bluuebunny/crossref_metadata_2025_split huggingface dataset:
AKTIVITAS ANTIBAKTERI INFUSA DAUN MUDA MANGROVE Sonneratia alba KERING
Authors: Ibrahim Yayu Mukhmin , Dotulong Verly , Wonggo Djuhria , Lohoo Helen Jenny , Montolalu Roike Iwan , Makapedua Daisy Monica , Sanger Grace 
Published: July 2019

Sonneratia alba mangroves are known to have bioactive compounds such as antibacterial. The purpose of this study was to determine the antibacterial activity of extract of S. alba dried mangrove leaves on Gram positive Staphylococcus aureus and Gram negative Escherichia coli bacteria. Extraction method by infusion, extraction time is 40 and 50 minutes. The extract obtained was then evaporated by the solvent above the water bath then the extracts were made concentrations of 5 and 10%. Antibacterial testing uses the modified Kirby-Bauer method. The highest yield is found in the treatment of 50 minutes infusion extraction time which is 15.6 ± 0.2%. The highest antibacterial activity against S. aureus was found in the treatment of 50 minutes extraction time both for 5% sample concentration of 7.0 mm (medium category) and at a sample concentration of 10% at 8.0 mm (medium category). While the highest antibacterial activity against E. coli bacteria was found in the treatment of 50 minutes extraction time both at 5% sample concentration of 8.0 (medium category) mm and at 10% sample concentration of 8.3 mm (medium category). From these results it can be seen that the S. alba extract of young mangrove leaf infusion has a broad spectrum antibacterial activity because it can inhibit both Gram positive S. aureus and Gram negative E. coli bacteria.Keyword: Mangrove, Sonneratia alba, infusion, rendemen, antibacterial. Mangrove Sonneratia alba diketahui memiliki senyawa bioaktif seperti antibakteri. Tujuan dari penelitian ini untuk mengetahui aktivitas antibakteri ekstrak Infusa daun muda mangrove S. alba kering terhadap bakteri Grampositif Staphylococcus aureus dan bakteri Gram negatif Escherichia coli. Metode ekstraksi dengan cara infusa, lama waktu ekstraksi yaitu40 dan 50 menit. Ekstrak yang didapatkan kemudian dievaporasi pelarutnya diatas penangas air kemudian hasil ekstrak dibuat konsentrasi 5 dan 10%. Pengujian antibakteri menggunakan metode Kirby-Bauer yang dimodifikasi. Rendemen tertinggi terdapat pada perlakuan lama ekstraksi infusa 50 menit yaitu sebesar 15,6±0,2 %. Aktivitas antibakteri tertinggi terhadap bakteri S. aureus terdapat pada perlakuan lama ekstraksi 50 menit baik untuk konsentrasi sampel 5% sebesar 7,0 mm (kategori sedang) dan pada konsentrasi sampel 10% sebesar 8,0 mm (kategori sedang). Sedangkan aktivitas antibakteri tertinggi terhadap bakteri E. coli terdapat pada perlakuan lama ekstraksi 50 menit baik pada konsentrasi sampel 5% sebesar 8,0 mm (kategori sedang) dan pada konsentrasi sampel 10% sebesar 8,3 mm (kategori sedang). Dari hasil ini dapat dilihat bahwa ekstrak infusa daun muda mangrove S. alba mempunyai aktivitas antibakteri dengan spektrum yang luas karena dapat menghambat baik bakteri Gram positif S. aureus maupun Gram negatif E. coli.Kata kunci: Mangrove, Sonneratia alba, infusa, rendemen, antibakteri.
Could heart-type fatty acid binding protein predict clinical outcome in coronary artery bypass graft surgery?
Authors: Aboelnasr Mohamed , Elfeky Wael , Adam Ali Dina , Al-Ashmawy Ghada , Sallam Ayman 
Published: July 2019

Background: Detection of myocardial damage and its degree during open heart surgery were studied previously using different biomarkers. Heart fatty acid binding protein (h-FABP) was used in the diagnosis of myocardial infarction with variable results. In this study, we aimed to find the possibility of the use of this biomarker as a predictor of myocardial damage after coronary artery bypass graft (CABG) surgery.
Methods: We conducted a prospective study on 47 patients who had CABG surgery. Blood samples (4 ml) were drawn from patients at 5 points: before induction of anesthesia, after aortic declamping, 1 hour after declamping, 6 hours after declamping and one day after surgery. Levels of h-FABP and creatine kinase muscle/brain (CK-MB) were estimated, and the relationship between h-FABP and operative and postoperative outcomes were recorded.
Results: There were statistically significant correlations between higher levels of h-FABP measured immediately after aortic declamping and need for intra-aortic balloon (116.55 + 9.26 vs, 84.34 + 19.55 ng/ml; p= 0.022), inotropes (107.04+ 14.79 vs, 79.95 + 17.59ng/ml; p< 0.001), defibrillators (97.73 + 15.18 vs 81.59 + 20.31 ng/ml; p=0.016), and postoperative atrial fibrillation (99.94 + 17.83 vs 80.84 + 18.89ng/ml; p= 0.004). No mortality was detected in our study. h-FABP levels showed an early peak just after aortic declamping and reached baseline by postoperative day one. CK-MB peaked 1 hour after aortic declamping and remained elevated for more than 24 hours.
Conclusion: h-FABP is a cardiac biomarker that could be used as a rapid indicator of ventricular dysfunction and atrial fibrillation post-CABG surgery.
Video assisted minimally invasive mitral valve replacement in rheumatic valve disease.
Authors: Abdel-Kareem Heba , Alaa Mohammed , Khairy Mahmoud , Abdel-Wahab Ali , Mohammed Morsi 
Published: July 2019

Objective:
Assessment early outcome of video assisted minimally invasive mitral valve replacement, in rheumatic valve disease. Also, to evaluate early postoperative quality of life by SF 36 questionnaire.
Methods: This is a prospective single center study which was conducted on 20 rheumatic heart patients, in Egypt; during the period from October 2015 to June 2018. The main pathological lesion was sever mitral regurgitation (MR), mitral stenosis (MS) or both. Patients underwent video assisted minimally invasive mitral valve replacement, through a right mini thoracotomy. 13 patients (65%) were via infra-mammary incision, 4 patients (20%) were via periareolar incision and 3 patients (15%) were via limited right anterolateral mini-thoracotomy.
Results: Mean length of surgical incision was (6.60 ± 1.35 cm). Mean duration of operation, cardiopulmonary bypass, and cross clamp times were (4.32 ± 1.08 hr.), (2.85 ± 0.75 hr.) and (1.78 ± 0.47 hr.) respectively.
ICU stay was 2.35 ± 1.14 days and Hospital stay was 6.45 ± 1.43 days.
The mean amount of blood loss was 398.50 ± 245.79 ml with two patients of bleeding requiring re-opening.
At discharge, all patients had normal mitral prosthetic valve function with no or trivial regurgitation, as shown by echocardiographic studies. The postoperative quality of life revealed faster recovery of usual activities.
Conclusions: Video assisted minimally invasive mitral valve surgery in the surgically challenging rheumatic valve disease has less surgical trauma, blood loss and pain, which translates into short hospital stay, rapid return to normal activities, less use of resources.
Chest wall reconstruction still has place in Today’s modern practice:" a tertiary center experience"
Authors: Osman Amr Ibrahim Abd Elaal , Ayyad Mohamed A. K. Salama , Elkhayat Hussein , Elwahab Ali A. 
Published: July 2019

Background: The key factor following chest wall resection is the preservation of the stability and integrity of the chest wall to support the respiration and protect the underlying organs. The present study aims to evaluate the use of the available grafts and prosthetic materials at our center in chest wall reconstruction with adherence to the proper surgical techniques, good perioperative and postoperative care to obtain good results.
Methods: This is a retrospective single center study that concludes all patients underwent chest wall reconstruction for a variety of defects resulting from resection of tumors, trauma due to primarily firearms or motor car accidents, resection of radio necrotic tissues, infection and dehiscence of median sternotomy wounds after cardiac surgery.
Results: Study population consisted of 30 patients between January 2015and may 2018, among them were 20 male (70%) and 10 female patients (30%), with a median age of 43 ± 16.3 years, resection and reconstruction was performed in 23 cases (15 neoplastic,5 infective and 3 firearm cases) while reconstruction alone was performed in 7 (traumatic flail chest) cases. Eighteen patients, underwent rib resection with an average 4.18 ± 2.2 ribs (range 2-6). Associated lung resection was performed in 5 patients (27.8 %): diaphragmatic resection was done in 2 cases in addition total sternal resection was performed in 5 cases. Most of the patients (96.7%) had primary healing of their wounds. there was one death (3.3%) in the early postoperative period. The average length of hospital stay for all patients was 8.7 days (range: 5–15). Respiratory complications occurred in three cases in the form of atelectasis and pneumonia at the ipsilateral side of reconstruction. Three cases suffered wound seroma which successfully managed by daily dressing and antibiotic coverage.
Conclusions: according to our study and the analysis of similar studies, adequate perioperative preparation of patient undergoing chest wall resection and reconstruction with adherence to effective surgical techniques allowed us to use the available materials at our center for chest wall reconstruction with good and effective results without adding burden in terms of cost on the patient.
The use of cardiopulmonary bypass in the extraction of intracardiac foreign bodies
Authors: Mostafa Mohamed Mahmoud 
Published: July 2019

Background: Intracardiac foreign bodies (FBs) are uncommon and have diverse presentations. The objectives of this study were to assess the types and presentation of intracardiac FBs and to evaluate the use of cardiopulmonary bypass (CPB) in their extraction.
Methods: A retrospective descriptive study was carried out on 12 patients with a history or radiological evidence of a foreign body in the heart or the great vessels who were admitted between 2013 and 2018. Sternotomy was performed in 8 patients and left anterior thoracotomy in 4 patients. CPB was used in 4 patients with cardioplegic cardiac arrest. Aorto-bicaval cannulation was performed in 3 patients and femero-femoral bypass in 1 patient.
Results: The mean age of our patients was 32.7 ±21.7 years (range 2-62 years), six were males. Six different intracardiac FBs were reported including retained bullets (n= 3), migrated catheter piece (n=3), sewing needles (n=3), displaced pacemaker lead (n= 1), circular saw (n=1) and missed pigtail catheter after pericardiocentesis (n=1). Recovery from cardiopulmonary bypass was smooth, and no hospital complications were reported. The mean duration of postoperative mechanical ventilation in all sternotomy patients was 7.8 ± 6.7 hours (5 ±2.1 in CPB patients and 10.7±8.9 in non- CPB). The duration of hospital stay in CPB cases vs. non-CPB was (5.5±1.3 vs. 5.7±0.9 days). No postoperative wound infection nor sternal dehiscence were reported. One baby who had lateral thoracotomy died on the fifth postoperative day because of severe gastroenteritis. No residual pericardial or pleural collection were reported in 6 months follow-up period.
Conclusions: Retrieval of intracardiac FBs can be performed safely with low morbidity and mortality. The use of CPB did not increase morbidity or mortality. Removal of all types of intracardiac FBs is recommended to avoid complications
Predictors of Early Mortality After Aortic Valve Replacement in Middle-Aged Rheumatic Patients
Authors: Hassan Essam , Sersar Sameh 
Published: July 2019

Background: Several risk factors, including emergency surgery, predicted early mortality after aortic valve replacement (AVR). Euroscore II is used to predict the mortality after cardiac operations. We aimed to review our experience in AVR and determine the early mortality predictors
Methods: We collected the data of 200 rheumatic patients who had standard AVR in two centers. Median sternotomy and cardiopulmonary bypass were used in all patients. Transcatheter and minimally invasive aortic valve replacement patients were excluded. We used 15 types of aortic valve prostheses, either mechanical or biological. Follow-up echocardiography was done in the intensive care unit, on discharge, and one month after discharge.
Results: 128 patients (64%) had mechanical AVR, and 130 patients (65%) were males. The mean age was 48.2 ± 19 years, and body mass index was 1.8 ± 0.2 Kg/m2. The mean preoperative ejection fraction was 54 ± 9.4 %, end-diastolic dimension was 5.3 ± 0.8 cm, and end-systolic dimension was 3.5 ± 0.9 cm. Nine patients (4.5%) died in the early postoperative period (6 months). Euroscore II was the only factor significantly associated with early mortality (P value= 0.031). The mean Euroscore II was 1.3 ± 0.9 and 10.1 ± 10.7 for survivors and non-survivors, respectively.
Conclusion: Euroscore II score was significantly associated with early mortality after aortic valve replacement in rheumatic patients and can be used for risk stratification in those patients.
Re-assessing the place of the “silent period” in the development of English as an Additional Language among children in Early Years settings
Authors: Harris Ruth 
Published: July 2019

This paper explores the acceptance of a “silent period” as a stage in second language development for children acquiring English as an Additional Language in Early Years settings. Current views suggest that it is normal for children to very quickly stop using their mother tongue and enter a period of silence. A positive perspective on this is that children may be using this time to observe and grow in understanding of the second language. However, there may also be negative effects, as children may become withdrawn and miss out on opportunities to develop relationships and language. It is the argument of this paper that if this silent period is normalised, there is potential for ambivalence around the well-being of the child which may run counter to best Early Years practice. This study consisted of a qualitative content analysis which drew on twenty case studies collected by Early Years Educators documenting children’s progress over the initial weeks and months in Early Years settings. The main findings were that some children did indeed enter a silent period and shyness was a risk factor for this being prolonged. Non-verbal communication was used positively by some children to develop relationships with other children, but negatively by others, in the form of aggression and frustration, until they developed enough language to communicate. The children who did best continued to use their home language and non-verbal communication which enabled them to form relationships. Over time this became a bridge into the second language. Strategies used by educators included supporting children in small groups and bringing the home language into the setting in keeping with recommendations of policy documents in Ireland. Ultimately, this paper argues that the normalisation of a silent period may infringe on children’s rights to be active participants in their own learning. Moreover, it may limit the extent to which they are meaningfully valued, respected, empowered, cared for and included in Early Years settings.
Supporting teachers to implement a pre-primary programme: changes in teacher beliefs and attitudes
Authors: Ellis Gail 
Published: July 2019

The integration of a foreign language into early childhood education is becoming more and more widespread. Yet there is a lack of specific teacher training and no clearly-defined pre-primary foreign language pedagogy to guide and support teachers. This article presents data from a recent initiative by a provider of out-of-school English classes in Europe to support teachers in implementing a pre-primary programme and in developing pre-primary foreign language pedagogy. This formed part of a wider change-management and innovation process looking at higher efficiencies and effectiveness, and bringing together in one coherent approach best practice throughout the region in the teaching of English to pre-primary children. The pre-primary programme is underpinned by the pedagogical principles of the UK’s Early Years Foundation Stage (EYFS) framework and the HighScope approach to early childhood education with its overarching ‘plan-do-review’ structure for learning sequences which values children’s voices and agency. Initially, there was some apprehension amongst teachers due to a lack of experience of teaching pre-primary children and some resistance from others who believed that young children are not capable of reflecting on their learning or of making choices about their learning. An important feature of the change-management process was the implementation of a normative-re-educative approach and the provision of ongoing training and professional development. This involved teachers in the adaptation of the organisation’s global statement of approach to English language teaching to an age-appropriate version for a pre-primary context in order to develop pre-primary foreign language pedagogy. It also encouraged teachers to re-examine their existing beliefs and attitudes in order to recognise children’s reflective capacities given appropriate support and scaffolding, and to rethink the power dynamics in the adult-child relationship moving to one of more shared control. Data from surveys conducted with teachers at the initial stage of the programme and 18 months later provides evidence which shows that, over time, teacher’s beliefs and attitudes have changed. Conclusions are drawn from the experience of the project and the factors influencing changes in teacher’s views are discussed.
Effect of Treatment on Damage and Hospitalization in Elderly Patients with Microscopic Polyangiitis and Granulomatosis with Polyangiitis
Authors: Weiner Maria , Goh Su Mein , Mohammad Aladdin J. , Hrušková Zdenka , Tanna Anisha , Sharp Phoebe , Kang Amy , Bruchfeld Annette , Selga Daina , Chocová Zdeňka , Westman Kerstin , Eriksson Per , Harper Lorraine , Pusey Charles D. , Tesař Vladimír , Salama Alan D. , Segelmark Mårten 
Published: July 2019

Objective.Age is a risk factor for organ damage, adverse events, and mortality in microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA). However, the relationship between treatment and damage, hospitalizations, and causes of death in elderly patients is largely unknown.Methods.Consecutive patients from Sweden, the United Kingdom, and the Czech Republic diagnosed between 1997 and 2013 were included. Inclusion criteria were a diagnosis of MPA or GPA and age 75 years or more at diagnosis. Treatment with cyclophosphamide (CYC), rituximab (RTX), and corticosteroids the first 3 months was registered. Outcomes up to 2 years from diagnosis included Vasculitis Damage Index (VDI), hospitalization, and cause of death.Results.Treatment data were available for 167 of 202 patients. At 2 years, 4% had no items of damage. There was a positive association between VDI score at 2 years and Birmingham Vasculitis Activity Score at onset, and a negative association with treatment using CYC or RTX. Intravenous methylprednisolone dose was associated with treatment-related damage. During the first year, 69% of patients were readmitted to hospital. Myeloperoxidase–antineutrophil cytoplasmic antibody positivity and lower creatinine levels decreased the odds of readmission. The most common cause of death was infection, and this was associated with cumulative oral prednisolone dose.Conclusion.Immunosuppressive treatment with CYC or RTX in elderly patients with MPA and GPA was associated with development of less permanent organ damage and was not associated with hospitalization. However, higher doses of corticosteroids during the first 3 months was associated with treatment-related damage and fatal infections.
Risk of Cancer in 767 Patients with Giant Cell Arteritis in Western Norway: A Retrospective Cohort with Matched Controls
Authors: Brekke Lene Kristin , Fevang Bjørg-Tilde Svanes , Diamantopoulos Andreas P. , Assmus Jörg , Esperø Elisabet , Gjesdal Clara Gram 
Published: July 2019

Objective.To determine the risk of cancer in a large Norwegian cohort of patients with giant cell arteritis (GCA).Methods.This is a hospital-based, retrospective, observational cohort study including patients diagnosed with GCA in the Bergen Health Area during 1972–2012. Patients were identified through computerized hospital records using the International Classification of Diseases coding system. Medical records were reviewed. Each patient was randomly assigned population controls matched on age, sex, and geography from the Central Population Registry of Norway. Data on the occurrence of cancer were obtained from the Cancer Registry of Norway. The cumulative risk of malignancy was estimated using Kaplan-Meier methods and potential differences were analyzed using the Gehan-Breslow and log-rank tests.Results.We identified 881 cases with a clinical diagnosis of GCA, of which 792 fulfilled the American College of Rheumatology (ACR) 1990 classification criteria and 528 were biopsy-verified. Cases with no registered cancer prior to GCA diagnosis were included in a time-to-event analysis, with first cancer as the event (n = 767 with clinical GCA diagnosis, 686 fulfilling ACR criteria for GCA, 463 biopsy-verified). These cases were matched with previously cancer-free population controls (n = 1437, 1284, 895, respectively). We found no significant difference in the risk of malignancy after time of diagnosis/matching for GCA patients compared to population controls (p > 0.05).Conclusion.In this study of a large and well-characterized cohort of patients with GCA, there was no difference in the risk of malignancy in patients with GCA compared to matched population controls.
Retour sur l'échec de l'« armée européenne » (1950-1954) : quelles leçons pour demain ?
Authors: Haroche Pierre 
Published: July 2019

Résumé Alors que nous assistons à une relance de la coopération européenne en matière de défense et que la perspective de la création à terme d'une « armée européenne » a été évoquée par plusieurs dirigeants européens et nationaux, cet article revient sur la première tentative d'intégration des armées nationales sous autorité européenne, la Communauté européenne de défense (CED). Nous chercherons à éclairer en particulier les causes de l'échec de ce premier projet d'armée européenne. À rebours des explications focalisées sur la dimension idéologique et parlementaire du débat, nous nous concentrerons sur les contraintes militaires qui pesaient alors sur la France afin de comprendre comment un projet jugé viable en 1950 finit par être jugé inapplicable quelques années plus tard. Nous nous appuierons sur le concept de dilemme géostratégique pour montrer que la concurrence entre un front est marqué par la menace soviétique d'une part, et un front sud marqué par les crises coloniales en Indochine et en Afrique du Nord d'autre part, est au c ur de l'évolution de la position française à l'égard de la CED. Enfin, nous montrerons que l'Union européenne actuelle souffre elle aussi d'un dilemme géostratégique, en particulier depuis la crise ukrainienne de 2014 opposant défense territoriale à l'Est et gestion de crise au Sud. Si ce dilemme géostratégique constitue une difficulté majeure pour l'intégration européenne en matière de défense, nous verrons cependant que des transactions institutionnalisées entre États ayant des priorités différentes pourraient permettre de le régler tout en posant les bases d'une culture stratégique européenne.