bluuebunny/crossref_metadata_2025 huggingface dataset:
Main Factors Related with the White Coat Effect Level in Patients with Arterial Hypertension and Bronchial Asthma
Authors: Andreeva G. F. , Smirnova M. I. , Gorbunov V. M. , Kurekhyan A. S. , Koshelyaevskaya Y. N.
Published: May 2021

Aim. To study the main relationships of the white coat effect (WCE) levels in patients with arterial hypertension (AH) with bronchial asthma (BA) who treated with AH and BA drugs in routine clinical practice.

Material and Methods. We analyzed the prospective cohort study data of AH patients, some of them had BA without exacerbation. We have formed two groups of patients:1 - control group, patients with AH without BA, the second - with AH + BA. The study consisted of three visits (first visit, 6 months and 12 months visits) and data collection period (30.1±7.6 months of follow-up). The following procedures were performed at the first and 12 month visits: clinical blood pressure (BP) measurements (sitting and standing), 24-hour monitoring ambulatory (ABPM), spirometry, clinical and biochemical blood tests, BA control questionnaires (ACQ) and quality of life (QL) questionnaire (GWBQ), at the second visit clinical BP measurement was performed and, if necessary, the drug dose was corrected.

Results. The study included 125 patients, 28 men, 97 women. The first group of AH patients without BA included 85 people, the second (AH + BA) - 40. In AH patients without BA with ischemic heart disease, arterial revascularization, regular alcohol intake and smoking we identified the association with the lower WCE levels. In AH+BA patients with diabetes mellitus, gastrointestinal diseases, higher education was identified WCE decrease. In AH patients without asthma we found inverse relationships WCE levels with respiratory function parameters, the nighttime BP decrease, heart rate and the difference between standing and sitting BP levels, and correlations with the EchoCG variables (the left ventricular hypertrophy (LVH) indices), with age, AH duration and body mass index (BMI). In patients with AH + BA we found inverse correlations between WCE levels and some EchoCG variables, the difference between standing and sitting BP levels, and correlations with body weight, BMI.

Conclusion. Thereby, in AH patients without BA with ischemic heart disease, revascularization, regular alcohol intake, smoking we identified the association with the lower WCE levels. This patients WCE indices had inverse correlations with height, respiratory function parameters, the BP nighttime decrease, the difference between standing and sitting BP levels and direct relationships with EchoCG variables of LVH, age, AH duration and BMI. In AH + BA patients with diabetes, gastrointestinal diseases, higher education we found relationships with lesser WCE manifestation. WCE levels in this group had inverse correlations with some EchoCG indicators, the standing and sitting BP difference and direct relations with weight and BMI.
The relationship between knowledge of socio scientific issue and nature of science in ecosystem material in high school students
Authors: Geopany Ilmi Octaviani , Hernawati Diana , Meylani Vita
Published: May 2021

The purpose of this study was to know the relationship between socio-scientific issues with nature of science students in ecosystem material of the XI Math and science class in one of the High Schools. This research was conducted from September- October 2020. The type of research was correlational with sample of 36 students taken using a purposive sampling technique as evidenced by the average value of daily tests. The technique on data collection was a non-test instrument socio-scientific issue questionnaire and essay test the nature of science. The research instruments used included a socio-scientific issue questionnaire which states 13 statements regarding controversial issues regarding ecosystems and the views nature of science form B (VNOS-B) description test to measure the nature of science dictated by Lederman et al. (1998) and have settled 14 questions. Data were analyzed using Pearson bivariate. The results of this study obtained a significance of 0.00 < (0.05) which indicates the relationship between socio-scientific issues with the nature of science and 0.729 as the display value. This analysis concludes that there is a positive relationship between socio-scientific issues with the nature of science at a high level. Teachers are expected to be able to improve skills in indicators of socio-scientific issues, one of which is by training sensitivity and awareness of environmental problems that students encounter on a daily basis.
Process Analysis of a Public Policy in Turkey: Medical Tourism
Authors: KANTAŞ YILMAZ Fatma , CAPAR Hasim , ŞEKER Canan
Published: May 2021

Medical tourism field, which is a developing industry in terms of variety and popularity of medical interventions, generated in the formation of policy, implementation, understanding the efficiency and effectiveness would help to build Turkey's future projections. The purpose of the research is to analyze the policy of medical tourism in Turkey in the context of actors by using “Process Analysis Model”. In the study which is designed with qualitative method, case study design and purposive sampling methods are used. The findings are analyzed by content analysis method under the headings of the model: agenda setting, formulation, legitimation, implementation and evaluation. The common opinion that the actors of medical tourism do not fully utlise the potential of medical tourism potential in Turkey, underlines the importance of enhancing the participation and collaboration of stakeholders in increasing the market share in Turkey.
International Trade of Cultural Products and Economic Growth: A Panel Data Analysis
Authors: ÖZBUĞDAY Fatih Cemil , ÖZGÜR Önder
Published: May 2021

The potential of international trade of cultural products in fostering economic growth has been neglected in the empirical economics literature. The study explores the relationship between international trade of cultural products and gross domestic product (GDP) per capita in 85 countries between 2004-2017 using the Pedroni cointegration test and Swamy (1970)’s random coefficient model. The results show that although the trade balance of cultural products does not affect economic growth, the volume of international trade in cultural products has a statistically significant and positive impact on GDP per capita. These findings indicate that policymakers should not require protective steps against the imports of cultural goods or services and the call of the 2005 UNESCO Convention on the Protection and Promotion of the Diversity of Cultural Expressions to developed economies to open their markets is an appropriate suggestion.
PENGARUH PEMBERIAN SARI TOMAT (Solanum lycopersicum L) DAN INSULIN TERHADAP KADAR GLUKOSA, KADAR LDL, KADAR KOLESTEROL DAN BERAT BADAN LAHIR TIKUS PUTIH STRAIN WISTAR (Rattus Norvegicus) BUNTING DENGAN MODEL DIABETES MELLITUS TIPE 2
Authors:   Midwifery Program, Universitas Brawijaya, Ubaidurrohmah Savitri Faradea , Andani Ayu Safitri Risma ,   Midwifery Program, Universitas Brawijaya, Pangesthi Maharani Wening ,   Midwifery Program, Universitas Brawijaya, Dwi Andriani Lela ,   Midwifery Program, Universitas Brawijaya, Kalsum Umi ,   Medical Faculty, Universitas Brawijaya, Proborini Astri ,   Midwifery Program, Universitas Brawijaya, Reksohusodo Subandi ,   Midwifery Program, Universitas Brawijaya, Dian Hanifarizani Rahma ,   Midwifery Program, Universitas Brawijaya
Published: May 2021

Diabetes Mellitus is a chronic disease caused by abnormal working insulin, insulin secretion or both so that the body tends to have high glucose levels. Type 2 diabetes mellitus can cause elevated levels of LDL and cholesterol. Risks obtained by fetuses with type 2 diabetes can be in the form of macrosomia due to hyperglycemia and hyperinsulin in the body of the fetus. Insulin is the first choice pharmacological therapy for type 2 DM that can be given during pregnancy. Non-pharmacological therapy as recommended by the World Health Organization (WHO) on a healthy diet by increasing consumption of fruits and vegetables. Good fruit consumed for pregnant women with diabetes mellitus (DM) type 2 is tomatoes (Solanum lycopersicum L). The purpose of this study was to determine the administration of tomato extract (Solanum lycopersicum L) and insulin can affect glucose levels, LDL levels, cholesterol levels and birth weight of white wistar galur (Rattus norvegicus) pregnant women with type 2 diabetes mellitus models. experimental design using the pre post test only control group design and post test only control group design. Termination was done on the 17th day of pregnancy and then followed by measurements of LDL levels, cholesterol and birth weight. Data analysis using the One Way Anova test and Kruskal Wallis then continued with the Post Hoc test using. The results showed that there were significant differences between glucose levels, LDL levels, cholesterol levels and BW born in the insulin treatment group and the tomato juice treatment (p value = 0.00 <α = 0.05). The conclusion of giving insulin and tomato juice affects a decrease in glucose levels, LDL levels, cholesterol levels and birth weight.
Pengetahuan dan Praktik Bidan tentang Standar Pelayanan Kehamilan di Era Pandemi Covid-19
Authors:   Pendidikan Profesi Bidan, Fakultas Ilmu Kesehatan, Universitas Muhammadiyah Sidoarjo, azizah nurul , Rosyidah Rafhani ,   Pendidikan Profesi Bidan, Fakultas Ilmu Kesehatan, Universitas Muhammadiyah Sidoarjo
Published: May 2021

Coronavirus 2019 (COVID-19) is a highly contagious new type of respiratory disease (pneumonia) caused by coronavirus 2 (SARS-CoV-2). All countries are making various efforts to control covid-19, but there are still many infected victims, so WHO has designated this case as a Covid-19 Pandemic. Pregnant women are more susceptible to viral infections; this is due to changes in the immune system and body anatomy. Pregnancy checks in the hospital will be a significant risk for the threat of covid-19 transmission, while services during pregnancy are essential to avoid complications that can occur during pregnancy. This study aims to identify midwives' knowledge and practice regarding the standard of pregnancy services during the Covid 19 pandemic, using a questionnaire given to midwives as health care workers. The study design used a crosssectional study with a chi-square statistical test to determine health services barriers during the pandemic. They were analyzed descriptively. Samples took with quota sampling, with a total of 30 midwives in Candi Sidoarjo sub-district. The research instrument used a questionnaire. This study indicates that 70% of midwives have good knowledge but do not implement standard pregnancy care during the pandemic. The analysis results show that there is no relationship between knowledge and standard practice of pregnancy services during the Covid-19 pandemic. Conclusion: Most midwives have good knowledge and do not practice standard pregnancy services during the Covid- 19 pandemic. Suggestion. The next research is to identify the achievements of the pregnancy service program during the Covid-19 pandemic
ANALISIS TINGKAT KEPUASAN MASYARAKAT DALAM PELAYANAN PUBLIK (STUDI KASUS: DI GORONTALO UTARA)
Authors: Abdussamad Zuchri , Tahir Arifin , Arsana I Kadek Satria
Published: May 2021

Abstrak: Analisis Tingkat Kepuasan Masyarakat Dalam Pelayanan Publik Studi Kasus: Di Gorontalo Utara. Pelayanan publik yang dilaksanakan oleh pemerintah daerah perlu dilakukan penilaian secara berkala. Hal ini berfungsi sebagai proses pembenahan layanan birokrasi pemerintahan. Tujuan penelitian ini adalah sebagai proses penilaian tingkat kepatuhan layanan yang diberikan oleh Organisasi Perangkat Daerah di Kabupaten Gorontalo Utara. Metode yang digunakan adalah mix metode yakni gabungan metode kualitatif dan kuantitatif. Untuk mendapat data yang valid maka terlebih dahulu dilakukan survei. Kesimpulannya hasil analisis survei pemerintah daerah Gorontalo Utara berkategori “Baik” dengan indeks sebesar 79.13. Bila dibandingkan dengan hasil indeks nilai kepatuhan pelayanan yang dipublikasikan oleh Ombudsman Republik Indonesia Tahun 2019 Kabupaten Gorontalo Utara memperoleh nilai sebesar 71.51. Berdasarkan hasil analisis tersebut menunjukkan bahwa ada peningkatan nilai indeks kepuasan pemerintah daerah Gorontalo Utara dari Tahun 2019 ke Tahun 2020 sebesar 7.62, nilai ini cukup signifikan. Artinya, Pemerintah Daerah Kabupaten Gorontalo Utara telah melakukan perbaikan-perbaikan dalam menunjang pelayanan publik pada setiap instansi di lingkungan pemerintahan. Kata Kunci: Survei Kepuasan Masyarakat; Pelayanan Publik; Gorontalo Utara; Pemerintah Daerah; Nilai Kepatuhan. Abstract: Analysis of Public Satisfaction Level in Public Service Case Study: In North Gorontalo. Public services implemented by local governments need to be assessed periodically. This serves as a process of improving government bureaucratic services. The purpose of this research is as a process of assessing the level of compliance of services provided by the Regional Device Organization in North Gorontalo Regency. The method used is a mix of methods that are a combination of qualitative and quantitative methods. To get valid data, a survey is first conducted. In conclusion, the results of the survey analysis of the North Gorontalo regional government are categorized as "Good" with an index of 79.13. When compared with the results of the service compliance value index published by the Ombudsman of the Republic of Indonesia in 2019, North Gorontalo District obtained a value of 71.51. Based on the results of the analysis shows that there is an increase in the satisfaction index value of the North Gorontalo regional government from 2019 to 2020 of 7.62, this value is quite significant. That is, the Regional Government of North Gorontalo Regency has made improvements in supporting public services in every agency in the government environment. Keywords: Public Satisfaction Survey; Public Service; North Gorontalo; Local Government; Compliance Value.
KETERLIBATAN KELUARGA DALAM TATA KELOLA DAN ORGANISASI PERUSAHAAN PADA KONTEKS ENTREPRENEURIAL ORIENTATION
Authors: Sienatra Krismi Budi , Laudo Syellen
Published: May 2021

Abstrak : Keterlibatan Keluarga Dalam Tata Kelola Dan Organisasi Perusahan Pada Konteks Entrepreneurial Orientation. Perusahaan keluarga sebagai kontributor terbesar dalam pertumbuhan ekonomi, seringkali memiliki performa yang inkonsisten. Penelitian ini bertujuan mengetahui bagaimana dimensi entrepreneurial orientation dapat memberi pengaruh terhadap family firm performance. Penelitian ini menggunakan tiga dimensi entrepreneurial orientation terdiri dari innovativeness, proactiveness dan risk taking. Keterlibatan keluarga dalam pengelolaan perusahaan keluarga digunakan sebagai moderasi apakah memiliki dampak pada family firm performance. Sampel dari penelitian ialah komunitas perusahaan keluarga yang dibentuk dari universitas di Surabaya. Penelitian menggunakan alat analisis PLS. Hasil penelitian memperlihatkan bahwa proactiveness berpengaruh signifikan terhadap family firm performance sedangkan innovativeness dan risk taking tidak berpengaruh. Hasil moderasi menunjukkan keterlibatan keluarga tidak memoderasi dimensi entrepreneurial orientation terhadap family firm performance. Temuan ini memberikan gambaran bagi perusahaan keluarga yang masih skala menengah dan kecil serta belum terbuka dengan melibatkan anggota keluarga dalam tata kelola organisasi belum memiliki dampak pada kinerja perusahaan. Keterlibatan anggota keluarga hanya bersifat administratif bagi pemillik perusahaan. Abstract: Family Involvement In Governance And Company Organizations In The Context Of Entrepreneurial Orientation. Family companies, as the biggest contributors to economic growth, often have an inconsistent performance. This study aims to determine how the dimensions of entrepreneurial orientation can have an influence on family firm performance. This study uses three dimensions of entrepreneurial orientation consisting of innovativeness, proactiveness and risk taking. Family involvement in the management of family companies is used as moderation whether it has an impact on family firm performance. The sample of this research is a family company community formed from a university in Surabaya. The research used PLS analysis tool. The results showed that proactiveness had a significant effect on family firm performance, while innovativeness and risk taking had no effect. The result of moderation shows that family involvement does not moderate the dimensions of entrepreneurial orientation towards family firm performance. These findings provide an overview for family companies that are still medium and small in scale and have not been open to involving family members in organizational governance yet have an impact on company performance. The involvement of family members is only administrative in nature for company owners
Reliabilitas test-retest dyer tennis test revision
Authors: Alim Abdul , Nurfadhila Risti
Published: May 2021

Banyak faktor yang mempengaruhi pencapaian prestasi olahraga, salah satu faktor yang mempengaruhi pencapaian prestasi pada cabang olahraga tenis lapangan adalah keterampilan dalam memukul bola. Instrumen tes yang valid dan reliabel diperlukan untuk mengetahui tingkat keterampilan pukulan untuk menentukan dan memantau hasil latihan. Tujuan penelitian ini adalah untuk mengetahui reliabilitas tes akurasi pukulan tenis lapangan menggunakan Dyer Tennis Test Revision. Pemilihan Dyer Tennis Test Revision sebagai intrumen tes pengukuran keterampilan akurasi pukulan tenis disesuaikan dengan subjek penelitian yaitu petenis pemula mahasiswa.  Sembilan puluh tujuh mahasiswa pemula (51 laki-laki dan 46 perempuan) yang mengambil mata kuliah tenis lapangan menjadi subjek dalam penelitian ini. Test retest digunakan dalam penelitian ini. Hasil analisis product moment menunjukkan bahwa nilai r adalah 0,975. Hasil terebut bermakna bahwa Dyer Tennis Test Revision dapat diandalkan untuk mengukur unjuk kerja keterampilan tenis berbasis keakuratan. Dyer Tennis Test Revision juga merupakan alat ukur yang mudah dan murah yang dapat digunakan guru/dosen/pelatih untuk memantau kemajuan pemain.Test-retest reliability for dyer tennis test revisionAbstractMany factors affect sports performance, one of the factors that affect performance in tennis is the skill in hitting the ball. A valid and reliable test instrument is needed to determine the skill level of the stroke to determine and monitor the results of the training. The purpose of this study was to determine the reliability of the hitting tennis accuracy test using the Dyer Tennis Test Revision. The choice of Dyer Tennis Test Revision as a test instrument for measuring the accuracy of tennis strokes was adjusted to the research subject, namely student novice tennis players. Ninety-seven (beginner students (51 male and 46 female) who took tennis court courses were the subjects in this study. The retest test was used in this study. The results of the product moment analysis show that the value of r is 0.975. These results mean that the Dyer Tennis Test Revision can be relied upon to measure the performance of tennis skills based on accuracy. Dyer Tennis Test Revision is also an easy and inexpensive measuring tool that teachers / lecturers / coaches can use to monitor player progress.
INKLUSI KEUANGAN DAN LITERASI KEUANGAN TERHADAP KINERJA DAN KEBERLANGSUNGAN SEKTOR USAHA MIKRO KECIL MENENGAH
Authors: Hilmawati Mei Ruli Ninin , Kusumaningtias Rohmawati
Published: May 2021

Abstrak: Inklusi Keuangan dan Literasi Keuangan terhadap Kinerja dan Keberlangsungan Sektor Usaha Mikro Kecil Menengah. Suatu kinerja unggul dan bisnis yang berkelanjutkan dapat terwujud apabila terdapat upaya-upaya strategis yang dilakukan. Jawa Timur merupakan salah satu provinsi dengan jumlah UMKM yang cukup banyak memiliki peluang yang besar untuk meningkatkan perekonomian Indonesia. Penelitian ini dilakukan untuk menganalisis pengaruh inklusi keuangan dan literasi keuangan terhadap kinerja dan keberlangsungan sektor UMKM yang terdapat di Kota Surabaya. Penelitian ini merupakan penelitian kuantitatif dengan inklusi keuangan (INKA) dan literasi keuangan (LIKA) sebagai variabel independen, serta kinerja usaha (KIUS) dan keberlangsungan usaha (KEUS) sebagai variabel dependen. Sampel pada penelitian ini berjumlah 113 UMKM yang kemudian dilakukan analisis dengan pendekatan Partial Least Square. Hasil penelitian menyimpulkan bahwa inklusi keuangan tidak berpengaruh terhadap kinerja dan keberlangsungan sektor UMKM. Sedangkan literasi keuangan memiliki pengaruh yang terhadap kinerja dan keberlangsungan sektor UMKM.Kata kunci: Inklusi Keuangan, Literasi Keuangan, Kinerja Bisnis, Keberlangsungan Bisnis, UMKMAbstract: Financial Inclusion and Financial Literacy on the Performance an Sustainability of the MSMEs. Excellent performance and sustainable business can be realized if there are strategic efforts. East Java, as one of the Province with a large number of MSMEs that have a great opportunity to improve the Indonesian economy. This study was conducted to analyze the effect of financial inclusion and financial literacy on the performance and sustainability of MSMEs in Surabaya. This research is a quantitative study with independent variables are financial inclusion (INKA) and financial literacy (LIKA), and the dependent variables are business performance (KIUS) and business continuity (KEUS). The sample in this study amounted to 113 MSMEs which were then analyzed using the Partial Least Square approach. this study concludes that financial inclusion has no effect on the performance and sustainability of MSMEs. while financial literacy has a influence on the performance and sustainability of MSMEs. Keywords: Financial Inclusion, Financial Literacy, Business Performance, Sustainability, MSMEs
Pengaruh ICT Self Efficacy terhadap Technopreneurship Intention dimediasi Motivasi Siswa
Authors: Fathonah Wulan Nur , Machmud Amir , Suwatno Suwatno
Published: May 2021

Penelitian ini memiliki tujuan untuk mengetahui dan menganalisis pengaruh ICT self efficacy terhadap technopreneurship intention dimediasi oleh motivasi siswa. Tingkat technopreneurship intention diukur melalui indikator norma subjektif, persepsi kontrol perilaku dan sikap terhadap perilaku. Tingkat ICT self efficacy diukur melalui indikator computer self efficacy dan internet self efficacy. Tingkat motivasi siswa diukur melalui indikator keinginan untuk berbuat sesuatu, dorongan atau impuls dan kekuatan motifnya. Penelitian ini menggunakan metode survei eksplanatori dengan teknik pengumpulan data melalui kuesioner yang dibagikan kepada siswa jurusan Teknik Komputer Jaringan di Sekolah Menengah Kejuruan Negeri (SMKN) 5 Bandung sebanyak 167 siswa dengan sampel sebanyak 120 siswa. Teknik analisis data menggunakan statistik deskriptif, statistik inferensial dan analisis regresi.  Hasil penelitian ini menunjukkan 1) tingkat technopreneurship intention, ICT self efficacy dan motivasi siswa berada pada kategori tinggi. 2) ICT self efficacy berpengaruh positif dan signifikan terhadap technopreneurship intention dan 3) motivasi siswa memediasi pengaruh ICT self efficacy terhadap technopreneurship intention. Temuan penelitian ini menjelaskan bahwa untuk meningkatkan technopreneurship intention siswa harus diselaraskan dengan meningkatkan ICT self efficacy dan motivasi siswa.
Identifikasi Perbedaan Keterampilan Berpikir Kritis Ditinjau dari Motivasi Belajar Peserta Didik
Authors: Liyanto Muhammad Samadya , Disman Disman , Dahlan Dadng
Published: May 2021

Keterampilan berpikir kritis merupakan salah satu kompetensi yang penting dimiliki peserta didik pada abad ke-21. Keterampilan berpikir kritis telah diakui sebagai keterampilan yang penting dimiliki untuk keberhasilan belajar, bekerja dan hidup di abad ke-21. Keterampilan berpikir kritis dapat dipengaruhi oleh banyak faktor. Motivasi belajar merupakan salah satu faktor yang dapat mempengaruhi keterampilan berpikir kritis. Motivasi belajar dinilai memiliki hubungan sangat kuat dengan keterampilan berpikir kritis. Penelitian ini bertujuan untuk melihat perbedaan keterampilan berpikir kritis berdasarkan tingkat motivasi belajar peserta didik. Metode dalam penelitian ini menggunakan metode deskriptif verifikatif yang akan menguraikan, menjelaskan dan menguji kebenaran untuk melihat perbedaan keterampilan berpikir kritis berdasarkan tingkat motivasi belajar peserta didik. Teknik pengumpulan data melalui penyebaran tes essay untuk mengukur keterampilan berpikir kritis yang terdir dari 5 butir pertanyaan dengan dan angket motivasi belajar yang terdiri dari 25 butir pertanyaan dengan penskoran menggunakan skala Likert. Pengujian statistik yang dilakukan menggunakan uji statistic inferential parametric one-way ANOVA. Dari hasil uji statistik diketahui nilai Signifikansi (Sig.) adalah sebesar 0.014<0.05, sehingga dapat ditarik kesimpulan bahwa terdapat perbedaan yang signifikan antara keterampilan berpikir kritis peserta didik berdasarkan tingkat motivasi belajar. Selanjutnya, dari hasil uji Analisis Post Hoc Test menunjukkan bahwa terdapat perbedaan rata-rata keterampilan berpikir kritis yang signifikan antara peserta didik yang memiliki motivasi belajar rendah dengan peserta didik yang memiliki motivasi belajar tinggi.
Análisis y reducción de costos alimenticios asociados a la producción láctea de un sistema bovino semiespecializado, mediante el uso de la metodología AHP
Authors: Paternina-Acosta Carol , Ruiz-Meza José , Hernández-Mendo Omar
Published: May 2021

La producción de leche es un renglón importante dentro del sector agropecuario y la economía de un país. En México, el aporte del sector agropecuario al producto interno bruto (PIB) nominal es del 4,2 %, con una participación del 30,2 % de la ganadería. Este tipo de producción presenta diversos sistemas mejorados para aumentar la tasa de rendimiento. Sin embargo, es necesario conocer los costos de producción asociados a la alimentación de los bovinos en términos de materia seca consumida. En esta investigación, realizamos el análisis de los costos variables de alimentación dentro del proceso de producción de leche para vacas de alta y baja producción en un sistema bovino semiespecializado. Se desarrollaron procesos de diagnóstico y levantamiento de la información, análisis bromatológico, análisis de producción láctea, cálculo de los costos asociados y, por último, evaluación de reducción de costos bajo la metodología multicriterio de proceso de análisis jerárquico (AHP, por sus siglas en inglés). Se calcularon los costos de alimentación asociados a forraje, ensilado y concentrado, los cuales alcanzan el 20,3 % y 21,9 % de los ingresos totales por venta de leche para grupos de vacas de alta y baja producción, respectivamente. Determinamos que la estrategia de reducción de costos que genera mejores resultados, en cuanto a criterios de productividad, eficiencia, ambiente y factores financieros, corresponde a elaboración de diferentes dietas según la tasa de producción de leche. El ahorro asociado a esta estrategia demuestra un potencial de disminuir los costos anuales de alimentación hasta en USD 444 para las vacas objeto de estudio.
Evaluación de características fisicoquímicas, compuestos fenólicos, contenido de minerales y color de mieles comerciales del Cauca (Colombia)
Authors: Ortega-Bonilla Rubén Andrés , Morales-Hormiga Carlos Hernán , Chito-Trujillo Diana María
Published: May 2021

La producción de miel en Colombia es una actividad secundaria destinada principalmente al abastecimiento regional. A nivel nacional, el departamento del Cauca ocupa el séptimo lugar en producción de miel. La miel como alimento debe satisfacer las preferencias del consumidor y los criterios de calidad exigidos por la legislación para garantizar sus propiedades nutricionales y funcionales. Estas características se asocian a factores tales como origen botánico y geográfico, prácticas apícolas, entre otros. El origen geográfico de diferentes mieles se puede definir a partir de sus parámetros fisicoquímicos. En este trabajo se analizaron las características fisicoquímicas (acidez libre, pH, °Brix, cenizas, conductividad eléctrica, materia insoluble y humedad), el contenido de compuestos fenólicos totales (CFT), minerales, y el color (escala PFund y CIELab) de veinticuatro muestras de mieles comerciales adquiridas en seis municipios del departamento del Cauca (Colombia): Caldono, La Vega, Paispamba, Silvia, Timbío y Totoró. No todas las muestras cumplieron los requerimientos de la Norma Técnica Colombiana NTC-1273 para mieles florales, excepto las de Silvia, y alrededor del 20 % de las muestras mostró características de mieles de mielada. El color predominante en las mieles analizadas fue ámbar claro y ámbar, y se encontró una fuerte correlación entre los parámetros color expresado en mm PFund y CFT (r = 0,9229, p < 0,05). El análisis de componentes principales (ACP) permitió distinguir parcialmente las mieles de Paispamba, Silvia y Totoró a partir de sus parámetros fisicoquímicos y contenido mineral. Se sugiere el análisis de más muestras de miel para lograr una diferenciación por origen geográfico.
Mobile App (WHEELS) to Promote a Healthy Lifestyle in Wheelchair Users With Spinal Cord Injury or Lower Limb Amputation: Usability and Feasibility Study
Authors: Hoevenaars Dirk , Holla Jasmijn F M , te Loo Leonie , Koedijker Johan M , Dankers Sarah , Houdijk Han , Visser Bart , Janssen Thomas W J , de Groot Sonja , Deutekom Marije ,   WHEELS Study Group
Published: May 2021

Background

Maintaining a healthy lifestyle is important for wheelchair users’ well-being, as it can have a major impact on their daily functioning. Mobile health (mHealth) apps can support a healthy lifestyle; however, these apps are not necessarily suitable for wheelchair users with spinal cord injury or lower limb amputation. Therefore, a new mHealth app (WHEELS) was developed to promote a healthy lifestyle for this population.

Objective

The objectives of this study were to develop the WHEELS mHealth app, and explore its usability, feasibility, and effectiveness.

Methods

The WHEELS app was developed using the intervention mapping framework. Intervention goals were determined based on a needs assessment, after which behavior change strategies were selected to achieve these goals. These were applied in an app that was pretested on ease of use and satisfaction, followed by minor adjustments. Subsequently, a 12-week pre-post pilot study was performed to explore usability, feasibility, and effectiveness of the app. Participants received either a remote-guided or stand-alone intervention. Responses to semistructured interviews were analyzed using content analysis, and questionnaires (System Usability Score [SUS], and Usefulness, Satisfaction, and Ease) were administered to investigate usability and feasibility. Effectiveness was determined by measuring outcomes on physical activity, nutrition, sleep quality (Pittsburgh Sleep Quality Index), body composition, and other secondary outcomes pre and post intervention, and by calculating effect sizes (Hedges g).

Results

Sixteen behavior change strategies were built into an app to change the physical activity, dietary, sleep, and relaxation behaviors of wheelchair users. Of the 21 participants included in the pilot study, 14 participants completed the study. The interviews and questionnaires showed a varied user experience. Participants scored a mean of 58.6 (SD 25.2) on the SUS questionnaire, 5.4 (SD 3.1) on ease of use, 5.2 (SD 3.1) on satisfaction, and 5.9 (3.7) on ease of learning. Positive developments in body composition were found on waist circumference (P=.02, g=0.76), fat mass percentage (P=.004, g=0.97), and fat-free mass percentage (P=.004, g=0.97). Positive trends were found in body mass (P=.09, g=0.49), BMI (P=.07, g=0.53), daily grams of fat consumed (P=.07, g=0.56), and sleep quality score (P=.06, g=0.57).

Conclusions

The WHEELS mHealth app was successfully developed. The interview outcomes and usability scores are reasonable. Although there is room for improvement, the current app showed promising results and seems feasible to deploy on a larger scale.
Willingness to Adopt Health Information Among Social Question-and-Answer Community Users in China: Cross-sectional Survey Study
Authors: Li PengFei , Xu Lin , Tang Tingting , Wu Xiaoqian , Huang Cheng
Published: May 2021

Background

COVID-19 has spread around the world and has increased the public’s need for health information in the process. Meanwhile, in the context of lockdowns and other measures for preventing SARS-CoV-2 spread, the internet has surged as a web-based resource for health information. Under these conditions, social question-and-answer communities (SQACs) are playing an increasingly important role in improving public health literacy. There is great theoretical and practical significance in exploring the influencing factors of SQAC users’ willingness to adopt health information.

Objective

The aim of this study was to establish an extended unified theory of acceptance and use of technology model that could analyze the influence factors of SQAC users’ willingness to adopt health information. Particularly, we tried to test the moderating effects that different demographic characteristics had on the variables’ influences.

Methods

This study was conducted by administering a web-based questionnaire survey and analyzing the responses from a final total of 598 valid questionnaires after invalid data were cleaned. By using structural equation modelling, the influencing factors of SQAC users’ willingness to adopt health information were analyzed. The moderating effects of variables were verified via hierarchical regression.

Results

Performance expectation (β=.282; P<.001), social influence (β=.238; P=.02), and facilitating conditions (β=.279; P=.002) positively affected users’ willingness to adopt health information, whereas effort expectancy (P=.79) and perceived risk (P=.41) had no significant effects. Gender had a significant moderating effect in the structural equation model (P<.001).

Conclusions

SQAC users’ willingness to adopt health information was evidently affected by multiple factors, such as performance expectation, social influence, and facilitating conditions. The structural equation model proposed in this study has a good fitting degree and good explanatory power for users’ willingness to adopt health information. Suggestions were provided for SQAC operators and health management agencies based on our research results.
Effect of Flaxseed Consumption on Central Obesity, Serum Lipids, and Adiponectin Levels in Overweight or Obese Women: A Randomized Controlled Clinical Trial
Authors: motlagh hoda ahmadniay , aalipanah erfaneh , mazidi mohsen , Faghih Shiva
Published: May 2021

Background: Flaxseed may be beneficial for the management of obesity due
to its high content of alpha-linolenic acid, fiber, and lignans.
Objective: We aimed to evaluate the effects of Flaxseed consumption on
serum lipids, adiponectin, leptin, and weight loss in overweight or
obese women. Methods: This randomized controlled clinical trial involved
60 overweight or obese women. Participants were randomly allocated to
two groups; a) a balanced diet plus 30 g/day milled Flaxseed and b) a
balanced diet plus 30g/day milled rice (as control group), for 12 weeks.
Anthropometric indices, serum lipids, leptin, and adiponectin levels
were measured at baseline and at the end of intervention. Results: After
12 weeks of intervention, there were significantly higher reductions in
waist circumference (WC) and waist to hip ratio (WHR) (both
P<0.05) in the flaxseed group compared to the controls.
Moreover, adiponectin level was significantly increased in the flaxseed
group (17.15±6.1) compared to the controls (16.83±10.5), (P=0.001).
However, there were no significant differences in serum lipid levels
between the study groups before and after the intervention (all
p>0.05). Conclusion: Flaxseed consumption may improve
adiposity markers, as well as adiponectin levels Thus, flaxseed
consumption could be an adjunctive therapy to attenuate central obesity.
Serum lipid profile has not changed significantly after flaxseed
consumption. Keywords: obesity, flaxseed, adiponectin, Leptin, blood
lipids
Overcoming very late severe calcific stenosis due to two layers of under-expanded stents with intravascular lithotripsy treatment: a case report
Authors: Doost Ata , Clugson Richard
Published: May 2021

Under-expanded stents in calcific coronary stenoses are a common
challenge for interventional cardiologists as we undertake more complex
coronary interventions for older population cohorts. It results in
short-term and long-term stent failure and adverse patient outcomes.
These complex lesions can be treated after many years with intravascular
lithotripsy (IVL-Shockwave).
Erroneous perception of a clinical sign: Sepsis-induced cholestasis mimicking hepatitis in an adolescent patient
Authors: Romano Fabrizio , Molinaro Marisa , Schibli Susanne , Agyemann Philipp , Löllgen Ruth
Published: May 2021

Background: In children and adolescents, isolated cholestasis rarely is
a first clinical sign of severe sepsis. Case: A previously healthy
14-year-old adolescent had severe S. aureus sepsis. Delayed diagnosis
required a prolonged antimicrobial treatment. Conclusion: This unique
case illustrates the importance of considering jaundice as an early sign
of sepsis.
The confused puzzles in ANCA-associated vasculitis activity evaluation：a case report
Authors: Zhang Ai-hua , Yao Wei-long , Liu Wen-hu
Published: May 2021

Disease activity and treatment-related toxicity are the most important
contributors to poor prognosis in patients with ANCA-associated
vasculitis (AAV). Sometimes, it is difficult to distinguish them. We
present a case to highlight the challenges in the management of AAV and
the complications with immunosuppression.
The feasibility of vagus nerve preservation and double-flap technique in laparoscopic proximal gastrectomy
Authors: SUN Ke-kang , WANG Zhen , PENG Wei , CHENG Ming , CHEN zheng-rong , REN rui , CHEN qiang , WU Yong-you
Published: May 2021

Background: Laparoscopic proximal gastrectomy with an anti-reflux
procedure, as a function-preserving surgery, has been a common treatment
strategy for proximal early gastric cancer. This study aimed to develop
a new surgical technique for these patients. Methods: Laparoscopic
proximal gastrectomy with vagus nerve preservation and double-flap
technique was performed in patients who could retain two-thirds of the
stomach. The hepatic branches and the celiac branches were both
preserved. A seromuscular double-flap was created through the auxiliary
incision, and the anastomosis was performed under laparoscopy. The
detailed surgical procedure and preliminary results were presented.
Results: Six patients underwent this procedure with no conversion to
open surgery. No intraoperative and postoperative complications occurred
during the perioperative period. No patients showed diarrhea and
appetite loss, and body weight regained preoperative level 6 month
later. No food residue and reflux esophagitis were observed via
endoscopic examination. Gallbladder contraction was observed in all the
patients by ultrasonography after high-fat diet. Conclusion: Although
long-term follow up and a larger number of patients are required to
evaluate the functional outcomes, this new technique provides a
minimally invasive surgical option for proximal early gastric cancer,
especially in the cardiac area.
Suicide and Accidental Death Among Women with Primary Ovarian Cancer: A population-based study
Authors: Chen Ying , Yu Kaixu , Zhu Qingqing , Tang Weicheng , Chen Dan , Xue Liru , Zhang Jinjin , Zhou Su , Dai Jun , Jin Yan , Wu Meng , WANG SHIXUAN
Published: May 2021

Objective To determine the relative risk of suicide and accidental death
among patients with ovarian cancer to that of the general population,
and to identify risk factors associated with suicide and accidental
death. Design The surveillance, epidemiology, and end results (SEER)
registry provided ovarian cancer data from 18 registries. Setting
Surveillance, Epidemiology, and End Results database. Population The
study population comprised 149,204 patients. Methods The standardized
mortality ratios (SMRs) were calculated and Fine-Gray models were
fitted, with stratifications on demographic and tumor-related
characteristics. Main outcome measures The standardized mortality
ratios. Results Women with ovarian cancer had a higher risk of suicide
and accidental death than the cancer-free group (SMR=1.86; 95% CI
[1.54-2.25] and SMR=1.54; 95% CI [1.39-1.71]). Subgroup
analysis indicated that only patients with type II epithelial ovarian
cancer (SMR=2.31; 95% CI [1.83-2.91]) had an increased risk of
suicide, and those with type I and type II epithelial ovarian cancer
(SMR=1.65; 95% CI [1.39-1.97] and SMR=1.49; 95% CI
[1.30-1.70]) were at a higher risk of accidental death. Patients
with ovarian cancer who were younger, white, diagnosed with high-grade,
non-metastatic cancer and pelvic exenteration were at a higher risk of
suicide. Additionally, pelvic exenteration increased the risk of suicide
but not the risk of accidental death among these women. Conclusion Women
with ovarian cancer had a higher risk of suicide and accidental death
compared with the general population. Clinicians should identify
high-risk subgroups of ovarian cancer patients for suicide and
accidental death as early as possible, with appropriate prevention
strategies.
Exceptional life threatening complication 19 years after Ravitch correction of pectus excavatum.
Authors: Greberski Krzysztof , Jarzabek Radoslaw , Perek Bartłomiej , Bugajski Pawel
Published: May 2021

Ravitch technique of chest correction has been considered, although
invasive, as safe and efficacious surgical method. We describe a case of
35-year-old woman with cardiac tamponade and in cardiogenic shock due to
exceptional late complication after pectus excavatum reconstruction by
means of classic Ravitch technique 19 years earlier. This very late
adverse event was caused by broken metal sternal wire that injured the
wall of the ascending aorta. Patient underwent salvage repair of this
segment of aorta in cardiopulmonary bypass. Postoperative course and
post-discharge 3-year follow-up have been uneventful.
Slope- watershed coupling simulation under different vegetation coverage based on GAST model
Authors: Yongde Kang , Jingming Hou , Yu Tong , Baoshan Shi , Zhanpeng Pan
Published: May 2021

A non-equilibrium sediment transport soil erosion model based on finite
volume method (FVM) coupled with two-dimensional hydrodynamic process is
proposed, application of the GPU techniques in the numerical model,
making it possible to simulate the sediment transport and bed evolution
in a high resolution but efficient way. The first-order Gudonov format
FVM is used to discreting the control equation. The variables on both
sides of the unit interface are obtained by limiting slope
interpolation. An efficient and robust non-negative depth reconstruction
algorithm is used to solve the dry-wet boundary problem. This algorithm
makes the model have second-order accuracy in space, and also
effectively suppresses the numerical oscillation. Harten, Lax van Leer
Contact (HLLC) approximate Riemann solver is used to calculate mass and
momentum flux, and the friction source term is calculated by the
proposed split point implicit method. These values are evaluated by a
novel 2D edge-based MUSCL scheme. The code is programmed using C++ and
CUDA, which can be run on GPU to greatly accelerate the calculation
speed. In this paper, two numerical experiments show that the model
performs well in accuracy and robustness of the algorithm in the process
of slope erosion and watershed erosion. The constructed model can
simulate the soil erosion of slope and watershed gully under different
vegetation coverage, and characterize the erosion process of interaction
between slope and gully.
Coagulation Profiles and Viscoelastic Testing in Multisystem Inflammatory Syndrome
Authors: Ankola Ashish , Bradford Victoria , Newburger Jane , Emani Sirisha , Dionne Audrey , Friedman Kevin , Son Mary Beth , Henderson Lauren , Lee Pui , Hellinger Amy , Hawkins Beth , Ventresco Courtney , Esteso Paul , VanderPluym Christina
Published: May 2021

Objective: To characterize viscoelastic testing profiles of children
with multisystem inflammatory syndrome in children (MIS-C). Methods:
This single-center retrospective review included 30 patients diagnosed
with MIS-C from January 1 to September 1, 2020. Thromboelastography
(TEG) with platelet mapping was performed in 19 (63%) patients and
compared to age- and gender- matched controls via Student’s t-test and
Wilcoxon rank sum test. Pearson’s and Spearman correlation were used to
assess relationships between TEG parameters and inflammatory markers.
Results: Patients with MIS-C had abnormal TEG results compared to
controls, including decreased K time (1.1 vs. 1.7 min,
P<0.01), increased alpha angle (75.0 vs. 65.7 degrees,
P<0.01), increased maximum amplitude (70.8 vs. 58.3 mm,
P<0.01), and decreased Ly-30 (1.1 vs. 3.7%, P=0.03);
consistent with increased clot formation rate and strength, and slower
fibrinolysis. TEG maximum amplitude was moderately correlated with
erythrocyte sedimentation rate (r=0.60, P=0.02), initial platelet count
(r=0.67, P<0.01), and peak platelet count (r=0.51, P=0.03).
TEG alpha angle was moderately correlated with peak platelet count
(r=0.54, P=0.02). 17 (57%) patients received aspirin (ASA) and
anticoagulation, 5 (17%) received only ASA, and 3 (10%) received only
anticoagulation. No patients had a thrombotic event. 6 (20%) patients
had a bleeding event, none of which was major. Conclusions: Patients
with MIS-C had evidence of hypercoagulability on TEG. Increased
erythrocyte sedimentation rate and platelets were associated with higher
clot strength. Treatment with ASA or anticoagulation was well tolerated.
Further multi-center study is required to characterize the rate of
thrombosis and optimal thromboprophylaxis algorithm in this patient
population.
Ruxolitinib for treatment of polycythemia vera and myelofibrosis in patients after liver transplantation
Authors: Dold Leona , Lutz Philipp , Heine Annkristin , Weismüller Tobias , Strassburg Christian , Spengler Ulrich
Published: May 2021

Patients after liver transplantation have an increased risk to develop
haematologic neoplasias. Information how to treat these patients in the
context of immunosuppression is sparse. Here, we report two patients
with polycythemia vera (PV) and myelofibrosis (MF) on ruxolitinib after
liver transplantation.
Evolution of a single-cell predictive model for packaging and budding of viruses based on TEM based measurements
Authors: Saxena Abha , Suryateja Ravutla , Mitra Kishalay , Chakraborty Jayanta , Murhammer David , Giri Lopamudra
Published: May 2021

Although detailed experimental investigations would provide insight into
viral infections and vaccine production, building a computational
framework is necessary to identify the parameters that regulate the
budding and packaging of nucleocapsids. This study shows that a
predictive model for the complete infection cycle can be built using
nonlinear coupled ODEs and parameter estimation using a Genetic
algorithm. Specifically, we have used a dataset containing the occluded
virus information, budded virus in infected cells obtained by
transmission electron microscopy (TEM). A novel parameter estimation
strategy is proposed based on the k-medoid clustering of infected cells.
Firstly, we show that the parameter estimation framework can be used for
model evolution and selection of the feedback structure. Secondly, we
show that the model was capable of capturing the distribution of
packaged and unpackaged nucleocapsids in the nucleus, cytoplasm, and
plasma membrane, the number of packaged and unpackaged ODV, and
polyhedra in the nucleus. The proposed framework assumes importance in
generating data for achieving quality by design in the optimization of
vaccine/recombinant protein yield.