bluuebunny/crossref_metadata_2025 huggingface dataset:
Parental drinking, mental health and educational level, and offspring’s subsequent prescription drugs treatment for sleep problems. A Longitudinal HUNT Survey and Registry Study
Authors: Lund Ingunn Olea , Andersen Njål , Ask Helga , Andreas Jasmina Burdzovic
Published: December 2022

Background
Parental drinking, mental health and family socioeconomic status are all associated with offspring sleep problems, but there is a paucity of research that considers the effect of several risk factors together, as they co-occur within and across families. Also, sleep problems are closely linked with mental health problems and disentangling the effects on one or the other are important. We examined whether parental risk constellations are differently associated with offspring’s subsequent prescription drug use for sleep problems during nine years with or without prescription drug use for anxiety and/or depression.
Methods
The sample included 8773 adolescent offspring of 6696 two-parent families who participated in the Nord-Trøndelag Health Study in Norway. The exposures were five parental risk constellations characterized by drinking frequencies and quantities, mental health, and years of education. The outcomes were dispensed prescription drugs in offspring for a) only sleep problems b) sleep problems and anxiety/depression or c) only anxiety/depression during 2008–2016. We used multinomial logistic regression to model the odds of the outcomes.
Results
Compared to the overall low-risk parental constellation, none of the four risky constellations were significantly associated with increased risk of being dispensed prescription drugs only for sleep problems. Offspring from two different risk profiles were at increased risk for being dispensed both sleep and anxiety/depression prescription drugs. These were parental profiles marked by 1) low education, symptoms of mental health problems and weekly binge drinking in both parents (OR 1.90, CI = 1.06;3.42); and 2) elevated drinking in both parents and elevated symptoms of mental health problems in fathers (OR 3.32, CI = 1.49;7.39). Offspring from the risk profile with lowest parental education were at increased risk of being dispensed only anxiety/depression prescription drugs (OR 1.25, CI = 1.05;1.49).
Conclusion
Our findings suggest that parental risk constellations are not associated with increased risk of offspring receiving sleep medications without also receiving anxiety/depression medications, as two risk constellations were associated with increased risk of dispensation of both sleep and anxiety/depression prescription drugs during nine years. Receiving both may be an indication of severity. The findings underscore the importance of including measures of mental health problems when investigating sleep problems to avoid misattribution of effects.
Twenty-one-year follow-up revealed guideline-concordant and non-concordant trends in intensive care of bronchiolitis
Authors: Selin Sofia , Mecklin Minna , Korppi Matti , Heikkilä Paula
Published: December 2022

Purpose
To evaluate the management of bronchiolitis in the paediatric intensive care unit (PICU) before and after publication of the national bronchiolitis guidelines in 2014.
Methods
All infants treated between 2016–2020 for bronchiolitis in the PICU of Tampere University Hospital at < 12 months of age were included. The data were retrospectively collected from electronic patient records. The current results reflecting the post-guideline era were compared with previously published results for the pre-guideline 2000–2015 period. These two studies used identical protocols.
Results
Forty-six infants treated in the PICU were included. During the post-guideline era, inhaled adrenaline was given to 26 (57%), salbutamol to 7 (15%), and hypertonic saline inhalations to 35 (75%) patients. Forty-three patients (94%) received high-flow oxygen therapy (HFOT). Seventeen patients (37%) were treated with nasal continuous positive airway pressure (CPAP) and 4 (9%) with mechanical ventilation.
Conclusion
When post-guideline years were compared with pre-guideline years, the use of bronchodilators decreased in agreement, but the use of inhaled saline increased in disagreement with the guidelines. The use of respiratory support increased, evidently because of an introduction of the non-invasive HFOT treatment modality.
Existence and stability results for nonlinear fractional integro-differential coupled system
Authors: ZHOU Jue-liang , HE Yu-bo , ZHANG Shu-qin , DENG Hai-yun , LIN Xiao-yan
Published: December 2022

In this paper, a class of nonlinear ψ−Hilfer fractional integro-differential coupled system on bounded domain is investigated. The existence and uniqueness result for the coupled system is proved based on the contraction mapping principle. Moreover, the Ulam-Hyers-Rassias, Ulam-Hyers and Semi-Ulam-Hyers-Rassias stabilities to the initial value problem are obtained.
2020 Mathematics Subject Classification: 26A33; 34A08; 34K20; 45D05.
Conditional Saddle-point Approximations for Bivariate Compound Distributions
Authors: Alhejaili Amal D. , Alghamedi Ateq A.
Published: December 2022

The majority of existing research aims to explain phenomena in various fields of application that rely on bivariate random variables [1]; [2]. Although these distributions have attracted some attention in the literature, little research exists on the bivariate compound distribution. Because of the computational difficulties in implementing such a distribution, research on it is limited. This study aims to use the saddle-point approximation method, which is more powerful than other methods. This article introduces conditional saddle-point approximations to the bivariate compound distribution in continuous and discrete settings. We discuss conditional approximations for cumulative distribution functions of bivariate compound distributions. Examples of continuous and discrete distributions from the bivariate compound truncated Poisson compound class are presented. Comparisons between saddle-point approximations and the exact calculations show the great accuracy of the saddle-point methods.
The clinical significance of focal active colitis and inflammatory bowel disease
Authors: Hosack Tom , Griffiths Cameron , Kumar Rohith , Mandal Amit Keiran John , Salam Imroz , Missouris Constantinos
Published: December 2022

Purpose
Focal active colitis (FAC) is a non-specific histological diagnosis of uncertain clinical significance. There is potentially a causal relationship between FAC and inflammatory bowel disease (IBD) in children, but this has not been adequately explored in adults. We sought to evaluate whether FAC is a reliable predictor of developing IBD in adults.
Methods
43 patients with FAC were retrospectively identified between October 2014 and May 2019 and reviewed using the electronic pathology database at our institution. Patients with known chronic colitis were excluded. Patients were followed up for a mean period of 36 months +/- 16. Clinical data and final diagnoses were recorded, and categorical analysis performed with Fisher’s exact χ2.
Results
43 patients (11 male: 32 female, mean age 53 years +/- 18) were included. 14 (33%) with FAC were subsequently diagnosed with infective colitis, 5 (12%) with IBD, of which 4 (80%) were diagnosed with ulcerative colitis and 1 (20%) was diagnosed with undetermined IBD. Of 34 patients (79%) with neither raised faecal calprotectin (FC) levels nor suspicious endoscopic findings, 1 (3%) patient subsequently developed IBD. This was statistically significant by Fisher’s exact (p = 0.0046), and the phi coefficient of 0.53 demonstrated that patients with neither raised FC levels nor suspicious endoscopic findings were statistically unlikely to develop IBD.
Conclusion
Our results suggest that having normal FC levels and endoscopic findings reduces the risk of future development of IBD in adults. Furthermore, a raised FC level and endoscopic features suggestive of IBD with histological FAC may predict progression to IBD.
Distinguishable DNA Methylation Defines a Cardiac-Specific Epigenetic Clock
Authors: Mongelli A. , Panunzi S. , Nesta M. , Gottardi-Zamperla M. , Atlante S. , Barbi V. , Mongiardini V. , Ferraro F. , DeMartino S. , Cis L. , Re A. , Maltese S. , Bachetti T. , LaRovere MT , Martelli F. , Pesce M. , Nanni S. , Massetti M , Pontecorvi A. , Farsetti A. , Gaetano C.
Published: December 2022

BACKGROUND
The present study investigates whether epigenetic differences emerge in the heart of patients undergoing cardiac surgery for an aortic valvular replacement (AVR) or coronary artery bypass graft (CABG). An algorithm is also established to determine how the pathophysiological condition might influence the human biological cardiac age.
RESULTS
Blood samples and cardiac auricles were collected from patients who underwent cardiac procedures: 94 AVR and 289 CABG. The CpGs from three independent blood-derived biological clocks were selected to design a new blood- and the first cardiac-specific clocks. Specifically, 31 CpGs from six age-related genes, ELOVL2, EDARADD, ITGA2B, ASPA, PDE4C, and FHL2, were used to construct the tissue-tailored clocks. The best-fitting variables were combined to define new cardiac- and blood-tailored clocks validated through neural network analysis and elastic regression. In addition, telomere length (TL) was measured by qPCR. These new methods revealed a similarity between chronological and biological age in the blood and heart; the average TL was significantly higher in the heart than in the blood. In addition, the cardiac clock discriminated well between AVR and CABG and was sensitive to cardiovascular risk factors such as obesity and smoking. Moreover, the cardiac-specific clock identified an AVR patient's subgroup whose accelerated bioage correlated with the altered ventricular parameters, including left ventricular diastolic and systolic volume.
CONCLUSION
This study reports on applying a method to evaluate the cardiac biological age revealing epigenetic features that separate subgroups of AVR and CABG.
Genome scan of rice landrace populations collected across time revealed climate changes’ selective footprints in the genes network regulating flowering time
Authors: AHMADI Nourollah , BARRY Mamadou Billo , FROUIN Julien , de Navascués Miguel , Touré Mamadou Aminata
Published: December 2022

Analysis of the genetic bases of plants adaptation to climate changes, using genome-scan approaches, are often conducted on natural populations, under hypothesis of out-crossing reproductive regime. We report here on a study based on diachronic sampling (1980 & 2010) of the autogamous crop species, Oryza sativa and Oryza glaberrima, in the tropical forest and the Sudanian savannah of West Africa. First, using historical meteorological data we confirmed changes in temperatures (+ 1°C on average) and rainfall regime (less predictable and reduced amount) in the target area. Second, phenotyping the populations for phenology, we observed significantly earlier heading time (up to 10 days) in the 2010 samples. Third, implementing two genome-scan methods (one of which specially developed for selfing species) on genotyping by sequencing genotypic data of the two populations, we detected 31 independent selection footprints. Gene ontology analysis detected significant enrichment of these selection footprints in genes involved in reproductive processes. Some of theme bore known heading time QTLs and genes, including OsGI, Hd1 and OsphyB. This rapid adaptive evolution, originated from subtle changes in the standing variation in genetic network regulating heading time, did not translate into predominance of multilocus genotypes, as it is often the case in selfing plants, and into notable selective sweeps. The high adaptive potential observed results from the multiline genetic structure of the rice landraces, and the rather large and imbricated genetic diversity of the rice meta-population at the farm, the village and the region levels, that hosted the adaptive variants in multiple genetic backgrounds before the advent of the environmental selective pressure. Our results provide a model for rice breeding and cultivars deployment strategies aiming resilience to climate changes. It also calls for further development of population genetics models for adaptation of plants populations to environmental changes.
Outcomes of patients with intracranial germ cell tumour with choriocarcinoma element or β-HCG level higher than 500 IU/L under radiotherapy-based treatments
Authors: Feng Jin , Chen Li , Li Chunde , Liu Wei , Chen Huiyuan , Qiu Xiaoguang , Li Bo
Published: December 2022

Background
In previous studies, patients with intracranial germ cell tumour (iGCT) with pure choriocarcinoma or mixed germ cell tumours with choriocarcinoma element showed similar dismal prognoses, with median overall survival (OS) of 22 months and 1-year survival rate of approximately 60%. However, these conclusions need to be updated because radiotherapy, which is the milestone for this disease, was not applied in a number of patients.
Methods
Clinical data of patients with iGCTs with histologically confirmed choriocarcinoma element or beta-human chorionic gonadotropin (β-HCG) > 500 IU/L were collected from the archives of our institution and retrospectively studied.
Results
A total of 76 patients were eligible for this study. In terms of the initial treatment, 11 patients underwent surgery, four patients received radiotherapy, and 61 patients received chemotherapy. Except for two early deaths, all patients received radiotherapy (craniospinal irradiation [CSI], n = 23; non-CSI, n = 51). The median follow-up duration for the entire series was 63 months (range, 6–188 months). The 5-year event-free survival (EFS) and OS rates were 81.5% and 84.1%, respectively. Among patients who did not have early death or progressive disease after induction chemotherapy, multivariate analysis revealed that chemotherapy cycles (> 4 vs. ≤4) (hazard ratio [HR] for EFS 0.144, p = 0.020; HR for OS 0.111, p = 0.028) and β-HCG levels (> 3000 IU/L vs. ≤3000 IU/L) (HR for EFS 4.342, p = 0.059; HR for OS 6.614, p = 0.033) were independent factors for survival. Radiation volume (non-CSI vs. CSI) was not proven to be a prognostic factor for either EFS or OS (hazard ratio [HR] for EFS 1.902, p = 0.59; HR for OS 2.425, p = 0.49).
Conclusions
Patients with iGCTs with choriocarcinoma element or β-HCG > 500 IU/L showed improved survival with radiotherapy-based treatments. Additional chemotherapy cycles could result in additional survival benefits. Patients with β-HCG level > 3000 IU/L had poorer prognosis.
A pan-cancer interrogation of intronic polyadenylation and its association with cancer characteristics
Authors: Liu Liang , Sun Peiqing , Zhang Wei
Published: December 2022

3’UTR-APAs have been extensively studied, but IPAs remain largely unexplored. We characterized the profiles of 22,260 IPAs in 9,679 patient samples across 32 cancer types from the TCGA cohort. By comparing tumor and paired normal tissues, we identified 180~4,645 dysregulated IPAs in 132~2,249 genes in each of 690 patient tumors from 22 cancer types that showed consistent patterns within individual cancer types. We selected 2,741 genes that showed consistently patterns across cancer types, including 1,834 pan-cancer tumor-enriched and 907 tumor-depleted IPA genes; the former were amply represented in the functional pathways such as DNA damage repair. Expression of IPA isoforms was associated with tumor mutation burdens and patient characteristics (e.g., sex, race, cancer stages, and subtypes) in cancer-specific and feature-specific manners, and could be a more accurate prognostic marker than gene expression (summary of all isoforms). In summary, our study reveals the roles and the clinical relevance of tumor-associated IPAs.
Green kingfishers as sentinel species for mercury contamination in Amazon
Authors: Oliveira Edvagner , Ignácio Áurea , Lázaro Wilkinson , Díez Sergi , Guimarães Jean , Santos-Filho Manoel
Published: December 2022

Mercury is a global contaminant naturally found in the Amazon; it can be biomagnified in the aquatic trophic chain. The use of piscivorous avians for mercurial contamination biomonitoring is increasing, mainly due to the non-mobility of mercury in avian feathers. We examined the concentrations of total mercury and methylmercury in different Chloroceryle americana tissues from the Teles Pires and Juruena Rivers in the southern Brazilian Amazon. We also evaluated total mercury in small Characidae fish (potential C. americana food) in the same areas. The results evidenced high mercury concentrations, on average two-times higher in the green kingfishers from the Teles Pires River compared to the Juruena River; the same results were found for the fish specimens. Mercury concentrations were lowest in the muscle, followed by liver and highest in feathers. Fifty-eight per cent of the feather samples from the Juruena River and 90% from the Teles Pires River had total mercury concentrations above 5 µg/g, a level previously associated with adverse effects related to avian breeding. The methylmercury concentration was lowest in the liver, followed by feathers and highest in muscle. Although Juruena River avian feathers had a lower total mercury concentration, > 96% of the total mercury was methylmercury, the highest amount for specimens from both rivers.
Climate pledges by major steel companies: a long way ahead towards zero emissions
Authors: Kuramochi Takeshi , Casas Maria Jose de Villafranca , Smit Sybrig , Nilsson Anna
Published: December 2022

This paper analyses the status, robustness, and the potential impact of greenhouse gas emission reduction targets set by the largest steel producer companies. For the 60 largest steel companies by volume, covering more than 60% of global steel production, we collected data on the targets and emission reduction measures from publicly available documents. We found that only 26 companies have their own greenhouse gas emission reduction targets of varying timeframes between 2025 and 2050. Even when excluding the 18 Chinese state-owned companies that are under the national 2060 net zero target, 16 companies had no emission reduction targets. Eighteen companies had long term targets (2040 of after), of which 15 were net zero emission targets; all but one also had interim targets. If all climate targets of the 26 companies with a target are achieved, CO2 emissions could be up to 11% lower in 2030 and up to 41% lower in 2050 in comparison to a baseline scenario. Assuming a gradual increase in global crude steel demand from 1.9 Gt in 2019 to 2.5 Gt in 2050 and assuming similar trends for the rest of the global steel industry as observed for the 60 companies, we estimate that the current ambition of the global steel industry on emission reductions would lead to a reduction of 37–51% by 2050 from 2019 levels (3.4 GtCO2 to 1.7–2.2 GtCO2), or compared to a 9–18% reduction in a baseline scenario. Steel companies are also lagging in setting clear emission reduction plans. We found that 12 out of the 26 steel producers with targets did not provide an emission reduction plan; 14 provided at least one measure to achieve their target, and from those only eight had a comprehensive, detailed emission reduction plan that includes timelines, technologies and measures to be implemented to achieve their targets. While it is encouraging that the steel companies have started acting toward long-term deep decarbonisation, our findings suggest that there is a long way ahead and the action needs to be accelerated considerably.
Vascular epiphytes on large old-growth trees: the influence of ecological zones in epiphyte species composition
Authors: Scipioni Marcelo , Fischer Vera Lúcia de Souza Teixeira , Melo Edilaine Andrade , Caglioni Eder , Santos Vanderlei dos
Published: December 2022

The over time establishment of epiphyte communities on large old-growth trees has shown that epiphyte numbers tend to rise in relation to the size of their phorophytes. The objective of our study was to perform a floristic survey of vascular epiphytes on last large old-growth trees in a subtropical forest and to compare species richness between conifers and hardwood trees. Nine phorophytes (0.9–2.1 m in diameter and 22–40 m in height) in one of the last remaining old-growth forests were selected for study. Epiphyte locations on the trees were divided into the following ecological zones: base of the trunk: first 1.30 m above ground; mid-section of the trunk: from the trunk base to the crown base; crown base: 1.30 m below the crown; and crown. We found 30 species of epiphytes, distributed in 21 genera and 11 families. Among the distribution patterns of the epiphytes there were species predominantly occurring in the basal or mid-trunk region of the phorophytes (e.g., Billbergia nutans); other species occupied the upper portion of the phorophyte, between the mid-trunk and the crown (e.g., Vriesea reitzii). The relationship between size in large old host trees and vascular epiphyte species richness is not positive and linear. Vascular epiphyte species richness by host trees species was indifferent among large old trees species, even though Ocotea porosa (hardwood) has an apparently larger crown greater and show more abundance of epiphytes than that of Araucaria angustifolia (conifer).
Key Performance Indicators for Project Success in Saudi Arabian Construction Industry
Authors: Hussain Sharafat , Hasmori Muhammad Fikri , Abas Nor Haslinda , Balasbaneh Ali Tighnavard , Khan Muhammad Wajidullah
Published: December 2022

Key Performance Indicators (KPIs) are a significant part of every successful construction project. Establishing KPIs that provide objective criteria for measuring project success is common in performance measurement on construction projects. A presumption is made that a project is successful if finished on time, within the agreed budget, and with the desired quality, often known as the "iron triangle." According to the evidence, this is far from the truth. In addition to the iron triangle, the construction industry must focus on other crucial success factors. Therefore, this study investigates the essential KPIs for construction projects in Saudi Arabia. This research employed a questionnaire survey as its major data source to determine the most critical KPIs for construction projects. The secondary data was collected from a comprehensive review of relevant literature, and the important performance indicators for construction projects in Saudi Arabia were selected and then evaluated using a questionnaire survey. The study found that the most important KPIs are Time, Cost, Quality, Safety, Sustainable Construction, Client Satisfaction, End-User Satisfaction, Risk management, Productivity of labour, and Profitability. This research adds to the corpus of knowledge on the Saudi Arabian key performance indicators for construction projects.
Fahren ohne (gültigen) Fahrschein
Authors: Schwerdtfeger Stefanie , Mehler Frederik , Wilde Mathias , Lanzendorf Martin
Published: December 2022

Das Fahren ohne (gültigen) Fahrschein wird bereits seit den späten 1980er Jahren in der Wissenschaft thematisiert. Bis heute wird das Thema vorwiegend aus einer rechtswissenschaftlichen, einer betriebswirtschaftlichen sowie einer kriminologischen Perspektive betrachtet. Weiterhin wird das Fahren ohne (gültigen) Fahrschein in Ansätzen sozialwissenschaftlich betrachtet. Eine Analyse des Themas aus der Perspektive der sozialwissenschaftlichen Mobilitätsforschung würde den wissenschaftlichen Diskurs erweitern. In den Print- und Onlinemedien wird das Thema ebenfalls relativ häufig thematisiert. Der Forschungsstand spiegelt sich in den Medien wieder, allerdings ist die Auseinandersetzung weitaus differenzierter, da beispielsweise auch politische Motivationen zum Fahren ohne (gültigen) Fahrschein angesprochen werden. Insgesamt lässt sich feststellen, dass Das Fahren ohne (gültigen) Fahrschein bereits Einzug in wissenschaftliche Untersuchungen und Debatten gefunden hat. Das Arbeitspapier fasst den Stand der Forschung zum Fahren ohne (gültigen) Fahrschein zusammen und bildet somit einen Einstieg für die Fokussierung des Themas aus Sicht der sozialwissenschaftlichen Mobilitätsforschung.
THE BUFFERING CAPACITY OF ERYTHROCYTE MEMBRANE SURROUNDINGS IN RELATION TO FREE PROTONS INSIGHTOF NEW ELUCIDATION OF EIGTH AND NINTH STAGES OF THE MEMBRANE REDOXY POTENTIAL THREE STATE DEPENDENT 9 STEPPED FULL CYCLE OF PROTON CONDUCTANCE IN THE HUMAN BODY
Authors:   New Medicine Medical University, Ulanbator, Mongolia., M. Ambaga , A. Tumen-Ulzii ,   New Medicine Medical University, Ulanbator, Mongolia., T. Buyantushig ,   New Medicine Medical University, Ulanbator, Mongolia.
Published: December 2022

It was became clear that the flow-fate of all many many protons,generated in mitochondria of 50-80 trillion cells (now by us mitochondria flow of protons named as 1-7 stages of proton conductance) have been needed another special structures - another system needs to soak up the extra H+ activity generated as a result of process conducted in the 1-7 stages of proton conductance in order for true buffering to occur, that system consists of intracellular proteins, of which haemoglobin is the key player, concretely speaking,one of these are the erythrocyte membrane surroundings for packaging of protons and alsoHydrochloric acid formationby Gastric parietal cells,also H+/Na antiport in the membrane transports H+ out of cell and Na ion in the level of Peritubular capillary-Interstitial fluid-Tubule epithelial cells-Tubular fluid with accompanying maintaining of serum and cell pH-7,4.By our suggestion, the buffering capacity of erythrocyte membrane surroundings in relation to free protons, formed in the proton conductance have implemented within Ninth stage -located in the Respiratory membrane, Pulmonary circuit, where occurred oxygen uptake from alveolar air under effect of increased bicarbonate entry by bicarbonate/chloride ion shift mechanism, leading to increase of HbO2 formation, resulting to release of proton,electron from food substrates under the undirect action of oxygen released from membrane surroundings of erythrocyte in the 8-th stage of proton conductance.
SPECIAL EDUCATION LEADERSHIP PRACTICES IN THE RURAL SCHOOL SETTING
Authors:   College of Education, Tarleton State University., Atchley Stephanie , Baumgardner Donna ,   College of Education, Tarleton State University., Hampton Penny ,   Weatherford Independent School District., Sheppard Tyler ,   Big Spring Independent School District.
Published: December 2022

This study examined the best practices and insights gained that will impact future practice in the rural special education setting with the return to post-COVID instruction. Hattie (2021) highlighted the importance of reflecting on what went right and encouraged schools to discuss the evidence of success during the pandemic school year. Following the scholar-practitioner framework, two special education directors in the rural central Texas area share their experiences during the pandemic and offer insight into new practices and procedures they are implementing post-COVID. Four common themes emerged from the thematic analysis: (a) the importance of technology, (b) changes in instructional practices, (c) barriers to student success, and (d) communication structures. This article aims to guide rural special education leaders as they continue to navigate instructional and financial challenges post-pandemic.
QUANTIFICATION OF LEAD CONTAMINATION IN DIFFERENT SAUDI CHOCOLATE BRANDS USING ATOMIC ABSORPTION TECHNIQUE
Authors:   Associate Professor, Department of Pharmaceutical Chemistry, College of Pharmacy AL-Kharj, Prince SattamBin Abdulaziz University, Saudi Arabia., A. Abdelgawad Sherif , M. Alanazi Abdulmohsen ,   Bachelor Degree in Pharmaceutical Science, College of Pharmacy AL-Kharj, Prince SattamBin Abdulaziz University, Saudi Arabia., S. Alharbi Abdulhadi ,   Bachelor Degree in Pharmaceutical Science, College of Pharmacy AL-Kharj, Prince SattamBin Abdulaziz University, Saudi Arabia.
Published: December 2022

Introduction: Although chocolate and candies are widely preferred snacks for children and adults, they can carry a risk of lead (Pb) contamination. The lead is considered as a toxic heavy metal that can cause many diseases to adults, including renal, reproductive, nervous, immune, and cardiovascular systems diseases. In children, lead can cause behavioral, developmental diseases and learning deficits. Aim and objectives:Our aim in this study is to measure the lead concentrations in different Saudi chocolate brands from different Saudi cities in order to compare it to the American FDA recommended levels of lead.Secondary objective: to assess if chocolate lead contamination contributes to the high blood lead levels that was found in our pediatric population. Methods: Ten different chocolate brands products were brought from different Saudi cities markets these samples were digested using (MARS 6) Microwave Digestion system. The clear digested samples were diluted to 50 ml and subjected for the trace elements determination by Flame atomic absorption spectrometry using AAS-7000. Results:All chocolate products that we investigated have shown lead levels between (0.00006 to 0.00654 ppm) which are below the recommended levels. Conclusion:Depending on our findings, the different chocolate brands that we have studied are within the acceptable ranges of lead contamination, as recommended by the American FDA. Further studies should focus on other causes of lead exposure as we have a high blood lead levels in our pediatric population.
RANDOMIZED, DOUBLE-BLIND STUDY TO COMPARE THE EFFECTS OF TWO ANALGESIC REGIMENS AS PREEMPTIVE ANALGESIA FOR PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY UNDER GENERAL ANAESTHESIA
Authors: Singh Tarandeep , Kotpal Avnish , Manish Lokman
Published: December 2022

Background: Preemptive analgesia is a method to provide effective pain relief after the surgery. This study was designed to compare the effects of single analgesic Ketamine intravenous (IV) versus combination of low dose Ketamine and Parecoxib IV as preemptive multimodal analgesia in patients undergoing Laparoscopic Cholecystectomy. Methods: This was a prospective, randomized, double blind study in 48 patients undergoing laparoscopic cholecystectomy. The study population was divided into two groups. Group I: treatment regimen of Injection (Inj.) Ketamine 0.3mg/kg IV plus Inj. Parecoxib 40mg IV. Group II: treatment regimen of Inj. Ketamine 0.3mg/kg IV plus saline. The treatment was given as single dose pre-operative. Inj. Fentanyl 0.5Âµg/kg was used as the rescue medication during the surgery and post-opertively. Total (intra-op and post-op) opioid, time for first opioid administration wasdetermined. Pain was assessed using Visual Analyzed Scale(VAS) and wasdetermined at 1 hour (hr.), 2 hr., 4 hr., and every 4 hr. interval till 24 hours after the surgery. Results: As compared to Group II, Group I patients were administeredsignificantly lower dose of opioid(0.16 Â± 0.26 versus 0.37 Â± 0.47Âµg/kg P= 0.032) during the surgery. Similarly, time to rescue medication post-operativewas significantly more in Group I patients as compared to Group II (68.1 Â± 41.1 versus 20.1 Â± 16.1 minutes P <0.001). In post-op, total opioidrequirement was lower in Group I versus Group II patients (7.9 Â± 4.1 vs 17.1 Â± 6.1 Âµg/kg P < 0.001). Conclusion: Multimodal analgesia regimen using combination of two different groups of analgesics (Ketamine and Parecoxib)was found to be more effective than single analgesic in reducing pain in the post-op laparoscopic cholecystectomy patients.
State support for the digitalization of SMEs in European countries
Authors: Strilets Viktoriia , Frolov Serhiy , Datsenko Viktoriia , Tymoshenko Oksana , Yatsko Maksym
Published: December 2022

COVID-19 and Russia’s war against Ukraine have created many challenges for the business models of SMEs, stimulating them to develop alternative forms of business. Among the key alternatives, one should single out digitization. However, imperfections of Ukraine’s state support system for digital transformation necessitate adapting the positive practice of leading countries with excellent business digitalization. Therefore, this paper structures the practical experience of state support of European countries in the digitalization of SMEs. The study conducts a cluster analysis to identify countries whose experience in state support for business digitalization is the best for adoption. Clustering employed the criterion of using key digitization instruments: internet of things, integration of business processes into electronic processes, digital integration with customers/suppliers, cloud services, big data analysis, and artificial intelligence. Thus, 4 clusters were identified (the first cluster comprises 16 countries, the second – 2, the third – 5, and the fourth – 7). These findings contributed to the selection of some key measures. They included: expanding the financial capabilities of SMEs to adopt digital technologies in their processes; formation of digital hard skills among entrepreneurs and increasing the personnel potential of SME digitization; creation of a favorable business environment to stimulate the digital activity of SMEs; and popularization of business digitalization strategy as a component of digital transformation strategy in society.
Medicine History “For Countries' Political History, for Humanity, Science History has Importance”
Authors: Şen Zekâi
Published: December 2022

The history of medicine shows that medical sciences are historically intertwined with different civilizations according to advice on linguistical forms and written books. The first medical treatments were based on superstitions that had been overturned by principles of rationality for the past 2500 years. For example, several medical treatments were based on amulets, totem symbols and tattoos, originally thought to drive away evil spirits from the sick body. The history of medicine offers visions of the evolution of medical treatments. In this chapter, all civilizations and their leading medical philosophers and recommendations are coherently explained in a harmonious manner so that the reader can understand centuries of valid and invalid disease treatment procedures and better alternatives.
Scientific Philosophy and Principles in Medicine
Authors: Şen Zekâi
Published: December 2022

Scientific Philosophy and Principles in Medicine is an accessible treatise on the philosophy that guides medical practice. It lays the foundation of a multidisciplinary framework behind the development of the medical profession. The book presents 10 chapters that cover issues that are frequently encountered by medical professionals in their career: philosophical and linguistic principles of rational thought, scientific, crisp and fuzzy logic, diagnostic aspects, the history of medicine, epistemological concepts, approximate reasoning, principles of medical wisdom, numerical and graphical diagnostics, and the collaboration of researchers involved in the fields of engineering and medicine.

The author of the book brings several years of teaching experience and medical practice into this reference with the goal of integrating principles of scientific philosophy and logic into medical education. Readers will understand the process of devising rational diagnostic and treatment approaches that support human health as a generative process that seeks to solve problems through creativity, rather than a classical process of following medical protocols.

This book is intended as a basic reference for medical students, teachers, and general readers interested in the application of logic, philosophy and scientific principles in medicine.
Laporan Kasus: Hiperplasia Pseudokarsinomatus Hipofaring oleh karena Sporotrikosis
Authors: Halim Andrew , Rahaju Pudji , Surjotomo Hendradi , Murdiyo Mohammad Dwijo
Published: December 2022

Hiperplasia pseudokarsinomatus merupakan proliferasi epitel reaktif jinak yang secara histopatologi mirip karsinoma sel skuamosa. Salah satu penyebabnya adalah infeksi jamur. Kami melaporkan 1 kasus hiperplasia pseudokarsinomatus hipofaring oleh karena sporotrikosis. Wanita 57 tahun mengeluh tenggorok terasa mengganjal disertai nyeri ulu hati dan sensasi pahit/kecut naik ke tenggorok. Pasien menderita refluks laringofaringeal,alergi seafood, dan riwayat Steven Johnson Syndrome. Pada pemeriksaan laringoskopi, tampak massa berdungkul pada hipofaring dengan kesan jinak. Dari hasil pemeriksaan histopatologi tampak infiltrasi epitel menuju dermis (mirip karsinoma sel skuamosa). Dengan pemeriksaan ulang secara patologi anatomi dan mikrobiologi (baku emas) serta komunikasi antara klinisi, ahli patologi, dan mikrobiologi, massa tersebut diidentifikasi sebagai hiperplasia pseudokarsinomatus oleh karena Sporothrix schenckii. Pasien menjalani eksisi massa dan diberikan ketokonazol dan lanzoprazol selama 6 minggu. Saat evaluasi ulang, pasien merasa rasa mengganjal hilang dan tidak ditemukan massa pada hipofaring. Hiperplasia pseudokarsinomatus hipofaring oleh karena sporotrikosis jarang terjadi. Di indonesia, belum ada laporan kasus mengenai hal ini. Kesalahan diagnosis sebagai karsinoma dapat berakibat fatal. Akan tetapi, dengan diagnosis yang lebih teliti dan tatalaksana yang tepat, prognosis pasien sangat baik.
Laporan Kasus: Myiasis pada Peristoma Trakeostomi
Authors: Hidayat Riza , Rahaju Pudji , Surjotomo Hendradi , Murdiyo Mohammad Dwijo
Published: December 2022

Myiasis adalah infestasi larva Diptera (lalat) pada jaringan hidup manusia atau hewan dalam periode tertentu. Kasus myiasis banyak terjadi didaerah tropis terutama pada masyarakat golongan sosio-ekonomi rendah. Myiasis pada trakeostomi jarang didapatkan, literatur di Inggris menyebutkan hanya 2 kasus myiasis pada trekeostomi. Dilaporkan kasus laki-laki 60 tahun dengan myiasis pada peristoma trakeostomi dan karsinoma laring T4N2cMo. Trakeostomi dilakukan 1 tahun yang lalu, datang dengan keluhan keluar belatung dari kanul trakea, terasa seperti ada benda asing dileher, dan rasa nyeri yang menggigit, Pada kassa kanul trakea Â sering merembes darah, Â dan kanul trakea tidak ditutup oleh kassa atau sapu tangan. Pasien menyatakan sering membersihkan sekitar kanul trakea menggunakan bulu ayam. Â Penatalaksanaan dilakukan dengan ekstraksi larva secara manual dan debridemen, serta diberikan antibiotik intravena. Selain itu juga dilakukan perawatan luka dan penggantian anak kanul secara berkala dan Â menutup kanul trakea dengan kassa. Larva teridenfikasi sebagai larva lalat Chrysomya sp. Myiasis pada trakeostomi jarang diterjadi, faktor predisposisi myiasis pada luka trakeostomi berupa kebersihan kanul trakea, bau dari luka trakeostomi, dan kebersihan lingkungan tempat tinggal.
Efektivitas Ekstrak Daun Sirsak (Annona Muricata) dalam Menurunkan Kadar TNFÎ± dan Meningkatkan Kadar NO Uji Coba pada Mencit Swiss yang Diinokulasi Plasmodium Berghei
Authors: K Maria Estela , H Fransisca Prameshinta , Dharmana Edi , Kisdjamiatun RA
Published: December 2022

Ekstrak daun sirsak (Annona muricata) mengandung antioksidan seperti flavanoid, acetogenins yang memiliki peran sebagai antiplasmodium secara in vitro. Penelitian ini bertujuan menguji pengaruh ekstrak etanol daun sirsak terhadap penurunan kadar Tumor Necrosis Fakctor-alpha (TNFÎ±) dan peningkatan kadar Nitric Oxide (NO) pada limpa mencit Swiss betina yang diinokulasi Plasmodium berghei ANKA. Desain penelitian ini adalah Post Test only randomized Control Group Design. Sampel terdiri dari mencit Swiss normal (K-), mencit yang diinokulasi P. berghei ANKA (K+), mencit yang diberikan ekstrak daun sirsak 100 mg/KgBB/hari (P1), mencit yang diberikan ekstrak daun sirsak 200mg/KgBB/hari (P2), mencit yang diinokulasi P. berghei ANKA dan diberikan ekstrak 100mg/KgBB/hari (P3), mencit yang diinokulasi P. berghei ANKA dan diberikan ekstrak 200mg/KgBB/hari (P4). Rerata kadar TNFÎ± kelompok P4 lebih rendah di banding kelompok yang lain (X=403,88). Uji Bonferroni kelompok P4 berbeda bermakna (p=0,04). Rerata kadar NO kelompok P3 (0,93) lebih tinggi dibanding K(+) dan P4. Hasil uji Mann whitney menunjukkan bahwa kadar NO berbeda bermakna antara K(+) dengan K(-), K(+) dengan P1, K(+) dengan P2, K(-) dengan P4, P1 dengan P4, P2 dengan P4. Hasil uji korelasi Spearmen Rank antara kadar TNFÎ± dan NO menunjukkan adanya korelasi (p <0,05).
Suplementasi Vitamin D3 Dosis Tinggi Menurunkan Kalsifikasi Tulang Femur pada Janin Mencit
Authors: Maranatha Timothy Imanuel , Herdiman Heddy , Wargasetia Teresa Liliana
Published: December 2022

Kelebihan asupan vitamin D pada mencit yang bunting dapat menyebabkan penurunan massa tulang janin. Penelitian dilakukan untuk mengetahui apakah pemberian suplementasi vitamin D3 dosis tinggi dapat mengganggu kalsifikasi tulang femur janin mencit. Metode eksperimental laboratorium dengan rancangan acak lengkap dilakukan menggunakan lima ekor mencit jantan dan lima ekor mencit (Mus musculus L.) betina galur Swiss Webster berumur 8-12 minggu. Subjek penelitian adalah lima janin mencit dari hasil perkawinan yang hidup. Mencit dibagi ke dalam lima macam perlakuan yaitu KN (kontrol negatif), perlakuan A (13 IU vitamin D3), perlakuan B (13 IU vitamin D3), perlakuan C (13 IU vitamin D3), dan perlakuan D (13 IU vitamin D3). Mencit dikawinkan, kemudian diberi suplementasi sejak usia kebuntingan 11 hari. Pada usia kebuntingan 20 hari, mencit dikorbankan kemudian dilakukan pewarnaan Alizarin Red S terhadap janin. Parameter yang diuji adalah panjang tulang femur janin mencit yang mengalami kalsifikasi setelah diberi perlakuan. Analisis data menggunakan uji Analysis of Varian (ANOVA) satu arah yang dilanjutkan dengan uji Least Significance Different (LSD) dengan Î±=0,05. Hasil menunjukkan bahwa janin mencit yang diberi vitamin D3 dosis tinggi (kelompok C dan D) memiliki panjang kalsifikasi tulang femur yang berbeda bermakna (pâ‰¤0,05) yaitu lebih pendek dibandingkan dengan kontrol negatif, kelompok A, dan kelompok B. Simpulan penelitian adalah pemberian vitamin D3 dosis tinggi menurunkan kalsifikasi tulang femur janin mencit.Kata Kunci: Janin, kalsifikasi tulang, vitamin D3
Hubungan antara Imunoekspresi ER-Î±, ER-Î², dan PR dengan Gradasipada Tumor Filodes Payudara
Authors: Quzwain Fairuz , Hernowo Bethy Suryawati
Published: December 2022

Berbeda dengan tumor dari unsur epitelial duktuli dan kelenjar payudara, penelitian tentang peranan hormonal pada tumor filodes masih menunjukkan hasil yang inkonsisten, sehingga patogenesis dan penatalaksanaan tumor ini dalam jalur hormonal masih kontroversi. Penelitian ini bertujuan untuk mengetahui hubungan antara imunoekspresi faktor hormonal yaitu Estrogen Receptor Alpha (ER-Î±), Estrogen Receptor Beta (ER-Î²) dan Progesteron Receptor (PR) dengan gradasi tumor filodes payudara. Dilakukan penilaian histologi dan imunoekspresi pada parafin blok jaringan tumor filodes payudara di Laboratorium Patologi Anatomi RSUP. Hasan Sadikin Bandung periode tahun 2011 sampai 2014. Subjek penelitian dibagi menjadi 3 kelompok gradasi berdasarkan kriteria WHO tahun 2012 yaitu benign, borderline dan malignant. Didapatkan 62 kasus tumor filodes yang sebagian besar menunjukkan distribusi imunoekspresi ER- Î±>50 % yaitu pada kategori benign sebesar 35(87,5%). Terdapat korelasi negatif yang signifikan antara imunoekspresi ER-Î± dengan gradasi histopatologis (p=0,001 r=-0,423), artinya nilai imunoekspresi ER-Î± yang tinggi justru banyak diekpresikan pada gradasi benign. Tidak ditemukan korelasi signifikan antara imunoekspresi ER-Î² dan PR dengan gradasi tumor filodes payudara pada penelitian ini. Dapat disimpulkan bahwa semakin tinggi nilai imunoekspresi ER-Î± maka gradasi tumor filodes semakin rendah. Kata Kunci: ER-Î±, ER-Î², PR, gradasi, tumor filodes
Hubungan Kadar Sistein, Kadar Interleukin (IL) -1 dan Lama Hari Rawat pada Anak Gizi Buruk
Authors: Chabibi Mochamad Chabibi , Puryatni Anik - , Sujuti Hidayat -
Published: December 2022

Gizi buruk masih menjadi masalah kesehatan utama di negara berkembang, dan melatar belakangi lebih dari 50% kematian. Pada gizi buruk terjadi penurunan protein maupun asam amino, salah satunya sistein, asam amino yang mengandung sulfur. Kekurangan sistein berkaitan dengan sistim kekebalan tubuh karena sistein merupakan unsur pembentuk gluthatione yang merupakan antioksidan. Tujuan penelitian untuk membuktikan bahwa pada anak gizi buruk, kadar sistein & IL-1Î² lebih rendah serta jumlah hari rawat lebih tinggi dibandingkan kontrol dan hubungan antara ketiga parameter tersebut. Penelitian dilakukan dengan desain cross sectional, pada 19 anak gizi buruk dan 19 kontrol, dengan mengukur kadar sistein, IL-1Î² dan hari rawat. Perbandingan kadar sistein, IL-1Î² dan hari rawat dianalisis menggunakan independent samples t-test. Korelasi antara kadar sistein, IL-1Î² dan hari rawat dianalisis menggunakan korelasi Pearson. Kadar sistein pada anak gizi buruk lebih rendah bermakna dibandingkan kontrol (3,493Â±1,015 vs 4,656Â±0,577ng/ml; p=0,000). IL-1Î² pada anak gizi buruk lebih rendah bermakna dibandingkan kontrol (52,66Â±9,95 vs 65,46Â±7,99)ng/mL; p=0,000). Lama hari rawat pada penderita gizi buruk lebih tinggi bermakna dibandingkan kontrol (21,89Â±10,31 vs 8,53Â±4,06)ng/L; p=0,000). Kadar sistein berkorelasi positif dengan kadar IL-1Î² (p=0,000; r=-0,961). Kadar sistein tidak berkorelasi dengan hari rawat (r=0,112;p=0,648). Kadar IL-1Î² tidak berkorelasi dengan hari rawat (r=-0,020; p=0,934). Pada anak dengan gizi buruk, kadar sistein dan IL-1Î² lebih rendah serta hari rawat lebih tinggi dibandingkan kontrol. Terdapat korelasi antara kadar sistein dengan IL-1Î², tidak ada korelasi antara sistein dan IL-1Î² dengan hari rawat pada anak gizi buruk.Kata Kunci: Gizi buruk, interleukin-1Î², hari rawat, sistein
Infeksi HIV Bersamaan dengan Systemic Lupus Erythematosus
Authors: Sariningsih Fajar , Suryana Bagus Putu Putra , Ismanoe Gatoet
Published: December 2022

Munculnya Systemic Lupus Erythematosus (SLE) dan Human Immuno Deficiency Virus (HIV) yang terjadi secara bersamaan merupakan hal yang eksklusif. Tulisan ini melaporkan kasus HIV dan SLE yang terjadi bersamaan pada seorang wanita usia 50 tahun. Pasien mengalami keluhan yang mendukung adanya infeksi HIV dengan ditemukannya gejala diare kronis, penurunan berat badan, batuk-batuk, demam-demam, kelelahan badan, sariawan, nyeri sendi, dan allopesia. Pemeriksaan laboratorium yang mendukung diagnosis HIV pada pasien ini adalah peningkatan LED, tes determinan yang reaktif, dan penurunan CD4+. Pasien juga menderita SLE yang ditunjukkan dengan ditemukannya gejala allopesia (kerontokan rambut), sariawan yang tidak nyeri, sering menderita sakit sendi-sendi, demam yang hilang timbul tanpa penyebab jelas, riwayat trombositopenia (penurunan jumlah trombosit), penurunan berat badan. Hasil pemerikaan laboratorium immunologi yang mendukung diagnosis SLE adalah ANA test yang positif, ds DNA yang positif dan coombs test +2. Pemberian terapi antiretroviral dan chloroquin yang diberikan menunjukkan hasil perbaikan gambaran laboratorium dan gejala klinis pada bulan keempat pengobatan.Kata Kunci: Human Immuno Deficiency Virus (HIV), Systemic Lupus Erythematosus (SLE)