces and uses census data.
Implementation of a Rooftop Farm Integrated With a Teaching Kitchen and Preventive Food Pantry in a Hospital Setting
Authors: Musicus Aviva A. , Vercammen Kelsey A. , Fulay Aarohee P. , Moran Alyssa J. , Burg Tracey , Allen Lindsay , Maffeo David , Berger Andi , Rimm Eric B.
Published: June 2019

Safety-net hospitals serving populations with disproportionately high levels of poverty, food insecurity, and chronic disease can utilize innovative strategies to improve the health and environment of their communities. Boston Medical Center in Boston, Massachusetts, constructed an on-site rooftop farm to provide fresh produce for the hospital’s preventive food pantry, teaching kitchen, cafeterias, and inpatient meal services. This novel model can be replicated by other organizations aiming to alleviate food insecurity, encourage healthy eating, and promote environmental sustainability.
Orthopaedic Faculty and Resident Sex Diversity Are Associated with the Orthopaedic Residency Application Rate of Female Medical Students
Authors: Okike Kanu , Phillips Donna P. , Swart Eric , O’Connor Mary I.
Published: June 2019

Background:

The representation of women in orthopaedics in the United States remains among the lowest in all fields of medicine, and prior research has suggested that this underrepresentation may stem from lower levels of interest among female medical students. Of the many proposed reasons for this lack of interest, the male-dominated nature of the field is one of the most commonly cited. The purpose of this study was to determine the degree to which the representation of women among orthopaedic faculty and residents influences female medical students at that institution to apply for a residency in orthopaedics.

Methods:

Using data provided by the Association of American Medical Colleges, we identified all U.S. medical schools that were affiliated with an orthopaedic surgery department and an orthopaedic surgery residency program (n = 107). For each institution, data on the representation of women among the orthopaedic faculty and residents from 2014 through 2016 were collected, as well as data on the proportion of female medical school graduates who applied to an orthopaedic residency program from 2015 through 2017. The association between institutional factors and the female medical student orthopaedic application rate was assessed.

Results:

Of 22,707 women who graduated from medical school during the 3-year study period, 449 (1.98%) applied to an orthopaedic surgery residency program. Women who attended medical school at institutions with high orthopaedic faculty sex diversity were more likely to apply for a residency in orthopaedics (odds ratio [OR], 1.30; 95% confidence interval [CI], 1.04 to 1.64; p = 0.023), as were women who attended medical school at institutions with high orthopaedic resident sex diversity (OR, 1.30; 95% CI, 1.05 to 1.61; p = 0.019).

Conclusions:

In this study, we found that increased sex diversity among orthopaedic faculty and residents was associated with a greater likelihood that female medical students at that institution would apply for an orthopaedic residency. These results suggest that at least some of the factors currently impeding female medical student interest in orthopaedics may be modifiable. These findings may have important implications for efforts to improve the sex diversity of the field of orthopaedics going forward.
Risk Factors for Failure After 1-Stage Exchange Total Knee Arthroplasty in the Management of Periprosthetic Joint Infection
Authors: Citak Mustafa , Friedenstab Jasmin , Abdelaziz Hussein , Suero Eduardo M. , Zahar Akos , Salber Jochen , Gehrke Thorsten
Published: June 2019

Background:

One-stage exchange arthroplasty in the management of periprosthetic joint infection was introduced at our institution. The purpose of this study was to analyze the risk factors of failure after periprosthetic joint infection following total knee arthroplasty treated with 1-stage exchange.

Methods:

Ninety-one patients who underwent failed treatment following 1-stage exchange total knee arthroplasty due to periprosthetic joint infection from January 2008 to December 2017 were included. From the same period, we randomly selected a 1:1 matched control group without a subsequent revision surgical procedure. Bivariate analyses, including preoperative, intraoperative, and postoperative factors, as well as logistic regression, were performed to identify risk factors for failure.

Results:

Bivariate analysis yielded 10 predictors (variables with significance at p < 0.05) for failure involving re-revision for any reason and 11 predictors for failure involving re-revision for reinfection. The binary logistic regression model revealed the following risk factors for re-revision for any reason: history of a 1-stage exchange for infection (odds ratio [OR], 26.706 [95% confidence interval (CI), 5.770 to 123.606]; p < 0.001), history of a 2-stage exchange (OR, 3.948 [95% CI, 1.869 to 8.339]; p < 0.001), and isolation of enterococci (OR, 16.925 [95% CI, 2.033 to 140.872]; p = 0.009). The risk factors for reinfection in the binary logistic regression analysis were history of 1-stage or 2-stage exchange arthroplasty, isolation of enterococci, and isolation of streptococci (OR, 6.025 [95% CI, 1.470 to 24.701]; p = 0.013).

Conclusions:

We identified several risk factors of failure after 1-stage exchange arthroplasty for periprosthetic joint infection, most of which were not related to the patient comorbidities. Among them, previous exchange due to periprosthetic joint infection and the isolation of Enterococcus or Streptococcus species were associated with a higher risk of failure. Besides a multidisciplinary approach, being aware of the identified risk factors when evaluating patients with periprosthetic joint infection could lead to better outcomes.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
EMTALA (Emergency Medical Treatment and Active Labor Act) Obligations
Authors: Zhou Joanne Y. , Amanatullah Derek F. , Frick Steven L.
Published: June 2019

Background:

The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted in 1986 in the United States to address “patient dumping,” or refusing to provide emergency care to patients and instead transferring them to other hospitals. Under EMTALA, the “reverse-dumping” provision prevents hospitals from refusing patients who require specialized capabilities or facilities if the hospital has the capacity to treat them. Despite this provision, patients continue to be transferred to distant tertiary care centers.

Methods:

We reviewed the literature on EMTALA in the context of a critically ill woman with an infection associated with an orthopaedic implant who was rejected from 2 geographically closer tertiary care centers and was ultimately transferred by helicopter ambulance to an academic teaching hospital that was 169 miles away from her home.

Results:

After transfer to our tertiary care, level-I trauma center, the patient spent 61 days in the intensive care unit; she required 9 operative procedures, which totaled 1,520 minutes of operative time. Eighteen medical specialties and 8 ancillary medical consulting teams were involved in her care. She underwent 1,436 laboratory and 83 radiographic studies. The total reimbursement from Medi-Cal (California’s Medicaid program) for her care in our tertiary care center was $463,753; the hospital charges were more than tenfold higher.

Conclusions:

Dumping and reverse dumping continue despite compromise of patient care and the high financial burden of the accepting institutions. This may be due to ineffective monitoring and enforcement, lack of uniformity among the courts, and lack of incentive to receive uninsured or poorly funded patients. Under EMTALA, it is difficult for tertiary care centers to argue lack of specialized capabilities or capacity to accept patients, and neither hospitals nor physicians are compensated for the charges of providing care to uninsured or underinsured patients. Moving forward, efforts to better align financial incentives through cost-sharing between community hospitals and tertiary care centers, increased clinician literacy regarding the provisions of EMTALA, and increased transparency with hospital transfers may help improve EMTALA compliance and patient care.
At a 10-Year Follow-up, Tendon Repair Is Superior to Physiotherapy in the Treatment of Small and Medium-Sized Rotator Cuff Tears
Authors: Moosmayer Stefan , Lund Gerty , Seljom Unni S. , Haldorsen Benjamin , Svege Ida C. , Hennig Toril , Pripp Are H. , Smith Hans-Jørgen
Published: June 2019

Background:

Tendon repair and physiotherapy are frequently used treatment methods for small and medium-sized rotator cuff tears. In 2 previous publications of the 1 and 5-year results of this study, we reported significant but small between-group differences in favor of tendon repair. Long-term results are needed to assess whether the results in both groups remain stable over time.

Methods:

In this study, 103 patients with a rotator cuff tear not exceeding 3 cm were randomly assigned to primary tendon repair or physiotherapy with optional secondary repair. Blinded follow-up was performed after 6 months and 1, 2, 5, and 10 years. Outcome measures included the Constant score; the self-report section of the American Shoulder and Elbow Surgeons score; the measurement of shoulder pain, motion, and strength; and patient satisfaction. Magnetic resonance imaging (MRI) was performed on surgically treated shoulders after 1 year, and ultrasound was performed on all shoulders after 5 and 10 years. The main analysis was by 1-way analysis of covariance and by intention to treat.

Results:

Ninety-one of 103 patients attended the last follow-up. After 10 years, the results were better for primary tendon repair, by 9.6 points on the Constant score (p = 0.002), 15.7 points on the American Shoulder and Elbow Surgeons score (p < 0.001), 1.8 cm on a 10-cm visual analog scale for pain (p < 0.001), 19.6° for pain-free abduction (p = 0.007), and 14.3° for pain-free flexion (p = 0.01). Fourteen patients had crossed over from physiotherapy to secondary surgery and had an outcome on the Constant score that was 10.0 points inferior compared with that of the primary tendon repair group (p = 0.03).

Conclusions:

At 10 years, the differences in outcome between primary tendon repair and physiotherapy for small and medium-sized rotator cuff tears had increased, with better results for primary tendon repair.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Mendeteksi Kondisi Organ Liver Melalui Citra Iris Menggunakan Teknik Pengolahan Citra Digital
Authors: Saktiono Maxima Ari
Published: June 2019

Besides Physical test normally, early detection on the condition of the body by using the image processing of iris is an alternative method to observe the health of human’s body, especially the internal organ of the body. This paper uses Dr. Bernard Jensen’s chart of iris as reference, in which part and how deep is the damage happens in the tissue of iris. Organ disorder is represented by the form of broken tissue of iris. The broken tissue usually seems to be like a hole in certain area in the iris. In this paper, the instrumentation for data mining uses video camera and the software that will be developed uses Visual Basic on image processing programming. In the image of eye, the region of interest is only on the iris, and it will be grabbed by using circle and line equations.The area of Liver organ lies on 07.15 – 07.45 in the third Quadran. After wards, this slice of image is prepared for image processing system. The method that is going to be used in this paper is grey level, enhancing and sobel operator. Then, the output of the system will be compared with physical test to measure the precision on detecting the problem on Liver organ.
ECONOMICS AND CULTURE
Authors: Jaya Aziz Iwan
Published: June 2019

The notion that something that cannot be measured does not exist seems to apply to the absence of consideration of culture in economics, where the role of institutions is at the center of the link between the two. Yet, economic prosperity, crisis, and deprivation result from human behavior, reflecting the outcome of social learning—a central concept of culture. Institutions and culture interact and evolve in complementary ways. Each can affect the process of exchange and transaction costs, which in turn determine economic performance. Although more work has been done to better understand the interrelation between economics and culture, most falls on deaf ears among mainstream economists, despite the fact that real-world cases show the critical role of this interrelation. This paper demonstrates a deficiency of mainstream economics in its disregard of the role of culture and institutions.
Teen-Computer Interaction: Building a Conceptual Model with Thoughts- Emotion-Behaviour
Authors: Et al. Omar
Published: June 2019

Teen-Computer Interaction (TeenCI) stands in an infant phase and emerging in positive path. Compared to Human-Computer Interaction (generally dedicated to adult) and Child-Computer Interaction, TeenCI gets less interest in terms of research efforts and publications. This has revealed extensive prospects for researchers to explore and contribute in the region of computer design and evaluation for teen, in specific. As a subclass of HCI and a complementary for CCI, TeenCI that tolerates teen group, should be taken significant concern in the sense of its context, nature, development, characteristics and architecture. This paper tends to discover teen’s emotion contribution as the first attempt towards building a conceptual model for TeenCI. Informal and in-person interview were conducted with two experts and a series of focus group discussion with 30 teens have also been conducted to gain their valuable insights. Interestingly, the findings suggest and lead us to considering the theory of psychosocial development towards a holistic model of TeenCI that considers not only emotion but three identifying keys – thoughts-emotion-behaviour. We justify that there is a strong connection between cognition and emotion that influences teen’s behaviour, which would be an important input to be included in TeenCI-related design and development.
An Analysis on the Applicability of Meta-Heuristic Searching Techniques for Automated Test Data Generation in Automatic Programming Assessment
Authors: Et al. Musa
Published: June 2019

Automatic Programming Assessment (APA) has been gaining lots of attention among researchers mainly to support automated grading and marking of students’ programming assignments or exercises systematically. APA is commonly identified as a method that can enhance accuracy, efficiency and consistency as well as providing instant feedback on students’ programming solutions. In achieving APA, test data generation process is very important so as to perform a dynamic testing on students’ assignment. In software testing field, many researches that focus on test data generation have demonstrated the successful of adoption of Meta-Heuristic Search Techniques (MHST) so as to enhance the procedure of deriving adequate test data for efficient testing. Nonetheless, thus far the researches on APA have not yet usefully exploited the techniques accordingly to include a better quality program testing coverage. Therefore, this study has conducted a comparative evaluation to identify any applicable MHST to support efficient Automated Test Data Generation (ATDG) in executing a dynamic-functional testing in APA. Several recent MHST are included in the comparative evaluation combining both the local and global search algorithms ranging from the year of 2000 until 2018. Result of this study suggests that the hybridization of Cuckoo Search with Tabu Search and lévy flight as one of promising MHST to be applied, as it’s outperforms other MHST with regards to number of iterations and range of inputs.
Analysis and Development of Customer Billing Telephony System
Authors: Et al. Raziera
Published: June 2019

The telecommunications industry has gone through series of development efforts to provide quality services to their consumers. Generally, telecommunication industry provides two main services such as telephony and internet which involved customer registration, billing and payment. However, the challenge confronting telecommunications industry is to meet the customer satisfaction in the billing system such as accuracy, easy to understand and unambiguous billing issue. In order to develop Customer Billing Telephony System,a user experience study is conducted to gather the user requirements. Hence, the CBTS was developed that takes into consideration user’s value experience that provides a support for managing and monitoring billing process. Then the CBTS was evaluated by the users using User Experience Questionnaire (UEQ) to prove the efficiency and correctness in billing process. The result shown that the users give the positive feedback of the CBTS.
The National External Quality Assessment Scheme for Diagnostic Medical Parasitology in the Philippines, 2009–2015
Authors: Galit Sherwin , Tangcalagan Dave , Rapanut Julius Matt , Sadiasa Alexander , Bautista Prince Ninja , Dominguez Kim Joshua , Bañaga Jahra , Roxas Celine Bernice , Navarro Rafael , Bugayong Mark Philip , Luchavez Jennifer , Mondoy Melisa , Sombrero Lydia , Lupisan Socorro
Published: June 2019

OBJECTIVE             The Research Institute for Tropical Medicine (RITM)–National Reference Laboratory (NRL) for Malaria and Other Parasites, mandated by the Department of Health–Philippines (DOH), administers an annual Proficiency Test (PT) in diagnostic medical parasitology to clinical laboratories throughout the Philippines through the National External Quality Assessment Scheme (NEQAS). The PT in Parasitology aims to monitor and evaluate the capability of Philippine laboratories in the identification of blood and intestinal parasites, and the estimation of malaria parasite density in malaria-infected blood films. As of 2018, participation in the NEQAS is an annual requirement by the Department of Health–Health Facilities and Services Regulatory Bureau (DOH-HFSRB) for each clinical laboratory to obtain a license to operate. This report aims to summarize the results of the PT for Parasitology and assess the performance of participating laboratories in malaria and fecal parasite microscopy from 2009 to 2015. METHODOLOGY             RITM–NRL oriented clinical laboratories in the NEQAS in 2008. Laboratories submitted their accomplished enrolment forms to RITM–NRL and paid fees to enroll in the PT in 2009 to 2015. Participating laboratories identified the species of malaria in blood films and the parasite/s in formalin-preserved fecal specimens. Estimation of parasite density in malaria blood films was performed as well. RESULTS             One thousand five hundred forty laboratories participated in 2009 to 2015. Mean and median scores in all seven years were below the cut-off score of 80. Schistosoma japonicum was the most difficult to identify with  only 7.7% of laboratories having correct identification result.  Majority of participants in 2010 to 2014 gave malaria parasite density estimates outside the acceptable range. CONCLUSION             Microscopy requires skill that is honed through training and refresher courses in order to enhance and maintain the quality of performance of laboratorians in diagnostic parasitology.
Wire-Free Virtual Breast Localization Using Liquid Carbon Nanoparticles
Authors: Buenaflor Ma. Theresa , Quimbo Ricardo Victorio , San Agustin Norman Val
Published: June 2019

The emergence of improved multi-modal diagnostics including functional imaging has enabled the diagnosis of more nonpalpable breast lesions. Lesions diagnosed as early unifocal breast cancers are amenable to breast-conserving surgery (BCS). The precise localization of these lesions is a caveat to its complete removal along with sufficient surgical margins and the preservation of normal breast tissues.Carbon marking is an alternative to needle wire localization that is easy to perform and simplifies the workflow of the multidisciplinary team involved in breast cancer care.
Ethylene signaling transcription factor promote grape growth induced by exogenous carbon
Authors: Zhao Xin , Wang Ying , Li Wen-Fang , Li Meng-Fei , Ma Zong-Huan , Dawuda Mujitaba , Zuo Cun-Wu , Chu Ming-Yu , Chen Bai-Hong , Mao Juan
Published: June 2019

Background

The carbon can be converted into sugar which is not only important for plant growth and development, but also for plant signal transduction, especially in plant hormone response. The objective of this work was to build available genomic and proteomic resource to investigate the molecular mechanisms of exogenous carbon regulating plant growth and development.

Results

Grape (Vitis vinifera L. cv. ‘Pinot Noir’) plantlets cultured with exogenous carbon (2% sucrose, 1000 μmol·mol-1 CO2 and with both 2% sucrose and 1000 μmol·mol-1 CO2 were designated as S1, C0 and Cs, respectively). We used S0 (without sucrose, ambient CO2) as CK to analyze the differential expression genes and proteins induced by exogenous carbon. Through the transcriptomic and proteomic analysis, with pooled data for Cs, C0 and S1 compared with CK, 70 differentially expressed genes (DEGs) and 65 differentially expressed proteins (DEPs) were identified. Based on biological functions and physiological characteristics, we identified 8 DEGs and 2 DEPs related to ethylene signaling process. Amongst the DEGs we focussed on ERF TFs, including ERF5 (LOC100244353, LOC100247763, LOC100254616 and LOC100261260), ERF105 (LOC100249507 and LOC100259725), ERF2 (LOC100254640) and CTr (CTr7). Also, there were 2 DEPs related to ethylene metabolism, such as S-adenosylmethionine synthase 5 (SAM synthase 5; XP_002280106.1) and 1-aminocyclopropane-1-carboxylic acid oxidase 2 (ACC oxidase 2; NP_001267871.1) were also identified. The transcriptome and proteome results suggested that exogenous carbon inhibits ethylene biosynthesis through ACC oxidase 2. Additionally, CTr7 and ERF5, which were up-regulated, are related to the ethylene signaling pathway. We speculate that exogenous carbon regulates plant growth through ethylene signaling pathways, but which inhibit ethylene biosynthesis.

Conclusions

Exogenous carbon regulates the expression of ethylene biosynthesis and signaling related genes, which may improve plant growth through the ethylene signaling pathway.
The precursor for nerve growth factor (proNGF) is not a serum or biopsy-rinse biomarker for thyroid cancer diagnosis
Authors: Rowe Christopher W , Faulkner Sam , Paul Jonathan W , Tolosa Jorge M , Gedye Craig , Bendinelli Cino , Wynne Katie , McGrath Shaun , Attia John , Smith Roger , Hondermarck Hubert
Published: June 2019

Background: Nerves and neurotrophic growth factors are emerging promoters of cancer growth. The precursor for Nerve Growth Factor (proNGF) is overexpressed in thyroid cancer, but its potential role as a clinical biomarker has not been reported. Here we have examined the value of proNGF as a serum and biopsy-rinse biomarker for thyroid cancer diagnosis.
Methods: Patients presenting for thyroid surgery or biopsy were enrolled in separate cohorts examining serum (n=204, including 46 cases of thyroid cancer) and biopsy-rinse specimens (n=188, including 26 cases of thyroid cancer). ProNGF levels in clinical samples were analysed by ELISA. Multivariate statistical analyses testing for potential confounders were used to compare proNGF levels with clinicopathological parameters.
Results: ProNGF was not detected in the majority of serum samples 176/204 (86%) and the detection of proNGF was not associated with thyroid cancer diagnosis. In the few cases where proNGF was detected in the serum, thyroidectomy did not affect proNGF concentration, demonstrating that the thyroid was not the source of serum proNGF. Intringuingly, an association between hyperthyroidism and serum proNGF was observed (OR 3.3, 95%CI 1.6-8.7 p=0.02). In biopsy-rinse, proNGF was detected in 73/188 (39%) cases, with no association between proNGF and thyroid cancer. However, a significant positive association between follicular lesions and biopsy-rinse proNGF was found (OR 3.3, 95% CI 1.2-8.7, p=0.02).
Conclusions: ProNGF levels in serum and biopsy-rinse are not increased in thyroid cancer and therefore proNGF is not a clinical biomarker for this condition.
Renal involvement as the first symptom of multiple myeloma
Authors: Du Yongjing , Zhang Ping , Zhong Xiang , Chen Shasha , Li Guisen , Wang Li , Wang Wei
Published: June 2019

Background

Renal involvement is a common complication of multiple myeloma (MM). However, most studies have focused on renal failure in MM, and little information is available about the other renal manifestations in MM and their association with immunophenotypes and renal pathology.

Methods

We retrospectively analyzed the clinical, laboratory and pathology data of 283 MM patients treated in Sichuan Provincial People’s Hospital, West China, between January 1990 and May 2017. The patients were divided into a renal involvement group (n = 200) and a non-renal involvement group (n = 83).

Results

In the renal involvement group, 90 (45.0%) patients were diagnosed with MM in the Nephrology department, and isolated proteinuria, renal failure and nephrotic syndrome were detected in 90(45.0%), 94 (47.0%) and 53 (27.0%) patients, respectively. 135 patients with renal involvement underwent immunofixation electrophoresis, and IgG, IgA, IgD, IgE, pure light chain and nonsecretory MM were detected in 52 (38.5%), 32 (23.7%), 1 (0.7%), 1 (0.7%), 45(33.3%) and 4 (3.0%) patients, respectively. 47 patients without renal involvement also underwent immunofixation electrophoresis, and IgG and IgA MM were found in 24 (51.0%) and 18 (38.3%) patients, respectively. Severe anemia and hypertension, hypercalcemia and pure light chain disease were more frequent in patients with renal involvement (P < 0.05). 9 patients with renal involvement were performed renal biopsy, and cast nephropathy and renal amyloidosis were proved in 5(55.6%) and 4(44.4%) patients, respectively.

Conclusions

Renal involvement was common at MM diagnosis and had diverse clinical manifestations. Nephrologists should rule out MM in patients presenting with renal involvement.
Monitoring of serum TWEAK levels guides glucocorticoid dosages in the treatment of systemic lupus erythematosus
Authors: Chen Jingyun , Wang Huixia , Wu Yi , Wu Xiaokang , Wang Li , Xiao Tong , Tan Fei , Luo Mai , Xiao Shengxiang , Xia Yumin
Published: June 2019

Background

Accurate assessment of systemic lupus erythematosus (SLE) disease activity is critical. Currently existing indices or measures for assessment are either expensive, intricate, or inaccurate. The novel indices with higher sensitivity and specificity have become one of the aims of the investigators. This study was designed to explore the relationship between serum tumor necrosis factor-like weak inducer of apoptosis (TWEAK) and systemic lupus erythematosus disease activity index (SLEDAI) as well as its role in guiding glucocorticoid dosages in the treatment of SLE. Of 59 patients with SLE, 20 patients with subacute cutaneous lupus erythematosus (SCLE), 13 patients with discoid lupus erythematosus (DLE) and 32 healthy volunteers, soluble TWEAK level was determined in both serum and urine. Monomeric C-reactive protein, antinuclear antibody, interleukin 6, complements, erythrocyte sedimentation rate, and white blood cells were measured in serum samples. Moreover, SLEDAI-2K was used for evaluating the disease. Finally, methylprednisolone was administrated orally to SLE patients with the doses depending on serum TWEAK levels.

Results

We found that serum TWEAK levels are higher in patients with SLE (383.0 ± 45.37 ng/ml, p < 0.001 for both) or SCLE (129.1 ± 25.73 ng/ml, p < 0.05 for both) than in patients with DLE (78.38 ± 22.85 ng/ml) or in healthy controls (78.38 ± 22.85 ng/ml). Also, serum TWEAK levels correlate positively with SLEDAI-2K in patients with SLE (r2 = 0.101, p < 0.001), whereas urine TWEAK levels reflect renal damage in patients with lupus nephritis. Moreover, serum TWEAK levels had a higher correlation coefficient with SLEDAI-2K scores compared with the other serum parameters. Furthermore, TWEAK-based glucocorticoid therapy is associated with lower SLEDAI-2K scores and fewer flares in patients with SLE.

Conclusions

Serum TWEAK is a useful biomarker reflecting SLE disease, and monitoring of serum TWEAK levels can improve the outcomes of glucocorticoid therapy for patients with SLE.
Prognostic Value of Pretreatment Inflammatory Biomarkers in Primary Small Cell Carcinoma of the Esophagus
Authors: Wang Nan , Li Xue , Luo Hui , Sun Yanan , Zheng Xiaoli , Fan Chengcheng , Wang Hao , Ye Ke , Ge Hong
Published: June 2019

Background: Growing evidence indicates that several inflammatory biomarkers may predict survival in patients with malignant tumors. The aim of this study is to evaluate the prognostic value of pretreatment biomarkers in patients with primary small-cell carcinoma of the esophagus（PSCCE）.
Methods: There were 73 PSCCE patients enrolled between January 2009 and December 2017 at the Affiliated Cancer Hospital of Zhengzhou University. The total lymphocyte counts (TLC), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) prior to anticancer therapy were collected as inflammation biomarkers. The cut-off value was determined by Receiver operating characteristic (ROC). The Kaplan–Meier method was utilized to analysis overall survival (OS). Cox proportional hazards regression was used to identify univariate and multivariate prognostic factors.
Results: Univariate analysis showed that high NLR group(hazard ratio (HR) ＝1.685; 95% CI: 1.001–2.838; P＝0.047) and high PLR group (hazard ratio (HR) ＝1.716; 95% CI: 1.039–2.834; P＝0.033) were associated with poor OS, and TLC was not correlated with OS. On multivariate analysis, high PLR(hazard ratio (HR) ＝1.751; 95% CI: 1.042–2.945; P＝0.035) was an independent prognostic factor of unfavorable OS.
Conclusions: Pre-treatment PLR and NLR are correlated with OS. These biomarkers are easily accessible, cost effective, and can serve as a marker to identify high-risk patients for further designing personalized treatment and predicting treatment outcomes.
Down-regulation of NAMPT expression by miR-154 reduces the viability of breast cancer cells and increases their susceptibility to doxorubicin
Authors: Bolandghamtpour Zahra , Nourbakhsh Mitra , Mousavizadeh Kazem , Madjd Zahra , Ghorbanhosseini Seyedeh Sara , Abdolvahabi Zohreh , Hesari Zahra , Ezzati Samira
Published: June 2019

Background
Nicotinamide phosphoribosyltransferase (NAMPT) acts as an important enzyme in the salvage pathway of nicotinamide adenine dinucleotide (NAD) biosynthesis. Deregulation of NAD could be associated with progression of many cancers including breast cancer. Here, we evaluated the effect of NAMPT inhibition via miR-154 on survival of breast cancer cells.
Methods
Breast cancer cell lines including MCF-7 and MDA-MB-231 were transfected with miR-154 mimic, inhibitor and their negative controls. Using real-time PCR and western blotting techniques the expression levels of NAMPT and miR-154 were determined and compared with the untreated cells. NAD levels were measured by an enzymatic method. Subsequently, colorimetric methods and flow cytometry were performed to evaluate cell viability and apoptosis. Bioinformatics analyses were performed to investigate whether NAMPT 3′-UTR is a direct target of miR-154 and the findings were confirmed by luciferase reporter assay.
Results
According to the obtained results, NAMPT 3′-UTR was identified as a direct target of miR-154 and the levels of this miRNA was inversely associated with NAMPT expression both at mRNA and protein levels in breast cancer cell lines. Functionally, miR-154 inhibited the NAD salvage pathway leading to a remarkable decrease in cell survival and induction of apoptosis. Co-treatment of breast cancer cells with doxorubicin and miR-154 mimic significantly reduced cell viability compared to treatment with doxorubicin alone in both cell lines.
Conclusions
Hence, it was concluded that the inhibition of NAD production by miR-154 might be introduced as a promising therapeutic strategy for the treatment of breast cancer either alone or in combination with other conventional chemotherapeutic agents.