bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of rhabdomyosarcoma in children and adolescent from four low health expenditures average rates countries
Authors: Mazic Maja Cesen , Bonevski Aleksandra , Mikeskova Martina , Mihut Emilia , Bisogno Gianni , Jazbec Janez 
Published: October 2020

Abstract

Background
Survival of children with cancer in Eastern and Central Europe is 10–20% lower than in high income European countries. We evaluated outcome of children and adolescents with rhabdomyosarcoma (RMS) in Slovenia, Croatia, Slovakia and in Romania.

Patients and methods
We retrospectively analysed event-free survival (EFS) and overall survival (OS) for all patients treated in Slovenia and Croatia. Slovakia included patients from two centers, representing half of expected cases. Romania included patients from single institution, representing only 10% of expected patients. Joint database for analysis was established.

Results
One hundred seventy-eight children and adolescent with RMS diagnosed from January 2000 to December 2015 were included. Mean patient age at diagnosis was 7.7 years, one third was older than 10 years. Twenty-five percent had alveolar histology and 72% unfavorable location. Higher than expected proportion of patients had nodal involvement (24%) or metastatic disease (27%). All patients received systemic chemotherapy, 57% had radiotherapy and 63% surgery as local control. Kaplan- Meier estimates for 5-year EFS and OS were 50.7% and 59.6%, respectively. Five-year OS for patients with localised disease was 72% compared to 24% for metastatic disease.

Conclusions
Children with RMS treated in Eastern and Central Europe have inferior outcome compared to their counterparts treated in high income European countries. Active participation of low health expenditures average rates (LHEAR) countries in international clinical trials may improve outcome of paediatric oncology patients.
Association between serum interleukin (IL)-12 level and severity of non-alcoholic fatty liver disease (NAFLD)
Authors: Darmadi Darmadi , Ruslie Riska Habriel 
Published: October 2020

Abstract

What is new? Serum IL-12 level is associated with NAFLD severity. Elevation in serum IL-12 level is in line with more severe NAFLD based on BARD score and NAFLD fibrosis score. Positive correlation is observed between serum IL-12 level and BARD score.

Introduction. Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases worldwide. Lipid accumulation in the liver triggers inflammation and leads to NAFLD. Prolonged inflammation will worsen the disease progression. Pro-inflammatory cytokines, including interleukin (IL)-12, plays a role in the inflammatory process. This study aimed to determine the association between IL-12 and NAFLD severity.

Methods. A cross-sectional study was conducted between January and July 2019 in Haji Adam Malik Hospital Medan, Indonesia. Subjects were patients aged 18 years or older diagnosed with NAFLD based on ultrasound. Exclusion criteria were excessive alcohol consumption, other primary liver diseases, malignancies, and cardio-metabolic disturbances. Serum IL-12 level was determined using an enzyme-linked immunosorbent assay method. The severity of NAFLD was assessed using the BARD score and NAFLD fibrosis score.

Results. A total of 100 subjects were enrolled with male predominant. The mean age of subjects was 54.97 ± 8.85 years, and the most frequent comorbidity was obesity. Most subjects had mild to moderate disease progression. Serum IL-12 level was higher in more severe NAFLD based on ultrasound grading (P < 0.001), BARD score (P = 0.003), and NAFLD fibrosis score (P = 0.005). A positive correlation was observed between serum IL-12 level and BARD score (P < 0.001) with sufficient accuracy (AUC = 0.691, P = 0.014).

Conclusion. Serum IL-12 level was associated with the severity of NAFLD. Higher serum IL-12 level was observed in more severe NAFLD progression.
Laboratory Test Methods for Assessing the Abrasivity of Rocks and Soils in Geotechnology and Mining Applications
Authors: Janc B. , Jovičić V. , Vukelić Ž. 
Published: October 2020

Abstract
In geotechnology and mining, tools and equipment interact with aggressive geological material, causing the wear of these components. For this reason, it is important to determine the rate of abrasivity of individual geological materials, depending on the type of interaction with the tool. Various abrasivity tests have been developed in laboratories. Some of them are general, while others are special. What they all have in common is that they attempt to determine the abrasivity of rocks or soils in relation to the wear of the test specimens. This article gives an overview of the laboratory test methods for assessing the abrasivity of geological materials, which are useful in the field of geotechnology and mining engineering. General and special abrasivity tests are presented in detail. The aim of the article is to present existing laboratory tests to assess the abrasivity of rocks and soils, based on which further investigations of wear can be considered as part of a comprehensive approach to this tribological problem. Understanding of the wear mechanisms is the basis for the development of wear-resistant tools and models for predicting the tool life.
Peripheral Nerve Block Versus Spinal Anesthesia for Total Knee Replacement in Elderly Patients
Authors: Vukotic Milovan , Vukotic Aleksandra , Bascarevic Zoran , Videnovic Nebojsa 
Published: October 2020

Abstract
Spinal anesthesia and peripheral nerve block anesthesia are used in total knee replacement. The aim of the study was to examine whether peripheral nerve block anesthesia would provide a more stable hemodynamic profile and analgesic effect in elderly patients undergoing total knee replacement, as compared to spinal anesthesia. This is a single-center case-control trial, with patients from our prospectively followed registry. The patients were divided into two groups, those with peripheral nerve block anesthesia and spinal anesthesia. Propensity score analysis was performed in 1:1 ratio. The primary outcome was analgesia with total analgesic effect and the secondary outcome was intraoperative hemodynamic status. The patients in peripheral nerve block anesthesia group had a longer length of analgesia (606.19±219.35 vs 359.48±106.82, P<0.01) and pain scores during 24h and 48h after the surgery were lower in the same group of patients (3.21±1.74 vs 5.02±2.23, P=0.037; 3.03±1.57 vs 5.67±2.51, P=0.028). Spinal anesthesia group had a larger number of patients with significant hypotension (3.84% vs 15.38%, P=0.01), as well as a larger number of patients who received vasopressors (0% vs 9.61%, P<0.01). Both anesthesia methods demonstrated sufficient analgesic efficacy in total knee replacement, although there was less pain severity and longer analgesic effect of peripheral nerve block anesthesia in patients who were 60 years old or older. Spinal anesthesia showed a significantly higher degree of hypotension than in those patients receivingperipheral nerve block anesthesia.
Sterility Testing of Platelets Concentrate Within Quality Control: Experiences and Opportunities to Extend the Application
Authors: Gojkov Dragana , Borovcanin Nemanja , Vucetic Dusan 
Published: October 2020

Abstract
Despite numerous measures, bacterial sepsis associated with the transfusion remains a major threat. The incidence of septic events induced by platelets transfusion is approximately 10 times higher than with transfused red blood cells due to their storage temperature. This caused new Standard that implements the methods for the detection and reduction of bacteria in the platelet concentrates (PC). The aim is to consider the possibility of wider application of this tests in order to extend the shelf-life of PC. Sterility testing of PC is done once or twice per month using BacT/Alert BPA and BacT/Alert BPN bottles. If positive, all products from the initial unit were tested to confirm or deny the status. During six years period, 67236 PC units were made and 872 of them were tested. Only two were found initially positive. After testing the other products from the same initial unit, results were negative so, final results proclaimed false positive. Pretransfusion bacterial detection is an important potential method for reducing the risk of bacteriemia and transfusion-associated septic reactions. In addition to routine measures, Mirasol PRT pathogen inactivation system, could be included. This allows certain amount of PC to be inactivated during the first 32 hours. Untreated PC units would be stored in standard conditions and for given time (three days) potentially present bacteria would reach a detectable level. This way the quantity of samples for sterility testing could be reduced, taking only 2 ml of each of four units of PC. Samples would be planted at the same vial-aerobic bottle, which would also, double the capacity in BacT/Alert 3D automated system.
Screening strategy modification based on personalized breast cancer risk stratification and its implementation in the national guidelines – pilot study
Authors: Krajc Mateja , Gareth Evans D , Blatnik Ana , Lokar Katarina , Žagar Tina , Tomšič Sonja , Žgajnar Janez , Zadnik Vesna 
Published: October 2020

Abstract

Background
One of the most consistent models for estimating personalized breast cancer (BC) risk is the Tyrer-Cuzick algorithm that is incorporated into the International Breast Cancer Intervention Study (IBIS) software. Our main objective was to provide criteria for the classification of the Slovenian population, which has BC incidence below the European average, into risk groups, and to evaluate the integration of the criteria in Slovenian guidelines. Our main focus was on women age <50 with higher BC risk, since no organized BC screening is available for these women.

Methods
Slovenian age-specific BC risks were incorporated into IBIS software and threshold values of risk categories were determined. Risk categories were assigned according to the individual’s ten-year risk for women aged 40 and older, and lifetime risk for women between 20 and 39. To test the software, we compared screening strategies with the use vs. no use of IBIS.

Results
Of the 197 women included in the study IBIS assigned 75.1% to the BC risk group, and the rest to the moderately increased risk. Without IBIS 80 women were offered mammographic and 33 ultrasound screening. In contrast, 28 instead of 80 would have been offered mammographic screening and there would have been no referrals for ultrasound if IBIS had been used.

Conclusions
The Slovenian IBIS has been developed, tested and suggested for personalized breast cancer risk assessment. The implementation of the software with the consideration of Slovenian risk thresholds enables a more accurate and nationally unified assessment.
Measles outbreak in a Roma community in the Eastern region of Slovakia, May to October 2018
Authors: Hudečková Henrieta , Stašková Janka , Mikas Ján , Mečochová Adriana , Staroňová Edita , Polčičová Alexandra , Baška Tibor , Novák Martin , Malinovská Nora , Zibolenová Jana , Švihrová Viera , Nováková Elena , Štefkovičová Mária 
Published: October 2020

Abstract

Background
Despite the effective National Immunization Programme of Slovakia, some population groups are incompletely vaccinated or unvaccinated. We aimed to describe the measles outbreak spread in Eastern Slovakia between May and October 2018, affecting the Roma communities in relation to the existing immunity gaps.

Methods
We defined a group of persons living in socially closed communities with low vaccination coverage.

Results
Of 439 measles cases (median age: 10 years), 264 (60.1%) were vaccinated, 137 (31.2%) received two doses and 127 (28.9%) one dose of measles vaccines, 155 (35.3%) were unvaccinated and 20 (4.6%) had an unknown vaccination status. Samples from 102 patients (with two-dose vaccination status) were additionally tested for antibodies against rubella and mumps. Of 102 cases, 68 (66.7%) cases had a positive IgM and 23 (22.5 %) IgG antibodies against measles. For rubella, only 20 (19.6%) cases had seropositive IgG levels, for mumps higher positivity was detected in 60 persons (58.8%). We could detect only a small percentage with positive serology results of rubella IgG antibodies across all age groups. We have assumed that rubella antibodies had to be produced following the vaccination. Their absence in the cases with two doses of MMR suggests that these vaccines could not have been administrated despite the fact that this data was included in the medical records. Sequential analysis of two samples showed measles genotype B3.

Conclusion
This outbreak can outline the existence of a vulnerable group of the Roma. Low vaccinate coverage represents a serious public health threat.
Training family doctors and primary care nurses in evidence-based prevention, screening and management of cardiovascular risks in Western Ukraine: A longitudinal study
Authors: Shushman Ivanna , Kolesnyk Pavlo , Schonmann Yochai , Harris Michael , Frese Thomas 
Published: October 2020

Abstract

Introduction
The Ukrainian primary healthcare programme of preventive and screening recommendations has not been evidence-based. The traditional system of continuous medical education in Ukraine places participants in the role of passive listeners. This study explored the effects of an interactive training course on evidence-based prevention and screening of cardiovascular risks, on changes in Ukrainian family doctors’ (FDs) and primary care nurses’ (PCNs) knowledge and readiness to change practice over time.

Methods
Three hundred and seven FDs and PCNs participated in the study. Changes in participants’ knowledge were assessed with 20 multiple choice questions, and their readiness to change practice with a five-item questionnaire. These were administered before, immediately after, three and twelve months after training.

Results
The mean pre-course knowledge score was 6.1 (SD 1.8) out of 20, increasing to 14.9 (SD 2.3) immediately afterwards (p<0.001). Three months later it was 10.2 (SD 3.2) and at one year it was 10.4 (SD 3.3), both of which were significantly higher than the pre-training level (p<0.005). The percentage of participants that were highly motivated to change their practice increased from 18.4% before the training to 62.3% immediately afterwards (p<0.001). Three months later, this fell to 40.4%. At 12 months it further reduced to 27.4%, but was still significantly higher than the baseline level (p<0.001).

Conclusions
The interactive training was effective in increasing both participants’ knowledge and their readiness to change their clinical practice. The impact of the training diminished over time, but was still evident a year later.
Determining the utility of peer-assisted learning to enhance clinical skills at the bedside in a Postgraduate Homoeopathic Institute
Authors: Jain Bipin Sohanraj 
Published: October 2020

Objectives:
Despite considerable clinical material in hospitals, students often cannot hone their bedside skills; these skills need continuous practice and input from teachers and medical officers (MOs). Making such inputs frequently available to students in busy wards and casualties is very demanding. We, therefore, conducted this study to explore the utility of peer-assisted learning (PAL) as an alternative to enhance students’ clinical skills at the bedside in a Postgraduate Homoeopathic Institute. This study was conducted at a 100-bedded Homoeopathic PG institute hospital with a 24-h emergency ward where various clinical conditions and emergency cases are treated. The objectives of the study were to study the role of PAL in enhancing clinical skills in terms of receiving the patient, history taking, clinical examination, and developing collaborative and constructive practices at the bedside and exploring the role of PAL in developing a conducive atmosphere of learning and to enhance sensitivity to peers.

Materials and Methods:
An orientation session and checklist were created after input from MOs and through a pilot study of 25 Part one senior. The students were educated regarding the concept and were asked to take up one case every week to observe and discuss each other’s clinical skills for 12 weeks with the help of a checklist. A retrospective pre-questionnaire was used to analyze the enhancement of clinical bedside skills. The MO analyzed these using the same questionnaire and collectively analyzed student performance at the end of 12 weeks.

Results:
Student responses were evaluated statistically using the Wilcoxon matched pairs signed-rank test (P ≤ 0.05). The results revealed a significant change in history-taking attitude, history-taking skills and knowledge, examination skills, investigation correlations, interpersonal relationships, and learning atmosphere.

Conclusion:
The process of PAL enables student physicians to improve their clinical knowledge, skills, and attitude along with interpersonal relations. This process also enables collaborative and constructive learning and improves students’ sensitivities, allowing them to learn from each other.
Studying the evolution of miasm in autism spectrum disorders: A case series
Authors: Nikumbh Sunita Bhanudas 
Published: October 2020

Objectives:
Autism spectrum disorder (ASD), a neurodevelopmental disorder, is one of the several developmental disorders observed in children. The current prevalence of ASD among those under 18 years of age is 0.09 and 0.11 in an urban and rural area, respectively. Being a developmental disorder, it starts showing signs in the first 3 years of life and is present for the rest of the individual’s life. Studies have identified genetic predominance and a disturbed mental state in the mother during pregnancy in the genesis of disease. Modern medicinal interventions target only some specific and uncontrolled behaviours in ASD children; hence, the management is focused mainly on self-sustenance with integrated care with the help of ancillary therapies. Homoeopathically, these factors carry considerable importance as they contribute to the fundamental or miasmatic load, based on which the totality is formulated to select homeopathic simillimum. This paper studies the miasm in ASD cases treated in the Child Psychiatry OPD at Dr. M. L. Dhawale Memorial Homoeopathic Institute, Palghar (2015–2018) by studying miasmatic load in detail.

Materials and Methods:
ASD cases diagnosed according to ICD-10 criteria were studied in detail with evolutionary data collected from parents in terms of current complaints and illnesses (past, personal and family) in both families and were analysed for miasmatic load. The fundamental and dominant miasm derived from the disease expressions and history of family illnesses. Homoeopathic simillimum selected based on the predominant miasm/s along with the totality erected as per the available characteristic expressions in the cases.

Results:
Administration of simillimum healed the patient at the constitutional and miasmatic level and resulted insignificant improvement in the characteristic expressions in the patients. Timely identification and intervention yield a quicker response.

Conclusion:
Selecting homoeopathic remedies that cover the miasmatic background yields good results in children with ASD.
PERAN CIVIL SOCIETY ORGANIZATION (CSO) DALAM PERUMUSAN KEBIJAKAN PUBLIK (KAJIAN DI KABUPATEN PONOROGO)
Authors: Mahardhani Ardhana Januar , Sulton Sulton , Sunarto Sunarto 
Published: October 2020

Setelah memasuki era reformasi, pergerakan Civil Society Organization (CSO) di Indonesia lebih berperan sebagai penyeimbang negara, peran itupun juga berlaku pada CSO yang ada di daerah, keberadaan CSO tersebut menjadi sangat penting karena menjadi alternatif penyeimbang antara kepala daerah dan DPRD, oleh karena itu keberadaan CSO dapat menjadi bagian terpenting dalam proses perumusan kebijakan agar lebih sehat, bersifat terbuka dan partisipatif. Kabupaten Ponorogo merupakan salah satu kabupaten yang sangat dinamis dalam hal keberadaan CSO yang ada ataupun kegiatan pemerintah dalam keluarnya kebijakan. Dalam proses politik yang timbul dalam penentuan kebijakan juga melibatkan peran CSO dalam rangka untuk memperkecil polemik yang ada di masyarakat Penelitian ini menggunakan desain kualitatif diskriptif karena akan menafsirkan fenomena yang terjadi di Kabupaten Ponorogo. Dari hasil penelitian, didapatkan kesimpulan yaitu Kabupaten Ponorogo akan melibatkan CSO dalam rangka menjaga prinsip keterbukaan dalam good governance, adapun peran CSO tersebut adalah: 1) Menjadi penghubung antara masyarakat dan pemerintah, 2) Mengakomodasi kepentingan masyarakat, 3) Mendorong adanya jaringan antar kelompok masyarakat, dan 4) Membangun kolaborasi antara pemerintah, masyarakat, serta pihak ketiga.
KEPEMIMPINAN TRANSFORMASIONAL SEKTOR PUBLIK
Authors: Fanani Abdul Fatah , Iqbal Mahathir Muhammad , Astutik Wahyu , Lestari Yuni 
Published: October 2020

Artikel ini mendeskripsikan tentang kebutuhan terhadap kepemimpinan transformasional di negara Indonesia. Hal tersebut disebabkan oleh terjadinya degradasi moral bangsa yang menggerogoti sendi-sendi kehidupan berbangsa dan bernegara. Berkembangnya korupsi, kolusi, dan nepotisme sebagai bukti begitu parahnya degradasi moral bangsa Indonesia, yang hampir menjerumuskan Negara Kesatuan Republik Indonesia (NKRI) ke dalam jurang kehancuran. Hadirnya beberapa tokoh pemimpin yang reformis yang mencirikan kepemimpinan transformasional pada era roformasi ini, khususnya di sektor publik memberi angin segar bagi permasalahan krisis kepemimpinan dan ketidakpercayaan masyarakat (distrust) kepada pemimpinnya. Para pemimpin transformasional ini memiliki jiwa altruisme dan filantropi yang tinggi. Mereka mampu menunjukkan kepeduliannya kepada masyarakat yang dipimpinnya, meskipun menghadapi tantangan dan ancaman dari berbagai pihak yang berseberangan dengan haluan politiknya. Dalam penelitian ini, peneliti menggunakan metode library research. Materi yang digunakan dalam menyusun artikel ini menggunakan bahan-bahan bacaan dan data skunder. Materi, data serta informasi yang terkumpul kemudian disusun dan dianalisis, sehingga menghasilkan kesimpulan yang bisa dipertanggungjawabkan. Dalam artikel ini menghasilkan suatu kesimpulan bahwa kepemimpinan transformasional sector publik sangat dibutuhkan di Indonesia pada saat ini. Keteladanan dan keberhasilan beberapa pemimpin transformasional yang telah ada menjadi panutan bagi pemimpin dan masyarakat. Keberanian dalam mengambil kebijakan untuk kepentingan masyarakat banyak dan kemampuan merubah mind set masyarakat yang dipimpinnya sehingga mendukung kebijakannya mampu meningkatkan kesejahteraan masyarakat. Kemampuannya pemimpin transformasional dalam mentransformasikan ide dan gagasan untuk kemajuan dan kesejahteraan masyarakat yang dipimpin menunjukkan keberhasilan yang signifikan.