bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep and HbA1c in Patients With Type 2 Diabetes: Which Sleep Characteristics Matter Most?
Authors: Brouwer Annelies , van Raalte Daniel H. , Rutters Femke , Elders Petra J.M. , Snoek Frank J. , Beekman Aartjan T.F. , Bremmer Marijke A. 
Published: November 2019

OBJECTIVE
Poor sleep has been identified as a risk factor for poor glycemic control in individuals with type 2 diabetes (T2D). As optimal sleep can be characterized in several ways, we evaluated which sleep characteristics are most strongly associated with glycated hemoglobin A1c (HbA1c).

RESEARCH DESIGN AND METHODS
A total of 172 patients with T2D completed 7-day wrist-actigraphy and sleep questionnaires. Linear regression was used to evaluate associations between sleep measures (total sleep duration, variability in sleep duration, midsleep time, variability in midsleep time, sleep efficiency, subjective sleep quality, and subjective insomnia symptoms) and HbA1c, individually and in concert.

RESULTS
Variability in sleep duration was individually most strongly associated with HbA1c (β = 0.239; P = 0.002; R2 = 4.9%), followed by total sleep duration (U-shaped: β = 1.161/β2 = 1.044; P = 0.017/0.032; R2 = 4.3%), subjective sleep quality (β = 0.191; P = 0.012; R2 = 3.6%), variability in midsleep time (β = 0.184; P = 0.016; R2 = 3.4%), and sleep efficiency (β = −0.150; R2 = 2.3%). Midsleep time and subjective insomnia symptoms were not associated with HbA1c. In combination, variability in sleep duration, total sleep duration, and subjective sleep quality were significantly associated with HbA1c, together explaining 10.3% of the variance in HbA1c. Analyses adjusted for covariates provided similar results, although the strength of associations was generally decreased and showing total sleep duration and subjective sleep quality to be most strongly associated with HbA1c, together explaining 6.0% of the variance in HbA1c.

CONCLUSIONS
Sleep in general may be a modifiable factor of importance for patients with T2D. The prevention of sleep curtailment may serve as a primary focus in the sleep-centered management of T2D.
PERLINDUNGAN HUKUM BAGI PEKERJA ANAK DI INDONESIA
Authors: Izziyana Wafda Vivid 
Published: November 2019

Fenomena pekerja anak di Indonesia dewasa ini merupakan persoalan yang kompleks, berdimensi pada faktor ekonomi, sosial, dan budaya yang sudah ada sejak berabad-abad. Permasalahan ekonomi pada keluarga merupakan persoalan dominan yang mengharuskan anak untuk bekerja demi menunjang ekonomi keluarga. Pekerja anak saat ini tidak bisa di pungkiri, menurut Undang-Undang Nomor 13 Tahun 2003 tentang Ketenagakerjaan secara jelas telah melarang anak dibawah 18 tahun untuk bekerja. Hal Ini menggambarkan upaya perlindungan hukum bagi hak anak, namun kondisi masyarakat, maka Undang-Undang Nomor 13 Tahun 2003 membolehkan anak berumur 13 tahun sampai 15 tahun untuk melakukan pekerjaan ringan sepanjang tidak mengganggu perkembangan dan kesehatan fisik, mental, dan sosial dengan persyaratan (Pasal 69). Disamping itu Undang-Undang Nomor 35 Tahun 2014 tentang Perubahan atas Undang-Undang Nomor 23 Tahun 2002 tentang Perlindungan Anak mengamanatkan untuk memberikan perlindungan yaitu perlindungan khusus bagi anak yang dieksploitasi secara ekonomi termasuk pekerja anak (Pasal 66). Dengan adanya berbagai peraturan perundang-undangan yang terkait dengan upaya melindungi pekerja anak dapat memberikan kepastian hukum dalam upaya perlindungan hukum bagi pekerja anak di Indonesia
Revisión taxonómica del complejo de Centaurea cyanus L. (Centaurea sect. Cyanus, Asteraceae) en la Península Ibérica. Taxonomic revision of the Centaurea cyanus L. complex (Centaurea sect. Cyanus, Asteraceae) in the Iberian Peninsula
Authors: Muñoz Adolfo Francisco , Devesa Juan Antonio 
Published: November 2019

Español. Se ha efectuado la revisión taxonómica de Centaurea sect. Cyanus en la Península Ibérica. Se reconocen seis táxones y se hacen dos nuevas combinaciones: C. triumfettii var. semidecurrens (Jord.) Muñoz Rodr. & Devesa y C. graminifolia (Lam.) Muñoz Rodr. & Devesa. Se aporta una clave para la identificación de los táxones, así como su descripción morfológica e información sobre la distribución geográfica, apetencias ecológicas, fenología y número cromosómico. English. A taxonomic review of Centaurea sect. Cyanus in the Iberian Peninsula was done. Six taxa are recognized and two new combinations are proposed: C. triumfetti var. semidecurrens (Jord.) Muñoz Rodr. & Devesa and C. graminifolia (Lam.) Muñoz Rodr. & Devesa. A key for the identification of taxa are provided, also their morphological description, information on geographical distribution, their ecology, their phenology and their chromosome numbers are given.
Effects of sacubutril/valsartan on nutritional status in heart failure with reduced ejection fraction
Authors: Dereli Seçkin , Bayramoğlu Adil , Kaya Ahmet 
Published: November 2019

Background
Malnutrition commonly occurs in patients with heart failure with reduced ejection fraction (HFrEF). Sacubitril/valsartan, which is an AT1 neprilysin inhibitor, has been shown to reduce mortality and hospitalization in patients with HFrEF. However, its effects on nutritional status remain unclear.

Methods
Sacubitril/valsartan was initiated in 164 symptomatic patients with HFrEF receiving an optimal medical treatment with angiotensin inhibition (mean age: 63 ± 20 years; 120 males, 60% ischemic cause). The New York Heart Association (NYHA) functional class and nutritional statuses of the patients were evaluated at the switching to AT1 neprilysin inhibitor and at the 6th-month follow-up of the maximum sacubitril/valsartan dose using the geriatric nutritional risk index (GNRI), controlling nutritional status (CONUT) score, prognostic nutritional index (PNI), and prealbumin.

Results
After the sacubutril/valsartan treatment, a significant reduction in the number (%) of malnourished patients was observed according to CONUT (before 47% vs. after 7%, P < 0.001), GNRI (before 39% vs. after 19%, P < 0.001), PNI scores (before 36% vs. after 12%, P = 0.002), and prealbumin (before 41% vs. after 12%, P < 0.001). Also significant changes were observed at the baseline and follow-up in the mean scores of the three different nutritional indexes and prealbumin levels [CONUT: 2.68 ± 2.5, 1.02 ± 1.0 (P < 0.001); GNRI: 97.1 ± 9.7, 101.2 ± 5.9 (P < 0.001); PNI: 38.8 ± 4.8, 41.6 ± 3.7 (P < 0.001); prealbumin: 14.6 ± 6.9 mg/dl, 17.1 ± 5.2 mg/dl (P < 0.001)]. Overall, the patients exhibited a significant functional improvement following the initiation of sacubitril/valsartan: 23% of the patients improved by two NYHA classes, 48% improved by one NYHA class, and 39% remained stable.

Conclusion
In patients with HFrEF, the switch from angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker therapy to sacubitril/valsartan resulted in a significant improvement in both nutritional and functional statuses.
Diabetic patients need higher furosemide doses: a report on acute and chronic heart failure patients
Authors: Cunha Filipe M. , Pereira Joana , Marques Pedro , Ribeiro Ana , Bettencourt Paulo , Lourenço Patrícia 
Published: November 2019

Introduction
Diuretics are first-line drugs in symptomatic heart failure treatment. Diabetes mellitus has been suggested as a determinant of diuretic resistance. Studies comparing the dose and efficacy of diuretics in patients with and without diabetes are lacking. We aimed to study if furosemide dose differed according to diabetes status.

Methods
We studied two cohorts of heart failure patients: a cohort of acute heart failure patients consecutively hospitalized with the primary diagnosis of heart failure and another of stable and optimized patients followed in a heart failure clinic. Data on comorbidities and medication were abstracted from patients’ files. Use and doses of furosemide were compared between diabetic and nondiabetic patients. Regression analysis was used to determine the association of variables with diuretic dose. The independent association of diabetes with furosemide dose was assessed using multivariate models.

Results
We studied 865 heart failure patients: 601 acute heart failure patients and 264 chronic stable heart failure patients. Acute heart failure patients with diabetes were more likely to need intravenous diuretic therapy and they were also more often discharged under higher doses of furosemide. They needed extra 6-mg furosemide at discharge in comparison with their nondiabetics counterparts and had an independent 26% higher odds of being discharged with at least 80-mg furosemide. Chronic patients were also more frequently prescribed with furosemide and on higher doses, although, diabetes was not independently associated with the use of higher furosemide doses.

Conclusion
Diabetic patients are more intensively treated with the loop diuretic furosemide. In acute heart failure, diabetes is an independent predictor of furosemide dose.
Pilot trial results in assessing english literacy of applicants to medical residencies
Authors: Sanabria Rivera Luis Eduardo , Polo Ledezma Reinaldo Emilio , Ramírez Cuellar Adonis Tupac 
Published: November 2019

Objective. The main goal of this paper is to statistically describe the results obtained by 355 applicants to medical residencies, after responding a technical English test with 24 exercises. Justification. English is indispensable for reading, understanding specialized medical texts, for listening podcasts with the last scientific and technological advances in Medicine, and for writing and communicating medical reports.
Main Results. From 355 applicants to medical residency only seven have the necessary com­petences in Medical English to be a postgraduate student. The majority of aspirants have problems related with bad english competences in the act of correct managing of verb ten­ses, medical vocabulary, semantics and English syntax.
Excessive daytime sleepiness and obstructive sleep apnea among aircrew: A questionnaire survey
Authors: Murthy HMK , Mohapatra SS 
Published: November 2019

Background:
Obstructive sleep apnea (OSA) is a condition resulting in disrupted sleep and excessive daytime sleepiness/somnolence (EDS) with demonstrable deficits in cognitive and psychomotor performance. Indian studies have shown the prevalence of 4.9–19.7% in males and 2.1–7.4% in females. Prevalence among military aviators is unknown.

Materials and Methods:
EDS was determined by employing Epworth Sleepiness Scale (ESS) among the 54 male aircrews in an airbase. The risk for OSA was also determined among these individuals using STOP-BANG questionnaire.

Results and Discussion:
It was found that none of the aircrews in the study group is found to have dangerously sleepy (DS). About 11.11% of the studied population were found to have EDS which is less than the prevalence rate in India as per a study conducted by the National Institute of Mental Health and Neuro Sciences on general population and the Western world (prevalence rate of 16.7%) as found by Gislason et al. OSA risk among the study population was (n = 9/54) 16.16%. The prevalence of OSA in India male is reported as 4.9–17.9%. Thus, percentage of aircrew showing the risk for OSA in this cross-sectional study is comparable with the general population in India. However, no correlation was found between the risk factors of OSA with ESS. The reasons for EDS could be attributed to factors such as personal lifestyle, sleeping habits, and poor work-rest schedules. It is interesting to note that none of the aircrew, who is positive for OSA risk, is showing EDS/DS. This further confirms that OSA risk individuals may not have EDS/DS and this could be a reason why, OSA largely remains underdiagnosed and untreated in clinical practice.

Conclusion:
This cross-sectional study has brought the conclusion that both EDS and risk for OSA coexists even in a fit and healthy population of aircrew.
Physiological interpretation of almost loss of consciousness
Authors: Khatua SS , Dahiya M , Gowda A , Sannigrahi P 
Published: November 2019

Background:
The phenomenon of almost loss of consciousness (A-LOC) is although known to the aviation fraternity since the 1980s, it is not well researched. Very few studies have attempted to elaborate the characteristics of A-LOC. The present study is a retrospective analysis which has endeavored to address the lacunae in literature.

Materials and Methods:
A retrospective analysis of the G training data in high-performance human centrifuge for a time span of 4 years (2009–2013) was carried out.

Results:
A total of 71 A-LOC incidents were reported and were analyzed for better understanding of A-LOC. On the basis of findings such as nystagmus, maintenance of postural tone, convulsions, amnesia, and dreams during A-LOC, neurophysiology of A-LOC has been hypothesized.

Conclusion:
The presence of nystagmus and maintenance of body posture suggest intact vestibulo-ocular reflex and sensory-motor tract, respectively. Non-recollection of dreams, amnesia suggests breach in memory and/ or information processing for higher functions. The mechanism of A-LOC in toto can be explained by regional differences in blood flow and vulnerability of cerebral centers to ischemic hypoxia. Convulsions in A-LOC could be attributed to hyperexcitability of nerve fibers due to hypoxia.
Understanding the Influence of Manufacturing and Material Parameters on the Mechanical Properties of Polymer-Clay Composites: An Exploratory Statistical Analysis
Authors: Botha Natasha , Coetzer Roelof , inglis helen , labuschagne johan 
Published: November 2019

This paper analyses a set of previously obtained experimental results on various clay fillers added to high density polyethylene (HDPE). The composite material was compounded using an extrusion process and manufactured into tensile test samples by means of hot pressing. Various manufacturing parameters (number of extrusions, press time, sample cooling method), material (polymer grade, clay type, clay weight loading) and testing parameters (strain rate) were investigated to determine their influence on the mechanical properties of the composite system. Exploratory data analysis was first employed by graphically representing the data using scatter plots to identify any main characteristics, patterns or anomalies. The statistical analysis was used to quantify the effects of the ultimate tensile strength by first conducting a one way ANOVA analysis before developing a linear model for the response variable analysis. For the percentage elongation to failure, the observations was first grouped into three groups, Brittle, Intermediate or Ductile. A linear discriminant analysis was performed to classify the groups considering a training set of 80% randomly selected observations and testing on the remaining 20%.
Competency of Islamic Education Teacher to Improve Student Learning Achievement
Authors: Mohammad Rasikhul Islam  
Published: November 2019

The competency of the teacher can contribute or increase learning achievement can be an active example of inofative criminative and have high integration in school. The purpose of this research is to know the role of the PAI master competence in enhancing student learning achievement. This research uses the method of decriptif with a qualitative approach, data collection techniques using observations, interviews and documentation studies. Research subjects are the principals and teachers of PAI. The results of the study showed: (1). Pedagogic competence, (2). Personality Competencies (3). Social competence and (4). Professional competence.
Analisis Maqashid Syari’ah Jasser Auda Terhadap Izin Perkawinan dan Perceraian Bagi Pegawai Negeri Sipil
Authors: Rahman Fawait Syaiful 
Published: November 2019

Abstract: Marriage under the provisions contained in the classical books of men who wish to have more than one wife, there is no requirement as regulated in the provisions of Government Regulation No. 45 of 1990 amendment to Government Regulation No. 10 of 1982 concerning Marriage and Divorce Permits Civil Servants, five sufficient conditions for the prospective wife, prospective husband, guardian, two witnesses, and sighat. While civil servants in the PP Article 4 Paragraph 1 men who want to have polygamy should seek permission from their superiors and Religious Courts. According to the researcher need to do re-analysis with appropriate methodology and precisely because the Government Regulation concerning state law order, in order to find whether Government Regulation Number 45 Year 1990 concerning Permit of Marriage and Divorce of Civil Servant have expediency or vice versa. For that the researcher chose Maqashid al-Shari'ah Jasser Auda as a knife of analysis in this study.
This study aims to test empirically the variables that have been formulated in the formulation of the problem, namely reveal the history of birth PP. No. 45 Th. 1990 amendment of PP. No. 10 Th. 1983 on the marriage and divorce of civil servant, the application of the theory of Maqashid al-Shari'ah Jasser Auda to the PP. No. 45 Th. 1990, and analyzed the PP. No. 45 Th. 1990 amendment of PP. No. 10 Th. 1983 on marriage permit and divorce of civil servants with the theory of Maqashid al-Shari'ah Jasser Auda. Research Methods with Approach and Type of Research is a qualitative approach oriented to the statutory approach (Statute Aproach) with the type of research Library (library research). Methods of data collection using documentation, and data analysis using descriptive - inductive.
Overcoming the failure of fruit-set and fruit drop of siam orange on off-season period through application of mycorrhizal inoculants and ZNSO4 micro fertilizer dosage
Authors: Astiari Ni Komang Alit , Sulistiawati Ni Putu Anom , Mahardika Ida Bagus Komang , Rai I Nyoman 
Published: November 2019

This research was carried out at Kintamani District, Bangli Regency, Bali-Indonesia, from February to October 2019 with aimed to overcome the failure of fruit-set and fruit drop of Siam orange on off-season period through application of mycorrhizal inoculants and ZnSO4 micro fertilizer dosage. This experiment was arranged as a randomized block design consisted of 2 factors. The first factor was mycorrhizal inoculant (0, 50, 100 and 150 g/tree), while the second factor was the dosage of ZnSO4 micro fertilizer (0, 5, 10 g/tree). All treatments were repeated 3 times. The results showed that the interaction between mycorrhizal inoculant treatment and ZnSO4 micro fertilizer dosage did not significantly affect all of the variables observed. Mycorrhizal inoculant dose 150 g/tree could overcome the failure of fruit-set and fruit drop and improved the quantity and quality of fruit of Siam oranges on off-season, which was reflected by increased number of fruits harvest per tree (249,00 fruits), weight per fruit (106,10 g), weight of fruit harvested per tree (26,34 kg) and total dissolved solids (13.52% Brix), or increase 31,44%; 18,15%; 54,58%; and 35,74%, respectively, compared to without mycorrhizal inoculant i.e 189,44 fruit; 17,04 kg; 89,80 g and 9,96% Brix.
Hubungan Kadar Kolesterol Total Dan Hipertensi Dengan Kejadian Penyakit Jantung Koroner DI RSUD dr. Soedarso Pontianak
Authors: Kamila Laila , Salim Maulidiyah 
Published: November 2019

Abstract: Coronary heart is a disease that offense to blood vessels and heart attack due to constriction of blood vessels. A high level of cholesterol in blood or exceeds the normal limit can form sediment in wall of blodd vessels which cause blood vessels constriction or blockage. This research object to determine whether there is a correlation between cholesterol level total and hypertension with coronary heart disease in patients who hospitalized in Regional Public Hospital of dr. Soedarso Pontianak. This study was used cross sectional design, purposive sampling technique, it gained 50 people as samples. The measurement of blood pressure was done in heart poly and cholesterol total level in clinic laboratory of Regional Public Hospital of dr. Soedarso by using enzymatic CHOD-PAP method. It can be obtained that 10 people had hypertension and 40 people did not.the average of total cholesterol was 224 mg/dl. Maximum value of total cholesterol was 224 mg/dl and 152 mg/dl as minimum value. Data has been analyzed by using statistical test, Chi-Square, to determine the correlation of total cholesterol wit coronary heart disease, obtained p value=0,024 (less than α=0,05). Correlation of hypertension and coronary heart disease gained p value=0,923 (more than α=0,05), it can be concluded that total cholesterol correlated with coronary heart disease, and there was not a correlation between hypertension and coronary heart disease.Abstrak: Jantung koroner adalah penyakit yang menyerang pembuluh darah dan serangan jantung, karena penyempitan pada pembuluh darah. Kadar kolesterol yang tinggi dalam darah melebihi normal dapat membentuk endapan pada dinding pembuluh darah sehingga menyebabkan penyempitan dan tersumbatnya pembuluh darah. Penelitian ini bertujuan untuk mengetahui hubungan kadar kolesterol total dan hipertensi dengan penyakit jantung koroner pada pasien di RSUD dr. Soedarso Pontianak. Disain penelitian ini menggunakan cross sectional, teknik pengambilan sampel yaitu purposive sampling, didapat jumlah sampel 50 orang. Pengukuran Tensi Darah dilakukan di poli Jantung dan pemeriksaan kadar kolesterol total di laboratorium klinik RSUD dr. Soedarso Pontianak dengan metode enzimatik CHOD-PAP. Hasil penelitian didapatkan 10 orang mengalami hipertensi dan 40 orang non hipertensi. Rata-rata kadar kolesterol total 224 mg/ dl. Nilai maksimum kadar kolesterol total yaitu 224 mg/dl dan nilai minimum yaitu 152 mg/dl. Analisa data dengan uji statistik Chi-square untuk mengetahui hubungan kolesterol total dengan penyakit jantung koroner didapatkan nilai p = 0,024 (lebih kecil dari α 0,05). Uji hubungan hipertensi dengan penyakit jantung koroner didapat nilai p = 0,923 (lebih besar dari α 0,05), dapat disimpulkan terdapat hubungan kadar kolesterol total dengan penyakit jantung koroner dan tidak ada hubungan hipertensi dengan penyakit jantung koroner.