bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE PORTRAYAL OF SOCIO- CULTURAL ISSUES IN AKHIL SHARMA’S AN OBEDIENT FATHER
Authors: Deivasigamani T. , Sharmila K. N. 
Published: October 2019

Purpose of the Study: The aim of this paper is to explore the portrayal of socio-cultural issues in Akhil Sharma’s novel, An Obedient Father and the issues of cultural identity tormenting situations and incidents in a family and in their relationship with one another.
Methodology: The research paper proposes to make use of the writings of Akhil Sharma’s novel, An Obedient Father through ground study with references drawn from a cultural perspective. The secondary data included related articles and web sources related to diaspora and cultural studies. The secondary data obtained help the researcher arrive at important inference and conclusion. The present paper analyses the cultural issues and problems faced by the characters and concentrates on the specific techniques and styles used by the novelist.
Main Findings: The finding of the study is that Sharma integrates conventional Indian ideologies born out of a colonial past with an unknown future, depicting the cultural trauma and the problems of survival It also brings out socio-cultural issues through the major characters particularly the protagonist Ram Karan reflects the contemporary modern man’s corrupted personality. It also focuses on how the modern man breaks away from the age-old Indian tradition and culture and how Indian politics failed to maintain the traditional socio-cultural values.
Applications of the Study: When analyzing the cultural issues in An Obedient Father, the readers can understand that Sharma is a diaspora novelist and his characters face the problems of expatriation, immigration, dislocation, disorientation, and displacement. This study is very useful to the researchers in the field of Indian Literature, Diaspora Literature, and Cultural studies.
Novelty/Originality of this study: This paper highlights a realistic picture of contemporary India is portrayed by recording the changing Indian social and political scene with carefully creating the fictional characters for creative purposes. Sharma draws an acid-etched picture of modern Indian society, in which the corrupt political system victimizes all citizens.
PENGAWASAN ORANG TUA DALAM INTENSITAS PENGGUNAAN MEDIA SOSIAL TERHADAP PROKRASTINASI AKADEMIK
Authors: Iris Rengganis  , Tarma  , Rasha  
Published: October 2019

This research aim is conducted to obtain description about the influence of parental control in the intensity of social media use on academic procrastination. The research was conducted in the SMP Putra 1 Jakarta. The method used in this quantitative assosiatif approach. The population in this research is VII, VII, IX grade students of SMP Putra 1 Jakarta, with the total sample of 83 respondents. Data was taken by using proportionate stratified random sampling. The prerequisite test in this study lilifoers normality test and rgresion linearity test, the result of the test that normal and linear. Result of correlation coefficient test are obtained -0,616 > 0,217. Result of t-test with significant level 0,05 obtained -7,04 > 1,99, it is explained that the are a negative correlation and significant correlation between parental control in the intensity of social media use on academic procrastination. Result of significant regression obtained 30,68 > 3,96, it is explained that there significant influence between parental control in the intensity of social media use on academic procrastination. Parental control in the intensity of social media use on academic procrastination of 37,9%, and the remaining 62,1% is determined by other factors which is not examined.
Abstrak
Penelitian ini bertujuan untuk memperoleh gambaran tentang pengaruh pengawasan orang tua dalam intensitas penggunaan media sosial terhadap prokrastinasi akademik. Penelitian ini dilaksanakan di SMP Putra 1 Jakarta. Jenis penelitian ini adalah kuantitatif asosiatif. Populasi pada penelitian ini adalah siswa/i SMP Putra 1 Jakarta kelas VII, VIII, dan IX, dengan jumlah sampel sebesar 83 responden. Teknik pengambilan data menggunakan proportionate stratified random sampling. Uji prasyarat pada penelitian ini menggunakan uji normalitas lilifoers dan uji linieritas regresi, diperoleh hasil bahwa data berdistribusi normal dan bersifat linear. Uji hipotesis data yang digunakan adalah korelasi koefisien product moment diperoleh -0,616 > 0,217. Hasil uji t dengan taraf signifikan 0,05 diperoleh 7,04 > 1,99, hal ini menjelaskan bahwa terdapat korelasi negatif dan hubungan yang signifikan antara pengawasan orang tua dalam intensitas penggunaan media sosial terhadap prokrastinasi akademik. Perhitungan uji signifikan regresi diperoleh 30,68 > 3,96, maka terdapat pengaruh yang signifikan antara pengawasan orang tua dalam intensitas penggunaan media sosial terhadap prokrastinasi akademik. Pengawasan orang tua dalam intensitas penggunaan media sosial memberikan sumbangan efektif terhadap prokrastinasi akademik sebesar 37,9%, sedangkan sisanya 62,1% ditentukan faktor lain yang tidak diteliti.
Does the shoe really fit? Characterising ill-fitting footwear among community dwelling older adults: an observational cross-sectional study
Authors: O'Rourke Brian , Walsh Mary E , Brophy Rachael , Vallely Shanice , Murphy Niamh , Conroy Bronagh , Cunningham Conal , Horgan Frances 
Published: October 2019

Abstract
Background Falls in older people are common and can result in loss of confidence, fear of falling, restriction in activity and loss of independence. Causes of falls are multi-factorial and include extrinsic factors such as unsafe footwear. Inappropriate footwear may increase the risk of falls. There is a paucity of research assessing the footwear characteristics among older people who are at high risk of falls, internationally and in the Irish setting. The aim of this study was to examine the proportion of older adults attending a geriatric day hospital in Ireland who were wearing incorrectly sized shoes. Methods A consecutive sample of 111 older adults aged 60 years and over attending a geriatric day hospital in a large Irish teaching hospital was recruited. Demographic data including age, mobility, medications, use of glasses, social support, footwear worn at home and falls history were recorded. Shoe size and foot length were measured in millimetres using an internal shoe gauge and SATRA shoe size stick, respectively. Subjects’ self-reported shoe size was recorded. Footwear was assessed using the Footwear Assessment Form (FAF). A Timed Up and Go (TUG) score was recorded. Participation was assessed using the Nottingham Extended Activities of Daily Living (NEADL) Scale. Those with shoes fitting on at least one foot were compared to those with ill-fitting footwear on both feet using Chi-square tests, T-tests or Mann–Whitney U tests. Results 72% of participants were wearing footwear that did not fit correctly on both feet according to our definition based on previous literature. Only 6% were wearing footwear that fitted correctly on both feet. 67% wore slippers at home. 90% had shoes with smooth, partly worn or fully worn sole treading. Participant age, TUG score and NEADL score were not associated with ill-fitting footwear. Conclusions Wearing incorrectly fitting shoes and shoes with unsafe features is common among older adults attending geriatric day services. The large number of participants who reported wearing slippers at home is also an important finding. Ill-fitting footwear and slippers are risk factors for falls thus warranting further investigation to help guide future falls prevention services at day hospitals.
Parenchymal central nervous system involvement in aggressive B-cell lymphoma: retrospective analysis of clinical and MRI features in a Chinese population
Authors: Wu Yuchen , Wang Yaming , Sun Xuefei , Bai Xueyan , Qian Jun , Zhu Hong , Cui Qu , Xing Ruixian , Chen Yuedan , Liu Qing , Guo Jiayuan , Ji Nan , Sun Shengjun , Liu Yuanbo 
Published: October 2019

Abstract
Background: Secondary central nervous system lymphoma (SCNSL) is defined as secondary central nervous system (CNS) involvement in patients with systemic lymphoma. It is considered a profoundly adverse complication with inferior clinical outcome. Parenchymal involvement in the CNS in aggressive B-cell lymphoma is not frequently seen and remains a diagnostic dilemma.
Methods: In our study, we retrospectively analyzed the clinical and magnetic resonance imaging (MRI) features of 26 parenchymal SCNSL patients. In addition, we compared MRI features of SCNSL and primary CNS lymphoma (PCNSL) patients after 1:1 propensity score matching. Also we presented two SCNSL cases with atypical MRI appearance.
Results: Among SCNSL patients, the median CNS relapse time was 3 months, and multiple lesions were found in 76.9% of the cases. In PCNSL, this percentage was 42.3% (p=0.011). None of the SCNSL patients and 23.1% of the PCNSL patients had solitary infratentorial lesions (p=0.003).
Conclusions: The majority of parenchymal involvement occurred within the first year of systemic lymphoma, in which mostly cases presenting with multiple and supratentorial locations, unlike what was found in PCNSL.
Compound heterozygous LPIN2 pathogenic variants in a patient with Majeed syndrome with recurrent fever and severe neutropenia: case report
Authors: liu jun , Hu Xu-Yun , Zhao Zhi-Peng , Guo Ruo-Lan , Guo Jun , Li Wei , Hao Chan-Juan , Xu Bao-Ping 
Published: October 2019

Abstract
Background: Majeed syndrome is a rare, autosomal recessive autoinflammatory disorder first described in 1989. The syndrome starts during infancy with recurrent relapses of osteomyelitis typically associated with fever, congenital dyserythropoietic anemia (CDA), and often neutrophilic dermatosis. Mutations in the LPIN2 gene located on the short arm of chromosome 18 have been identified as being responsible for Majeed syndrome.
Case presentation: We report an 8-month-old boy, who presented with recurrent fever, mild to moderate anemia, and severe neutropenia. Erythrocyte sedimentation rate and C-reactive protein were elevated. Molecular testing identified a paternal splicing donor site variant c.2327+1G>C and a maternal frameshift variant c.1691_1694delGAGA (Arg564Lysfs*3) in LPIN2.
Conclusions: Only a few cases with LPIN2 mutation have been reported, mainly in the Middle East with homozygous variants. Our patient exhibited a mild clinical phenotype and severe neutropenia, different from previous reports.
Clinical significance of self-reported cough intensity and frequency in patients with interstitial lung disease: a cross-sectional study
Authors: Sato Ryuhei , Handa Tomohiro , Matsumoto Hisako , Kubo Takeshi , Hirai Toyohiro 
Published: October 2019

Abstract
Background: The intensity and frequency of cough remain unclear in interstitial lung disease (ILD). The aim of this study was to evaluate the intensity and frequency of cough in idiopathic interstitial pneumonias (IIPs), connective tissue disease-associated interstitial lung disease (CTD-ILD), and chronic hypersensitivity pneumonia (CHP), and examine their associations with clinical indices.

Methods: In this cross-sectional study, the intensity and frequency of cough were evaluated using a 100-mm visual analogue scale. Scores on the Leicester Cough Questionnaire, chronic dyspnoea scale, and a frequency scale for symptoms of gastro-oesophageal reflux disease (FSSG) were collected. The correlations of cough intensity and frequency with potential predictor variables were tested using bivariate and multiple logistic regression analysis.

Results: The study included 70 patients with IIPs, 49 with CTD-ILD, and 10 with CHP. Patients with IIPs had the most severe cough intensity among the three patient groups. In patients with IIPs, both the intensity and frequency of cough were negatively associated with diffusing capacity of the lung for carbon monoxide and positively with the Composite Physiologic Index (CPI). In CTD-ILD, both the intensity and frequency of cough correlated with a higher FSSG score. In multivariate analysis of patients with ILD, IIPs and the FSSG score was independently associated with both components of cough, and CPI tended to be independently associated with cough frequency alone. Finally, we examined the features of differences between cough intensity and frequency in all patients with ILD. Patients in whom cough frequency was predominant had greater impairment of health status relative to other patients.

Conclusions: The intensity of cough was greater in IIPs than in other ILDs. Different clinical indices were associated with patient-reported cough intensity and frequency according to the subtype of ILD. The frequency of cough was more strongly associated with health status than was the intensity of cough. These findings suggest that medical staff could manage patients with ILD by considering cough-related factors when assessing the intensity and frequency of cough.
Two Novel Mutations in the ALPL gene of Unrelated Chinese Children with Hypophosphatasia: Case Reports and Literature Review
Authors: Mao Xiaojian , Liu Sichi , Lin Yunting , Chen Zhen , Shao Yongxian , Yu Qiaoli , Liu Haiying , Lu Zhikun , Sheng Huiyin , Lu Xinshuo , Huang Yonglan , Liu Li , Zeng Chunhua 
Published: October 2019

Abstract
Objective: Hypophosphatasia (HPP) is an inherited disorder of defective skeletal mineralization caused by mutations in the ALPL gene that encodes the Tissue Non-specific Alkaline Phosphatase (TNSALP). It is subdivided into six forms depending on the age of onset: perinatal lethal, prenatal benign, infantile, childhood, adult, and odonto HPP. Among these, infantile HPP is characterized by early onset and high frequency of lethal outcome. Few studies have reported the phenotype and genetic characteristics of HPP in Chinese children. Case presentation: Three forms of HPP were identified in four unrelated patients from four different Chinese families, including one lethal infantile (patient 1), two childhood (patient 2 and 3) and one odonto HPP (patient 4). Six variants in the ALPL gene were identified, including five missense mutations and one frameshift mutation. Of which, none were reported previously in the Chinese population, and two were novel (c.359G>C: p.G120A and c.1017dupG: p.H340AfsX3). Patient 1 carrying a novel homozygous (c.359G>C) mutation showed respiratory distress and pneumonia at first day of his life. He presented nearly negligible level of serum ALP activity, overall skeletal hypominaralization and died at 3 months old. Patient 2, 3 and 4 were compound heterozygotes with decreased serum ALP activity. Patient 2 and 3 presented premature loss of deciduous teeth, muscle weakness and bone pain, whereas patient 4 had early loss of deciduous teeth only. All four pedigrees exhibited autosomal recessive pattern of inheritance. Conclusions: In this study, six mutations in the ALPL gene were found in four Chinese HPP patients. Two of which were novel: c.359G>C in exon 5 and c.1017dupG in exon 10. Our results strongly indicated that the novel mutation c.359G>C might be disease-causing and associated with severe infantile form of HPP.
Reinterpretation, reclassification, and its downstream effects: Challenges for clinical laboratory geneticists
Authors: Mecky Julia el , Johansson Lennart , Plantinga Mirjam , Fenwick Angela , Lucassen Anneke , Dijkhuizen Trijnie , Hout Annemieke van der , Lyle Kate , Langen Irene van 
Published: October 2019

Abstract
Keywords Reinterpretation; reclassification; genetics; laboratory; focus group.

Background In recent years, the amount of genomic data produced in clinical genetics services has increased significantly due to the advent of next-generation sequencing. This influx of genomic information leads to continuous changes in knowledge on how genetic variants relate to hereditary disease. These changes can have important consequences for patients who have had genetic testing in the past, as new information may affect their clinical management. When and how patients should be recontacted after new genetic information becomes available has been investigated extensively. However, the issue of how to handle the changing nature of genetic information remains underexplored in a laboratory setting, despite it being the first stage at which changes in genetic data are identified and managed.
Methods The authors organized a 7-day online focus group discussion. Fifteen clinical laboratory geneticists took part. All (9) Dutch clinical molecular genetics diagnostic laboratories were represented.
Results Laboratories in our study reinterpret genetic variants reactively, e.g. at the request of a clinician or following identification of a previously classified variant in a new patient. Participants currently deemed active, periodic reinterpretation to be unfeasible and opinions differed on whether it is desirable, particularly regarding patient autonomy and the main responsibilities of the laboratory. The efficacy of reinterpretation was questioned in the presence of other strategies, such as reanalysis and resequencing of DNA. Despite absence of formal policy regarding when to issue a new report for clinicians due to reclassified genetic data, participants indicated similar practice across all laboratories. However, practice differed significantly between laboratory geneticists regarding the reporting of VUS reclassifications.
Conclusion Based on the results, the authors formulated five challenges needing to be addressed in future laboratory guidelines: 1. Should active reinterpretation of variants be conducted by the laboratory as a routine practice? 2. How does reinterpretation initiated by the laboratory relate to patient expectations and consent? 3. When should reinterpreted data be considered clinically significant and communicated from laboratory to clinician? 4. Should reinterpretation, reanalysis or a new test be conducted? 5. How are reclassifications perceived and how might this affect laboratory practice?
ETV add-on Peg-interferon therapy plays a positive role in reversing hepatic fibrosis in treatment-naïve chronic hepatitis B patients: a prospective and randomized controlled trial
Authors: Yang jingmao , Chen Liping , Wang Yajie , Lv Bei , Zhao Hong , Shang Zhiyin , Li Jun , Fan zhenyu , Wu Shengdi , Ming Xiao , Li Xian , Huang Shaoping , Cheng Jilin 
Published: October 2019

Abstract
Background and Aim The efficacy of entecavir (ETV) add-on peg-interferon therapy compared with ETV monotherapy in treatment-naïve hepatitis B virus (HBV) patients remains controversial. We investigated whether adding Peg-interferon to ongoing ETV treatment leads to a better curative effect or not. Methods Eligible HBV patients (n=144) were randomly divided (1:1) to receive either ETV monotherapy (n=70) or peg-interferon add-on therapy from weeks 26 to 52 (n=74). Patients were followed-up for 2 years. We evaluated hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) seroconversion rate, sustained virologic response (SVR), transient elastography value, and histological scores. Results At week 26, no patient achieved HBsAg seroconversion in either group. At week 52, one patient in the monotherapy group was HBsAg-negative but there was none in the combination therapy group. The monotherapy group showed significantly better liver function recovery results than the combination therapy group. At week 78, one patient in combination group had HBsAg seroconverted. At week 104, only three patients in the combination therapy group were HBsAg-negative compared with one patient in monotherapy. The mean alanine aminotransferase (ALT)and aspartate aminotransferase (AST) levels and transient elastography values decreased significantly compared with baseline. Both group showed a favorable decrease in alpha fetoprotein(AFP) (monotherapy:23.4±77.3 vs 2.4±0.91, P=0.149; combination therapy: 33.3±96.9 vs 4.3±5.5,P=0.085) and an improved result of liver biopsy examination scores. The combination group showed a better improvement in histology compared with the monotherapy group(mean transient elastography value 7.5±3.4 kPa [SD 1.9] vs. 12.8±13.9 kPa [SD 1.9], P=0.037). But this research didn’t show significant difference in HBsAg conversion rate (1.79% (1/56) vs 4.11% (3/73), P=0.632) as well as HBV-DNA sustained virologic response(93.2% vs 98.5%,P=0.15) between two groups. Conclusions Both therapies supported liver function recovery and histology improvement. Combination therapy did not show better antiviral efficacy in HBsAg or HBeAg seroconversion compared with monotherapy. However, combination therapy played a more positive role in reversing hepatic fibrosis compared with monotherapy.
Obesity combined with low grip strength is correlated with cardiac autonomic nervous function in the Chinese elderly-an observational study
Authors: Fu Liyuan , Shao Bohan , Guo Jinlong , Chen Xiaoyu , Yu Xing , Hou Lin , Zhang Yuanyuan , Song Peiyu , Yang Fengying , Guo Qi 
Published: October 2019

Abstract
Background: Heart rate variability (HRV) provides indices related to all types of risks for death, increased risk of cardiovascular disease and diabetes, especially in elderly. Obesity and grip are related to diseases, thus decrease elderly healthy life. However, there is no definitive link between HRV and muscle strength and obesity. We conducted a cross-sectional study to determine whether grip strength and obesity are associated with HRV in elderly, community-dwelling Chinese individuals.Method: Our study population consisted of residents of Township Central Hospital of Chadian, Tianjin, China. We measured short term HRV, grip strength, and body mass index (BMI). The HRV measures were transformed to the natural log to normalize the distribution and we used logistic regression to explore the relationship.Results: A total of 534 participants over the age of 60 (200 men, mean age 69.2±6.0) had complete data at the baseline and were included in the analysis. Compared with the isolated-obesity group and isolated-low-grip-strength group, the group with concurrent obesity and low grip strength has a stronger relation with LF n.u.[0.94(0.90-0.98)], ln(LF) [0.50(0.29-0.95)], and ln(LF/HF) [0.41(0.20-0.83)].Conclusion: Our results demonstrate that low HRV is associated with concurrent low grip strength and obesity in older adults, rather than isolated low grip strength or isolated obesity. These results may provide a reference for early screening of cardiac autonomic function disorders in patients with potential heart disease in clinic, thus contributing indirectly to the prevention or rehabilitation of cardiovascular disease. It also provides a new idea for further mechanism research.Clinical trial registry Our research was registered on Research Registry website (URL: http://www.chictr.org.cn/index.aspx ), the registry number was ChiCTR1800016308.