bluuebunny/crossref_metadata_2025 huggingface dataset:
The Correlation between icaA and icaD Genes with Biofilm Formation Staphylococcus epidermidis In Vitro
Authors: Rachmawati Dian , Kuntaman Kuntaman , Alimsardjono Lindawati
Published: February 2020

This study was conducted to identify the presence of icaA and icaD genes in S. epidermidis and to analyze the relationship between the presence of icaA and icaD genes with the ability of in vitro biofilm formation in S. epidermidis. S. epidermidis isolates from patients and healthy people were collected and PCR was examined to detect icaA and icaD genes. which then continued to examine the ability of biofilm formation by the method of Congo Red Agar. The results of this genotypic and phenotypic examination were then tested for correlation with statistical tests using SPSS 23.0. A total of 40 S. epidermidis isolates were collected, consisting of 20 clinical isolates and 20 isolates of normal flora. The icaA gene was positive in 5 isolates (12.5%), and 8 isolates (20%) were positive for the icaD gene, 3 isolates with icaA and icaD were both positive. One hundred percent of isolates with icaA or icaD positively formed biofilms, but there were 15 isolates (42.9%) who did not have the icaA gene but showed the ability to form biofilms, while 12 isolates (37.5%) who did not have the icaD gene also formed biofilms. Fifty percent of S. epidermidis isolates showed the ability to form biofilms at CRA. The Fisher Exact test showed a significant relationship between the icaA gene and the ability of biofilm formation (p=0.047 (p<0.05)) as well as the icaD gene (p=0.03 (p<0.05)). The icaA and icaD genes have a significant relationship to biofilm formation in S. epidermidis. There was another mechanism in the formation of biofilms that are not dependent on the ica gene.
Effect of Glutamine Supplement Administration on the Reduction of Muscular Fatigue Post-Eccentric Exercise
Authors: Rusdiawan Afif , Taufikkurrachman Taufikkurrachman
Published: February 2020

Eccentric activity can cause pain due to muscle damage and fatigue. Tired and damaged muscular state will degrade athletes' performance during a competition. Glutamine supplements are known to maintain plasma protein levels and can also improve muscle weakness due to inflammation that occurs after eccentric activity. The purpose of this study was to prove the effect of glutamine supplementation on the reduction of muscle fatigue after eccentric activity based on muscle strength and joint ROM. The subjects of this study were students of PJKR, IKIP Budi Utomo, who were randomly divided into 2 groups, the control group (K1) and treatment group (K2), each consisting of 22 respondents. The design of this research is randomized grsoup pre-test and post-test design. The eccentric activity performed was drop jumps on the bench with a height of 0.5 meters. Glutamine was administered orally after eccentric activity with a dose of 0.4 grams/kg BW in 450 ml water mineral 3 times (3 days). Measurement of Leg muscle strength was performed using Back and Leg Dynamometer by pulling with all the strength using leg muscles, whereas ROM measurements were measured using a goniometer performed on the knee joint in a passive way. The result of measurement obtained the mean of muscle strength of control group 63.7 ± 17.0 kg and treatment group 81.1 ± 17.0 kg at 72 hours. While result of ROM measurement obtained the mean of control group 124.3 ± 3.2 degrees and treatment group  131.7 ± 4.1 degrees at 72 hours. The analysis showed that glutamine administration in treatment group after eccentric activity increased leg muscle strength with p=0.000, and also increased knee joint ROM with p=0.000 at 72 hours after eccentric activity. In conclusion, glutamine administered with a dose of 0.4 gram/kg BW/day can increase leg muscle strength and knee joint ROM at 72 hours after eccentric activity.
ORTHOPAEDIC EMERGENCY CASES AT HASAN SADIKIN HOSPITAL BANDUNG CAUSED BY TRADITIONAL BONE SETTER PRACTICE
Authors: Hantonius Hantonius , Rasyid Hermawan Nagar , Alpharian Gibran Tristan
Published: February 2020

Traditional bone setting is common in developing nations. The practitioners are barely educated and rely so much on experience. Although they are popular in public, traditional bone setter are known in hospital practice for their failures and complications which present to hospitals for remediation.The purpose of the study is to report the orthopaedic emergency cases  caused by the practice of traditional bone setter. This was an observational descriptive study, 36 patients with complications after practice of traditional bone setters and subsequently presented to emergency ward in Hasan Sadikin Hospital between 1st January 2015 and 31st August 2017 were evaluated.Among emergecy orthopaedic cases at Hasan Sadikin Hospital caused by bonesetter practice, compartment syndrome and gangrene are the most common complications occured. Twenty patients (56%) with infected wound and compartment syndrome had successful operation., thirteen patients (36%) with gangrene of the extremities had amputations, and three patients (11%) with multiple organ failure died. Twelve percent of amputations in our centre were related to bonesetter practice.The result of this study indicates that traditional bone setters practice may caused patients to develop complications, lose their limbs even lives due to inappropriate treatments.
RISK FACTORS FOR IMPAIRED BONE DENSITY IN MALE PATIENTS UNDERWENT HEMODIALYSIS DUE TO CHRONIC KIDNEY DISEASE
Authors: Santo Ismoyo Patritius Kelik Dwi , Yuwana Sugeng
Published: February 2020

Background: Chronic kidney disease (CKD) is associated with impairment of mineral metabolism that, in turn, may result in the derangement of bone density, i.e. osteopenia or osteoporosis. Purpose: The objective of this study is to assess the impairment of bone density in male patients underwent routine hemodialysis due to stage V CKD.Methods: Subjects in this cross sectional study were male patients underwent routine hemodialysis in Hemodialysis Unit Dr. Sardjito General Hospital Yogyakarta in June 2014. Subjects were invited when they were over 18 years old and had undergone hemodialysis for at least 6 months. Bone density of lumbar spine, total hip and femoral neck were assessed using DEXA. We collected information on age and the etiology of the CKD from medical records. Body weight and height were measured using calibrated apparatus. Data were analyzed using OpenEpi.Results: We invited 30 male patients with mean (SD) age of 56.8 (13.8) years. Bone density of lumbar spine and femoral neck were significantly associated with the duration of hemodialysis, i.e. OR (95% CI) of 31.7 (3.8-856.0), p=0.0003 and 12.0 (1.9-111.0), p=0.005, respectively for those underwent hemodialysis of more than 12 months. Obesity was only protective for the bone density of the total hip, OR(95%CI) of 0.1 (0.004-0.9), p=0.03. There was no association between the etiology of the CKD and the decrease in bone density.Conclusion: This study observed significant association between the duration of hemodialysis and bone density.
NEGLECTED COXITIS TUBERCULOSA MANAGEMENT IN CHILDREN
Authors: Bayusentono Sulis , Ramawan Erwin , Dominica Henry
Published: February 2020

Background: Tuberculosis is one of serious health problems throughout the world, including in Indonesia. The incidence of tuberculosis continue to increase annually, especially the case of bone tuberculosis which is part of tuberculosis extra pulmonary as much as 10-20%.Case: A case report of 2 years old girl, with a neglected posterior hip dextra et causa coxitis tuberculosa dextra in Dr. Soetomo General Hospital, in period October 2013 until September 2015. Data were taken from the retrospective medical record through the anamnesis, physical findings, radiological, and laboratory examinations.Discussion: A 2 years old girl diagnosed as Neglected Posterior Hip dextra et causa Coxitis TB dextra, carried out of open biopsy, debridement, and open repositioning through the anterior approach Smith Peterson. Do installation of K-Wires and external fixation with hemispica. Given anti-tuberculosis drug for 12 months. In the monitoring for 2 years post-operatively, the patient reported an improvement.Conclusion: Hip Tuberculosis have a variety of mànifestasi similar to other diseases. Biopsy of the bone tissue lesions is a gold standard diagnosis for coxitis TB. However interpretation of the early picture of pelvic radiology can be a predictor outcome in the case of coxitis TB.
JONES TENDON TRANSFER MODIFICATION WITH ERWIN RAMAWAN TECHNIQUE
Authors: Ramawan Erwin , Wardhana Teddy Heri , Rahman Ansari
Published: February 2020

Background: Drop hand is a clinical manifestation of radial nerve lesion that cause hand dysfunction. Jones tendon transfer is one of the therapeutic modalities in overcoming it with many modifications, but there is still no mutual agreement for which technique is the best. One of them is the Erwin Ramawan technique. The purpose of this study was to determine the differences in results before and after tendon transfer surgery with the Erwin Ramawan technique in patients with radial nerve lesions.Methods: Retrospectively, we evaluated patients with high-type lesions of radial nerve carried out by tendon transfer surgery using Erwin Ramawan, to reroute PL to EPL, so the thumb can do abduction and extension, then the FCR tendon is positioned parallel to the ECRB and EDC, then connected 45° direction. The outcome was evaluated using the DASH score and with the Robert G. Chouinard method.Results: The average DASH score in patients with high-type lesions of  radial nerve before surgery 56.83 ± 16.69 had a significant improvement (p <0.05) after tendon transfer surgery with Erwin Ramawan technique to 32.00 ± 11.88. Functionally, dorsiflexion from wrist postoperative is 75.00 ± 10.00 (excellent), palmarflexion 52.00 ± 24.65 (excellent). For finger, the metacarpophalangeal extension reaches 166.00 ± 19.49 (good). The distance from the fingertip to metacarpophalangeal crease is 0.10 ± 0.22 (good). On thumb, abduction reaches 40.00 ± 15.81 (excellent), interphalangeal extension 166.00 ± 11.44 (good).Conclusion: Based on these results, we found significant clinical differences before and after tendon transfer with the Erwin Ramawan technique.
CONSTANT MURLEY SCORE ON PATIENTS POST SUPRASPINATUS RECONSTRUCTION WITH MEMBRANE AMNION COMPOSITE AND FAT TISSUE ALLOGENIC MESENCHYMAL STEM CELL AUGMENTATION
Authors: Suroto Heri , Hadi Bayu Antara , Gultom Goklas Ridwan Ricardo
Published: February 2020

Background: Rotator cuff tears are the most common cases in nontrauma upper extremities in group patient more than 50 years old. Incidence on rotator cuff can’t show the real population. New Approaches healing rotator cuff syndrome is tendon regeneration like mesenchymal stem cell injection and growth factor or tissue engineering that has been developed.Methods: Retrospective comparation study of 15 postsupraspinatus reparation patients who has been treated for more than 4 months at the Dr. Soetomo general hospital. Patients is divided into group undergone supraspinatus reparation and patient supraspinatus reparation with augmented by membrane amnion composite and mesenchymal stem cell. Its’ functional results were evaluated using constant murley score.Results: Pain score average on supraspinatus reparation patients which augmented by membrane amnion and mesenchymal stem cell and those without augmentation is 15 and 13.7 (p=0.036). Daily activity score average on patients with and without augmentation are 20 and 17 (p=0.037). Flexion score average on patients with and without augmentation are 10 and 8.6 (p=0.114). External rotation score average on patients with and without augmentation are 9.6 and 7.2 (p=0.004). Internal rotation score average on patients with and without augmentation are 9.2 and 7.2 (p=0.012).Conclusion: The constant murley score pain score, ADL score, external rotation score, and internal rotation score in the group with the addition of amniotic membrane and mesenchymal stem cells were significantly better than the group with supraspinatus repair only, but not significantly on the flexion score and lateral elevation score components.
Hybrid Machine Learning Model of Extreme Learning Machine Radial Basis Function for Breast Cancer Detection and Diagnosis: A Multilayer Fuzzy Expert System
Authors: Mojrian Sanaz , Pinter Gergo , Hassannataj Joloudari Javad , Felde Imre , Szabo-Gali Akos , Nadai Laszlo , Mosavi Amir
Published: February 2020

Mammography is often used as the most common laboratory method for the detection of breast cancer, yet associated with the high cost and many side effects. Machine learning prediction as an alternative method has shown promising results. This paper presents a method based on a multilayer fuzzy expert system for the detection of breast cancer using an extreme learning machine (ELM) classification model integrated with radial basis function (RBF) kernel called ELM-RBF, considering the Wisconsin dataset. The performance of the proposed model is further compared with a linear-SVM model. The proposed model outperforms the linear-SVM model with RMSE, R2, MAPE equal to 0.1719, 0.9374 and 0.0539, respectively. Furthermore, both models are studied in terms of criteria of accuracy, precision, sensitivity, specificity, validation, true positive rate (TPR), and false-negative rate (FNR). The ELM-RBF model for these criteria presents better performance compared to the SVM model.
PEMAPARAN DAN FOCUS GROUP DISCUSSION : UPAYA PERUMUSAN STRATEGI PEMBINAAN PASAR RAKYAT DALAM MENGHADAPI PUSAT PERBELANJAAN DAN TOKO SWALAYAN
Authors: Muafi Muafi
Published: February 2020

The existence of modern market (shopping center and supermarket) considered have been cornered the existence of traditional market, either urban area or suburban area. Its ever-growing existence, which also added with other public facility such as station, terminal, hotel, or even apartment, make the modern market in demand and become the main choices for consumer to shop. Even so, traditional market has its own excellence that is no less interesting than modern market. Both of these markets have to complete and synergize each other. That is why it needed an effort to frame the strategy and policy that is expected to implement by the main stakeholder (government, businessman, business manager).
Key word: traditional market, modern market, stakeholders, strategy
PENGEMBANGAN PANGAN LOKAL MELALUI PEMBUATAN “DOKUN” (DONAT SUKUN) ANEKA TOPING DI DESA TANJUNGHARJO, NANGGULAN, KULONPROGO
Authors: Setiyoko Agus , Slamet Agus
Published: February 2020

Tanjungharjo Village, Nanggulan, Kulonprogo, has wide variety of agricultural products that has not been processed optimally. One example is breadfruit. The cultivation and development of this breadfruit has been started by the government of Special District of Yogyakarta since 2003. With several ways of processing, breadfruit fruits can be used to support food diversification. The Successful of development and diversification of breadfruit processing into region’s food can increase its selling value so that impact on improving public welfare. Klajuran is one Hamlet of Tanjungharjo Village, has ‘Kelompok Wanita Tani (KWT) Ngudi Makmur’ with 25 members joining. This group is usually processing breadfruit using the traditional ways by steaming or friying, but the product is not so acceptable by the community. One of the factors causing the lack of processing of these products is the lack of knowledge about the various ways of processing, packaging technology and financial management in producing various foods from breadfruit as business opportunity. Based on the description, the research and community service institutions of Mercu Buana University of Yogyakarta has provided counseling and training on the processing of breadfruit’s donut cake, packaging and financial management to increase the economic income of the group members.
Keywords: Bredfruit, donut cake, counseling, training, production
SAĞLIK ÇALIŞANLARINDA PSİKOLOJİK SERMAYE, İŞ TATMİNİ VE ÖRGÜTSEL SİNİZM İLİŞKİSİ
Authors: KOÇAK R. Dilek , ELÇİÇEK BOYALI Gizem A.
Published: February 2020

Bu çalışmada, psikolojik sermayenin iş tatmini ve örgütsel sinizm ile ilişkisi araştırılmıştır. Araştırmanın modeli, psikolojik sermayenin iş tatmini ve örgütsel sinizm ile ilişkisinin olduğu varsayımıyla oluşturulmuştur. Araştırmanın örneklemi, Ankara ili sınırları içinde yer alan 11 özel hastanedeki sağlık çalışanlarından oluşmaktadır. Bu kapsamda 397 katılımcının verileri ile analiz gerçekleştirilmiştir. Anket, 4 bölümden ve toplamda 50 sorudan oluşmaktadır. Anketin ilk bölümünde demografik sorular yer almaktadır. Değişkenlerin ilişkilerini ölçmek amacı ile” Psikolojik Sermaye Ölçeği”, “İş Tatmin Ölçeği”, ve “Örgütsel Sinizm Ölçeği” kullanılmıştır. Psikolojik sermaye ölçeği, “Öz Yeterlilik”, “Umut”, “İyimserlik” ve “Psikolojik Dayanıklılık” alt boyutlarından oluşmaktadır. Bireylerin genel iş tatminlerini ölçmek için geliştirilen iş tatmini ölçeği kullanılmıştır. Örgütsel sinizm ölçeği ise “Bilişsel”, “Duyuşsal” ve “Davranışsal” alt boyutlarından oluşmaktadır. Verilerin analizinde “SPSS” ve “SmartPLS” programı kullanılmıştır. Elde edilen bulgular neticesinde, psikolojik sermayenin iş tatminini, bilişsel sinizmi, duyuşsal sinizmi ve davranışsal sinizmi etkilediği görülmüştür. İyimserlik ve psikolojik dayanıklılık boyutunun iş tatminini; iyimserlik boyutunun bilişsel ve duyuşsal sinizmi, umut ve psikolojik dayanıklılık boyutunun ise davranışsal sinizmi etkilediği tespit edilmiştir. Öz yeterlilik ve umut boyutlarıyla iş tatmini arasında; öz yeterlilik, umut ve psikolojik dayanıklılık boyutlarıyla bilişsel ve duyuşsal sinizm arasında; öz yeterlilik ve iyimserlik boyutlarıyla davranışsal sinizm arasında ise istatistiksel açıdan anlam tespit edilememiştir.
OECD ÜLKELERİNİN SAĞLIK HARCAMA GÖSTERGELERİNİN KÜMELEME ANALİZİ İLE SINIFLANDIRILMASI
Authors: ÇETİNTÜRK İskender , GENÇTÜRK Mehmet
Published: February 2020

Günümüzün rekabetçi koşullarında, ülkelerin sağlık harcamalarının payı, gelişim düzeylerinin önemli bir göstergesidir ve sağlık sonuçlarını etkileyen en önemli faktörlerden biridir. Bu nedenle, sağlık harcamalarındaki artış ve ülkelerin sağlık politikalarının benzerliği, ülkelerin harcama türlerine göre sınıflandırılmasını ve benzer hususların belirlenmesini gerekli kılmaktadır. Araştırmanın amacı, OECD ülkelerinin 2003-2017 yılları arasında gerçekleştirdikleri sağlık harcamalarını miktar ve oransal bakımdan değerlendirerek, harcama türlerine göre benzer OECD ülkelerini tespit etmek ve Türkiye’nin OECD ülkeleri içindeki yerini belirlemektir. Araştırmada, ülkelerin benzer yanları ve farklılıklarını göz önüne alarak gruplandırmaya yarayan kümeleme analizi kullanılmıştır. 36 OECD ülkesinin 2003-2017 yılları arasında sağlık hizmetlerinde kullandıkları 14 farklı harcama değişkeni Ward yöntemi kullanılarak analize tabi tutulmuştur. Analiz sonucunda ülkeler sağlık harcama türlerine göre kümelenmiş ve Türkiye’nin çeşitli sağlık harcama türlerinde en fazla benzerlik gösterdiği ülkeler; Estonya, Letonya, Meksika, Çek Cumhuriyeti, Lüksemburg, Belçika ve Avustralya olarak belirlenmiştir. OECD ülkelerinin sınıflandırılmasında Türkiye’nin konumuna bakıldığında; sağlık harcamalarında gelişmiş ülkelerin gerisinde kaldığı ve nispeten düşük sağlık harcamalarına sahip ülkelerle aynı kümede yer aldığı görülmektedir.
Experimental Investigation of Bubble Size in Flotation: Effect of Salt, Coagulant, Temperature, and Organic Compound
Authors: Sadeghi Farhad , Vissers Arno J. W. H.
Published: February 2020

Flotation is an important segment of water treatment. Bubbles are generated and dispersed in water where they capture oil and solids residuals and lift them up to the surface. Bubbles are generated either mechanically by agitation or hydraulically by induced gas ejectors. The bubble size has a crucial role in this kind of separation. In general, the smaller the bubbles, the better separation. Water chemistry has an important role in bubble formation and size. A laboratory scale flotation unit was developed to generate the microbubbles with diameters of 10 to 100 µm. The effects of salinity, coagulant, temperature, and ethanol on bubble size were investigated. The addition of 5000 mg/L of sodium chloride (NaCl) affected mainly bubble size with 50 µm diameter, whereas bubble size reduced and diameter decreased by one-half with the addition of NaCl. The bigger bubbles (100 µm size) were affected only at a salinity of 40 000 mg/L, whereas the smaller bubbles (20 to 30 µm) remained stable and did not change with the further increase of salinity. Coagulant affected the water chemistry with a high effect on pH and oxidation-reduction potential (ORP), creating a more acidic and oxidant environment; however, the effect on bubble size was not very significant. Increasing water temperature from 20 to 55°C slightly decreased the bubble size, especially for larger bubbles (diameter of 100 µm). The effect of organic compounds such as ethanol on bubble size reduction was significant. The effect of the hydrostatic level of a water column on bubble size was also investigated. The bubble size did not change with increasing the water level; however, the frequency of bubble generation reduced and reached zero at high water elevation. The effect of flotation in oil removal was investigated, and it was observed that ratio of bubble to droplet size was an important factor. The oil coating of bubbles was the main mechanism of oil removal. The smaller bubbles were more readily coated with oil droplets, whereas bigger bubbles tended to attach to clusters.
Ombitasvir/Paritaprevir/Ritonavir & Dasabuvir ± Ribavirin following protease inhibitors failure - A Prospective Multi-Centre Trial
Authors: Deutsch Liat , Houri Inbal , Ben-Ari Ziv , Shlomai Amir , Veitsman Ella , Cohen-Ezra Oranit , Issachar Assaf , Mor Orna , Gozlan Yael , Bruck Rafael , Menachem Yoram , Zelber-Sagi Shira , Katchman Helena , Shibolet Oren
Published: February 2020

Background

Hepatitis C virus (HCV) infection is a leading cause of chronic liver disease and hepatocellular carcinoma. Treatment with first generation protease inhibitors (PI)+peg-interferon (pegIFN) and ribavirin (RBV) achieved sustained virologic response (SVR) rates of 65-75% but was associated with multiple side effects. The aim of this study was to evaluate safety and efficacy of Ombitasvir/Paritaprevir/Ritonavir and Dasabuvir (3D)±RBV in HCV genotype 1 patients that failed previous treatment with first generation PIs.

Methods

An investigator-initiated, open-label, multi-centre clinical trial. HCV Genotype 1 patients who were previously null/partial responders or relapsers to telaprevir, boceprevir or simepravir+pegIFN/RBV and met eligibility criteria were included. 3D±RBV were administrated for 12 or 24 weeks according to label. The primary outcome was antiviral response (SVR12); Secondary outcomes were patient reported outcomes, adverse events and resistance associated variants.

Results

Thirty-nine patients initiated treatment according to study protocol (59% men, age 54.0±8.7 years, BMI 28.7±4.5 kg/m 2 ). Thirty-seven (94.9%) completed the study. Thirty-five patients had genotype 1b (9 cirrhotics) and 4 had genotype 1a (2 cirrhotics). Intention-to-treat SVR12 was 92.3% and per-protocol SVR12 was 97.3%. The rate of advanced fibrosis (FibroScan ® score F3-4) declined from 46.2% to 25.7% (P=0.045). Abnormal ALT levels declined from 84.6% to 8.6% (P<0.001). Seven patients (17.9%) experienced serious adverse events (3 Psychiatric admissions, 1 pneumonia, 1 ankle fracture, 2 palpitations), and 12 patients (30.8%) experienced self-reported adverse events, mostly weakness.

Conclusion

3D±RBV is safe and effective in achieving SVR among patients with HCV genotype 1 who failed previous first-generation PI treatment.

Clinical trial number

NCT02646111 (submitted to ClinicalTrials.gov, December 28, 2015)
Serum 25 hydroxyvitamin D levels and affecting factors among preconception fertile women
Authors: Fan Haiyan , Hui Lingyun , Yan Xiaoting , Hou Wei , Bai E , Wang Li , Yu Xuewen
Published: February 2020

Background: Recent study found that vitamin D before conception was considered as a potential additional determinant for achieving pregnancy and live births. The study aimed to evaluate the serum 25 hydroxyvitamin D (25(OH)D) levels and its affecting factors among preconception fertile women.
Methods: This cross-sectional study enrolled 410 women aged 22-44 years who attended a preconception genetic counseling clinic from January 2018 to May 2019. Sociodemographic characteristics and reproductive history of women were collected, and height and weight were measured. Serum 25(OH)D concentration was assayed with chemiluminescence immunoassay. Descriptive statistics were used to examine serum 25(OH)D concentration, and socio-demographic characteristics and reproductive history among preconception women. Determinants of vitamin D deficiency and its affecting factors were assessed using χ2 test.
Results: Findings showed 84.4% of women had serum 25(OH)D concentration below 20 ng/mL. Women working indoors as well as without a history of childbirth had significantly lower 25(OH)D levels compared with those non-working individuals and having delivered a previous child (both P <0.05). The 25(OH)D levels were the lowest in winter than in spring, summer, and autumn (all P <0.001). Women in winter have significantly elevated OR of 5.00 (95%CI 1.75–14.25) to develop vitamin D deficiency. Seasonal variation in serum 25(OH)D levels was not present in non-working individuals and women aged 31-44 years.
Conclusions: Vitamin D deficiency is common among preconception women especially nulliparous women and working women, which propose to screen serum 25(OH)D on preconception evaluation and emphasize need vitamin D supplements and get sunshine exposure.
Vaccination Coverage with the Pneumococcal and Influenza Vaccine Among Persons with Chronic Diseases in Shanghai, China, 2017
Authors: Author) Yuheng Wang(Former Corresponding , Cheng Minna , Wang Siyuan , Wu Fei , Yan Qinghua , Yang Qinping , Li Yanyun , Guo Xiang , Fu Chen , Author) Yan Shi(New Corresponding , Wagner Abram L. , Boulton Matthew L.
Published: February 2020

Background: Adults with chronic conditions such as heart disease, diabetes, or lung disease are more likely to develop complications from a number of vaccine-preventable diseases, including influenza and pneumonia. In this study, we use the data from a chronic disease management information system in Shanghai to estimate vaccination coverage and characterize predictors of seasonal influenza and 23-valent pneumococcal polysaccharide vaccine (PPSV23) vaccination among people with chronic disease in Shanghai. Methods: The Shanghai Centers for Disease Control and Prevention have information systems related to chronic disease management, hospital records, and immunizations. Data from individuals with hypertension, diabetes and chronic obstructive pulmonary disease (COPD) were abstracted during July 2017. The main outcome was coverage of pneumococcal and influenza vaccination. Vaccination coverage was calculated across demographic groups. Significance in bivariate associations was assessed through Pearson’s chi-square tests, and in multivariable models through logistic regression models with a forward stepwise method to select variables. Results: In the sample of 2,531,227 individuals ≥15 years, 22.8% were vaccinated for pneumonia from January 2013 to July 2017, and the vaccination coverage of influenza in the 2016/17 influenza season was 0.4%. Vaccination coverage was highest in those 70-79 and lowest in those younger than 60. Compared to urban areas, uptake in rural areas was higher for pneumonia vaccination (OR: 2.43, 95% CI: 2.41, 2.45), but lower for influenza vaccination (OR: 0.55, 95% CI: 0.51, 0.59). Having a greater number of chronic diseases was associated with higher likelihood of pneumonia vaccination (3 vs 1: OR: 1.68, 95% CI: 1.64, 1.71), but this relationship was not statistically significant for influenza vaccination. Conclusions: We found low levels with of pneumococcal vaccination, and extremely low uptake of influenza vaccination among individuals with high risk conditions in Shanghai who should be priority groups targeted for vaccination. Interventions could be designed to target groups with low uptake – like younger adults, and individuals who have not yet retired.
Relapse after conservative surgery combined with Triptorelin Acetate versus conservative surgery only in women with focal adenomyosis: study protocol for a multicenter, prospective, randomized controlled trial
Authors: Wang Wenwen , Ma Xiangyi , Zhang Wei , Li Zhiying , Wang Yan , Yu Zhiying , Zhang Chunlian , Hong Li , Luo Ruoyu , Xing Hui , Wang Wuliang , Yue Qingfen , Wei Jia , Zhang Minli , Wang Shixuan
Published: February 2020

Background: To preserve fertility or integrity of organs was on the rise for the most women with adenomyosis. Adenomyomectomy is now a widely applied conservative surgery, however relapse is a serious problem after operation. Postoperative treatment, such as gonadotropin-releasing hormone agonist (GnRHa) has been suggested to result in reducing the recurrence rate in patients. However, there is still a lack of evidence from randomized clinical trials comparing the efficacy of GnRHa for decreasing the postoperative recurrence rate. Method/Design：Relapse after conservative surgery combined with Triptorelin Acetate versus conservative surgery only in women with focal adenomyosis is a multicenter, prospective, randomized controlled trial. The primary outcome is relapse accessed with Visual Analogue Scale (VRS) and Numeric Rating Scale (NRS), Pictorial blood loss assessment chart (PBAC) score and the size of uterus and lesion are measured by two/three-dimensional color doppler ultrasonography (2D/3D-CDUS) or magnetic resonance imaging (MRI). The secondary outcomes include quality of life, clinical pregnancy, ovarian reserve, and adverse events, assessing by Short Form (36) Health Survey and Female Sexual Function index, serum follicle-stimulating hormone, estradiol levels and anti-muellerian hormone and so on. All these indexes are measured at 3, 6, 12, 18, 24, 30, 36 months after conservative surgery. Discussion：The result of this large multicenter randomized trial will provide evidence for one of the strategies of long-term management in focal adenomyosis after conservative operation.
The association between symptoms of depression during pregnancy and low birth weight:a prospective study
Authors: Li Xiu xiu , Gao Rui , Dai Xiaowei , Liu Hong , Zhang Jinxin , Liu Xuemei , Si Dongmei , Deng Te , Xia Wei
Published: February 2020

Background

Most studies have showed that maternal depression is associated with pregnancy complications. However, there were limited evidences in Chinese population. We examined the associations of antenatal depression symptoms with pregnancy outcomes, especially for low birth weight.

Methods

A total of 1377 singleton pregnant women were recruited from Nanshan Maternity & Child Healthcare Hospital of Shenzhen in this prospective cohort study. Depression symptoms were assessed by the Edinburgh postnatal depression scale (EPDS) questionnaire in the second trimester of gestation; cut-points for the indication of antenatal depression were ≧12 scores in this study. Socio-demographic data, life-style and pregnancy outcomes were collected through Shenzhen Maternity & Child Healthcare database. The risks of adverse outcomes in pregnant women with antenatal depression were determined by multivariate logistic regression and represented as odds ratio(OR) and 95% confidence interval (CI).

Results

Of the 1377 subjects, the prevalence of antenatal depression was 19.1%. The EPDS scores were 13.8±2.0 and 6.5±2.9 ( P <0.001) in subjects with and without antenatal depression, respectively. After adjustment for maternal age, education, parity, pre-pregnancy body mass index (BMI), residential area, fetal gender, an EPDS score≥12 (versus. <12) was associated with an increased risk for low birth weight(odds ratio: 2.05, 95% CI: 1.12-4.64), but not for preterm birth, large for gestational age, small for gestational age or macrosomia.

Conclusion

Pregnant women presenting antenatal depressive symptoms are at elevated risk of low birth weight. Mental health problems of pregnancy should be addressed for the prevention of low birth weight.
Efficacy of acupuncture in improving the symptoms and the quality of life of patients with moderate or severe acne vulgaris: a protocol for a randomized controlled trial
Authors: Jiao Ruimin , Huang Man , Zhang Weina , Liu Zhishun
Published: February 2020

Background : Acne vulgaris (AV) is a common chronic dermatologic disease that tends to impair the appearance and the quality of life (QoL) of patients. Although several trials have indicated the effectiveness of acupuncture for treatment of patients with AV, the results of these trials have been contested owing to potential bias in their design. Thus, there is a lack of robust data to evaluate the efficacy of acupuncture in patients with AV. In addition, none of the previous clinical trials of acupuncture therapy for AV used QoL as a primary outcome or employed a sham acupuncture control arm. The aim of the study is to evaluate the effect of acupuncture on the symptoms and the QoL of patients with moderate or severe AV. Methods/design: One hundred eligible participants with AV will be randomly assigned to acupuncture or sham acupuncture groups (1:1 allocation). All participants will receive 4-week treatment comprising of a total of 12 sessions (3 sessions per week). The primary outcome will be change from baseline in the Skindex-16 scale total score at treatment completion. The secondary outcomes will be: Skindex-16 subscale score; the Dermatology Life Quality Index scale total score; the total lesion count and inflammatory lesion count; visual analogue scale scores for assessment of itch and pain; patient expectations of acupuncture; and the blinding of the effect of sham acupuncture. Follow-up evaluation will be performed at weeks 16 and 28. All outcome analyses will be performed in the intention-to-treat population. Discussion: We expect to evaluate the effectiveness of acupuncture in ameliorating the symptoms and improving the QoL of patients with moderate or severe AV compared with sham acupuncture with more robust evidence. The limitations of the trial design are its single center scope, relatively small sample size, and lack of blinding of the acupuncturists. Trial Registration: Chinese Clinical Trial Registry, ChiCTR-1900023649 (Date of registration: Jan 2, 2019). Keywords: acupuncture, acne vulgaris, quality of life, randomized-controlled trial, protocol.
Development and content validity of the Abilitator: A self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position
Authors: Wikström Miia , Anttila Heidi , Savinainen Minna , Kouvonen Anne , Joensuu Matti
Published: February 2020

Background: The unemployed have lower work ability and poorer health than the employed. This situation deteriorates when unemployment continues. The long-term unemployed often have co-morbidities and face many other challenges. This increases the need for a multidimensional assessment of work ability and functioning in different service settings. In this study, we describe the development and analyse the content validity of the Abilitator, a self-report questionnaire on work ability and functioning for those in a weak labour market position. Methods: The Abilitator was developed in 2014–2017. Its construct was assessed by members of academic expert panels (n=30), practical expert panels of professionals (n=700) and target group clients (n=28). The structure and the content of the questionnaire was co-developed in 29 workshops and adjusted twice based on the expert panels’ feedback. The Abilitator was also implemented among target group clients (n=3360) in different services and projects. During its development the Abilitator was linked to the International Classification of Functioning, Disability and Health (ICF). The content validation process followed the guidelines recommended by the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) panel. Results: The construct of the Abilitator combines the multidimensional and biopsychosocial models of work ability and functioning. It also includes aspects of social inclusion and employability. It evaluates social, psychological, cognitive and physical functioning, and the ability to cope with everyday life. The content of these concepts was validated by the academic and practical expert panels. The Abilitator’s 79 ICF codes covered 57% of the Generic, 77% of the Brief Vocational Rehabilitation, and 8% of the Minimal Environmental ICF Core Sets. When compared with the Work Ability Index (WAI) and the World Health Organization Disability Assessment Schedule (WHODAS 2.0), the direct equivalences of the ICF codes were 36% and 44%, respectively. Conclusion: The Abilitator sufficiently comprehensively covers the relevant aspects to enable the assessment of the overall work ability and functioning of the population in a weak labour market position.
Enabling routine β-Thalassemia Prevention and Patient Management by Scalable, Combined Thalassemia and Hemochromatosis Mutation Analysis
Authors: Hashmi Ghazala , Qidwai Asim , Fernandes Kristopher , Seul Michael
Published: February 2020

Background : Beta (β)-thalassemia is one of the most common inherited disorders worldwide, with high prevalence in the Mediterranean, the Middle East and South Asia. Over the past 40 years, many countries have implemented awareness and prevention campaigns that have greatly reduced the incidence of affected child births. In contrast, much remains to be done in South-Asia. Thus, for Pakistan, current estimates of the number of children born with thalassemia are at ~7,000 per annum, with no sign of improvement. Although there is good agreement that intermarriage of carriers is a principal source of the high prevalence of the disorder, effective tools for screening and diagnosis on which to base prevention programs are not readily available. Methods : Here, we present results for a novel “LeanSequencing” process to identify 18 β-thalassemia and related sickle cell anemia, and simultaneously a set of 3 hemochromatosis mutations in a multi-ethnic population of 274 pediatric and adolescent patients treated at Afzaal Memorial Thalassemia Foundation hospital in Karachi, Pakistan. Results : We found substantial differences in the abundance of disease-causing mutations among the principal ethnic groups in our cohort. We also found the hemochromatosis mutation H63D C > G in 61 (or 22.1%) of our patients including 7 (or 2.6%) homozygotes. Conclusions : To our knowledge, this is the first screen combining β-thalassemia and hemochromatosis mutations in a single test, so as to facilitate the early identification of patients who may be at increased potential risk for complications from iron overload and thereby to improve the prospective management of thalassemia patients.
Supporting perinatal anxiety in the digital age; A qualitative exploration of stressors and support strategies.
Authors: Harrison Virginia , Moore Donna , Lazard Lisa
Published: February 2020

Background: The period surrounding childbirth is one of profound change, which can often be experienced as stressful and overwhelming. Indeed, around 20% of women may experience significant levels of anxiety in the perinatal period. However, most women experiencing perinatal anxiety (PNA) go unrecognised and untreated. The Internet offers a potentially scalable solution to improve access to support, however a dearth of research is area means that work is needed to better understand women’s experience of PNA, so that potential targets for intervention can be identified, and possible barriers to support overcome. This study aimed to qualitatively explore women’s experience of anxiety triggers and support in the perinatal period; and gain insight into what online support is acceptable for women with PNA.
Methods: Women who were either pregnant or within one year post-partum were invited to participate in focus groups across the UK. Focus groups were used to allow a diversity of perspectives to be heard, while simultaneously promoting the identification and prioritisation of important support needs and solutions. Interviews were transcribed and thematically analysed.
Results: Five key themes emerged in relation to women’s experience with PNA: holding unrealistic expectations of birth and motherhood; stigma; the importance of peer support; uncertainty and poor maternal confidence; and a lack of mental health support and knowledge. Perinatal women felt under-supported and poorly prepared for motherhood. A mismatch between their expectations and the reality of their experience, alongside a pressure to be the ‘perfect mum’ was the primary source of their anxiety. Furthermore, stigma associated with PNA may have exacerbated these issues and led to help-seeking avoidance. Overall, women felt these issues could be addressed via online support, through the delivery of more realistic information, providing psychoeducation about PNA symptoms and management, and the inclusion of authentic peer experiences. Thus, delivering evidence-based information and interventions online may provide a solution that is acceptable to this cohort.
Conclusions: This work provides unique insight into potential sources of anxiety for women in the PNA, while also offering potential internet-based support solutions that are likely to be acceptable and helpful for women with PNA.
The Median Effective Dose (ED50) of cis-Atracurium for Laryngeal Mask Airway Insertion during General Anaesthesia for Patients Undergoing Urinary Surgery
Authors: Wang Xiaohua , Huang Ke , Yan Hao , Lan Fei , Yao Dongxu , Li Yanhong , Xue Jixiu , Wang Tianlong
Published: February 2020

Background
In clinical practice, the laryngeal mask airway is an easy-to-use supraglottic airway device. However, the cis- atracurium dosage for laryngeal mask insertion is not standardised. We aimed to determine the optimal dose of cis- atracurium using a sequential method for successful laryngeal mask insertion.
Method s :
The cohort study protocol is registered at clinicaltrial.gov (NCT-03668262). Twenty-three patients undergoing elective urinary surgery were sequentially administered doses (μg· kg -1 ) of cis- atracurium as follows: 150, 100, 70, 50, 30, and 20. The main outcome was the response to laryngeal mask airway insertion: ≥16 points and <16 points indicated “satisfactory” and “unsatisfactory” responses, respectively. The median effective dose was estimated using the mean of the seven crossovers from “satisfactory” and “unsatisfactory” responses. The primary outcome was to determine the median effective dose (ED50) of cis- atracurium for laryngeal mask airway insertion.
Result s :
The median effective dose of cis- atracurium was 26.5 μg·kg -1 (95% CI 23.6-29.8) using the sequential method. The heart rate was decreased in the 50μg·kg -1 group compared to the 30μg·kg -1 group at timepoints T7, T8, and T10 ( P = 0.0482, P = 0.0460, and P = 0.0236, respectively), but no difference with 20 μg·kg -1 group. The systolic blood pressure was decreased in the 50 μg·kg -1 group compared to the 20 μg·kg -1 group at timepoints T2, T3, T4 ( P = 0.0159, P = 0.0233, and P = 0.0428, respectively). The train-of-four value was significantly lower in the 50 μg·kg -1 group than in the 30 μg·kg -1 group at timepoint T3( P = 0.0326).
Conclusion s :
The ED50 of cis- atracurium was 26.5 μg·kg -1 for laryngeal mask airway insertion.
Glycogen synthase kinase 3 (GSK-3) controls T-cell motility andinteractions with antigen presenting cells
Authors: Taylor Alison , Rudd Christopher E.
Published: February 2020

Objective: The threonine/serine kinase glycogen synthase kinase 3 (GSK-3) targets multiple substrates in T-cells and regulates the expression of Tbet and PD-1. However, it has been unclear whether GSK-3 has any effect on T-cell motility or their interactions with antigen presenting cells.
Results: Here, we show that GSK-3 controls T-cell motilityand interactions with other cells. Inhibition of GSK-3, using structurally distinct inhibitors, reduced T-cell motility in terms of speed and distance travelled. Furthermore, SB415286 reduced the number of cell to cell contacts, however the duration of these established contacts with other cells did not differ in the presence of SB415286. This inhibition of motility did not affect the ability of GSK-3 inhibitors to enhance cytolytic T-cell (CTL) function in killing tumor targets. These data show that the inhibition of GSK-3 has differential effects on T-cell motility and CTL function where the negative effects on cell-cell interactions is overridden by the increased cytolytic potential of CTLs.
Pilot test of an online training module on near-infrared spectroscopy monitoring (NIRS) for the randomised clinical trial SafeBoosC III
Authors: Hansen Mathias , Rasmussen Marie Isabel , Rubin Snorre , Pellicer Adelina , Cheng Guoqiang , Xu Xin , Zhaoqing Yin , Zoffmann Vibeke , Greisen Gorm
Published: February 2020

Background

SafeBoosC-III is an international randomised clinical trial, to evaluate the effect of treatment of extremely preterm infants during the first three days of life based on cerebral near-infrared spectroscopy monitoring (NIRS) versus treatment and monitoring as usual. To ensure high quality of the trial intervention as well as of patient care, we have developed a multilingual web-based training program, to train relevant staff and test their competence. As we enter an under-explored area of e-learning, we have conducted a pilot study on the first of the five modules comprising the web-based training program, to test the feasibility of developing such a program for an international trial with limited resources.

Methods

The module in this study focuses on the principles and practice of NIRS monitoring. The pedagogical idea was to integrate training and certification. One-hundred doctors and nurses from five Neonatal Intensive Care Units across China, Spain and Denmark were invited to participate in the piloting. Upon completion of the NIRS module, participants were invited to evaluate their experience by completing an online survey. Data from close-ended questions were analysed using descriptive statistics while data from open-ended questions underwent thematic analysis.

Results

In total, 81 of 100 invited staff members entered the training module and completed the online survey. The median time and the number of questions to pass the module was fifteen minutes and seven questions, respectively. Most staff found the academic level of the learning material and quiz appropriate (85% and 93% of all staff members, respectively), as well as agreeing that the module was relevant to prepare them to ‘use the NIRS device’ (90%). Thematic analysis revealed issues such as a discrepancy between learning material and quiz questions, lack of clarity and technical issues.

Conclusion

We provide evidence of the feasibility of developing a multilingual web-based training program for an international trial, despite challenges such as low budget, language barriers and possibly differences in the clinical training of staff. Exploring the integration of training and certification for international trials, the positive results of this study motivate further developments.

Trial registration: ClinicalTrial.gov NCT03770741 (registered 10/12-2018), https://clinicaltrials.gov/ct2/show/NCT03770741?recrs=b&cond=cerebral+near+infrared+spectroscopy&rank=3