bluuebunny/crossref_metadata_2025 huggingface dataset:
PENERAPAN MODEL PEMBELAJARAN JIGSAW UNTUK MENINGKATKAN PRESTASI BELAJAR SISWA PADA MATERI SEGI EMPAT
Authors: Hariyani Sri , Hamidah Niswatul , Rahaju Rahaju
Published: October 2019

Prestasi belajar matematika siswa masih rendah, salah satu penyebab menurunnya prestasi belajar siswa yaitu metode konvensional yang kontinu sehingga siswa merasa bosan dan cenderung pasif dalam pembelajaran. Untuk mengatasi hal tersebut, guru menggunakan metode dan model pembelajaran yang bervariatif selama mengajar. Dalam penelitian ini, guru menggunakan model pembelajaran jigsaw. Adapun jenis penelitian yang digunakan adalah penelitian tindakan kelas (PTK). Subjek penelitian ini adalah siswa kelas VIIB sebanyak 24 anak, terdiri atas 12 siswa laki-laki dan 12 siswa perempuan. Prosedur pengumpulan data meliputi observasi, tes dan dokumentasi. Hasil penelitian pada siklus 1 yaitu: (1) siswa gaduh pada saat pembagian kelompok; (2) ada siswa yang mendominasi kegiatan mengerjakan tugas dalam kelompok; (3) peneliti kurang bisa mengalokasikan waktu; (4) beberapa siswa yang tidak presentasi kurang memperhatikan presenter dan berbicara dengan temannya; dan (5) beberapa siswa kurang percaya diri saat mengikuti tes. Hasil analisis tes siklus 1 menunjukkan bahwa siswa yang tuntas belajar sebanyak 19 siswa dari 24 siswa, sehingga prosentase siswa yang tuntas belajar sebesar 79,10% dan prosentase siswa yang tidak tuntas belajar sebesar 20,90% dengan nilai rata-rata kelas 73,5. Hasil tes analisis siklus 2 menunjukkan bahwa siswa yang tuntas belajar sebanyak 22 siswa dari 24 siswa, sehingga prosentase siswa yang tuntas belajar sebesar 91,67% dan prosentase siswa yang tidak tuntas belajar sebesar 8,33% dengan nilai rata-rata kelas.
METODE TRITAWA UNTUK MENINGKATKAN MINAT DAN HASIL BELAJAR MATEMATIKA DI PONDOK PESANTREN
Authors: Wahyuni Nurlaili , Lutfiyah Lutfiyah , Taufik Taufik , Tafrilyanto Chairul Fajar
Published: October 2019

Penelitian ini merupakan penelitian tindakan kelas (PTK). dimana dalam setiap siklus terdiri dari 4 komponen yaitu planning (perencanaan), acting (tindakan), observing (observasi) dan reflecting (refleksi). Rata-rata aktivitas siswa pada pertemuan pertama siklus I sebesar 2,95 dengan kategori Baik sedangkan pada siklus II sebesar 3,46 dengan kategori Baik. Hasil observasi aktivitas siswa pada siklus I dan siklus II di atas menunjukkan adanya peningkatan rata-rata aktivitas siswa dalam pembelajaran menggunakan metode tritawa sebesar 0,51. Rata-rata respon siswa pada pertemuan pertama siklus I sebesar 82,32% dengan kategori Positif sedangkan pada siklus II sebesar 87,52% dengan kategori Positif . Hasil angket respon siswa pada siklus I dan siklus II di atas menunjukkan adanya peningkatan rata-rata angket respon siswa dalam pembelajaran menggunakan metode tritawa sebesar 5,20%. Tes hasil belajar siswa pada pertemuan pertama siklus I sebesar 60, dari 25 siswa terdapat 12 siswa dinyatakan tuntas dengan persentase ketuntasan sebesar 48% sedangkan pada siklus II rata-rata tes hasil belajar sebesar 80,84, dari 25 siswa terdapat 22 siswa dinyatakan tuntas dengan persentase ketuntasan sebesar 88%. Rata-rata dan persentase ketuntasan hasil belajar siswa pada siklus I dan siklus II di atas menunjukkan adanya peningkatan rata-rata hasil belajar sebesar 20,84 dan persentase ketuntasan sebesar 40%.
Influence of Gas and Oil State on Oil Mobility and Sweet-Spot Distribution in Tight Oil Reservoirs from the Perspective of Capillary Force
Authors: Li Yaohua , Song Yan , Jiang Shu , Wang Qianyou , Jiang Zhenxue , Zhang Fan
Published: October 2019

The coexisting free gas, solution gas, and oil in a tight oil reservoir, constrained by the capillary force of the micrometer/nanometer pore/pore-throat system, are of crucial importance to the sweet spot of a tight oil reservoir. Equations of modified total capillary force for the liquid phase are proposed to indicate the tight oil mobility in situ, and are derived from the Kelvin capillary force equation, the Peng-Robinson (PR) equation of state (EOS) (Robinson et al. 1977), and the Van-Laar (VL) equation (Renon and Prausnitz 1968). In addition, relationships between the vapor/liquid state, phase-flow state for production, and gas/oil ratio (GOR) are established in correspondence with the production data of North American and Chinese (Yanchang) tight oil plays. The following conclusions can be drawn.

We proposed a modified total capillary force function to indicate the tight oil mobility in situ, using the PR EOS method and the EOS+λ (VL equation) method. We identified five phase stages according to the gas volume ratio ( yi) in situ: the single-phase oil flow stage, the multiphase transient-flow stage, the multiphase stable-flow stage, the multiphase supercritical-flow stage, and the single-phase gas flow stage. Tight oils are more mobile in three stages: near the critical point of yi-critical(1), such as in the Yanchang and Bakken tight oils; at the transition zone between oil and wet-gas zones before yi-critical(2), such as in the Eagle Ford tight oil; and between the yi-critical(2) and yi-critical(3) in a gas-condensate state, which is at the transition zone between wet-gas and dry-gas zones.
Transcriptome sequencing of a keystone aquatic herbivore yields insights on the temperature-dependent metabolism of essential lipids
Authors: Windisch Heidrun Sigrid , Fink Patrick
Published: November 2019

Background:
Nutritional quality of phytoplankton is a major determinant of the trophic transfer efficiency at the plant-herbivore interface in freshwater food webs. In particular, the phytoplankton’s content of the essential polyunsaturated omega-3 fatty acid eicosapentaenoic acid (EPA) has been repeatedly shown to limit secondary production in the major zooplankton herbivore genus Daphnia. Despite extensive research efforts on the biological model organism Daphnia, and the availability of several Daphnia genomes, little is known regarding the molecular mechanisms underlying the limitations in Daphnia related to dietary EPA availability.
Results:
We used RNA-seq to analyse the transcriptomic response of Daphnia magna which were fed with two different diets — each with or without supplementation of EPA — at two different temperature levels (15 and 20°C). The transcripts were mapped to the D. magna genome assembly version 2.4, containing 26,646 translations. When D. magna fed on green alga, changing the temperature provoked a differential expression of 2,001 transcripts, and in cyanobacteria-fed daphnia, 3,385 transcripts were affected. The supplementation of EPA affected 1,635 (on the green algal diet), or 175 transcripts (on the cyanobacterial diet), respectively. Combined effects for diet and temperature were also observed (669 for the green algal and 128 transcripts for the cyanobacterial diet). Searching for orthologous genes (COG-analysis) yielded a functional overview of the altered transcriptomes. Cross-matched transcript sets from both feed types were compiled to illuminate core responses to the factors temperature and EPA-supplementation.
Conclusions:
Our highly controlled eco-physiological experiments revealed an orchestrated response of genes involved in the transformation and signalling of essential fatty acids, including eicosanoid-signalling pathways with potential immune functions. We provide an overview of downstream-regulated genes, which contribute to enhance growth and reproductive output. We also identified numerous EPA-responsive candidate genes of yet unknown function, which constitute new targets for future studies on the molecular basis of EPA-dependent effects at the freshwater plant-herbivore interface.
Implementing a clinical-educator curriculum to enrich internal medicine residents’ teaching capacity
Authors: Habboush Yacob , Stoner Alexis , Torres Claribel , Beidas Sary
Published: October 2019

Background Physicians-in-training (residents) are typically the primary educators for medical students (MS) during clinical clerkships. However, residents are not formally trained to teach or to assess their teaching. The aim of this study was to assess the implementation of a clinical educator rotation aimed at developing residents’ competencies related to clinical teaching and professional growth. Methods A mixed-methods approach was used to develop and assess the clinical educator rotation at a teaching community hospital. Internal medicine residents who participated in the rotation and consented to the research were assigned to the clinical educator trainee group (CET), the remaining residents were assigned to the control group. Osteopathic MS rotating in the medicine service line were invited to participate. Five key assessment tools were developed and used to measure four constructs: Communication, Professional-Based Learning, Professional Engagement and System-based learning. The study used descriptive and qualitative analyses to measure primary and secondary outcomes. Results The primary outcome measure showed a positive change in resident knowledge, skills and behaviors in communication, reflection, feedback, precepting, and facilitation. MS perceptions of resident teaching skills confirmed the observed changes in CETs. Some CETs continued to practice and build their capacity for teaching after completing the rotation. Qualitatively, we categorized the described codes under four pre-identified themes; communication, professional engagement, professional-based learning, and systemic-based practice. Conclusion Resident teaching and professional capacity is enriched after completing the clinical educator rotation. Other benefits included: enhanced patient communication and education, increased resident confidence, personal satisfaction with training, work life-balance and enhanced career satisfaction. Future research should focus on curricular content, faculty development and delivery assessment. Also, research efforts should identify appropriate emerging technologies to include in the curriculum for enhancing teaching capacity.
Expression analysis of Rab11 during zebrafish embryonic development
Authors: Zhang Haijun , Gao Yu , Qian Peipei , Dong Zhangji , Hao Wenjin , Liu Dong , Duan Xuchu
Published: November 2019

Background: Rab proteins are GTPases responsible for intracellular vesicular trafficking regulation. Rab11 proteins, members of the Rab GTPase family, are known to regulate vesicular recycling during embryonic development. In zebrafish, there are 3 rab11 paralogues, known as rab11a, rab11ba and rab11bb, sharing high identity with each other. However, the expression analysis of rab11 is so far lacking. Results: Here, by phylogeny analysis, we found the three rab11 genes are highly conserved especially for their GTPase domains. We examined the expression patterns of rab11a, rab11ba and rab11bb using RT-PCR and in situ hybridization. We found that all the three genes were highly enriched in the central nervous system, but in different areas of the brain. Apart from brain, rab11a was also expressed in caudal vein, pronephric duct, proctodeum, pharyngeal arches and digestive duct, rab11ba was detected to express in muscle, and rab11bb was expressed in kidney, fin and spinal cord. Different from rab11a and rab11ba, which both have maternal expressions in embryos, rab11bb only expresses during 24hpf to 96hpf. Conclusions: Our results suggest that rab11 genes play important but distinct roles in the development of the nervous system in zebrafish. The findings could provide new evidences for better understanding the functions of rab11 in the development of zebrafish embryos.
Failure patterns after curative resection for intrahepatic cholangiocarcinoma: Possible implications for postoperative radiotherapy
Authors: Yu Wei , Hu Chunxiu , Shui Yongjie , Wu Kui , Zhang Lili , Chen Ying , Li Chao , Xu Jing , Wei Qichun
Published: October 2019

Background: To document the patterns of failure，identify sites at highest risk of recurrence following curative resection of intrahepatic cholangiocarcinoma (IHCC), in order to guide adjuvant postoperative radiotherapy (PORT).

Methods: Patients with IHCC who had undergone radical surgery at our institution from July 2010 to August 2017 were retrospectively analyzed. The survival and prognostic factors were evaluated using univariate and multivariate analysis. All sites of recurrence were recorded and classified including the surgical margin, regional lymph nodes, liver remnant and distant metastasis. The sites at highest risk of recurrence form the basis of the target volume of potential adjuvant radiotherapy.

Results: The median follow-up time was 23.5 months (2-85 months). The median recurrence free survival (RFS) and overall survival (OS) were 12.1 months and 24.8 months, respectively. Seventy-three (73/127, 57.5%) IHCC patients developed tumor recurrence. The number of initial recurrences occurring in the potential PORT volume, remnant liver and distant sits were 46 (46/73, 63.0%), 36 (36/73, 49.3%) and 22 (22/73, 30.1%) cases, respectively. Of the 46 patients whose initial recurrence were inside the potential PORT volume, 29 (29/73, 39.7%) developed recurrence confined to the potential PORT volume, including 13 tumor bed recurrences, 7 lymph node metastases, and 9 with both tumor bed recurrences and lymph node metastases. The most common lymph node metastases were nodes around the abdominal aorta, followed by lymph nodes along the celiac artery, the common hepatic artery, and in the hepatoduodenal ligament.

Conclusions: A high proportion of the recurrences occurred only within the potential PORT volume, implying that adjuvant radiotherapy might improve local-regional control. It seems reasonable to include surgical margins and lymph node stations No.16a2, 9, 8, 12, 13, and 14 in the radiation treatment volume.
Effects of Supervised Early Resistance Training versus standard care on cognitive recovery following cardiac surgery via median sternotomy (The SEcReT study): Protocol for a randomised controlled pilot study
Authors: Pengelly Jacqueline Marie Stacey , Royse Alistair , Bryant Adam , Williams Gavin , Tivendale Lynda , Dettmann Tim , Canty David , Royse Colin , El-Ansary Doa
Published: November 2019

Introduction: Mild cognitive impairment is considered a precursor to dementia and significantly impacts upon quality of life. The prevalence of mild cognitive impairment is higher in the post-surgical cardiac population than the general population, with older age and co-morbidities further increasing the risk of cognitive decline. This significantly impacts upon quality of life. Exercise improves neurogenesis, synaptic plasticity and inflammatory and neurotrophic factor pathways, which may help to augment the effects of cognitive decline. However, the effects of resistance training on cognitive, functional and overall patient-reported recovery have not been investigated in the surgical cardiac population. This study aims to determine the safety and feasibility of early moderate intensity resistance training in people undergoing cardiac surgery via a median sternotomy, compared to standard care. The effect of this exercise program on cognitive and functional recovery will also be examined. Methods: This study will be a prospective, pragmatic, pilot randomised controlled trial comparing a standard care group (low-intensity aerobic exercise) and a moderate-intensity resistance training group. Participants aged 18 years and older with coronary artery and/or valve disease requiring surgical intervention will be recruited pre-operatively and randomised 1:1 to either the resistance training or standard care group post-operatively. Feasibility and safety will be assessed through recruitment and retention rates; exercise program adherence; dropout rate; exercise and session stoppages due to pain, any adverse event or incident; and, any major adverse cardiac and cerebral events. Secondary measures include cognitive function, muscular strength, physical function, multiple-domain recovery, balance and patient satisfaction. Assessments will be conducted at baseline (pre-operatively) and post-operatively at 2 weeks, 8 weeks, 14 weeks and 6 months. Discussion: The results of this study will inform the safety and feasibility of early intervention resistance training for patients following cardiac surgery. In addition, this study will provide insights into the effect of resistance training on postoperative cognitive recovery to inform rehabilitation guidelines. Trial registration: This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), ID: ACTRN12617001430325p. Registered on 9 October 2017. Universal Trial Number (UTN):U1111-1203-2131. Keywords: Median sternotomy, resistance training, cognition, cardiac surgery, recovery, rehabilitation, exercise
Global scale transcriptome analysis reveals differentially expressed genes involve in early somatic embryogenesis in Dimocarpus longan Lour.
Authors: Chen Yukun , Xu Xiaoping , Liu Zhuanxia , Zhang Zihao , Xu XuHan , Lin Yuling , lai zhongxiong
Published: November 2019

Background: Somatic embryogenesis (SE) is a process of somatic cells that dedifferentiate to totipotent embryonic stem cells and generate embryos in vitro. Longan SE has been established and wildly used as model system for studying embryogenesis in woody plants, SE-related genes had been characterized. In spite of that, a comprehensive overview of SE at a molecular level is still absent. To understand the molecular mechanisms during longan SE, we examined the transcriptome changes by using Illumina HiSeq from the four distinct developmental stages, including NEC, EC, ICpEC, GE.Results: RNA-seq of the four samples generated a total of 243.78 million high quality reads, approximately 81.5% of the data were mapped to longan genome. The cDNA libraries of NEC, EC, ICpEC and GE, generated 22743, 19745, 21144, 21102 expressed transcripts, 1935, 1710, 1816, 1732 novel transcripts, 2645, 366, 505, 588 unique genes, respectively. Comparative transcriptome analysis showed that a total of 10,642, 4,180, 5,846 and 1,785 genes were differentially expressed in the pairwise comparisons of NEC_vs_EC, EC_vs_ICpEC, EC_vs_GE, ICpEC_vs_GE, respectively. Among them, plant hormones signalling related genes were significantly enriched, especially the auxin and cytokinin signalling components. The transcripts of flavonoid biosynthesis related genes were mainly expressed in NEC, while fatty acid biosynthesis related genes mainly accumulated in early SE. In addition, the extracelluar protein encoding genes LTP, CHI, GLP, AGP, EP1 were related to longan SE. Combined with the FPKM of longan nine tissues transcription, 27 SE specific or preferential genes (LEC1, LEC1-like, PDF1.3, GH3.6, AGL80, PIN1, BBM, WOX9, WOX2, et al.) and 28 NEC preferential genes (LEA5, CNOT3, DC2.15, PR1-1, NsLTP2, DIR1, PIP1, PIP2.1 and POD5 et al.) were characterized as molecular markers for longan early SE. qRT-PCR validation of SE-related genes showed a high correlation between RNA-seq and qRT-PCR data.Conclusion: This study provides new insights into the role of the transcriptome during early SE in longan. Differentially expressed genes reveal that plant hormones signalling, flavonoid and fatty acid biosynthesis, and extracelluar protein related genes were involved in longan early SE. It could serve as a valuable platform resource for further functional studies addressing embryogenesis in woody plants.
The heterogeneous health state profiles of high-risk healthcare utilizers and their longitudinal hospital readmission and mortality patterns
Authors: Ng Shawn Choon Wee , Kwan Yu Heng , Yan Shi , Tan Chuen Seng , Low Lian Leng
Published: October 2019

Background: High-risk patients are most vulnerable during transitions of care. Due to the high burden of resource allocation for such patients, we hypothesize that segmentation of this heterogeneous population into distinct subgroups will enable improved healthcare resource planning. In this study, we segmented a high-risk population with the aim to identify and characterize a patient subgroup with the highest 30-day and 90-day hospital readmission and mortality.
Methods: We extracted data from our transitional care program (TCP) from June to November 2018. Latent class analysis (LCA) was used to determine the optimal number and characteristics of latent subgroups, assessed based on model fit and clinical interpretability. Regression analysis was performed to assess the association of class membership on 30- and 90-day all-cause readmission and mortality.
Results: Among 752 patients, a 3-class best fit model was selected: Class 1 “Frail, cognitively impaired and physically dependent”, Class 2 “Pre-frail, but largely physically independent” and Class 3 “Physically independent”. The 3 classes have distinct demographics, medical and socioeconomic characteristics (p<0.05), 30- and 90-day readmission (p<0.05) and mortality (p<0.01). Class 1 patients have the highest age-adjusted 90-day readmission (OR=2.04, 95%CI: 1.21-3.46, p= 0.008), 30- (OR=6.92, 95%CI: 1.76-27.21, p=0.006) and 90-day mortality (OR=11.51, 95%CI: 4.57-29.02, p<0.001).
Conclusions: We identified a subgroup with the highest readmission and mortality risk amongst high-risk patients. We also found a lack of interventions in our TCP that specifically addresses increased frailty and poor cognition, which are prominent features in this subgroup. These findings will help to inform future program modifications and strengthen existing transitional healthcare structures currently utilized in this patient cohort.
Shu-mu point Catgut embedding therapy for abdominal obesity: study protocol for a randomized controlled trial
Authors: Feng Jialei , Ren Yulan , Jin Yuhao , Meng Jiangqiong , Yang Qiming , Zhong Yuan , Xing Chonghui , Guo Taipin
Published: October 2019

Background: Obesity has become a multifactorial epidemic, affecting individuals, families, societies and countries. Abdominal obesity (AO) is the most harmful kind in obesity. Acupoint catgut embedding (ACE), one of the acupuncture therapies, has been widely used in China while its efficacy has not been tested by randomized controlled trial (RCT). The aim of this study is to evaluate the efficacy and safety of ACE for AO.
Methods: This is a randomized, participant-blind trial. A total of ninety-two patients who met the inclusion criteria for this trial will be enrolled from two independent hospitals and randomly assigned to shu-mu point group and non-acupoint group. Treatment will be conducted once every two weeks, three times for one course. There will be a total of two courses in the whole treatment, and a follow-up will be performed after four weeks of treatment. The primary outcomes are weight and waist circumference (WC). The secondary outcomes are body mass index (BMI), hip circumference (HC), Quality of Life Scale (SF-36), Zung Self-Rating Anxiety Scale (SAS) and Zung Self-Rating Depression Scale (SDS).
Discussion: This trial will evaluate the effectiveness and safety of ACE for AO, and will also observe the changes in the physical conditions of patients before and after the treatment. This trial will be first good quality clinical evidence of ACE for AO.
Association of sleep quality during pregnancy with stress and depression: a prospective birth cohort study in China
Authors: Gao Ming , Hu Jiajin , Yang Liu , Ding Ning , Wei Xiaotong , Li Lin , Liu Lei , Ma Yanan , Wen Deliang
Published: November 2019

Background: The sleep quality of pregnant women in the third trimester is related to mental health. However, there is still a lack of large-scale cohort research exploring this relationship in the second trimester. Thus, we assessed the associations of sleep quality during the second trimester with antenatal stress and antenatal and postnatal depression.
Methods: We examined 1152 pregnant women from a prospective cohort study in China to assess the associations of sleep quality in the second trimester with antenatal stress, antenatal depression, and postnatal depression. We used linear regression models and logistic regression models to examine the associations of sleep quality (Pittsburgh Sleep Quality Index [PSQI]) during pregnancy with perinatal stress (Pregnancy Pressure Scale [PPS]) and depression (Edinburgh Postnatal Depression Scale [EPDS]) status. We further assessed the relationship in groups divided according to maternal age.
Results: PSQI scores were positively associated with antenatal PPS scores (β: 1.52, 95% confidence interval [CI]: 1.28, 1.76), antenatal EPDS scores (β: 0.68, 95% CI: 0.58, 0.78), and postpartum EPDS scores (β: 0.51, 95% CI: 0.38, 0.64). Poor sleep quality (PSQI scores ≥ 5) was associated with antenatal stress status (odds ratio [OR]: 2.60, 95% CI: 1.79, 3.77), antenatal depression status (OR: 3.42, 95% CI: 2.48, 4.72), and postpartum depression status (OR: 2.40, 95% CI: 1.58, 3.64) after adjusting maternal age, BMI, gestational age, smoking, educational level, annual household income and social support. The association of poor sleep quality (PSQI scores ≥ 5) in the second trimester with postnatal depression status was significant among women more than or equal to 30 years old (OR: 4.12, 95% CI: 2.18, 7.78) but not among women less than 30 years old after adjusting covariates above.
Conclusion: Poor sleep quality in the second trimester among Chinese pregnant women is associated with stress and depression symptoms. Strategies to boost sleep quality should be considered during prenatal health care to improve women’s mental health status.
TIA and minor stroke: A qualitative study of long-term impact and experiences of follow-up care
Authors: Turner Grace M , McMullan Christel , Atkins Lou , Foy Robbie , Mant Jonathan , Calvert Melanie
Published: October 2019

Background Transient ischaemic attack (TIA) and minor stroke are often considered transient events; however, many patients experience residual problems and reduced quality of life. Current follow-up healthcare focuses on stroke prevention and care for other long-term problems is not routinely provided. We aimed to explore patient and healthcare provider (HCP) experiences of residual problems post-TIA/minor stroke, the impact of TIA/minor stroke on patients’ lives, and current follow-up care and sources of support. Methods This qualitative study recruited participants from three TIA clinics, seven general practices and one community care trust in the West Midlands, England. Semi-structured interviews were conducted with 12 TIA/minor stroke patients and 24 HCPs from primary, secondary and community care with framework analysis. Results A diverse range of residual problems were reported post-TIA/minor stroke, including psychological, cognitive and physical impairments. Consultants and general practitioners generally lacked awareness of these long-term problems; however, there was better recognition among nurses and allied HCPs. Residual problems significantly affected patients’ lives, including return to work, social activities, and relationships with family and friends. Follow-up care was variable and medically focused. While HCPs prioritised medical investigations and stroke prevention medication, patients emphasised the importance of understanding their diagnosis, individualised support regarding stroke risk, and addressing residual problems. Conclusion HCPs could better communicate lay information about TIA/minor stroke diagnosis and secondary stroke prevention, and improve their identification of and response to important residual impairments affecting patients.
Nutrition knowledge and Attitude in Medical Students of Tabriz University of Medical Sciences in 2017-2018
Authors: Dolatkhah Neda , Aghamohammadi Dawood , Khalili Azizeh Farshbaf , Hajifaraji Majid , Hashemian Maryam , Esmaeili Sepideh
Published: November 2019

Objectives : In this cross-sectional study among 220 medical students we aimed to determine the nutritional knowledge and attitude of medical students through clinical training courses (externship and internship) of Tabriz University of Medical Sciences, Iran. A nutritional knowledge questionnaire included 51 questions was used to determine the correct, perceived and accuracy of knowledge of the participant in different aspects of nutrition sciences. Nutritional knowledge was calculated as percentage of correct responses. The nutrition attitude questionnaire included 30 questions. Both questionnaires were confirmed in terms of the validity and reliability for assessing nutritional knowledge and attitude in this sample of Iranian medical students.
Results: The mean score of correct knowledge was not significantly different among externs and interns (68.20±7.50% and 67.87±6.04% respectively, p=0.729). Results showed that most of the participants (49.61% of externs and 57.14% of inters) had a poor nutritional knowledge, significantly varied by age (p=0.035). The mean attitude index of the subjects was not significantly different among externs and interns (106.37±13.66 and 108.16±13.35 out of 145 respectively, p=0.337). Most students (92.7%) had a very appropriate attitude toward nutrition, significantly varied by sex (p=0.010). These findings indicate that there are multiple deficiencies in nutrition knowledge of medical students.
Impact of Early Chimerism Status on Clinical Outcome in Children with Acute Lymphoblastic Leukaemia after Haematopoietic Stem Cell Transplantation
Authors: Lejman Monika , Zaucha-Prażmo Agnieszka , Zawitkowska Joanna , Mroczkowska Aleksandra , Grabowski Dominik , Kowalczyk Jerzy Roman , Drabko Katarzyna
Published: October 2019

Background: The significance of very early chimerism assessment before day +28, which is considered the moment of engraftment, is still unclear. In this retrospective study, we evaluated the clinical impact of very early chimerism on the clinical outcome after allogeneic haematopoietic stem cell transplantation (allo-HSCT) in children with acute lymphoblastic leukaemia (ALL).
Methods: The study group included 38 boys and 18 girls. Very early chimerism was evaluated on days +7, +14, +21 and +28 after the transplant. Short tandem repeat polymerase chain reaction (STR PCR) was used to analyse chimerism.
Results: Overall survival (OS) and event-free survival (EFS) were 84% and 80%, respectively. The OS in the group of 24 patients with complete donor chimerism on day +14 was 83%, and it did not differ statistically compared to the 32 patients with mixed chimerism on day +14 (OS was 84%). In our cohort of patients, the matched unrelated donor, male of donor, number of transplanted cells above 4.47 x 106 kg and no serotherapy with ATG were statistically related to a higher level of donor chimerism. The immunophenotypes of disease, age of patient at time HSCT, recipient sex, stem cell source (peripheral blood/bone marrow) and conditioning regimen had no impact on early chimerism. Acute graft versus host disease grades II-IV was diagnosed in 23 patients who presented with donor chimerism levels above 60% on day 7.
Conclusion: The data presented in this study provide valuable insight into the analysis of very early chimerism in children with ALL treated with HSCT.
Digital Postpartum Hemorrhage Management Device (DPHMD)
Authors: Tekela Derartu Dereje , Asmare Abeba Getachew , Gebremariam Birhan Meskelu , Assegahegn Christian Adamu , Wami Kidst Dejene , Nemomssa Hundessa Daba , Simegn Gizeaddis Lamesgin
Published: October 2019

Background

Primary postpartum hemorrhage (PPH) is an obstetric emergency caused by excessive blood loss that occurs most commonly after the placenta is delivered. PPH can lead to volume depletion, hypovolemic shock, anemia, and it is the leading cause of maternal mortality worldwide. With 470 deaths per 100,000 live births, the maternal mortality ratio in Ethiopia is one of the highest in the world. It is estimated that 94% of births occur at home in Ethiopia and that 10% of maternal deaths are attributed to PPH. Currently, physicians use visual estimation to calculate blood loss and provide fluid during delivery. This traditional method is subjective and generally inaccurate.Method

In this project, after delivery blood loss measurement system integrated with fluid delivery and vital sign monitoring method is proposed. The collection and measurement system collects blood loss after delivery and measures the amount of blood loss. The management system continuously monitors the mother’s heart rate and blood pressure. These vital sign values are integrated with the measured blood loss to estimate the amount of IV fluid required to be delivered for the mother. The rate of IV fluid delivery is regulated by a flow rate sensor and solenoid valve.Results

The prototype was built and undergone through different tests and iterations. The proposed device was tested for accuracy, cost effectiveness and ease to use. 91.28% accuracy has been achieved and the prototype was built with less than 210 USD.Conclusion

The proposed design allows physicians, especially those in low resource setting, to estimate blood loss and deliver fluid accurately. This helps to reduce maternal mortality rate that may occur due to postpartum hemorrhage.
Prevalence and genotyping of Toxoplasma gondii in stray cats in Mashhad area, Iran.
Authors: Khodaverdi Majid , Razmi Gholamreza
Published: October 2019

Background: Cats as a definitive host have an important role in the epidemiology of toxoplasmosis in humans and animals. The aim of the study was to determine the frequency of Toxoplasma gondii infection and isolate and identify the genotypes of T. gondii in stray cats in Mashhad suburb.
Methods: From April 2016 to August 2017, 175 fecal samples from stray cats and 31 brain samples from cats killed in driving accidents were collected. The fecal samples were examined by fecal flotation technique and T. gondii-specific PCR. The brain samples were investigated by T. gondii-specific PCR and consequently examined by mice bioassay. The DNA of T. gondii isolated was genotyped using SAG1, SAG2, SAG3, BTUB and GRA6 as PCR-restriction fragment length polymorphism (PCR-RFLP) markers.
Results: In the present study, Toxoplasma-like oocysts were microscopically observed in 2.2% (4/175) fecal samples. The presence of Toxoplasma oocysts was confirmed in one microscopy-positive sample by PCR. In addition, T. gondii DNA was detected in 4% (7/175) microscopy-negative samples using PCR. T. gondii was isolated from one brain PCR-positive sample by mice bioassay. The isolate was avirulent and many T. gondii cysts were observed in mice brain. The isolate was successfully genotyped by PCR-RLFP analysis .The isolated genotyped was type II. Beside, eight Toxoplasma-positive fecal samples contained insufficient DNA and only amplified at SAG-3 locus in PCR. These samples were also showed type II pattern at this locus.
Conclusions: Parasitological and molecular results showed low frequency of Toxoplasma infection in the stray cats, and identified the genotype of T. gondii isolate as type II, for the first time in Mashhad area, Khorasan Razavi Province.
Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children
Authors: Hsu Yao-Jen , Fu Yu-Wei , Chin Taiwai
Published: October 2019

Background
Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months.
Methods
The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed.
Results
The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups.
Conclusions
The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.
In vitro and in situ study on characterizationand mechanismofthe intestinal absorptionof 2,3,5,4'-tetrahydroxy-stilbene-2-O-β-D-glucoside
Authors: Wang Cheng , Zhou Yimeng , Gong Xiaohong , Zheng Li , Li Yunxia
Published: October 2019

Background: 2,3,5,4'-tetrahydroxystilbence-2-O-β-D-glucoside(TSG) is a polyhydroxyphenolic compound, which exhibited a broad spectrum of pharmacological activities, such asanti-inflammatory, anti-depression, anti-oxidation and anti-atherosclerosis.However, the compound had poor bioavailability and the underlying absorption mechanisms had not been studied. Therefore, the purpose of this study was to investigate the intestinal absorption mechanism of TSG.
Methods:This study used Caco-2 cell monolayer model and single-passintestinal perfusion modelto explore the gastrointestinal absorption mechanisms of TSG. The effects of basic parameters such as drug concentration, time and pH on the intestinal absorption of TSG were analyzed by high performance liquid chromatography.The absorption susceptibility of TSG to three inhibitors, P-gp inhibitors verapamil hydrochloride and quinidine, and MRP2 inhibitor probenecid were also assessed.
Results: TSG was poorly absorbed in the intestines and the absorption of TSG in stomach is much higher than that in intestine. Both in vitro andin situ experiments showed that the absorption of TSG was saturated with increasing concentration and it was better absorbed in a weakly acidic environment pH 6.4. Moreover, TSG interacts with P-gp and MRP2, and TSG was not only the substrate of the P-gp and MRP2, but also affected the expression of P-gp and MRP2.
Conclusions: It wasconcluded that the gastrointestinalabsorption mechanisms ofTSG involved processes passive transport and the participation ofefflux transporters.
Intratumoral reciprocal expression of monocarboxylate transporter 4 and glypican-3 in hepatocellular carcinomas
Authors: Yorita Kenji , Ohno Akinobu , Nishida Takahiro , Kondo Kazuhiro , Ohtomo Toshihiko , Kataoka Hiroaki
Published: October 2019

Objective: We previously reported the identification of monocarboxylate transporter 4 (MCT4) and glypican-3 (GPC3) as prognostic factors for hepatocellular carcinoma (HCC), which are now considered significant poor prognostic factors for the disease. This study aimed to clarify the detailed interaction of these two factors in HCC t o improve our understanding of aggressive HCC phenotype s. A total of 225 Japanese patients with HCC from our previous study were subjected to immunohistochemical analyses.
Results: The number of MCT4-positive (MCT4+) HCC cases was 47 (21%), and most MCT4+ HCC showed high GPC3 expression (94%, 44/47 cases). In 44 MCT4+/GPC3+ HCC cases, intratumoral heterogeneity of GPC3 or MCT4 expression was further evaluated. We observed reciprocal (inverse), synergistic, mixed reciprocal and synergistic, or irrelevant interaction of MCT4 and GPC3 expression in 29 (66%), 5 (11%), 1 (2%), and 9 cases (21%), respectively. The cases exhibiting reciprocal expression of both markers tended to have cirrhosis without a history of neoadjuvant therapy. In summary, although MCT4+ HCC cases are mostly GPC3+, intratumoral expression patterns of MCT4 and GPC3 are frequently reciprocal each other, suggesting that dual targeting of MCT4 and GPC3 may achieve a better antitumor effect for MCT4+ HCC cases.
Frequency Electromagnetic field effects on Gram-Positive and Gram-Negative Bacteria
Authors: Bayatiani Mohamad Reza , seif fatemeh , Arjomandzadegan mohamad , moradabadi alireza , parvin arash
Published: October 2019

Abstract

Objective: The effects of electromagnetic waves on the growth of living organisms and the determination of the threshold of these radiations have remained elusive. Therefore, in this research, we have investigated the growth rate of gram-positive (Staphylococcus aureus) and gram-negative (Escherichia coli) bacteria that had been exposed to the different frequencies of electromagnetic fields.
Results: The more frequency increased the slower bacteria grew; however, in gram-positive bacteria such as S. aureus, this effect was seen less. The effect of the 1mT electromagnetic field in the growth of S. aureus was significant between the two groups, nonetheless, in the 2mT electromagnetic field, the effect was not significant between the two groups at different frequencies. Noteworthy, no significant change was observed by increasing the frequency in S. aureus exposed bacteria in comparison to the control group. The study of bacterial growth in terms of frequency in both case and control groups showed an increasing trend. Increasing the frequency from 50 Hz to 150Hz, significantly, enhanced the rate of bacterial growth. On the whole, the magnetic field had an increment effect on the growth of bacteria; in fact, this effect was greater on the gram-negative than on the gram-positive bacteria.
Comparative Randomized Multicenter Study Of Plastic Vs. Self-expanding Metal Stents In The Endoscopic Ultrasound-guided Drainage Of Walled-off Pancreatic Necrosis
Authors: gornals joan b , Perez-Miranda Manuel , Vazquez-Sequeiros Enrique , Vila Juan , Esteban Jose M , Gonzalez-Huix Ferran , Guarner-Argente Carlos , Sanchez-Yague Andres , Teran Alvaro , Bas-Cutrina Francesc , Serna Carlos De La , De Paredes Ana Garcia Garcia , Ballester Raquel , Velasquez-Rodriguez Julio , Salord Silvia , Tebe Cristian , Hereu Pilar , Videla Sebastia
Published: November 2019

Background: It seems that the appearance of lumen-apposing metal stents (LAMS), are displacing the role of plastic stents in the therapy of pancreatic fluid collection as walled-off necrosis (WON). To date there is no quality of evidence to recommend LAMS as the standard treatment in management of WON. The theoretical benefit of LAMS over PLASTIC stents, need to be proved.Methods/design: This is a multicenter prospective study, superiority, randomized controlled clinical trial by parallel groups, without masking. One hundred fourteen patients with WON will be Endoscopic ultrasound (EUS)-guided transmural drained in 9 tertiary hospitals in Spain and will be randomized to the LAMS or PLASTIC stent group. The primary endpoint is to assess the short-term (4 weeks) clinical success determined by the reduction of the collection (to <50% or < 5cm in size), along with clinical improvement. Secondary endpoints: the long-term (4 months) clinical success (total resolution or 5cm); the procedure’s duration, the level of difficulty, safety and recurrences.Discussion: The PROMETHEUS trial has been designed to response if LAMS are superior over PLASTIC stents in the EUS-guided transmural drainage of WON. Trial registration: ClinicalTrials.gov, NCT03100578. Registered on April 4, 2017. https://clinicaltrials.gov/ct2/home
Associations between early childhood caries and malnutrition and anemia: A global perspective
Authors: Folayan Morenike , Tantawi Maha El , Schroth Robert J , Vukovic Ana , Kemoli Authur , Gaffar Balgis O , Obiyan Mary
Published: October 2019

Background To determine the relationship between country-level prevalence of early childhood caries (ECC), malnutrition and anemia in infants and preschool children.Methods Matched country level ECC, malnutrition and anemia prevalence information were generated from databases covering the period from 2000 to 2017. Multivariate general linear models were developed to assess the relationship between outcome variables (prevalence of stunting, wasting, overweight, and anemia) and the explanatory variable (ECC prevalence) adjusted for Gross National Income per capita. The adjusted regression coefficients (B) and partial eta squared were computed.Results The mean (standard deviation (SD)) ECC prevalence for 0-2 year-olds was 23.8 (14.8)% and 57.3 (22.4)% for 3-5 year-olds. The mean (SD) prevalence of wasting was 6.3 (4.8)%, overweight was 7.2 (4.9)%, stunting was 24.3 (13.5)%, and anemia was 37.8 (18.1)%. For 0-2-year-olds, the strongest and only significant association observed was between the prevalence of ECC and overweight (η2= 0.21): one percent higher ECC prevalence was associated with 0.12% higher prevalence of overweight (B= 0.12, P= 0.03). In 3-5-year-olds, the strongest and only significant association was observed between the prevalence of ECC and anemia (η2= 0.08): one percent higher prevalence of ECC was associated with 0.14% lower prevalence of anemia (B= -0.14, P= 0.048).Conclusion There were age-related disparities in the relationship between country-level prevalence of ECC, malnutrition and anemia. The relationship between ECC and overweight may be due to intake of sugars. The relationship between ECC and anemia needs further investigations.
Tracing cross species transmission of Mycobacterium bovis at the wildlife/livestock interface in South Africa
Authors: Sichewo Petronillah Rudo , Hlokwe Tiny M. , Etter Eric M.C. , Michel Anita L.
Published: October 2019

Background Bovine tuberculosis (bTB) affects cattle and wildlife in South Africa with the African buffalo ( Syncerus caffer ) as the principal maintenance host. The presence of a wildlife maintenance host at the wildlife/livestock interface acting as spill-over host makes it much more challenging to control and eradicate bTB in cattle. Spoligotyping and mycobacteria interspersed repetitive unit-variable number of tandem repeat (MIRU-VNTR) genotyping methods were performed to investigate the genetic diversity of Mycobacterium bovis ( M. bovis ) isolates from cattle and wildlife, their distribution and transmission at the wildlife/livestock interface in northern Kwa-Zulu Natal (KZN), South Africa. Results SB0130 was identified as the dominant spoligotype pattern at this wildlife/livestock interface, while VNTR typing revealed a total of 29 VNTR profiles (strains) in the KZN province signifying high genetic variability. The detection of 5 VNTR profiles shared between cattle and buffalo suggests M. bovis transmission between species. MIRU-VNTR confirmed co-infection in one cow with three strains of M. bovis that differed at a single locus, with 2 being shared with buffalo, implying pathogen introduction from most probably unrelated wildlife sources. Conclusion Our findings highlight inter and intra species transmission of bTB at the wildlife/livestock interface and the need for the implementation of adequate bTB control measures to mitigate the spread of the pathogen responsible for economic losses and a public health threat.
Formation of ultralong DH regions through genomic rearrangement
Authors: Smider Brevin A. , Smider Vaughn
Published: October 2019

Background: Cow antibodies are very unusual in having exceptionally long CDR H3 regions. The genetic basis for this length largely derives from long heavy chain diversity (DH) regions, with a single “ultralong” DH, IGHD8-2, encoding over fifty amino acids. Most bovine IGHD regions are homologous but have several nucleotide repeating units that diversify their lengths. Genomically, most DH regions exist in three clusters that appear to have formed from DNA duplication events. However, the relationship between the genomic arrangement and long CDR lengths is unclear. Results: The DH cluster containing IGHD8-2 underwent a rearrangement and deletion event in relation to the other clusters in the region corresponding to IGHD8-2, with possible fusion of two DH regions and expansion of short repeats to form the ultralong IGHD8-2 gene. Conclusions: Length heterogeneity within DH regions is a unique evolutionary genomic mechanism to create immune diversity, including formation of ultralong CDR H3 regions.