bluuebunny/crossref_metadata_2025 huggingface dataset:
Agmatine prevents oxidative-nitrative stress in blood leukocytes under streptozotocin-induced diabetes mellitus
Authors: Bila Ivanna , Dzydzan Olha , Brodyak Iryna , Sybirna Natalia
Published: July 2019

Changes in cellular metabolism, development of oxidative-nitrative stress and intensification of glycation and lipid peroxidation (LPO), are significant processes that occur during diabetes mellitus (DM)-associated chronic hyperglycemia. These processes contribute to deviations in the structural organization and functional activity of leukocytes. The development of oxidative-nitrative stress in peripheral blood cells during DM can be prevented by agmatine, an endogenous metabolite of L-arginine, which is a nitric oxide synthase (NOS) inhibitor, and possesses hypoglycemic properties. The administration of agmatine to animals with DM lead to the inhibition of both constitutive and inducible NOS in leukocytes, which in turn decreased total nitrite/nitrate (NOx) levels. Additionally, we observed corresponding increases in reduced glutathione content and activity of antioxidant enzymes (SOD, CAT, GPx, GR), along with decreased levels of the thiobarbituric acid reactive substance, advanced oxidation protein products (AOPPs) and advanced glycosylation end-products (AGEs) as compared to the non-treated diabetic group. Our results indicate that treatment of diabetic animals with agmatine restores redox homeostasis and a balances antioxidant defence system enzymes in leukocytes. This corrective effect on the functional capacity of leukocytes is exerted by preventing oxidative-nitrative stress in animals with DM.
An improved method to isolate primary human osteocytes from bone
Authors: Bernhardt Anne , Wolf Sophie , Weiser Emilia , Vater Corina , Gelinsky Michael
Published: July 2019

Osteocytes are of high importance in bone metabolism as they orchestrate bone remodeling, react to mechanosensory stimuli and have endocrine functions. In vitro investigations with osteocytes are therefore of high relevance for biomaterial and drug testing. The application of primary human cells instead of rodent osteocyte cell lines like MLOY4 and IDG SW3 is desirable but provides the challenge of isolating these cells, which are deeply embedded into the mineralized bone matrix. The present study describes an improved protocol for the isolation of human primary osteocytes. In contrast to an already established protocol, resting steps between the demineralization /digestion steps of the bone particles considerably improved the yield of osteocytes. Real-time polymerase chain reaction (PCR) analysis revealed the expression of typical osteocyte markers like osteocalcin, E11/podoplanin and dentin matrix protein 1 (DMP-1).
Nursing care and outcome in surgical patients – why do we have to care?
Authors: Nestler Nadja
Published: July 2019

Nurses have an important role in patient care. They continuously work in very close contact with patients and foster the realization of activities of daily living as well as ensure quality medical treatment. For both, a high educational level is needed. A large proportion of patients with complex health situations involving chronic illnesses and multimorbidities are treated in hospitals with shortened hospital lengths of stay, changing the caring needs and the demands on nursing. Nurses must handle complex nursing tasks for which a higher educational level is indispensable, including the ability to implement evidence-based practice. In addition, studies show a correlation between the educational level of nursing staff and the health outcomes of patients. If there are too few highly educated nurses, there is an increase in patient mortality as well as the risk of patient complications, such as falls. Also, a low number of nursing staff and a high proportion of admissions decrease the quality of nursing and result in unfavorable patient outcomes. Both developments call for the necessity of a changing nursing practice and the possibilities to transform interprofessional work.
Terminalia ferdinandiana, a traditional medicinal plant of Australia, alleviates hydrogen peroxide induced oxidative stress and inflammation, in vitro
Authors: Chaliha Mridusmita , Sultanbawa Yasmina
Published: July 2019

Background

Oxidative stress and inflammation are the underlying factors in many chronic debilitating diseases and commonly intertwined. Terminalia ferdinandiana is a traditional medicinal plant, endemic to Australia and is a rich source of many bioactive phytochemicals such as ellagic acid (EA) with known antioxidant capacity.

Methods

We investigated the in vitro antioxidant and anti-inflammatory activity of an aqueous food grade EA enriched (EAE) extract of T. ferdinandiana. Caco-2 and KERTr cell lines were treated with EAE or pure EA (used as reference control), followed by the exposure to hydrogen peroxide (H2O2). Levels of reactive oxygen species (ROS) production and gene expression of molecular markers associated with oxidative stress and inflammation were monitored.

Results

Significant reduction in ROS production was observed in both cell types treated with 100 or 200 µg/mL EA or EAE. Treatment of cells with EAE or EA showed upregulation of mRNA expression of the antioxidative gene superoxide dismutase (SOD)-2 and downregulated the expression of inducible nitric oxide synthase (iNOS), soluble cell adhesion molecule (sICAM), and cyclooxygenase (COX)-2. Neither EAE nor EA had any effect on the constitutively expressed COX1.

Conclusions

The antioxidant and anti-inflammatory activity of T. ferdinandiana extract on mammalian cells exposed to H2O2 suggests the potential of using this traditional medicinal plant in preventing oxidative damage and inflammation related diseases.
Prophylactic thyroidectomy in multiple endocrine neoplasia type 2A in children: a single centre experience
Authors: Garcés Visier Cristina , Espinoza Vega Manuel , Guillén Redondo Pilar , Ollero Fresno Juan Carlos , Souto Romero Henar , Luis Huertas Ana , Espinosa Góngora Rocío , Rico Espiñeira Clara , Bautista Francisco José , Alonso Calderón Jose Lorenzo
Published: July 2019

Background

To describe the complications and long-term results in patients with multiple endocrine neoplasia type 2A (MEN 2A) syndrome in whom a prophylactic thyroidectomy was performed, in relation to the recommendations of the American Thyroid Association (ATA).

Methods

A retrospective study of 14 patients with MEN 2A thyroidectomized between 2000 and 2017. We reviewed demographic, clinical, analytical and radiological data. Postoperative complications and long-term follow-up were analyzed.

Results

We treated eight boys and six girls with a median age of 5 years old (range 2–10). The predominant genetic mutation belonged to codon 634 (8/14, 57.14%). Total thyroidectomy (TT) without cervical lymphadenectomy was performed in all patients. A right upper parathyroidectomy was performed in one patient due to intraoperative suspicion of increased volume. Histological study revealed no alterations. Two patients presented transient hypocalcemia postoperatively and no patient had permanent hypocalcemia or nerve damage. Pathological anatomy confirmed medullary thyroid microcarcinoma in 5/14 patients: all carrying codon 634 mutation and three of them with preoperative basal calcitonin levels <20 pg/mL. No recurrences or metastases have been detected after a mean follow-up of 8 years. A patient with codon 634 mutation developed a unilateral pheochromocytoma at 25 years of age. No patient has presented hyperparathyroidism.

Conclusions

Prophylactic thyroidectomy without cervical lymphadenectomy is an effective and safe preventive treatment in patients with MEN 2A syndrome when it is performed by experienced surgeons in reference centers.
Nuclear and chemical characterization of heavy actinides
Authors: Nagame Yuichiro
Published: July 2019

Recent progress in the production of heavy nuclei far from stability and in the studies of nuclear and chemical properties of heavy actinides is briefly reviewed. Exotic nuclear decay properties including nuclear fission of heavy nuclei, measurements of first ionization potentials of heavy actinides, and redox studies of heavy actinides are described. Brief history of discovery of the transuranium elements is also presented.
Sorption of cesium on Tamusu clay in synthetic groundwater with high ionic strength
Authors: Zhang Han , Dong Yang , He Hanyi , Li Honghui , Zhao Shuaiwei , Liu Jun , Jia Meilan , Yang Jijun , Yang Yuanyou , Liu Ning , Liao Jiali
Published: July 2019

The sorption behaviour of cesium on Tamusu clay was first investigated by batch experiments under synthetic groundwater and deionized water conditions. The results showed that the sorption could be well described by the pseud-second-order kinetic model or by the Freundlich isotherm model, and the Kd
values decreased rapidly when temperature was greater than 328 K. However, the influence of initial cesium concentration, initial pH and Humic acid (HA) on the sorption behaviour in the synthetic groundwater exhibited a significant difference from those in the deionized water. In particular, the Kd
value in the synthetic groundwater (5.47 mL/g) was much lower than that in the deionized water (58.97 mL/g). The SEM/EDS, effect of ion strength and pH-independent results in the synthetic groundwater indicated the cesium sorption on Tamusu clay was mainly involved in an ion exchange process. Additionally, the research reported in this work implies that the retardation of cesium on Tamusu clay was significantly lower than that on other clay rock in the world. The results suggest that the sorption behaviour of cesium or other nuclides on Tamusu clay should be evaluated in synthetic or actual groundwater but not in deionized water.
Transverse Injection Experiments within an Axisymmetric Scramjet Combustor
Authors: Assis Shan M. , Suppandipillai Jeyakumar , Kandasamy Jayaraman
Published: July 2019

Investigations on the performance of a rear wall angled cavity with upstream transverse fuel injection in a Mach 1.8 flow field is experimentally studied in a non-reacting flow facility. The high speed flow is directed to a circular cross sectional supersonic combustor and proceeded towards the cavities having two consecutive angles being inclined towards the downstream flow direction. Wall mounted injector is positioned at a distance of 10 mm upstream from the cavity. Air is used as the injectant to simulate the gaseous fuel. The experiments are performed to explore the effect of the increase in injection pressures within various rear wall angled cavities by comparing with the ‘no-injection’ case and to finally assess the mixing performance of the flow. Transverse injection through upstream wall orifice of the cavities outlines a more uniform mixing compared to ‘no-injection’ configuration. Increase in injection pressures enhances mixing and stagnation pressure loss values.
Edicts and Decrees during the Republic: A Reappraisal
Authors: Lanfranchi Thibaud
Published: July 2019

In this paper, edicts and decrees are examined from the perspective of their meaning and their relations. After a brief overview of the literature, this article aims at setting out the difference between edicts and decrees and its evolution during the Roman Republic, mainly focusing on Latin sources. As Praetors' edicts and decrees are rather wellknown, this article focuses on edicts and decrees by other magistrates and in literary sources. Edictum appears to be originally a kind of order, decided by the sole magistrate and linked to his coercitio, whereas decretum is a collective decision, linked to iurisdictio, made to settle a very precise circumstance. Both of those acts gradually lost their differences and were reused in a different manner during the Empire.
Functional Assessment of Port Pavements: The Case of Container Terminals
Authors: Marcobal-Barranco José Ramón , Lara-Galera Antonio L. , Camarero-Orive Alberto
Published: July 2019

Pavements play an essential role in the handling of cargo in port areas. This led the Spanish State Ports Authority, together with the Technical University of Madrid (UPM), to embark on an initiative these past ten years to improve pavements in Spanish ports. Part of the doctorate program at UPM on port pavement maintenance is being developed into a pavement condition index for container storage and operation areas. This index includes some aspects of the pavement that directly affects operations, namely, pavement distresses related to roughness, terminal zone, occupancy level and capacity of the terminal, and importance assessed by traffic intensity. Pavement roughness directly affects driver comfort, working speed and pace of work, crane breakdowns, and general operation efficiency. The other factor regarding pavement condition considers the real influence on the transportation line in terms of cost. All the steps of the process were checked by an expert panel formed by technicians involved in this activity area to complete a good functional assessment process for port pavements.
The Neural Basis of Approach-Avoidance Conflict: A Model Based Analysis
Authors: Zorowitz Samuel , Rockhill Alexander P. , Ellard Kristen K. , Link Katherine E. , Herrington Todd , Pizzagalli Diego A. , Widge Alik S. , Deckersbach Thilo , Dougherty Darin D.
Published: July 2019

Approach-avoidance conflict arises when the drives to pursue reward and avoid harm are incompatible. Previous neuroimaging studies of approach-avoidance conflict have shown large variability in reported neuroanatomical correlates. These prior studies have generally neglected to account for potential sources of variability, such as individual differences in choice preferences and modeling of hemodynamic response during conflict. In the present study, we controlled for these limitations using a hierarchical Bayesian model (HBM). This enabled us to measure participant-specific per-trial estimates of conflict during an approach-avoidance task. We also employed a variable epoch method to identify brain structures specifically sensitive to conflict. In a sample of 28 human participants, we found that only a limited set of brain structures [inferior frontal gyrus (IFG), right dorsolateral prefrontal cortex (dlPFC), and right pre-supplementary motor area (pre-SMA)] are specifically correlated with approach-avoidance conflict. These findings suggest that controlling for previous sources of variability increases the specificity of the neuroanatomical correlates of approach-avoidance conflict.
The Use of Science Reflective Journal Writing by JAS Approach to Train Students Metacognitive Ability
Authors: Septina Esky Purba , Marianti Aditya , Widiatningrum Talitha
Published: July 2019

This research aims to train students’ metacognitive ability used Science Reflective Journal Writing by JAS approach on the material of reproductive system. This type of research was One shot case study which was conducted at SMA Negeri 2 Pemalang. The subjects of this research were students of grade XI MIA 4 and XI MIA 5. The Independent variable of this research was Science reflective journal writing in problem-based learning by JAS approach, while dependent variables were metacognitive ability, activity and students’ cognitive learning results. The students’ metacognitive ability was measured by using observation sheets of students’ activity, discussion assessment sheets, and post-test questions. The results of analysis showed that the use of science reflective journal writing has good influence to train the students’ metacognitive ability. The students’ metacognitive ability of  SMA Negeri 2 Pemalang was included in good category which is 76% , it also gave an influence to cognitive learning result with mastery learn classical ≥ 75% and student activity with a range of 62.51% - 81.25% classified as active. Based on the results of the research, it can be concluded that the students’ metacognitive ability at SMA Negeri 2 Pemalang for reproductive system material classified as good on the aspects of describing, interpreting, evaluating, planning, and also has good influence to the activity and students’ cognitive learning results on the material of reproductive system.
The Development of Plant Encyclopedia Based on Datebase in Adiwiyata Senior High School
Authors: Asyifa Bella Firdha , Rudyatmi Ely , Abdullah Muhammad
Published: July 2019

SMA Negeri 1 Cawas does not have a digital inventory of plants. Digital inventory can be stored for  long time and updated. The study aims to develop an encyclopedia of-based plants database in adiwiyata schools. Research design with Research and Development (RnD). The steps include analysis of potential and problems; data collection; product design; design validation by media experts (lecturers and media experts BPMPK) and material experts (expert classification lecturers); revision 1; small-scale trials (for biology teachers, Wakakur and responses by class XI MIA students 2); revision 2; large-scale trials (all students of class XI MIA); revision 3; and the final product. Based on the results of the study there were 46 plant species. Encyclopedia design (Ensiya) includes templates, systems coding, and finalization program. Ensiya is used to facilitate the management of plant inventories. Revision 1, carried out on the program name, label, motivation, and location of the outbox. Revision 2 of the program name; label box size; motivation box and outbox. The results of a large-scale trial, Ensiya obtained a very feasible assessment by students and received positive responses. Revision 3, program name font; picture box; motivation, and the location of the outbox. Conclusion of this study, that  the plant encyclopedia (Ensiya) in the database-based adiwiyata school was successfully developed using Microsoft Visual Basic Express. Ensiya digital documents, 165 MB file size, accessed offline, transferred between computers with data transfer, and can be changed by studying Microsoft Visual Basic Express programming, is very valid and very feasible.
The Effectiveness of Team Games Tournament with Edmodo on Students’ Learning Outcome and as an Attempt to Support the Pillar of Paperless Conservation
Authors: Rizaki Ibnu , Peniati Endah , Purwantoyo Eling
Published: July 2019

Model and learning media is the important component that can affect the result of learning outcomes. The appropriate model of learning can improve students learning activity. The result of interest questionnaire and interview with biology teachers in SMA N 1 Jatibarang showed that student activity interest at medium category and paper became the main option for all administration and documentation needs. Team Games Tournament with edmodo was rated as the most appropriate model that match the situations and conditions in SMA N 1 Jatibarang nowadays. This model has high efficacy level to solve the activity and learning outcome problem, meanwhile Edmodo is the proper rated class-based website as the solution for paperless attempt. This study aim is to evaluate the effectiveness of Team Games Tournament with edmodo toward student learning outcome and as an attempt to support the pillar of paperless conservation in SMA N 1 Jatibarang. A pre-experimental, One Group Pretest-Posttest Design was used. Samples was collected by purposive sampling methods. All XI MIPA students used as experiment class. Data collection method in this study is a test and questionnaire based methods. Data analysis result showed that classical mastery at 93.26% and N-gain score at 0.70 with high category. The student opinion towards TGT method with edmodo has a very good category. The conclusion is Team Games Tournament model with edmodo effective towards student learning outcome and as an attempt to support the pillar of paperless conservation.
Effectiveness of Model Problem Based Learning with Video in Learning Imun System Materials in SMA N 1 Semarang
Authors: Aulia Ike Nur , Pukan Krispinus Kedati , Widiyaningrum Priyantini
Published: July 2019

Problem based learning (PBL) with video can be the concept of student knowledge on immune system material. The PBL 2013 model is widely used in learning or curriculum, but implementation is rarely used in learning. Based on preliminary observation at SMA N 1, it is known that the absorption capacity of immune system is 21.91% at national exam is the lowest. This research on the effectiveness of problem-based learning models with videos on student learning results in cognitive, affective and psychomotor aspects. The research sample consists of three experimental classes. Data sources include students' cognitive learning outcomes (pretest-posttest), affective learning outcomes, psychomotor learning outcomes, teacher qualitative descriptive analysis (interview) and student responses with descriptive percentage analysis. Data were analyzed by using the cognitive learning outcomes (pretest-posttest) in experimental classes. The questionnaire of learning implementation shows that the PBL with video on the immune learning system has been done well. The calculation of the N-gain value, the experimental classes has been increased by 0.77 with the high category. Based on the results of the research, it can be concluded that the PBL model for students is effective in applying material to cognitive, affective and psychomotor learning outcomes of students in SMA N 1 Semarang.
Parental Permissiveness And Family Functions On Unwanted Pregnancy In Teenagers
Authors: Septiarum Rina , Suwarni Linda , Alamsyah Dedy
Published: July 2019

Abstract 

ASFR (Age Specific Fertility Rate) in Sintang District of pregnancy on 15-19 years old teenagers was 9.85%, the highest in West Kalimantan. The aim of the study was to determine the association between parental permissiveness to teen dating behavior and the concept of family function with unwanted pregnancy in teenagers in the work area of Mensiku Health Center Sintang District. The study used a cross-sectional design with a quantitative approach. The sample in this study were 60 people. Statistical tests used the chi-square test with a confidence level of 95%. The results showed parental permissiveness (p-value = 0.004; PR = 2.176), religious function (p-value = 0.02; PR = 1.726), and reproductive function (p-value = 0.033; PR = 1.696) were associated with unwanted pregnancy. Social-cultural function, affection function, protection function, socialization and education function, economic function, environmental function were not associated with unwanted pregnancy (p value> 0.05). It was concluded that parental control, sex education, and the strengthening of religious education in the family environment were important factors associated to the incidence of unwanted pregnancy in teenagers.

 

Abstrak

ASFR (Age Spesific Fertility Rate) di Kabupaten Sintang pada kehamilan 15-19 tahun sebanyak 9.85%, tertinggi di Kalimantan Barat. Tujuan penelitian untuk mengetahui hubungan antara permisifitas orang tua terhadap perilaku pacaran remaja dan konsep 8 fungsi keluarga dengan kehamilan tidak diinginkan pada remaja di wilayah kerja Puskesmas Mensiku Kabupaten Sintang. Penelitian menggunakan desain crosss sectional dengan pendekatan kuantitatif. Sampel dalam penelitian ini sebanyak 60 orang. Uji statistik menggunakan uji chi square dengan tingkat kepercayaan 95%. Hasil penelitian menunjukkan ada hubungan yang signifikan antara permisifitas orang tua (p value =0,004; PR=2,176), fungsi agama (p value=0,02; PR= 1,726), dan fungsi reproduksi (p value = 0,033; PR= 1,696) dengan kehamilan tidak diinginkan. Variabel yang tidak berhubungan yaitu fungsi sosial budaya, fungsi cinta kasih, fungsi perlindungan, fungsi sosialisasi dan pendidikan, fungsi ekonomi, fungsi lingkungan (p value > 0,05). Disimpulkan bahwa kontrol orang tua terhadap pergaulan anak remaja mereka, sex education, dan penguatan pendidikan agama di lingkungan keluarga menjadi faktor penting yang berkaitan dengan kejadian kehamilan tidak diinginkan pada remaja.
Evaluation of Basic Emergency Obstetric and Newborn Care (BEMONC) Implementation
Authors: Gustina Erni , Rahmi Syarifah Alfiana
Published: July 2019

Abstract

Maternal Mortality Rate is one indicator in describing the health status of people in a region. This study aimed to evaluate the implementation of Basic Emergency Obstetric and Newborn Care (BEMONC) at the Tegalrejo Yogyakarta Public Health Center with Basic Emergency Obstetric and Newborn Care. This research was qualitative with a case study design. The subjects were 5 BEMONC Core Team informants and 3 BEMONC patients. The instrument used in-depth interviews and checklists. The results of the Input: do not have nurses in the BEMONC core Team, due to a lack of nurses and not all BEMONC officers have received training. Infrastructure facilities were insufficient, but budget was enough. The BEMONC implementation went well but on holydays the doctors did not stand by and the shift was not evenly distributed. The implementation output reached the target and the service was satisfactory but found officers who were not friendly with the patient's family. Input is in accordance with the standard, but health personnel and training are not up to standard. The output reached the target and the service was satisfactory but one of the officers was not friendly. The Team must try to focus on customer satisfaction in a friendly manner so that the services provided meet patient expectations.

Abstrak

Angka Kematian Ibu merupakan salah satu indikator dalam menggambarkan derajat kesehatan masyarakat di suatu wilayah. Penelitian ini bertujuan untuk mengevaluasi pelaksanaan Pelayanan Obstetri Neonatal Emergensi Dasar (PONED) di Puskesmas PONED Tegalrejo Yogyakarta. Penelitian ini adalah kualitatif dengan rancangan studi kasus. Subyek sebanyak 5 informan Tim Inti PONED dan 3 pasien PONED. Instrumen menggunakan wawancara mendalam dan checklist. Hasil pada Input tidak terdapat perawat di dalam Tim inti PONED, disebabkan kurangnya perawat dan belum semua petugas PONED mendapatkan pelatihan. Sarana prasarana kurang tercukupi namun pendanaannya tercukupi. Pelaksanaan PONED berjalan baik namun pada hari-hari besar dokter tidak stand by dan pembagian shift kurang merata. Output pelaksanaan mencapai target dan pelayanannya memuaskan namun ditemukan petugas yang kurang ramah dengan keluarga pasien. Input sesuai dengan standar, namun tenaga kesehatan dan pelatihan tidak sesuai standar. Output mencapai target dan pelayanan yang memuaskan namun salah satu petugasnya kurang ramah. Sehingga Tim harus berusaha fokus terhadap kepuasan pelanggan secara ramah agar pelayanan yang diberikan memenuhi harapan pasien.
The Association between Marketing Mix and Decision Process for Choosing Outpatient Health Services
Authors: Farantika Dwiki Yessi , Witcahyo Eri , Utami Sri
Published: July 2019

Abstract

The hospital marketing mix is ​​a set of marketing tools used by hospitals in influencing and knowing the response of service buyers. Dr. Abdoer Rahem Situbondo Regional General Hospital experienced a decrease in the number of patient visits over the past three years from 2014 to 2016, respectively 59,537, 53,720 and 47,699. This shows that patient loyalty is reduced. This study aimed to analyze the marketing mix association with the decision process of choosing outpatient health services at Dr. Abdoer Rahem Situbondo Regional General Hospital. The type of research used is analytic with cross-sectional design. Samples of 94 people were taken by systematic random sampling technique and analyzed using the contingency coefficient test with a confidence level of 95%. The results of this study were that type of employment, product mix, price mix, and promotion mix had weak association with the decision process of choosing outpatient health services. While variables that were not associated with the decision process of choosing outpatient health services were age, gender, education level, monthly income and place mix. The conclusion of this study was that the hospital can focus on improving product mix, price mix, and promotion mix.

  

Abstrak

Bauran pemasaran rumah sakit merupakan seperangkat alat pemasaran yang digunakan rumah sakit dalam mempengaruhi dan mengetahui tanggapan pembeli pelayanan. RSUD dr. Abdoer Rahem mengalami penurunan  jumlah kunjungan pasien lama selama tiga tahun terakhir dari tahun 2014 hingga 2016 secara berturut turut 59.537, 53.720 dan 47.699. Hal ini menunjukkan loyalitas dari pasien berkurang. Penelitian ini bertujuan untuk menganalisis hubungan bauran pemasaran dengan proses keputusan memilih pelayanan kesehatan rawat jalan RSUD dr. Abdoer Rahem Situbondo. Jenis penelitian yang digunakan adalah analitik dengan design cross sectional yang. Sampel sebanyak 94 orang yang diambil dengan teknik systematic random sampling dan dianalisis menggunakan uji koefisien kontingensi dengan tingkat kepercayaan 95%. Hasil penelitian ini adalah ada hubungan yang lemah antara jenis pekerjaan, bauran produk, bauran harga, dan bauran promosi dengan proses keputusan memilih pelayanan kesehatan rawat jalan. Sedangkan variabel yang tidak berhubungan dengan proses keputusan memilih pelayanan kesehatan rawat jalan adalah umur, jenis kelamin, tingkat pendidikan, pendapatan per bulan dan bauran tempat. Kesimpulan penelitian ini adalah pihak rumah sakit dapat berfokus pada pembenahan bauran produk, bauran harga, dan bauran promosi.
Consumption Pattern and Nutrition Conseling Roles on Obesity of Integrated Primary School Students
Authors: Hadi Anto J. , Manggabarani Saskiyanto , Yetti R Erni , Tombeg Zadrak , Ishak Syamsopyan , Said Irfan
Published: July 2019

Tumbuh kembangnya anak usia sekolah yang optimal tergantung pemberian zat gizi dengan kualitas dan kuantitas yang baik dan benar. Salah satu upaya kesehatan tersebut adalah dengan perbaikan gizi anak usia sekolah dasar. Tujuan penelitian ini untuk menganalisis hubungan pola konsumsi dan konseling gizi terhadap kejadian obesitas. Jenis penelitian yang digunakan adalah observasional dengan pendekatan cross sectional study. Populasi dan sampel penelitian ini adalah siswa dengan pengambilan sampel secara exhaustic sampling dengan jumlah 146 sampel. Penelitian ini dilaksanakan di Sekolah Dasar Islam Terpadu Rama Kota Makassar. Hasil penelitian diperoleh bahwa pola konsumsi berhubungan dengan kejadian obesitas dengan nilai p (0,00) < 0,05, konseling gizi berhubungan dengan kejadian obesitas dengan nilai p (0,01) < 0,05. Kesimpulan diperoleh bahwa ada hubungan pola konsumsi dan konseling gizi terhadap kejadian obesitas. Bagi siswa yang sudah terlanjur menderita obesitas agar menjaga pola makan dan aktivitas fisik secara teratur dan ketat serta berkonsultasi ke ahli gizi.

Abstract

The optimal growth of school-age children depends on providing nutrients with good and correct quality and quantity. One of the health efforts is to improve nutrition of elementary school age children. The purpose of this study was to analyze the relationship of consumption patterns and nutrition counseling to the incidence of obesity. The type of research used was observational with a cross sectional study approach. The population and sample of this study were students with exhaustic sampling with 146 samples. This research was conducted at the Rama Integrated Islamic Primary School in Makassar City. The results showed that consumption patterns associated with the incidence of obesity with a value of p (0.00) <0.05, nutritionlcounseling was associated with the incidence of obesity with a value of p (0.01) <0.05. The conclusion is that there is a relationship between consumption patterns and nutritional counseling on the incidence of obesity. For students who have already suffered from obesity in order to maintain regular and strict diet and physical activity and consult a nutritionist.
Pulmonary embolism as the presenting symptom and a confounder in ACTH-secreting bronchial carcinoid
Authors: Yang Wei , Pham David , Vierra Aren T , Azam Sarah , Gui Dorina , Yoon John C
Published: July 2019

Ectopic ACTH-secreting pulmonary neuroendocrine tumors are rare and account for less than 5% of endogenous Cushing’s syndrome cases. We describe an unusual case of metastatic bronchial carcinoid tumor in a young woman presenting with unprovoked pulmonary emboli, which initially prevented the detection of the primary tumor on imaging. The source of ectopic ACTH was ultimately localized by a Gallium-DOTATATE scan, which demonstrated increased tracer uptake in a right middle lobe lung nodule and multiple liver nodules. The histological diagnosis was established based on a core biopsy of a hepatic lesion and the patient was started on a glucocorticoid receptor antagonist and a somatostatin analog. This case illustrates that hypercogulability can further aggravate the diagnostic challenges in ectopic ACTH syndrome. We discuss the literature on the current diagnosis and management strategies for ectopic ACTH syndrome.

Learning points:

In a young patient with concurrent hypokalemia and uncontrolled hypertension on multiple antihypertensive agents, secondary causes of hypertension should be evaluated.

Patients with Cushing’s syndrome can develop an acquired hypercoagulable state leading to spontaneous and postoperative venous thromboembolism.

Pulmonary emboli may complicate the imaging of the bronchial carcinoid tumor in ectopic ACTH syndrome.

Imaging with Gallium-68 DOTATATE PET/CT scan has the highest sensitivity and specificity in detecting ectopic ACTH-secreting tumors.

A combination of various noninvasive biochemical tests can enhance the diagnostic accuracy in differentiating Cushing’s disease from ectopic ACTH syndrome provided they have concordant results. Bilateral inferior petrosal sinus sampling remains the gold standard.
Adrenal insufficiency from steroid-containing complementary therapy: importance of detailed history
Authors: Kempegowda Punith , Quinn Lauren , Shepherd Lisa , Kauser Samina , Johnson Briony , Lawson Alex , Bates Andrew
Published: July 2019

A 62-year-old Asian British female presented with increasing tiredness. She had multiple co-morbidities and was prescribed steroid inhalers for asthma. She had also received short courses of oral prednisolone for acute asthma exacerbations in the last 2 years. Unfortunately, the frequency and dose of steroids for asthma was unclear from history. Her type 2 diabetes mellitus (DM) control had deteriorated over a short period of time (HbA1c: 48–85 mmol/mol). Blood tests revealed undetectable cortisol and ACTH (<28 mmol/L, <5.0 ng/L). Renin, electrolytes and thyroid function were within normal limits. A diagnosis of secondary adrenal insufficiency, likely due to long-term steroid inhaler and recurrent short courses of oral steroids for asthma exacerbations was made. Patient was commenced on hydrocortisone 10 mg, 5 mg and 5 mg regimen. Steroid inhaler was discontinued following consultation with respiratory physicians. Despite discontinuation of inhaled steroids, patient continued not to mount a response to Synacthen®. Upon further detailed history, patient admitted taking a ‘herbal’ preparation for chronic osteoarthritic knee pain. Toxicology analysis showed presence of dexamethasone, ciprofloxacin, paracetamol, diclofenac, ibuprofen and cimetidine in the herbal medication. Patient was advised to discontinue her herbal preparation. We believe the cause of secondary adrenal insufficiency in our patient was the herbal remedy containing dexamethasone, explaining persistent adrenal suppression despite discontinuation of all prescribed steroids, further possibly contributing to obesity, hypertension and suboptimal control of DM. In conclusion, a comprehensive drug history including herbal and over-the-counter preparations should be elucidated. Investigation for the presence of steroids in these preparations should be considered when patients persist to have secondary adrenal insufficiency despite discontinuation of prescribed steroid medications.

Learning points:

The likelihood of complementary and alternative medicines (CAMs) in medication-induced secondary adrenal insufficiency should be considered in any patient presenting with potential symptoms of adrenal insufficiency.

If the contents of CAM preparation cannot be ascertained, toxicology screening should be considered.

Patients should be advised to stop taking CAM preparation when it contains steroids and hydrocortisone replacement therapy commenced, with periodic reassessment of adrenal function, and then if indicated weaned accordingly.

Patients should be informed about the contents of CAM therapies, so they can make a truly informed choice regarding the risks and benefits.

This case also highlights a need to increase regulatory processes over CAM therapies, given their propensity to contain a number of undisclosed medications and potent steroids.
Specific Gene Disruption in the Major Livestock PestsCochliomyia hominivoraxandLucilia cuprinaUsing CRISPR/Cas9
Authors: Paulo Daniel F , Williamson Megan E , Arp Alex P , Li Fang , Sagel Agustin , Skoda Steven R , Sanchez-Gallego Joel , Vasquez Mario , Quintero Gladys , Pérez de León Adalberto A , Belikoff Esther J , Azeredo-Espin Ana M L , McMillan W Owen , Concha Carolina , Scott Maxwell J
Published: July 2019

Cochliomyia hominivorax and Lucilia cuprina are major pests of livestock. Their larvae infest warm-blooded vertebrates and feed on host’s tissues, resulting in severe industry losses. As they are serious pests, considerable effort has been made to develop genomic resources and functional tools aiming to improve their management and control. Here, we report a significant addition to the pool of genome manipulation tools through the establishment of efficient CRISPR/Cas9 protocols for the generation of directed and inheritable modifications in the genome of these flies. Site-directed mutations were introduced in the C. hominivorax and L. cuprina yellow genes (ChY and LcY) producing lightly pigmented adults. High rates of somatic mosaicism were induced when embryos were injected with Cas9 ribonucleoprotein complexes (RNPs) pre-assembled with guide RNAs (sgRNAs) at high concentrations. Adult flies carrying disrupted yellow alleles lacked normal pigmentation (brown body phenotype) and efficiently transmitted the mutated alleles to the subsequent generation, allowing the rapid creation of homozygous strains for reverse genetics of candidate loci. We next used our established CRISPR protocol to disrupt the C. hominivorax transformer gene (Chtra). Surviving females carrying mutations in the Chtra locus developed mosaic phenotypes of transformed ovipositors with characteristics of male genitalia while exhibiting abnormal reproductive tissues. The CRISPR protocol described here is a significant improvement on the existing toolkit of molecular methods in calliphorids. Our results also suggest that Cas9-based systems targeting Chtra and Lctra could be an effective means for controlling natural populations of these important pests.
News Related to the Association of Canadian Map Libraries and Archives
Authors: Dodsworth Eva
Published: July 2019

Information as it pertains to the annual CARTO Conference, the AGM, and Award recipient.
Educación y gestión en América Latina
Authors: Solano Alpízar José
Published: July 2019

El presente artículo constituye un ejercicio descriptivo acerca del tema de la gestión educativa en América Latina. El mismo ofrece una visión general del contexto socio-histórico en que ésta ha tenido lugar.

En primera instancia, se sitúa el modelo de desarrollo diseminado por la CEPAL en América Latina, a partir de la segunda mitad del siglo XX y sus implicaciones en la configuración del modelo educativo adoptado en la región por los diferentes países.

Posteriormente, hace una revisión del tránsito experimentado por el proceso de gestión educativa durante las décadas subsiguientes; por último, presenta una breve caracterización de las transformaciones más significativas que ha experimentado la gestión educativa de cara a los desafíos que se vislumbran con el ingreso al siglo XXI.
Análisis de las prácticas evaluativas desde la perspectiva de los propios actores y actoras en la Región Atlántica
Authors: Badilla Chavarría Leda
Published: July 2019

Esta investigación evaluativa se propuso valorar, desde una perspectiva cualitativa, el componente “Evaluación Escolar” del Proyecto “Mejoramiento de la calidad de la Educación Ministerio de Educación / Banco Mundial” en la Zona Atlántica del país.

Participan diferentes actores y actoras de la comunidad educativa: equipos regionales docentes, padres, madres, alumnos y alumnas. Se utilizan diversas técnicas para la producción de la información. El análisis parte de las lógicas vivenciales en el proceso evaluativo que experimentan diferentes actores y actoras.

Por las características del estudio, se incluyen las voces de los y las participantes, y los textos se presentan tal y como fueron expresados por ellos.
Being a Small State: Discussion on the Role of Size
Authors: Lingevičius Justinas
Published: July 2019

This paper discusses theoretical debates regarding small states and their foreign policy and also argues that research should include more analysis of small states’ identities and the dominant meanings related to being a small state. Using poststructuralistic theoretical perspective and discourse analysis, two empirical cases – Lithuania and New Zealand – are analysed with attention paid to the meanings of smallness and the ways these meanings are constructed. Empirical analysis follows with suggestions for how future research of small states could be improved.
Modeling and adaptive tracking for stochastic nonholonomic constrained mechanical systems
Authors: Zhang Zhongcai , Wu Yuqiang
Published: July 2019

This paper is devoted to the problem of modeling and trajectory tracking for stochastic nonholonomic dynamic systems in the presence of unknown parameters. Prior to tracking controller design, the rigorous derivation of stochastic nonholonomic dynamic model is given. By reasonably introducing so-called internal state vector, a reduced dynamic model, which is suitable for control design, is proposed. Based on the backstepping technique in vector form, an adaptive tracking controller is then derived, guaranteeing that the mean square of the tracking error converges to an arbitrarily small neighborhood of zero by tuning design parameters. The efficiency of the controller is demonstrated by a mechanics system: a vertical mobile wheel in random vibration environment.
Estimation of the current population total for a four-phase sampling design
Authors: Chadyšas Viktoras , Krapavickaitė Danutė
Published: July 2019

The combined ratio-type estimators of the finite population total and their variances in the case of sample rotation for two-phase and four-phase sampling schemes are constructed in the paper. Combined estimators of the finite population total without and with the use of auxiliary information known from the previous survey are built. Two types of sampling design are used for sample selection in each of the phases: simple random sampling without replacement and successive sampling without replacement with probabilities proportional to size. A simulation study, based on the real data, is performed, and the accuracy of the estimators proposed is compared.
Best proximity point results in set-valued analysis
Authors: Choudhury Binayak S. S. , Maity Pranati , Metiya Nikhilesh
Published: July 2019

Here we introduce certain multivalued maps and use them to obtain minimum distance between two closed sets. It is a proximity point problem which is treated here as a problem of finding global optimal solutions of certain fixed point inclusions. It is an application of set-valued analysis. The results we obtain here extend some results and are illustrated with examples. Applications are made to the corresponding single valued cases.
Spatial variability of soil pH sampled by two methodologies used in precision agriculture in farms under crop rotation
Authors: Ferraz Gabriel Araújo e Silva , Souza Barbosa Brenon Diennevan , Reynaldo Étore Francisco , Dos Santos Sthéfany Airane , Moreira Ribeiro Gonçalves Jose Roberto , Ferreira Ponciano Ferraz Patrícia
Published: July 2019

This study aimed to characterize the spatial variability of pH in soils of two farms in the state of Paraná, Brazil, based on two different sampling methods used in precision agriculture, by means of geostatistical analyzes. The first method of sampling the pH grid consisted in the collection of soil samples by the traditional method (1 point / ha). The second method of pH determination was by on-the-go soil sensor (200 points / ha). The spherical model was better suited to most semivariograms, regardless of the sampling method. After adjusting the semivariograms for soil pH determination methods, thematic maps were made using normal kriging. The best spatial distribution of pH was obtained where the attribute was sampled by the on-the-go sensor. The number of pH samples collected and the sampling method influenced the visual representation of pH variability.
Design of a sodium-reduced preservative mixture for use in standard frankfurter sausages
Authors: González Rodríguez Diana Marcela , Restrepo Molina Diego Alonso , Ciro Velásquez Héctor José , Arroyave-Maya- William , Sepúlveda Valencia Jose Uriel
Published: July 2019

High sodium intake increases blood pressure, as well as the risks of heart disease and stroke. The objective of this research was to design a reduced sodium mixture for use in standard frankfurter sausages. A simplex experimental design with four salts was performed using sodium chloride (NaCl), sodium tripolyphosphate (TPPNa), potassium chloride (KCl) and tetrapotassium pyrophosphate (TKPP), with ten mixing points. Textural characteristics (TPA), ionic strength (IS) and cooking losses (CL) were evaluated. The results indicated that the lowest cooking losses were found when reducing the NaCl content by using the highest TPPNa levels (T2, T4, T6 and T9). Furthermore, formulations with larger amounts of TPPNa and TKPP (T2, T3 and T6) had the highest values of for hardness, cohesiveness and chewiness. Finally, T2 shows the best results for CL and texture variables
A new scheme for multiple fault detection and isolation for rotational mechatronic systems through analytical redundancy and adaptive filtering
Authors: Villarreal López Edwin
Published: July 2019

Although Fault Detection and Isolation systems have been widely studied in recent years, it is still a very active research field due to its relevance in industrial production systems. In this paper, a new approach for multiple fault detection by using residual evaluation is proposed. First, an analytical redundancy scheme for residual generation is applied using nonlinear autoregressive networks with exogenousinputs for normal and faulty conditions. Simultaneous fault data is included in the training set in order to ensure multiple fault detection.Then, an adaptive filter considering statistic measures from input is used to increase sensibility and robustness. Filter coefficients are obtained off-line through genetic algorithm optimization. Finally, a neural network classifier is used for fault isolation. The proposed algorithm is tested on a rotary mechatronic test bench for backlash, bearing static friction and transmission faults to show the effectiveness of the proposed detection.