bluuebunny/crossref_metadata_2025 huggingface dataset:
Pendayagunaan Zakat Produktif Dalam Penurunan Tingkat Kemiskinan Material Dan Kemiskinan Spiritual Berdasarkan Cibest Model ( Studi Kasus Pada Laz Umat Sejahtera Kabupaten Ponorogo)
Authors: Susilawati Ika
Published: August 2019

Penelitian ini bertujuan untuk mengetahui seberapa efektif program dana zakat produktif dapat meningkatkan kesejahteraan material dan meningkatkan spiritualitas mustahik. Tempat penelitian di LAZ Umat Sejahtera. Penelitian ini mengambil sampel secara acak yang berada di dua kecamatan yaitu kecamatan kota dan kecamatan siman, dalam penelitian ini terdiri dari 25 responden. Metode penelitian yang digunakan adalah metode deskriptif dengan menggunakan pendekatan kuantitatif dan kualitatif. Serta menggunakan Model Center of Islamic Business and Economics Studies (CIBEST) untuk mengukur hal-hal yang bersifat material (Material Value) dan hal-hal yang bersifat spiritual (Spiritual Value). Hasil penelitian menunjukkan bahwa program ekonomi mandiri dari Masyarakat Ekonomi Sejahtera LAZ Umat Sejahtera dapat dikatakan berhasil. Karena dari 25 mustahik yang di teliti sebanyak 24 keluarga mengalami peningkatan baik dari sisi material maupun spiritual, dan hanya 1 keluarga  yang tidak mengalami peningkatan baik dari sisi material maupun spiritual. Dengan Alasan karena harus bekerja secara berat.
Rekonstruksi Wacana Modernis-Tradisionalis: Kajian Atas Pemikiran Keislaman Muhammadiyah Dan Nahdlatul Ulama Pasca Reformasi
Authors: Aminuddin Luthfi Hadi
Published: August 2019

Membincang mengenai Islam di Indonesia melalui telaah organisasi Islam Muhammadiyah dan NU merupakan cara yang sangat positif dan efektif, karena bangsa Indonesia mayoritas muslim. Dua organisasi Islam tersebut, melalui sejarah panjang bangsa Indonesia mampu bertahan di tengah-tengah gempuran eksternal maupun eksternal. Secara eksternal berhadapan dengan organisasi Islam yang punya jaringan Internasional semisal HTI, IM, Salafi, dan lain sebagainya. Secara internal NU dan Muhammadiyah, saling berhadapan secara ideologis, material, kultural maupun politik untuk punya pengaruh besar di kalangan masyarakat Muslim Indonesia. Embrional dari pertarungan tersebut menghasilkan perbedaan secara dikotomis dengan mengatakan Muhammadiyah lebih bercorak modernis sedangkan NU sebaliknya cenderung berperilaku tradisionalis. Dalam perjalanan sejarahnya, baik Muhammadiyah maupun NU mengalami pergeseran pemikiran dan identitas baru, seperti Liberalisme-Transformatif dan Islam Berkemajuan di Muhammadiyah, dan Post-Tradisonalis dan Islam Nusantara di NU. Identitas-identitas tersebut menjadi penanda pergeseran baik pada level pemikiran maupun sosiologis yang ada pada Muhammadiyah maupun NU. Berangkat dari ide di atas dan diiringi perubahan-perubahan sosiologis yang terjadi dalam pemikiran dan gerakan Islam Indonesia beserta pergeseran identitasnya, tulisan ini mencoba merambah pada ruang waktu pasca reformasi yang mengacu tumbangnya otoritarianisme Orde Baru sebagai arena eksplorasi rekonstruksi wacana dikotomi modernis-tradisionalis pada Muhammadiyah dan NU beserta pergeseran identitasnya.
Eufimisme Dalam Dua Novel Duka Cinta Sebagai Wujud Kesantunan Berbahasa
Authors: Puspidalia Yuentie Sova
Published: August 2019

Untuk menghormati pihak lain dan menghindari ketabuan dalam berkomunikasi, tidak sedikit pemakai bahasa menggunakan eufemisme yang umumnya memiliki beberapa makna asosiatif. Dalam kegiatan berbahasa pun, seseorang perlu memperhatikan aspek kesantunan untuk meminimalisasi kesalahapahaman dan membuat lawan tutur merasa nyaman dan sejuk hatinya ketika berkomunikasi. Kesantunan berbahasa dapat ditemukan dalam berbagai aspek kehidupan masyarakat, baik di lingkungan sosial nyata maupun dalam cerita atau fiksi. Karena itu, peneliti melakukan kajian terhadap aspek-aspek penggunaan bahasa terkait dengan eufemisme dan kesantunan berbahasa dalam novel Roro Mendut (RM) karya Y.B. Mangunwijaya dan San Pek Eng Tay (SE) karya Oka Tiang.Penelitian ini mendeskripsikan bentuk dan fungsi eufemisme, frekuensi pemakaiannya dan wujud kesantunan berbahasa untuk mengetahui persamaan dan perbedaan keduanya. Hasil penelitian menunjukkan bahwa eufimisme berupa kata dan frasa memiliki bentuk dan fungsi ekspresi figuratif, satu kata untuk menggantikan kata yang lain, penggunaan kata serapan, flipansi, metafora, idiom, hiperbola, metafora dan hiperbola, metafora dan personifikasi. Penggunaan bentuk eufimisme ekspresif figuratif paling banyak digunakan. Perbedaannya, jika dalam RM digunakan bentuk eufimisme serapan, dalam SE tidak ditemukan, dalam RM ditemukan penggunaan bentuk eufimisme yang tidak ada dalam teori Allan Buridge, sedangkan dalam Novel SE tidak ditemukan. Dalam hal kesantunan berbahasa, jika dalam RM ditemukan maksim kedermawanan, dalam SE tidak ada. Wujud kesantunan berbahasa juga lebih banyak ditemukan pada RM daripada SE.
Optimalisasi Kemampuan Pedagogik Calon Guru IPA Melalui Program Perkuliahan Pimak (Pembelajaran IPA Muatan Ayat Kauniyah)
Authors: Fadly Wirawan
Published: August 2019

Penelitian ini bertujuan untuk mengetahui hasil rekonstruksi program perkuliahan pembelajaran IPA yang diorientasikan pada pembelajaran abad 21 bermuatan ayat kauniyah atau yang disebut sebagai program PIMAK agar layak digunakan untuk meningkatkan kemampuan pedagogis mahasiswa. Metode penelitian yang digunakan adalah eksperimen dengan desain penelitian onegroup pre-test-post-test design. Teknik pengumpulan data dilakukan melalui observasi dan tes yang kemudian datanya dianalisis melalui deskriptif kuantitatif, deskriptif kualitatif serta statistik inferensial. Hasil penelitian menunjukkan bahwa program PIMAK atau Pembelajaran IPA Muatan Ayat Kauniyah dapat meningkatkan kemampuan pedagogik mahasiswa. Hal ini dapat ditunjukkan dari: 1) Program PIMAK dapat diterapkan dan berhasil mendukung pembelajaran IPA abad 21, 2) Program perkuliahan PIMAK efektif meningkatkan kemampuan pedagogik mahasiswa secara signifikan.
Rekonstruksi Metodologi Hadits Kontemporer ( Telaah Atas Metode Takhrij Kontekstual )
Authors: Rumtianing Irma
Published: August 2019

Mayoritas umat Islam telah sepakat bahwa hadits merupakan sumber ajaran agama kedua setelah al-Qur’an. Kedudukan hadits sebagai mashadirul ahkam tidak akan pernah berubah, akan tetapi pemahaman hadits bisa berubah karena ajaran Islam yang termaktub di dalam al-hadits dituntut untuk sesuai dengan perkembangan zaman (mashalih likulli zaman wa makan ). Tulisan ini bermaksud menawarkan metode baru dalam memahami hadits dengan cara merekonstruksi metodologi hadits menggunakan metode takhrij kontekstual, yaitu sebuah metode yang dapat digunakan sebagai usaha untuk meretas kebekuan kajian hadits dengan memahami hadits secara aktual dan kontekstual. Hadits yang selama ini dipandang shahih dan termaktub dalam shahih Bukhari-Muslim dipandang perlu untuk dikaji ulang dengan menggunakan beberapa pendekatan yaitu; pendekatan  historis, sosiologis, antropologis, bahasa, psikologi, kultural dan pendekatan ilmu pengetahuan. Diharapkan tulisan berikut mampu merekonstruksi metode baru dalam memahami hadits sesuai dengan kontek kehidupan saat ini. Dengan menggabungkan antara analisis sanad, analisis matan dan reinterpretasi pemahaman serta menggunakan beberapa  pendekatan diatas, diharapkan hadits lebih dapat dimaknai sesuai dengan konteks kekinian, sehingga lebih dapat memberikan pemahaman yang tepat sesuai dengan kebutuhan umat.
Can cluster analyses of linked healthcare data identify unique population segments in a General Practice-registered population?
Authors: Nnoaham Kelechi , Cann Kimberley
Published: August 2019

Background

Population segmentation is useful for understanding the health needs of populations. Expert-driven segmentation has limitations which are theoretically overcome by more data-driven approaches. Previous explorations of utilisation-based cluster analysis for segmentation demonstrated feasibility but were limited in potential usefulness for local service planning. This study explores the potential for using utilisation-based cluster analyses to segment a local General Practice-registered population in the South Wales Valleys.

Methods

Primary and secondary care datasets were linked to create a database of 79,607 patients including socio-demographic variables, morbidities, care utilisation, cost and risk factor information. We used k-means cluster analysis to group the population into segments with distinct healthcare utilisation patterns based on seven utilisation variables: elective inpatient admissions, non-elective inpatient admissions, outpatient first & follow-up attendances, Emergency Department visits, GP practice visits and prescriptions. We analysed segments post-hoc to understand their morbidity, risk and demographic profiles

Results

Ten population segments were identified which had distinct profiles of healthcare use, morbidity, demographic characteristics and risk attributes. Although half of the study population were in segments characterised as ‘low need’ populations, there was heterogeneity in this group with respect to variables relevant to service planning – e.g. settings in which care was mostly consumed. Significant and complex healthcare need was a feature across age groups and was driven more by deprivation and behavioural risk factors than by age and functional limitation.

Conclusions

This analysis shows that cluster analysis of linked primary and secondary healthcare use data for a local GP-registered population can segment the population into distinct groups with unique health and care needs, providing useful intelligence to inform local population health service planning and care delivery. More detailed understanding of the health and care priorities of population groups could drive integration of health and care, reducing fragmentation and reducing healthcare costs. It could also inform a comprehensive approach to bridging population healthcare quality gaps and strengthening existing value-based healthcare frameworks.
School Suspension Predicts Trichomonas Five Years Later in a Matched Sample
Authors: Rosenbaum Janet E.
Published: August 2019

Background

Young adults who were suspended from school during adolescence are more likely than matched non-suspended youth to be arrested, on probation, or not graduate from high school, which are STI risk factors. This study evaluates whether suspension is a marker for STI risk among young adults who avoid subsequent negative effects.

Methods

This study evaluated whether suspension predicts a positive test for chlamydia, gonorrhea, or trichomonas in a urine sample using matched sampling in the National Longitudinal Study of Adolescent and Adult Health (Add Health), and evaluated potential mediators between suspension and STI status using causal mediation analysis. We used Mahalanobis and exact matched sampling within propensity score calipers to compare 381 youth suspended for the first time in a 1-year period with 980 non-suspended youth. The suspended and non-suspended youth were similar on 67 pre-suspension variables. We evaluated STI outcomes 5 years after suspension.

Results

Before matching, suspended youth were more likely to test positive for trichomonas and gonorrhea, but not chlamydia, than non-suspended youth. Suspended youth were more likely to test positive for trichomonas 5 years after suspension than matched non-suspended youth (OR=2.87 (1.40, 5.99)). Below-median household income before suspension explained 9% of the suspension-trichomonas association (p=0.02), but criminal justice involvement and educational attainment were not statistically significantly mediators.

Conclusions

School suspension is a marker for STI risk. Punishing adolescents for initial deviance may cause them to associate with riskier sexual networks even if they graduate high school and avoid criminal justice system involvement. Suspension may compound disadvantages for youth from below-median-income families, who have fewer resources for recovering from setbacks.
The neutrophil-lymphocyte ratio has a role in predicting the effectiveness of nivolumab in Japanese patients with metastatic renal cell carcinoma: A multi-institutional retrospective study
Authors: Nishiyama Naotaka , Hirobe Megumi , Kikushima Takuya , Matsuki Masahiro , Takahashi Atsushi , Yanase Masahiro , Ichimatsu Keisuke , Egawa Masayuki , Hayashi Norihiro , Masumori Naoya , Kitamura Hiroshi
Published: August 2019

Background: The neutrophil-lymphocyte ratio (NLR) is a well-known prognostic marker in various cancers. However, its role as a predictive marker for the effectiveness of nivolumab in patients with metastatic RCC (mRCC) remains unclear. We evaluated the relationships between the NLR and progression-free survival (PFS) or overall survival (OS) in mRCC patients treated with nivolumab.
Methods: The data of 46 mRCC patients who received nivolumab therapy were collected from six institutes and evaluated. The median follow-up period from treatment with nivolumab was 12.5 months (IQR 10.0-16.7).
Results: The median duration of nivolumab therapy was 6.5 months (IQR 3.3-13.7). The objective response rate was 22% and the 1- and 2-year PFS rates were 49.4% and 34.8%, respectively. The median NLR values at baseline and 4 weeks were 3.7 (IQR 2.7-5.2) and 3.7 (IQR 2.5-5.9), respectively. In the multivariate analysis, an NLR of ≥ 3 at 4 weeks was an independent predictor of PFS (P = 0.005) and OS (P = 0.031). The 1-year PFS of patients with an NLR of < 3 at 4 weeks was better than that of those with an NLR of ≥ 3 (83% versus 27%, P = 0.001). The 1-year OS of patients with an NLR of < 3 at 4 weeks was also better than that of those with an NLR of ≥ 3 (94% versus 71%, P = 0.002).
Conclusions: Although the baseline NLR was not associated with PFS or OS, an NLR of ≥3 at 4 weeks after the initiation of therapy might be a robust predictor of poor PFS and OS in mRCC patients undergoing sequential treatment with nivolumab.
Prevalence Rates and Associated Factors of Urinary Incontinence in Chinese Women
Authors: Xue Kaikai , Palmer Mary H , Zhou Fang
Published: August 2019

Background: This review of studies on urinary incontinence (UI) was focused primarily on UI prevalence rates and associated factors across the adult lifecourse of Chinese women. UI is a urologic symptom that has a significant impact on women's physical and mental health and quality of life. Although researchers from many countries have reported UI, little is known about the prevalence of UI specifically for women in China’s especially large female population. Of the published studies, language may act as a barrier to their inclusion in English-language journals. To overcome this barrier and to add to the global knowledge base about UI in women, the authors reviewed and discussed findings from epidemiological studies published in Chinese language.
Method: The authors retrieved research studies from databases: Wanfang, China National Knowledge Infrastructure, VIP for Chinese Technical Periodicals and China Biology Medicine. The authors used PubMed to search English-language studies published in Chinese journals on UI in Chinese women.
Results: This literature review includes 40 articles published between January 2013 and August 2017. The overall UI prevalence rates reported in adult Chinese women ranged from 8.7% to 59.4%, representing 43 to 297 million women, respectively. For women aged 17 to 40 years, 41 to 59 years, and 60 years and older, prevalence rates ranged from 2.6% to 30.0%, 8.7% to 47.7%, and 16.9% to 59.4%, respectively. Significant associated factors for overall UI included age, body mass index, constipation, parity, and menopause. Despite the 17 to 40 age range being peak reproductive years, the literature revealed little focus on UI prevalence rates. For women aged 41 to 59 years, the main associated factors included those related to pregnancy and gynecologic diseases. For women 60 years and older, chronic diseases represented most of the associated factors.
Conclusions: About 43 to 297 million Chinese women may experience UI. Many of the identified associated factors could be mitigated to reduce UI prevalence rates. Little is known about the prevalence rates and associated factors for UI among young (aged 17 to 40) Chinese women. Future research should investigate UI in young women to improve bladder health across their lifecourse.
Zhengyuan capsule for the treatment of cancer-related fatigue in lung cancer patients undergoing operation: study protocol for a randomized controlled trial
Authors: Zhang Zhouji , Zhang Ming , Wu Xiaoting , Cui Qing , Guo Yijun
Published: August 2019

Background: Cancer-related fatigue (CRF) is one of the most common and painful symptoms in patients with lung cancer undergoing treatment with operation, affecting patients’ physical, psychological, family and social functions as well as their quality of life. However, there is very little evidence for treatment guidelines at home and abroad. Traditional Chinese Medicine (TCM) has been proved to improve the symptoms of general weakness and shown to be beneficial to cancer patients’ recovery. TCM treatment should be based on syndrome differentiation. Aiming at the CRF, we should focus on bolstering the deficiency while simultaneously attacking and reinforcing it. This trial preliminarily evaluated the efficacy and safety of Zhengyuan capsule for CRF in lung cancer patients undergoing operation. Methods/design: The single center clinical study is a two-group, double-blind, prospective, placebo-controlled, randomized controlled trial (RCT) designed to assess the efficacy and safety of Zhengyuan capsule for CRF in lung cancer patients undergoing operation. Eligible participants will randomly divided into two groups: a treatment group receiving a 8-week Zhengyuan capsule regimen therapy and a control group receiving a 8-week placebo capsule regimen therapy. The main efficacy indicator is fatigue, assessed using severity scores from the Cancer Fatigue Scale(CFS) measurement system. Secondary efficacy measures include fatigue which assessed using severity scores from the Multidimensional Fatigue Symptom Inventory-Short Form(MFSI-SF) measurement system, TCM syndrome pattern differentiation, levels of immunologic indicators(TNF-α, IL-6, IL-1, T lymphocytes subsets and B lymphocyte subsets), patient’s pulmonary functionality and adverse events (AEs). Evaluation will be carried out at the screening period, baseline, the middle of the intervention and the end of the intervention, respectively. Discussion: Experimental results of Zhengyuan capsule can guide the improvement of CRF and provide evidences that Zhengyuan capsule is effective and safe in lung cancer patients undergoing operation. The data can be imported into the management and treatment guidelines of CRF for patients with lung cancer undergoing operation throughout China nationwide. Trial registration: Chinese Clinical Trial Registry (chictr.org.cn), ChiCTR1900022712/YZJ-TCM-ZYJN-02. Registered on 23 April 2019.
Physical and Mental Aspects of Patients With Sickle Cell Disease: a Portrait of Quality of Life in a Developing Country
Authors: Rodrigues Camila Freitas de Andrade , Rodrigues Thiago Alves , Cartágenes Maria do Socorro de Sousa
Published: August 2019

OBJECTIVE

This study aimed at analysing quality of life (QOL) indicators of patients with sickle cell disease (SCD) in treatment, investigating the epidemiological, socioeconomic and care situation provided to patients with SCD in the State of Maranhão, one of the poorest states of Brazil. METHODS: A cross-sectional study was carried out from March 2018 to February 2019, with the application of a generic quality of life questionnaire, SF-36, to patients attending a referral center for treatment of hemoglobinopathies in the State of Maranhão. 113 patients with SCD were interviewed and sociodemographic data, disease characteristics and laboratory tests (hemogram, foetal haemoglobin, DHL and reticulocytes) were collected. The SF-36 questionnaire was then applied. RESULTS: Most of the 113 patients were female, with a mean age of 26 years, declaring themselves to be of brown colour and living in the interior of the State. Most were unemployed, having low income and low schooling. About 92% were of the SS subtype, the most serious subtype. The percentage of neonatal diagnosis was only 27.4%. Regarding the SF-36 questionnaires, quality of life was classified as poor in relation to the physical component and good in the mental component. The use of hydroxyurea, the only medication approved in Brazil for the control and prevention of pain, promoted an improvement in the physical appearance of patients with SCD, howbeit, with no relation to the prevalence of clinical complications. CONCLUSIONS: The use of the SF-36 generic questionnaire showed impairment in the quality of life in the physical domains of patients with SCD, worsening in cases in which there was delayed diagnosis; in those individuals who claimed to have suffered prejudice; and in patients hospitalised for pain attacks. No deterioration of the mental components was observed. This scenario implies a need for government action sensitive to this public health problem.
The effects of occupational pollutants on the reproductive health of female informal street traders in Warwick Junction, Durban, South Africa – a cross-sectional study
Authors: Hariparsad Sujatha , Naidoo Rajen
Published: August 2019

Background:
Informal street traders are exposed on a daily basis to traffic emissions and biomass fuel smoke containing a variety of pollutants. These exposures are likely to place the female traders at increased risk for adverse reproductive outcomes.
Aim
The aim of this study was to compare the reproductive outcomes among street traders exposed to pollutants from their work-related activities and traders without such exposure.
Methods:
A cross-sectional study was conducted among 305 female traders selected from exposed and non-exposed areas within the Warwick Junction trading hub, located in Durban, South Africa. Validated reproductive questionnaires and clinical assessments were conducted on all participants. Adverse reproductive outcomes such as low birth weight, spontaneous abortions and infertility were assessed
Results:
The mean age of the traders was 43.6 years (SD:12.1), mostly single (63%) and worked in trading hub for an average of 14 years. There were 876 pregnancies reported in the total sample. Traders pregnant while working in in this location accounted for 120 pregnancies There was an increased risk of exposed traders having a low birth weight infant as compared to non-exposed traders (OR=3.7; CI: 1.8, 7.6). Exposed traders were also almost 3 times more likely to be infertile as compared to non-exposed traders (OR=2.6; CI: 1.6, 4.3).
Conclusions:
Working as a street trader may have a causal association with developing adverse reproductive outcomes in females. Recommendations to mitigate adverse exposures have been suggested which include short term safety interventions and better cooking practices and future long term policy interventions.
Anterior Controllable Antedisplacement and Fusion (ACAF) technique for the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis (MCSMSS): a retrospective study of 45 cases
Authors: Luo Xi , Sun Kaiqiang , Sun Jingchuan , Wang Shunmin , Wang Yuan , Yang Haisong , Jiang Jialin , Guo Yongfei , Shi Jiangang
Published: August 2019

Background To investigate the clinical effect of anterior controllable antedisplacement and fusion (ACAF) technique for the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis (MCSMSS), and compare ACAF with hybrid decompression fixation (HDF).
Methods A retrospective analysis of 85 cases with MCSMSS was carried out. 45 patients were treated with ACAF, while 40 patients were treated with HDF. The operation time, intraoperative bleeding volume, postoperative complications, Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) score, Computed Tomography (CT) transverse measurement, cervical curvature and Kang's grade were compared between two groups.
Results The patients were followed up for 12 to 17 months. Compared with HDF, ACAF group achieved better decompression according to CT measurement and Kang’s grade (P < 0.05), and recovered to a greater cervical Cobb’s angle (P < 0.05). However, JOA score and NDI index showed no significant difference one year after surgery (P＞0.05). Additionally, ACAF presented longer operation time and greater intraoperative blood loss (P < 0.05). As to complications, ACAF developed less incidences of cerebrospinal fluid examination (CSF) leakage, neurologic deterioration, epidural hematoma and C5 palsy by comparing with HDF.
Conclusions ACAF is an effective method for the treatment of MCSMSS. Compared with HDF, ACAF has the advantages of significant decompression, increasing cervical curvature, and reducing the incidences of complications.
Characteristics and management of iatrogenic proximal humeral fracture during manual reduction of shoulder dislocation
Authors: Zhou Yan , Ming Jianghua , Liu Shiqing
Published: August 2019

Purpose

This study aimed to investigate the characteristics, management and patient outcomes of iatrogenic proximal humeral fracture during manual reduction of shoulder dislocation.

Methods

A retrospective chart review from January 2014 to June 2017 identified 10 patients of iatrogenic proximal humeral fracture during shoulder dislocation reduction. The sex and age of patients, associated injuries and location, first-time or habitual shoulder dislocation, the type of anesthesia, the time from injury to revision surgery as well as functional outcomes were analyzed.

Results

There were 1 male and 9 females (female/male ratio 9:1) with an average age of 66.9 years (range, 50-77 years). All patients presented with first-time anterior shoulder dislocation, and 7 patients (70%) associated with greater tuberosity fractures (GTF). Four patients (40%) underwent reduction under general anesthesia and 6 reduction (60%) under propofol sedation. The revision surgery was performed by open reduction and internal fixation. The mean follow-up period was 18.2 months (range, 12–36 months). The mean visual analog score (VAS) was 3.0 ± 1.6 (range, 1-6), and the mean Neer scores were 82.1 ± 6.5 (range, 71-93). Significant differences were observed in the Neer score and VAS with the time (more or less 8 h) from injury to revision surgery (P < 0.05).

Conclusion

A high risk of iatrogenic proximal humeral fracture is present in first-time anterior shoulder dislocation with GTF in senile female. Effective reduction and internal fixation performed timely may help to improve functional outcomes in case of iatrogenic injury.
Use of over-the-counter medicines: a window into chronic disease management by private medical insurance schemes in South Africa
Authors: Padayachee Neelaveni , Rothberg Alan Dan , Butkow Neil , Truter Ilse
Published: August 2019

Background

In South Africa (SA) privately-insured individuals have easy access to over-the-counter (OTC) medicines. For patients registered with the insurer for management of a chronic disease through a disease management programme (DMP), the manner in which OTCs are accessed may provide insight into how well the disease is controlled and also how well the DMP is performing.

Objective

The study aimed to measure access to commonly-used OTC products by individuals registered for management of prevalent chronic diseases, and to consider why the medicines were selected in addition to mainstream drugs usually prescribed for treatment.

Methodology

Data were extracted from a large corporate database. Individuals of interest were aged ≥40 years and registered for management of one of the prevalent non-communicable diseases. Utilization of aspirin, inhaled corticosteroids and bronchodilators was assessed.

Results

The study population included 4 149 individuals registered for management of hypertension, hyperlipidaemia, Type 2 diabetes, asthma, chronic obstructive pulmonary disease, bronchiectasis, coronary artery disease, cardiomyopathy, cardiac failure, arrhythmia, vascular disease or glaucoma, and 12 105 controls without any of the chronic conditions. The conditions were grouped together as metabolic, respiratory, cardiovascular or glaucoma. Whether accessed directly by individuals or prescribed by doctors, there was high utilisation of bronchodilators in the respiratory group, likely for supplementary management of disease. Bronchodilators were possibly accessed for management of side effects of medicines prescribed for treatment of cardiovascular disease. Bronchodilator access was also high among control subjects, possibly indicating that this group included those with asymptomatic or undiagnosed disease. Aspirin appeared to be appropriately utilised for management of cardiovascular and metabolic disease. All the OTC medicines were inappropriately funded out of the acute medicines benefit pool instead of being funded from the chronic medicines pool.

Conclusions

Disease management programmes are an integral part of managed care, which itself is written into legislation as a tool to mitigate clinical and financial risk within privately-funded medical insurance schemes. Analysis of OTC medicines accessed by DMP-registered individuals strongly suggests that DMPs are falling short in both clinical and financial areas. Routine system-driven claims analysis would enable insurers to develop performance-enhancing interventions.
A nomogram by adding atrial fibrillation to multicenter stroke survey score to predict intracranial hemorrhage in stroke patients undergoing thrombolysis
Authors: Miao Changqing , Yin Xiaoyan , Liang Simin , Mu Chunying , Zhang Yurong
Published: August 2019

Background: Identiﬁcation of stroke patients at risk of postthrombolysis intracranial hemorrhage (ICH) in the clinical setting is essential. However, studies in this area spare.We aimed to develop a nomogram by adding atrial fibrillation to the Multicenter Stroke Survey (MSS) score to predict the probability of ICH in acute ischemic stroke patients undergoing thrombolysis.

Methods: A retrospective observational study was conducted with 287 participants from a single center (67.2% males, median age 65 years). Head computed tomography scan was performed after 24 hour to evaluate ICH occurrence, and a computed tomography scan was done immediately in case of clinical worsening. The risk factors associated with ICH were analysed. Based on multivariate logistic model, a nomogram was generated for ICH on the basis of atrial fibrillation and the MSS score. We assessed the discriminative performance by using the area under curve (AUC) of receiver-operating characteristic (ROC) and calibration of risk prediction model by using calibration plot.

Results: A total of 41(14.3%) ICH events occurred.The MSS score and atrial fibrillation were independent predictors of ICH in multivariate logistic regression analysis. Discrimination of the nomogram was superior to the MSS score alone (0.794 vs 0.741; P=0.034). The model was internally validated by using bootstrap (1000 samples) with AUC-ROC of 0.795. The calibration plot showed good agreement.

Conclusion: We developed and internally validated a new nomogram using the MSS score and atrial fibrillation as predictors.The nomogram is a simple and accurate tool for predicting ICH in acute ischemic stroke patients undergoing thrombolysis. Further studies are warranted to validate our findings.
Comparative Analysis of the Effects of Propofol and Sevoflurane on Postoperative Cognitive Function in Elderly Patients with Lung Cancer
Authors: Yan Tao , Ai Bolun , Zhang Huimin , Kong Xiangyi , Lee Wan-Ting , Sun Li , Zhang Guohua , Zheng Hui
Published: August 2019

Background
The potential risk for cognitive impairment following surgery and anesthesia is a common concern, especially in the elderly and more fragile patient. The risk for various neurocognitive effects is thus an area of importance. The independent impact of surgery and anesthesia is still not known. Likewise, the independent effect of different drugs used during anesthesia is a matter of debate as is the number and amounts of drugs used and the "depth of anesthesia". So, understanding the drug-related phenomenon and mechanisms for postoperative cognitive impairment is essential. This meta-analysis aims to compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function in elderly patients with lung cancer.

Methods
This study is a systematic review and meta-analysis for controlled clinical studies. Public-available online databases were searched to identify eligible randomized placebo-controlled trials or prospective cohort studies concerning the effects of propofol and sevoflurane on postoperative cognitive function. The primary endpoints are postoperative mini-mental state examination (MMSE) scores at various time points; the secondary endpoint is the serum S100beta concentration 24 hours after surgery. SMDs along with 95% CIs were extracted and analyzed using random or fixed effects models. Analyses regarding heterogeneity, risk of bias assessment, and sensitivity were performed.

Results
We searched 1626 eligible publications and 14 studies of 1404 patients were included in the final analysis. The majority of included studies had been undertaken in Asian populations. Results suggested that propofol has a greater adverse effect on cognitive function in the elderly patients with lung cancer than sevoflurane. There were significant differences in issues of MMSE 6h (11 studies; SMD -1.391, 95% CI -2.024, -0.757; p < 0.001), MMSE 24h (14 studies; SMD -1.106, 95% CI -1.588, -0.624; p < 0.001), MMSE 3d (11 studies; SMD -1.065, 95% CI -1.564, -0.566; p < 0.001), MMSE 7d (10 studies; SMD -0.422, 95% CI -0.549, -0.295; p < 0.001), and serum S100beta concentration at 1 day after surgery (13 studies; SMD 0.746, 95% CI 0.475, 1.017; p < 0.001).

Conclusion
Propofol has a more significant adverse effect on postoperative cognitive function in elderly patients with lung cancer than sevoflurane.
Cross-sectoral rehabilitation intervention for patients with intermittent claudication versus usual care for patients in non-operative management - The CIPIC Rehab study: study protocol for a randomised controlled trial
Authors: Siercke Maj , Jørgensen Lise Pyndt , Missel Malene , Thygesen Lau Caspar , Blach Pernille Peppercorn , Sillesesn Henrik , Berg Selina Kikkenborg
Published: August 2019

Introduction: Intermittent claudication (IC) caused by Peripheral Artery Disease (PAD) is a common cardiovascular disease. Patients with IC have reduced walking capacity, restricted activity levels and mobility, and reduced health-related quality of life. The disease leads to social isolation, the risk of cardiovascular morbidity, and mortality. Non-operative management of IC requires exercise therapy and studies show that supervised exercise training is more effective than unsupervised training, yet many patients with IC lack motivation for changes in health behavior. No studies investigating the effects of existing cardiac rehabilitation targeted patients with IC have been published. The aim of this paper is to present the rationale and design of the CIPIC Rehab Study, which examines the effect of a cross-sectoral rehabilitation programme versus usual care for patients in non-operative management for IC. Methods and analysis: A randomised clinical trial aims to investigate whether cardiac rehabilitation for patients with IC in non-operative management versus usual care is superior to treatment as usual. The trial will allocate 118 patients, 1:1 individual randomisation to either the intervention or control group. The primary outcome is maximal walking distance measured by the standardised treadmill walking test. The secondary outcome is pain-free walking distance measured by the standardised treadmill walking test, healthy diet measured by a fat-fish-fruit-green score, and level of physical activity measured by activity score within official recommendations. Statistical analyses will be blinded. Several exploratory analyses will be performed. A mixed-method design is used to evaluate qualitative and quantitative findings. A qualitative and a survey-based complementary study will be undertaken to investigate patients’ post-discharge experiences. A qualitative post-intervention study will explore experiences of participation in rehabilitation. Discussion: The study is the first to assess the effect of a cardiac rehabilitation programme designed for patients with intermittent claudication. The study will describe how to monitor and improve rehabilitations programme for patients with intermittent claudication in a real-world setting. Mixed method strategies can allow for both exploration and generalization in the same study, but the research design is a complex intervention and any effects found can not be awarded a specific component.
Vision status of children aged 7 - 15 years referred from school vision screening in Norway during 2003 - 2013: a retrospective study
Authors: Falkenberg Helle K , Langaas Trine , Svarverud Ellen
Published: August 2019

Background: Undetected vision problems is an important cause of reduced academic achievement, performance in everyday life and self-esteem. This receives little attention in national health care services in Norway even though most of these vision problems are easily correctable. There are no published data on how many Norwegian schoolchildren are affected by correctable vision problems. This study aims to determine the vision status in primary and secondary schoolchildren referred from vision screening during the 10 year period of 2003 -2013.
Methods: Of the 1126 children (15%) aged 7 - 15 years referred to the university eye clinic by the school screening program, all 782 who attended the eye clinic were included in the study. Patient records were retrospectively reviewed with regard to symptoms, refractive error, best corrected visual acuity (BCVA) of logMAR, binocular vision, ocular health and management outcomes.
Results: Previously undetected vision problems were confirmed in 650 (83%) of the children. The most frequent outcomes were glasses (346) or follow-up (209), but types of treatment modalities varied with age. Mean refractive errors were hyperopic for all age groups but reduced with age (ANOVA, p < 0.001). Overall, 51% were hyperopic, 32% emmetropic and 17% myopic. Refractive errors did not change across the decade (linear regression, all p > 0.05). Mean logMAR BCVAs were better than 0.0 and improved with age (ANOVA, p < 0.001). The most prevalent symptoms were headaches (171), near vision problems (149) and reduced distance vision (107).
Conclusions: The vision screening identified children with previously undetected visual problems. This study shows that the types of visual problems varied with age and that most problems could be solved with glasses. Our results stress the importance of regular eye examinations and that vision examinations should be included in primary health care services. Furthermore, there is a need for raised awareness among parents and teaching staff regarding vision problems in children.
MULTIPLEX qPCR FACILITATES IDENTIFICATION OF BETAHERPESVIRUSES IN PATIENTS WITH ACUTE LIVER FAILURE OF UNKNOWN ETIOLOGY
Authors: Raposo Jéssica Vasques , Alves Arthur Daniel Rocha , Silva Alexandre Dos Santos Da , Santos Damião Carlos Dos , Melgaço Juliana Gil , Moreira Otacilio Cruz , Pinto Marcelo Alves , de Paula Vanessa
Published: August 2019

Background: The etiology of acute liver failure (ALF) is often unknown and reported to be associated with herpesviruses in a number of cases. In this study, we examined for betaherpesviruses infections in patients with ALF of unknown etiology using a multiplex qPCR to Betaherpesviruses subfamily.
Methods: Liver explant and serum samples from 27 patients with ALF of unknown etiology were analyzed with the aid of multiplex qPCR to identify betaherpesviruses. All positive samples were sequenced to confirm herpes infection and liver enzyme levels evaluated.
Results: Betaherpesviruses infection was effectively detected using multiplex qPCR. Six (22%) HHV-6, one (3%) HCMV and two (7%) dual infections (one with HHV-7/HHV-6, and the other with HHV-7/ HCMV). Interestingly, HHV-7 was only detected in the presence of other betaherpesviruses. Sequencing information confirmed betaherpesviruses infection. High hepatic enzyme levels and INR values>1.5 were determined in all betaherpesvirus-positive patients.
Conclusions: Multiplex qPCR facilitated efficient quantification, indicating that differentiation between betaherpesviruses is possible with the sole use of real-time PCR. Liver explant and serum samples were positive for some betaherpesviruses, and coinfection of HHV-7 with HHV-6 and HCMV was additionally detected. Based on these results, we propose that ALF patients should be screened for the presence of betaherpesviruses.
Estimating the annual risk of infection with Mycobacterium tuberculosis among adolescents in Western Kenya in preparation for TB vaccine trials
Authors: Nduba Videlis , Hoog Anna H. van’t , de Bruijn Annefleur , Mitchell Ellen M.H. , Laserson Kayla , Borgdorff Martien
Published: August 2019

Background: Adolescents are a prime target group for tuberculosis (TB) vaccine trials that include prevention of infection (POI). The BCG vaccine is given at birth and does not prevent TB infection. TB infection, a critical endpoint for POI vaccine trials would need to be documented to estimate sample sizes in target populations.
Methods: Adolescents aged 12-18 years of age were enrolled in an area under continuous demographic surveillance. A tuberculin skin test (TST) survey was conducted as part of a study on TB prevalence and incidence. All adolescents got TSTs at enrolment and returned after 72 hours for reading. A TST of ≥10mm if HIV negative or ≥ 5mm if HIV positive, was considered positive.
Results: Of 4808 adolescents returning for TST readings (96% of those enrolled), mean age was 14.4 (SD 1.9), 4518(94%) were enrolled in school and 21(0.4%) gave a previous history of tuberculosis. Among adolescents with TST reactivity, the mean TST induration was 13.2 mm (SD 5.4). The overall prevalence of latent TB infection was 1544/4808 (32.1%, 95% CI 29.2-35.1) with a corresponding annual risk of TB infection (ARTI) of 2.6% (95% CI 2.2-3.1). Risk factors for a positive TST included being male (OR 1.3, 95%CI 1.2,1.5), history of having a household TB contact (OR 1.5, 95%CI 1.2,1.8), having a BCG scar (OR 1.5,95%CI 1.2,1.8), living in a rural area (OR 1.4, 95%CI 1.1,1.9), and being out of school (OR 1.8, 95%CI 1.4,2.3).
Conclusion: We conclude that the high TB transmission rates we found in this study, suggest that adolescents in this region may be an appropriate target group for TB vaccine trials including TB vaccine trials aiming to prevent infection.
Therapeutic effect of vasoactive intestinal peptide on form-deprived amblyopic kittens
Authors: Li Bo , Zou Yunchun , Li Liwen , Deng Hongwei , Mi Wei , Wang Xing , Yin Ximin
Published: August 2019

Background: Exploring the role of vasoactive intestinal peptide (VIP) in the lateral geniculate body (LGBd) in visual development and studying the therapeutic effect of VIP on amblyopic kittens.
Methods: Three-week-old domestic cats were divided into a control group (n = 10) and a monocular deprivation group (n = 20), with an eye mask covering the right eye of those in the deprived group. After pattern visual evoked potential (PVEP) recording confirmed the formation of monocular amblyopia, the left LGBd was isolated from 5 kittens in each group. The remaining control kittens continued to be raised, and the remaining deprivation group was divided into a VIP intervention group (n = 5), Sefsol (caprylic acid monoglyceride, VIP solution) intervention group (n = 5) and amblyopia non-intervention group (n = 5) after removal of the eye mask. Three weeks later, PVEPs, VIP immunohistochemistry and VIP mRNA expression in the left LGBd were compared across groups.
Results: At 6 weeks of age, there were significant differences in P100 wave latency and amplitude and VIP immunohistochemistry and in situ hybridization between the control group and the deprivation group (P < 0.05). After 3 weeks of the corresponding interventions, the latency and amplitude in the VIP intervention group were better than that in the Sefsol intervention group and amblyopia non-intervention group (P < 0.05). Furthermore, VIP treatment increased the number of immunohistochemical VIP-positive cells (P < 0.05) and the average optical density of positive cells (P > 0.05), as well as the number (P < 0.05) and average optical density of VIP mRNA-positive cells (P < 0.05).
Conclusions: VIP plays an important role in visual development. Nasal administration of VIP can improve the function of neurons in the LGBd of kittens and has a certain therapeutic effect on amblyopia.
Democracia y seguridad en UNASUR. La protodemocracia (illiberal democracy) como característica de los regímenes suramericanos: Colombia - Venezuela y la autocracia en el siglo XXI
Authors: Guzmán Gámez Harvey
Published: August 2019

Dentro del contexto de la UNASUR el enfrentamiento entre Colombia y la República Bolivariana de Venezuela ha resaltado tanto por las intervenciones de los personajes que ostentan el poder como por las posiciones que cada uno muestra en los temas de la agenda internacional. Es evidente que existe un enfrentamiento al mejor estilo de la Guerra Fría en donde cada una de estas facciones ostenta y presume de sus aliados. Criterios como libertad, democracia, legalidad están constantemente siendo esgrimidos en casi todos los países de la América del Sur en tanto que sus gobernantes tratan de hacer de sus gobiernos piedras basales para el desarrollo de una nueva sociedad. La seguridad en este contexto juega un papel crítico dentro de las relaciones internacionales en tanto que los problemas de los pueblos Suramericanos trascienden las fronteras generando nuevas dinámicas y formas de asumir el tema de la seguridad interna y cómo serán las relaciones entre los países a la hora de acordar, concretar e implementar una política de seguridad hemisférica. Este artículo pretende hacer un recorrido histórico por los acontecimientos que pudieron forjar el carácter de los pueblos del norte de Sur América y su eterno enfrentamiento, a pesar de su simbiótica relación, tratando de definir cuál es el tipo de democracia que se ha formado en estas tierras.
Realidades y perspectivas de la Unión Europea
Authors: Londoño Adriana
Published: August 2019

Entrevista al profesor Gustavo Puyo
La ineficacia del negocio jurídico en el derecho privado colombiano
Authors: Uribe Vargas Hernando
Published: August 2019

Esta reflexión describe los elementos fundamentales de la ineficacia del negocio jurídico en sentido y amplio y en sentido estricto, así como su regulación en los Códigos Civil y de Comercio de Colombia.Dentro del concepto amplio de ineficacia se hace alusión al régimen de las nulidades consagrado en la legislación civil y mercantil.
Las zonas de reservas campesina: ¿Posibilidad real de una política de tierras en Colombia?
Authors: Valencia Toro Marcela
Published: August 2019

El problema de la distribución de la propiedad rural continúa vigente hoy en Colombia. Desde una lectura de los instrumentos de política pública, la Ley 160 de 1994 se convierte en el marco normativo fundamental de esta política pública, teniendo como base fundamental, la lógica del Mercado Asistido de Tierras.En esta Ley se crea un instrumento de política interesante con la figura de las Zonas de Reserva Campesina, que puede ser leída como una forma de organización territorial, y que podría hacer parte de una verdadera política de tierras en el país si el diagnóstico del problema apelara a la solución del problema de la concentración de la propiedad rural.