bluuebunny/crossref_metadata_2025_split huggingface dataset:
WITHDRAWN: “After the transition is before the transition” – Experiences of medically induced treatment discontinuation of disease-modifying therapies in people with multiple sclerosis: A qualitative descriptive study.
Authors: Ammann Robert , Fringer André 
Published: October 2019

Abstract
Background: Treatment discontinuation and non-adherence are widely discussed topics in the context of multiple sclerosis (MS). However, little is known about the experience of medically induced discontinuation of disease-modifying therapies in people with MS. Serious side effects or treatment failure are possible reasons for discontinuation. Prevalence of treatment switches is high in people with MS. Doctors initiate almost 50% of treatment switches. Methods: The aim of this study was to explore how people with MS experience medically induced treatment discontinuation. Using a qualitative-descriptive approach, ten semi-structured interviews were conducted with adult persons suffering from MS. Data analysis followed the procedure suggested by Saldaña. Open and axial coding were applied. The analysis was continued until it was possible to draw conclusions about participantsˊ experiences and to answer the research question. At the end, the experiences could be synthesised into categories, resulting in a conceptual model. Results: „ After the transition is before the transition “ was identified as central phenomenon. People with MS experience medically induced discontinuation as part of a cycle of repeated treatment switches. They get to know treatment options, develop criteria for treatment and decide about treatment, taking into account professional advice and personal preferences. Once treatment starts, health care professionals and people with MS assess whether it is well-tolerated and effective. If not, a decision about treatment discontinuation is necessary. Discontinued treatment implies that the cycle begins again. Health personnel initiates the cycle and supports patients with professional advice. Family and friends ensure that the perspective of people with MS is considered in the decision process. Conclusions: Experiencing medically induced treatment discontinuation is a silent phenomenon requiring health care professionals′ attention. Uncertainty associated with treatment adds to uncertainty of the disease trajectory. Knowledge can contribute to a feeling of control. Finding normality in the context of a treatment switch is essential. People with MS need continuing support from health care professionals beyond the moment of treatment decision.
Plant- and Nutraceutical-based Approach for the Management of Diabetes and its Neurological Complications: A Narrative Review
Authors: Öztürk Yusuf , Öztürk Nilgün 
Published: October 2019

:Diabetes is an important metabolic disease affecting many organs and systems in the body. The nervous system is one of the body systems affected by diabetes and neuropathic complications are troublesome in diabetic patients with many consequences. As diabetes has deleterious influences almost on bodily systems, an integrative approach seems to be necessary accepting the body as a whole and integrating body systems with lifestyle and living environment. Like some traditional health systems such as Ayurveda, integrative approach includes additional modalities to overcome both diabetes and diabetic complications. In general, these modalities consist of nutraceuticals and plant products. Prebiotics and probiotics are two types of nutraceuticals having active ingredients, such as antioxidants, nutrient factors, microorganisms, etc. Many plants are indicated for the cure of diabetes. All of these may be employed in the prevention and in the non-pharmacological management of mildto- moderate diabetes. Severe diabetes should require appropriate drug selection. Being complementary, prebiotics, probiotics, plants and exercise may be additive for the drug therapy of diabetes. Similarly, there are complementary approaches to prevent and cure neurological and/or behavioral manifestations of diabetes, which may be included in therapy and prevention plans. A scheme is given for the prevention and therapy of comorbid depression, which is one of the most common behavioral complications of diabetes. Within this scheme, the main criterion for the selection of modalities is the severity of diseases, so that personalized management may be developed for diabetic patients using prebiotics and probiotics in their diets, plants and drugs avoiding possible interactions.
Sera/Organ Lysates of Selected Animals Living in Polluted Environments Exhibit Cytotoxicity against Cancer Cell Lines
Authors: Jeyamogan Shareni , Khan Naveed A. , Sagathevan Kuppusamy , Siddiqui Ruqaiyyah 
Published: October 2019

Background:
Species of crocodiles and cockroaches can withstand high radiation, reside in unsanitary
conditions, thrive on germ-infested feed, and are exposed to heavy metals, yet they are not reported to
develop cancer. It has been postulated that such species have mechanisms to defend themselves against developing
cancer. Here, selected species have been tested for potential cytotoxicity against selected cancer cell lines.

Methods:
In this study, various species of vertebrates and invertebrates were procured including Columba livia,
Gallus gallus domesticus, Varanus salvator, Cuora kamamora amboinensis, Reticulatus malayanus, Oreochromis
mossambicus, Rattus rattus, American bullfrog, Donax sp., Polymesoda coaxans, Tenebrio molitor,
Lumbricus terrestris, Blatta lateralis, Grammostola rosea, and Penaeus monodon. Species were dissected and
their organ lysates/sera/haemolymph were prepared. Cytotoxicity assays were performed using Prostate Cancer
cells (PC3), Henrietta Lacks cervical adenocarcinoma cells (HeLa) and human breast adenocarcinoma cells
(MCF7) as well as human keratinized skin cells (Hacat), by measuring lactate dehydrogenase release as an indicator
for cell death. Growth inhibition assays were performed to determine the effects on cancer cell proliferation.
Liquid Chromatography-Mass Spectrometry (LC-MS/MS) was performed for molecular identification.

Results:
The results revealed that body lysates of Polymesoda coaxans demonstrated more than 99% growth
inhibition of all cancer cell lines tested but not on normal Hacat cells. More importantly, the serum of M. reticulatus
abolished growth and produced cytotoxicity. Hence these samples were subjected to Liquid Chromatography-
Mass Spectrometry (LC-MS/MS), which detected 81 small molecules and putatively identified 20 molecules
when matched against the METLIN database. Out of 1094 peptides, 21 peptides were identified, while
1074 peptides were categorized as novel peptides. Based on properties such as peptide amino acid composition,
binary profile, dipeptide composition and pseudo-amino acid composition, 306 potential peptides were
identified.

Conclusion:
To our knowledge, here for the first time, we report a comprehensive analysis of sera exhibiting
cytotoxicity against cancer cell lines tested and identified several molecules using LC-MS/MS.
Synthesis, Anticancer, and Antibacterial Activity of Betulinic and Betulonic Acid C-28-Triphenylphosphonium Conjugates with Variable Alkyl Linker Length
Authors: Tsepaeva Olga V. , Nemtarev Andrey V. , Salikhova Taliya I. , Abdullin Timur I. , Grigor`eva Leysan R. , Khozyainova Svetlana A. , Mironov Vladimir F. 
Published: October 2019

Background:
Conjugation of triterpenoids such as betulinic acid 1 with the Triphenylphosphonium
(TPP) group is a powerful approach to generating medicinal compounds. Their development proposes structure
optimization in respect of availability and activity towards target cells and organelles. Selection of 1 or its precursor
betulonic acid 2 and the optimal linker is of particular importance for drug candidate identification among
the TPP-triterpenoid conjugates.

Objective:
In this study, new C-28-TPP conjugated derivatives of 1 and 2 with the alkyl/alkoxyalkyl linkers of
variable length were synthesized and compared regarding their anticancer, antibacterial, and mitochondriatargeted
effects.

Methods:
The TPP conjugates of 1 and 2 [6a-f, 7a-f] were synthesized by the reaction of halogenalkyl esters
[3a-f, 4a-f, 5] with triphenylphosphine in acetonitrile upon heating. Cytotoxicity (MTT assay), antibacterial
activity (microdilution assay), and mitochondrial effects (flow cytofluorometry) were studied.

Results:
Conjugation with the TPP group greatly increased the cytotoxicity of the triterpenoids up to 30 times.
The conjugates were up to 10-17 times more active against MCF-7 (IC50 = 0.17μM, 72h, 6c) and PC-3 (IC50 =
0.14μM, 72h, 6a) cancer cells than for human skin fibroblasts. The enhanced antibacterial (bactericidal) activity
of the TPP-triterpenoid conjugates with MIC for Gram-positive bacteria as low as 2μM (6a, 7a) was for the first
time revealed. The conjugates were found to effectively inhibit fluorescence of 2′,7′-dichlorofluorescin probe in the
cytosol upon oxidation, decrease transmembrane potential, and increase superoxide radical level in mitochondria.

Conclusion:
Relationships between the effects and structure of the TPP-triterpenoid conjugates were evaluated
and are discussed. Based on the results, 6a can be selected for further preclinical investigation as a potential
anticancer compound.
Pengembangan Tool Holder untuk Meningkatkan Kompetensi Mahasiswa pada Pembelajaran Praktik Pemesinan
Authors: Surono Surono , Ristadi Febrianto Amri , Nurdjito Nurdjito , Asnawi Asnawi 
Published: October 2019

This research aims to: (1) design a tool holder specified for existing machine tools in Machining Workshop at Mechanical Engineering Education of Universitas Negeri Yogyakarta; (2) Assess the feasibility of the developed design. The research used Research and development (R&D) design incorporating ADDIE Model. Data collection were performed using observation, questionnaire, and documentation. Data were analyzed using descriptive quantitative technique. The results are: (1) tool holder design was suited to the needs of the tools in the workshop, which are mill bits, internal turning tool holder, and tap holder; (2) the overall interpretation are “Agree” that the tool holder is feasible to use in machining practice.Tujuan penelitian ini adalah untuk: (1) menciptakan desain tool holder yang disesuaikan dengan mesin perkakas yang ada di bengkel pemesinan Jurusan Pendidikan Teknik Mesin, Universitas Negeri Yogyakarta; (2) mengetahui kelayakan tool holder yang telah dikembangkan. Desain penelitian yang digunakan adalah Penelitian dan Pengembangan/Reseach and Development (R&D) dengan menggunakan ADDIE Model. Pengumpulan data menggunakan teknik observasi, angket, dan dokumentasi. Analisis data menggunakan teknik deskriptif kuantitatif. Hasil penelitian ini adalah: (1) desain tool holder yang dikembangkan disesuaikan dengan tingkat kebutuhan pemakaian peralatan tersebut di bengkel mesin, yaitu mill bits, holder pahat bubut dalam, dan holder tap; (2) berdasarkan intepretasi data penilaian terhadap tool holder yang telah dikembangkan, secara keseluruhan diperoleh intepretasi “Setuju” bahwa alat (tool holder) tersebut layak digunakan sebagai alat bantu pemegang pahat pada proses pemesinan.
Design of HHO Generator to Reduce Exhaust Gas Emissions and Fuel Consumption of Non-Injection Gasoline Engine
Authors: Harman Harman , Ahyar Ahyar 
Published: October 2019

The continuous increase of fuel consumption has caused fossil fuel shortages, rising its price tremendously. Transportation activities have the largest contribution to air pollution in the form of exhaust gas compared to other industrial activities. Various methods have been used to reduce the air pollution level as well as reducing fuel consumptions, one of which is the use of environmentally friendly fuel gas. The fuel gas is obtained from the electrolysis of water into oxy-hydrogen gas (HHO) as an additive in the fuel combustion process. The research methodology is experimental research which consists of designing and manufacturing of HHO, and field testing. In the planning and manufacturing stages, an HHO generator is produced, equipped with an input voltage regulator in order to produce the gas as needed, with shape and size adapted to the available space on the engine room. The testing stage was conducted on a 1781 cc engine, 2015 Toyota pick up truck which included laboratory test and on the road test. The results show that by activating the HHO generator, there is a reduction of CO and HC emissions, and also a reduction in fuel consumption when compared to the operation of the vehicle at the same load but without HHO generator.Meningkatnya konsumsi bahan bakar minyak secara terus menerus menyebabkan kelangkaan ketersediaan bahan fosil di alam, sehingga harganya menjadi mahal. Kegiatan transportasi menyumbangkan polusi udara dari hasil emisi gas buang kendaraan terbesar dibanding kegiatan industri lainnya. Oleh karena itu dilakukan berbagai cara untuk menurunkan tingkat polusi udara sekaligus menurunkan konsumsi bahan bakar minyak. Salah satunya adalah penggunaan gas bakar ramah lingkungan yang diperoleh dari elektrolisis air gas oksihidrogen (HHO) sebagai bahan tambah dalam proses pembakaran bahan bakar. Metodologi penelitian ini adalah penelitian eksperimental yang terdiri atas perancangan dan pembuatan generator HHO serta pengujian lapangan. Pada tahap perancangan dan pembuatan dibuat generator gas HHO yang dilengkapi dengan pengatur tegangan input agar menghasilkan gas sesuai kebutuhan, dengan bentuk dan ukuran yang disesuaikan dengan tempat yang tersedia pada ruang mesin. Sedangkan pengujian dilakukan pada Mobil Toyota Kijang Pick Up 1781cc pembuatan tahun 2005 yang meliputi uji laboratorium dan uji jalan di jalan raya. Hasil yang diperoleh bahwa dengan mengaktifkan generator HHO, terjadi penurunan emisi CO dan HC serta penurunan konsumsi bahan bakar pada beban yang sama, dibandingkan jika kendaraan dioperasikan tanpa generator HHO
How Online Reviews and Services Affect Physician Outpatient Visits: Content Analysis of Evidence From Two Online Health Care Communities
Authors: Lu Wei , Wu Hong 
Published: October 2019

Background
Online healthcare communities are changing the ways of physician-patient communication and how patients choose outpatient care physicians. Although a majority of empirical work has examined the role of online reviews in consumer decisions, less research has been done in health care, and endogeneity of online reviews has not been fully considered. Moreover, the important factor of physician online services has been neglected in patient decisions.

Objective
In this paper, we addressed the endogeneity of online reviews and examined the impact of online reviews and services on outpatient visits based on theories of reviews and channel effects.

Methods
We used a difference-in-difference approach to account for physician- and website-specific effects by collecting information from 474 physician homepages on two online health care communities.

Results
We found that the number of reviews was more effective in influencing patient decisions compared with the overall review rating. An improvement in reviews leads to a relative increase in physician outpatient visits on that website. There are channel effects in health care: online services complement offline services (outpatient care appointments). Results further indicate that online services moderate the relationship between online reviews and physician outpatient visits.

Conclusions
This study investigated the effect of reviews and channel effects in health care by conducting a difference-in-difference analysis on two online health care communities. Our findings provide basic research on online health care communities.
Klasifikasi Tindak Pidana Hudud dan Sanksinya dalam Perspektif Hukum Islam
Authors: Surya Reni 
Published: October 2019

Tindak pidana dalam hukum pidana Islam disebut jarimah, yaitu segala perbuatan yang dilarang oleh Allah swt. dan diancam dengan hukuman had dan ta’zir. Had adalah tindak pidana dan sanksi pidananya sudah diatur sedemikian rupa dalam nash Al-Qur’an dan Al-Hadis, sedangkan ta’zir adalah tindak pidana yang sanksi pidananya ditetapkan oleh pemimpin. Tindak pidana atau jarimah hudud adalah: Had zina, dihukum bagi yang ghairu muhsan 100 kali cambuk dan muhsan dihukum rajam, had qadhaf (menuduh orang berbuat Zina) dihukum 80 kali cambuk, had sariqah (pencurian), apabila sudah mencapai nisab dihukum potong tangan, had minum khamar dihukum 40 kali cambuk, had hirabah (perampokan) dihukum sesuai dengan kiteria perbuatan yang dilakukan, had al-baghyu (pemberontakan) dihukum mati, dan had riddah (murtad) dihukum mati apabila tidak mau diajak untuk bertaubat. Ketujuh bentuk had tersebut merupakan hak Allah swt. yang apabila sudah terbukti, maka hakim tinggal memutuskan sesuai dengan yang ditetapkan menurut Al-Qur’an dan Al-Hadis.
Upaya Meminimalisir Kasus KDRT di Aceh: Studi Kasus P2TP2A Provinsi Aceh
Authors: Jamhuri Jamhuri , Rafiah Rafiah 
Published: October 2019

Pusat Pelayanan Terpadu Pemberdayaan Perempuan dan Anak mempunyai tugas dan fungsi untuk mencegah dan menangani kekerasan dalam rumah tangga yang dialami para korban. Kinerja lembaga P2TP2A mengalami peningkatan dalam meminimalisir kasus KDRT yang terjadi di Provinsi Aceh. Pertanyaan penelitian artikel ini adalah apa saja bentuk-bentuk kekerasan dalam rumah tangga sebagai salah satu penyebab terjadinya perceraian di Provinsi Aceh dan bagaimana upaya P2TP2A dalam meminimalisir kasus kekerasan dalam rumah tangga terhadap perempuan di Provinsi Aceh. Metoede penelitian yang digunakan adalah jenis penelitian yuridis normatif yaitu library research (perpustakaan) dan field research (lapangan) dan menggunakan metode kualitatif yaitu data yang berasal dari wawancara, catatan laporan, dokumen dan lain-lain. Berdasarkan dari penelitian tersebut diatas dapat diperoleh hasil sebagai berikut: bentuk-bentuk kekerasan dalam rumah tangga yang menjadi penyebab ialah faktor ekonomi dalam keluarga, faktor perselingkuhan, faktor narkoba, faktor bawaan prilaku pelakunya sendiri, dan hubungan antara pasangan suami isteri yang tidak seimbang. Sedangkan upaya P2TP2A dalam meminimalisir kekerasan dalam rumah tangga ialah dengan melakukaan sosialisasi ke gampong-gampong kepada masyarakat tentang adanya Undang-Undang PKDRT agar masyarakat mengetahui tentang ranah hukum yang terjadi atas kekerasan yang terjadi pada kaum perempuan. Dari paparan diatas disimpulkan bahwa kekerasan dalam rumah tangga terjadinya penurunan dengan adanya sosialisasi dan kinerja lain dari lembaga P2TP2A. Saran penulis ialah agar membuat rumah aman untuk dapat melindungi korban kekerasan yang terjadi para perempuan dan anak yang mengalami kekerasan.
PRODUTIVIDADE NOS SERVIÇOS NO RIO GRANDE DO SUL: DINÂMICA, ESPECIALIZAÇÃO E DESEMPENHO
Authors: Jacinto Paulo De Andrade , Ribeiro Eduardo Pontual 
Published: October 2019

O setor de serviços responde pela maior parte do valor adicionado daeconomia gaúcha e por grande parte do emprego no estado. Apesar de não servisto como motor da economia, seu desempenho pode ser determinante para ocrescimento da renda. Apresenta-se uma análise inédita da evolução da produtividadedesse setor de serviços no Rio Grande do Sul, comparando-se seu patamar, evoluçãoe estrutura com os do Brasil. A estrutura produtiva e a produtividade nos serviçosno estado apresentam semelhanças com as do país. A evolução da produtividadeno período é negativa, em que ganhos nominais são revertidos quando avaliados apreços constantes. Utilizando-se decomposições shift-share, conclui-se que a dinâmicaagregada dos serviços no Brasil e no Rio Grande do Sul depende principalmente docomportamento intra-setorial, com tímido efeito da mudança estrutural e do bônusestrutural.
PELATIHAN PEMERIKSAAN TAJAM PENGLIHATAN PADA SISWA KELAS 5 SD GEDONGAN I, COLOMADU, KARANGANYAR
Authors: Sutrisna Em , Hanwar Dedi , Indrayudha Peni , Sujono Tanti Azizah 
Published: October 2019

Seeing is crucial aspect in life includes in the field of education. Ifit is not cured the reduction of sharpness of seeing/visus can affect thestudent ability to study. This action is done to detect this reduction early.Therefore, the eyes will not be getting worse. The research is done bytraining and demonstrating how to check visus. The location of the researchis SD Gedongan I, Gedongan, Colomadu, Karanganayar. The 31 studentsare checked. The result is that there are 3 students have visus with miop.All the students can participate in this research well.
PENGEMBANGAN KEMITRAAN KA WASAN MATEMATIKA(MATH MASTER ZONE) DI KECAMATAN SA WAHAN KABUP ATEN NGANJUK
Authors: Muhtadi Muhtadi , Sutama Sutama , Anif Sofyan , Prayitno Harun Joko 
Published: October 2019

PEMITRA service activities in the kecamatan Sawahan kabupaten Nganjuk, had conducted educational activities, training, and mentoring for elementary school teachers, principals, supervisors and the person in charge of Math Masters Zone program to improve the basic concepts of mathematics and its teaching method. In this Pemitra conducted training activities learning methods of Math Masters, so that teachers had an understanding and basic mathematical concepts were true, and instructed it so easy and fun to their students. In the implementation of this Pemitra service activities, had given results and achievements were very enjoyable because math test scores elementary school students in the kecamatan Sawahan on the 2013/2014 school year had average to 8.5 and the highest value reached 10.0. Math Olympiad activities also quite lively, as students becomed more enthusiastic andexcited. Based on indicators of progress and this proves that the method Math Master who had been introduced by the Executive Team Pemitra, had helped to solve problems Numeric Phobia for elementary school students in the kecamatan Sawahan. Mathematics was considered subjects which so easy and very fun by the students.Constraints and problems still be faced today is the support and consistency of Nganjuk government has not been consistent in developing subdistrict Sawahan as Math Master Zone.
Assessing bleeding in acute coronary syndrome using the Bleeding Academic Research Consortium definition
Authors: Fortuni Federico , Crimi Gabriele , Morici Nuccia , De Luca Giuseppe , Alberti Luca Paolo , Savonitto Stefano , De Servi Stefano 
Published: October 2019

Background
The Bleeding Academic Research Consortium (BARC) definition was proposed to overcome the heterogeneity among the many bleeding definitions. The aim of this study-level meta-analysis was to explore the incidence of BARC-assessed bleeding in acute coronary syndrome (ACS) studies and to ascertain the relation between these events and variables related to bleeding risk.

Methods and Results
We searched the literature for studies that reported bleeding events according to BARC criteria in ACS patients. An analysis on heterogeneity between studies in bleeding reports was performed with I
2 test. A meta-regression was conducted to explore the relation between different types of BARC bleedings and patient and procedural features. Nine studies were included in the analysis. Overall, BARC 2 rates were higher than BARC 3 or 5 rates (6.3 versus 2.6%). An extremely high level of heterogeneity was detected both for BARC 2 (I
2 99.3%) and BARC 3 or 5 (I
2 97.5%) bleedings. Increasing age [β coefficient 0.4% (0.2–0.6%); P < 0.001] and renal impairment [β coefficient 1 6.5% (1–32.1%); P
= 0.037] were associated with increased BARC 3 or 5 rates, whereas the use of glycoprotein IIb/IIIa inhibitors was the only factor related to an increased incidence of BARC 2 bleeding [β coefficient 2 2.3% (5.5–39%); P
= 0.009].

Conclusion
The high level of heterogeneity in BARC bleeding reports only partially explained by bleeding risk profile suggests that a regulatory guidance to properly evaluate bleedings and to estimate the risk--benefit in clinical trials investigating different antithrombotic treatments in ACS patients is needed.