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Background Evidence suggests that LPA risk genotypes are a possible contributor to the clinical diagnosis of familial hypercholesterolemia (FH). This study aimed at determining the prevalence of LPA risk variants in adult individuals with FH enrolled in the Italian LIPIGEN (Lipid Transport Disorders Italian Genetic Network) study, with (FH/M+) or without (FH/M-) a causative genetic variant. Methods and Results An lp(a) [lipoprotein(a)] genetic score was calculated by summing the number risk-increasing alleles inherited at rs3798220 and rs10455872 variants. Overall, in the 4.6% of 1695 patients with clinically diagnosed FH, the phenotype was not explained by a monogenic or polygenic cause but by genotype associated with high lp(a) levels. Among 765 subjects with FH/M- and 930 subjects with FH/M+, 133 (17.4%) and 95 (10.2%) were characterized by 1 copy of either rs10455872 or rs3798220 or 2 copies of either rs10455872 or rs3798220 (lp(a) score ≥1). Subjects with FH/M- also had lower mean levels of pretreatment low-density lipoprotein cholesterol than individuals with FH/M+ (t test for difference in means between FH/M- and FH/M+ groups

The photocurrent output of the C6H4NH2CuBr2I/TiO2 heterojunction photoelectrode in an aqueous solution is super stable, and it could be largely enhanced by a reverse electric field.

The aim of this study was focuses on the analysis of international publications related to critical thinking skills in education including the number of publications and how they trend, the distribution of study countries, study types, study subjects, critical thinking linkages that arise from published publications. analyzed, data collection instruments, data analysis and results of study on these publications. the most distribution of data related to critical thinking skills in 2021 with the distribution of countries namely Indonesia, USA, Iran, Malaysia, Turkey, UAE and the most publications obtained by Indonesia. The most common type of study is qualitative study, followed by quantitative study and then study and development. The study subjects used in the article are quite spread out from early childhood, elementary school students, junior high school students, high school students, university students, teachers to the books used. Most of the study trends discussed here relate to teacher pedagogical competence, problem solving, achievement, creative thinking, peer shared intervention and communication skills as a form of cooperation in 21st century skills. Test instruments are used the most, then questionnaires, interviews, continued questionnaire and observation guide, systematic literature review and finally book scoring. data analysis using percentage is the most, data analysis with descriptions then t test and ANOVA.

Kemampuan pemecahan masalah merupakan hal yang harus dimiliki peserta didik. Dalam belajar matematika peserta didik sering kali mengalami kesulitan ketika menyelesaikan soal yang berbeda dengan contoh yang diberikan guru. Tujuan dari penelitian ini untuk mendeskripsikan kemampuan pemecahan masalah siswa ditinjau dari disposisi matematis. Jenis penelitian yang digunakan adalah metode kualitatif yang bersifat deskriptif dengan desain penelitian studi kasus. Subjek penelitian ini berjumlah 3 orang yang masing-masing diambil dari hasil angket disposisi matematis pada kategori tinggi, sedang, dan rendah Pengumpulan data pada penelitian ini menggunakan angket, tes, dan wawancara. hasil penelitian ini, yaitu: 1) siswa yang memiliki disposisi matematis tinggi berada pada kemampuan pemecahan masalah kategori tinggi, 2) siswa yang memiliki disposisi matematis sedang berada pada kemampuan pemecahan masalah kategori sedang, 3) siswa yang memiliki disposisi matematis rendah berada pada kemampuan pemecahan masalah kategori rendah.

Tujuan pengabdian ini yaitu (1) Untuk memberikan sosialisasi kepada Anak-anak Yayasan mengenai pentingnya pengenalan keuangan, (2) Untuk memberikan bukti bahwa pelaksanaan kegiatan kunjungan pengabdian masyarakat khususnya ke Yayasan Panti Asuhan perlu dilakukan oleh pihak Dosen dan Mahasiswa. Metode pelaksanaan ini adalah sosialisasi secara langsung (direct socialization) ke Yayasan untuk memberikan pengarahan mengenai pentingnya keuangan. Hasilnya adalah anak-anak yang berada di Yayasan dapat mengetahui pentingnya keuangan secara dasar serta memberikan informasi tentang menabung. Dampak pengabdian adalah (1) Bagi Anak-anak Yayasan yaitu dapat memahami mengenai dasar-dasar keuangan khususnya pengaturan uang secara sederhanadengan menggunakan metode games yang menarik. Anak-anak Yayasan juga bisa mendapatkan ilmu tentang perhitungan dasar matematika seperti uang pecahan dan nominal uang yang bermanfaat untuk kedepannya, (2) Bagi Mahasiswa yaitu dapat mengetahui kondisi dan situasi yang terjadi di Yayasan untuk menjadi lebih peka terhadap masyarakat, (3) Bagi Dosen yaitu dapat melatih untuk memberikan materi dengan situasi yang berbeda, misalnya penyampaian kepada anak-anak harus menggunakan bahasa yang mudah dimengerti sehingga tidak terjadi kebingungan, selanjutnya juga mengasah kemampuan dalam melakukan komunikasi dengan berbagai situasi yang terjadi.

Erectile dysfunction (ED) and diabetic foot (DF) are common complications in patients with diabetes. However, the relationship between ED and DF has been little studied. In particular, no study has evaluated whether ED is associated with the outcomes of DF. The aim of this retrospective cohort study was to investigate whether ED is a predictor of the outcomes of DF in a large population of men with DF.Three hundred and twenty-six consecutive men with type 2 diabetes and a recent and single DF ulcer were recruited and followed up for 41.7 ± 22.7 months.Among men with DF, 56.1% had ED (ED group) and 43.9% did not (NO ED group). Wound healing rate was significantly higher in the NO ED than in the ED group (90.2 versus 73.3%; p = 0.0001). Minor amputation rate (13.7 versus 4.8%; p = 0.007) and mortality (25.7 versus 0.7%; p 0.001) were significantly greater in the ED than in the NO ED group. Among 263 patients with healed ulcers, recurrence rate was significantly higher in the ED than in the NO ED group (51.5 versus 26.3%; p 0.001). Multivariate analysis showed that the absence of ED was associated with wound healing (OR: 0.459; 95% CI: 0.213-0.993; p = 0.048), while the presence of ED predicted mortality (OR: 22.644; 95% CI: 2.976-34.271; p = 0.002) and DF recurrence (OR: 3.498; 95% CI: 1.882-6.499; p 0.001).Our data show that among men with DF the prevalence of ED is very high. Moreover, ED may be a strong predictor of wound healing, mortality, and ulcer recurrence.

This study aims to determine the differences in the ability to understand mathematical concepts of students who learn to use the RME-based Mind Mapping learning model with Mind Mapping and direct learning. And to find out which learning model is better than them. The method used in this research is quantitative method. This type of research uses a quasi-experimental design. The population in this study were all eighth grade students of Azzainiyyah junior high school. The sampling technique was carried out by drawing lots of the four classes in the population and then three classes were taken, namely students of class VIII C as the experimental class 1, VIII D as the experimental class 2, and VIII B as the control class. Data collection techniques with validity, reliability, discriminatory power, and level of difficulty using Anatest V4. Data analysis testing was carried out using SPSS software version.19 using Kolmogorov-Smirnov and Shapiro-Wilk test statistics for normality and homogeneity tests with Homogenity of Variance tests. The data analysis technique used One Way ANOVA and Post Hoc tests. Based on the results of the normality and homogeneity tests, it was found that the test data from the three groups were normal and homogeneous, followed by the One Way ANOVA and Post Hoc hypothesis testing. From the results of the research and discussion, it can be concluded that there are differences in the ability to understand mathematical concepts of students using the RME-based Mind Mapping learning model with Mind Mapping, and direct learning. Understanding the mathematical concepts of students using the RME-based Mind Mapping learning model is better than the Mind Mapping learning model, the RME-based Mind Mapping learning model is better than the direct learning model, and the Mind Mapping learning model is better than the direct learning model.

Background: Milk proteins (MPs) and their derivative whey proteins (WPs) are important components of human diet that might prevent bone loss. We aimed to investigate the effects of MP on the bones of postmenopausal women, along with the effects of WP on osteoblast cells. Methods: We conducted a feasibility controlled clinical study with 62 postmenopausal women who were asked to consume an MP-enriched ice cream. We also investigated the effect of WP on the ERK1/2 and AKT pathways, RUNX2, alkaline phosphatase, RANKL/OPG ratio, and COL1A of Saos-2. Results: After 12 weeks, we found a greater bone mineral density and bone alkaline phosphatase reduction in women who consumed the MP-enriched ice cream compared to the control group (p = 0.03 and p = 0.02, respectively). In Saos-2 cells, WP upregulated ERK1/2 and AKT pathways (p = 0.002 and p = 0.016), cell proliferation (p = 0.03), and osteoblast differentiation markers, along with downregulating RANKL/OPG (p < 0.001). Moreover, the inhibition of ERK1/2 by PD184253 reverted the effects on both the RUNX2 and ALP mRNA expression and cells proliferation (p = 0.028, p = 0.004, and p = 0.003, respectively) when treated with WP. Conclusions: WP upregulates cell proliferation, RUNX2, and alkaline phosphatase through the activation of the ERK1/2 pathways on Saos-2. These mechanisms probably contribute to preventing bone loss in postmenopausal women.

Orthorexia Nervosa (ON) is an eating disorder of growing interest that is characterized by an obsession with healthy eating. Nowadays, people spend an increasing amount of time on social media, which may negatively impact eating behaviors. The aim of this study was to investigate the relationship between social media usage and risk of ON.We conducted an online survey using the 10-item Italian-Düsseldorf Orthorexia Scale questionnaire (I-DOS). A total of 4,107 individuals participated and were classified according to sex, age, education level, marital status, BMI, main occupation, and diet.The prevalence of ON was 28.5%. Participants who reported using social media for over 60 minutes per day had a higher prevalence of ON than those using social media for less than 15 minutes per day.The results of this study suggest that longer time spent on social media is associated with ON.

Artikel ini bertujuan untuk menganalisis kemampuan pemahaman konsep matematis siswa dengan materi aljabar. Penelitian ini dilakukan di MTs Plus As-Sa’idah kelas VII J melibatkan 20 orang siswa. Pendekatan penelitian yang digunakan adalah kualitatif dengan metode deskriptif. Instrumen terdiri dari soal pemahaman konsep. Teknik pengumpulan data menggunakan uji intrumen tes. Tes yang dikerjakan oleh siswa diberikan penilaian disetiap indikator untuk mengetahui bahwa siswa tergolong dalam kategori kemampuan pemahaman konsep tinggi, rendah dan sedang. Ada 7 indikator yang akan tes kepada siswa yaitu: (1) Menyatakan ulang sebuah konsep, (2) Mengklasifikasikan objek menurut sifat-sifat tertentu sesuai dengan konsep, (3) Memberikan contoh dan noncontoh dari suatu konsep, (4) Menyajikan konsep dalam berbagai bentuk representasi matematika, (5) Mengembangkan syarat perlu/syarat cukup dari suatu konsep, (6) Menggunakan dan memanfaatkan serta memilih prosedur atau operasi tertentu, (7) Mengaplikasikan konsep/algoritma ke pemecahan masalah. Setiap indikatornya mewakili satu soal. Hasil dari penelitian ini diketahui bahwa subjek S10 dan S3 memiliki kemampuan pemahaman konsep tinggi dan S1 memiliki kemampuan pemahaman konsep rendah.

Background and Objectives: Hyperuricemia and liver steatosis are risk factors for cardiovascular diseases and mortality. The use of natural compounds could be a safe and effective alternative to drugs for the treatment of fatty liver and hyperuricemia. Polyphenolic fraction of Citrus Bergamia in association with the extract of Cynara Cardunculus, as nutraceutical, is able to reduce body weight, hepatic steatosis and markers of oxidative stress. Then, we performed a secondary analysis of a double-blind placebo-controlled trial to examine the effects of this nutraceutical on serum uric acid levels in adults with fatty liver. Materials and Methods: The study included 94 individuals with hepatic steatosis. For six weeks, the intervention group was given a nutraceutical (300 mg/day) comprising a Bergamot polyphenol fraction and Cynara Cardunculus extract. The control group received a daily pill of placebo. Serum uric acid, lipids, glucose and anthropometric parameters were assessed at baseline and after 6 weeks. Results: We found a greater reduction in serum uric acid in the participants taking the nutraceutical rather than placebo (−0.1 ± 0.7 mg/dL vs. 0.3 ± 0.7 mg/dL, p = 0.004), and especially in those with moderate/severe hepatic steatosis also after adjustment for confounding variables. In addition, we analysed the two groups according to tertiles of uric acid concentration. Among participants taking the nutraceutical, we found in those with the highest baseline serum uric acid (>5.4 mg/dL) the greater reduction compared to the lowest baseline uric acid (−7.8% vs. +4.9%; adjusted p = 0.04). The stepwise multivariable analysis confirmed the association between the absolute serum uric acid change and nutraceutical treatment (B = −0.43; p = 0.004). Conclusions: A nutraceutical containing bioactive components from bergamot and wild cardoon reduced serum uric acid during 6 weeks in adults with fatty liver. Future investigations are needed to evaluate the efficacy of this nutraceutical in the treatment of hyperuricaemia.

Tujuan dari penelitian ini yaitu untuk mengetahui kemampuan pemecahan masalah matematis siswa dalam mnyelesaikan soal Higher Order Thinking Skills (HOTS) pada materi aljabar. Jenis penelitian ini yaitu penelitian studi kasus dengan pendekatan kualitatif dan desain penelitiannya menggunakan deskriptif kualitatif. Pengambilan subjek dilakukan dengan metode non probability sampling dan menggunakan pendekatan purposive sampling yang dilakukan di SMP Karya Guna 17 Bogor. Data dikumpulkan melalui tes kemampuan pemecahan masalah matematis dan wawancara. Teknik analisis data meliputi pengumpulan data, reduksi data, penyajian data dan penarikan kesimpulan. Hasil penelitian ini menunjukkanada sebagian siswa yang belum memenuhi indikator kemampuan pemecahan masalah sehingga dapat disimpulkan bahwa kemampuan pemecahan masalah matematis siswa pada soal HOTS masih tergolong rendah.

Siswa banyak yang kesulitan memahami pelajaran matematika, melihat fenomena tersebut maka perlu diterapkan suatu sistem pembelajaran yang melibatkan peran siswa secara aktif dalam kegiatan belajar mengajar, guna meningkatkan kemampuan pemahaman belajar matematika siswa di SMP. Perlu adanya bahan ajar yang mampu membantu permasalahan tersebut, dengan adanya Lembar Kerja Siswa yang peneliti buat berbasis kolaborasi yang dikembangkan guna membangun rasa tanggung jawab dalam diri siswa sehingga pemahaman konsep dapat tercapai. Penelitian ini bertujuan untuk mengetahui kevalidan hasil pengembangan Lembar Kerja Siswa (LKS) berbasis kolaborasi dengan model pembelajaran TAI (Team Assisted Individually) pada siswa SMP. Pengembangan bahan ajar ini mengikuti prosedur pengembangan ADDIE yang meliputi lima tahap yaitu : (1) Analisis, (2) desain, (3) development/pengembangan, (4) Implementasi, (5) Evaluasi. Tahap Awal penelitian dilakukan sampai tahap pengembangan. Akhir dari tahapan pengembangan adalah melakukan validasi terhadap LKS.Nilai hasil uji validasi melalui penilaian oleh validator dinyatakan sangat valid dengan persentase 90%. Hasil tersebut menujukan bahwa LKS berbasis kolaborasi dengan model TAI pada pelajaran matematika valid.

The World elderly population is expected to double before 2050. Unhealthy habits and unhealthy lifestyles are commonly associated with age-related diseases or their worsening. Modification in daily lifestyle and diet may help preventing age-related diseases onset and efficiently affecting their evolution, thus promoting the Healthy Aging process, concept recently coined to describe the disease-free aging process. This review highlights the role of nutrition science in promoting healthy aging. Since the Mediterranean Model demonstrated to be a useful style in supporting healthy aging, promotion of this correct lifestyle by health policies seems to be the best approach to achieve this target.

Among all neoplasms, melanoma is characterized by a very high percentage of cancer stem cells (CSCs). Several markers have been proposed for their identification, and lipid droplets (LDs) are among them. Different techniques are used for their characterization such as mass spectrometry, imaging techniques, and vibrational spectroscopies. Some emerging experimental approaches for the study of LDs are represented by correlative light–electron microscopy and by correlative Raman imaging–scanning electron microscopy (SEM). Based on these scientific approaches, we developed a novel methodology (CREL) by combining Raman micro-spectroscopy, confocal fluorescence microscopy, and SEM coupled with an energy-dispersive X-ray spectroscopy module. This procedure correlated cellular morphology, chemical properties, and spatial distribution from the same region of interest, and in this work, we presented the application of CREL for the analysis of LDs within patient-derived melanoma CSCs (MCSCs).

Penelitian ini bertujuan untuk mengkaji tantangan pembelajaran PPKn pada masa pandemi Covid-19 di kelas VIIIA SMPN 22 Kerinci. Dalam aktivitas pembelajaran PPKn secara daring terkadang menimbulkan berbagai masalah bagi siswa, seperti kurangnya bimbingan guru menjadi kendala utama dalam pembelajaran jarak jauh yang dilakukan selama masa pandemi Covid-19. Penelitian ini adalah penelitian kualitatif dengan menggunakan pendekatan studi kasus. Penelitian dilakukan di SMPN 22 Kerinci yang berada di desa Sungai Pegeh Kecamatan Siulak Kabupaten Kerinci. Teknik pengumpulan data dilakukan melalui observasi, wawancara, dan studi dokumentasi. Hasil penelitian menunjukkan proses pembelajaran ada 3 hal yang harus dipersiapkan yaitu: perencanaan pembelajaran, pelaksanaan pembelajaran (aplikasi yang digunakan, proses pembelajaran, dan penugasan), dan evaluasi pembelajaran. Sementara itu, kendala yang dihadapi adalah jaringan internet yang tidak stabil, kurangnya sarana dan prasarana, kurangnya kreativitas guru menyampaikan materi, dan siswa kurang mendapat pengawasan atau dampingan dari orangtua.

A learning system that was directly face-to-face in class, had to be substituted with a learning system that is virtually integrated with the inter-net (online learning). The system uses online learning that connects teaching staff with the learning participants. Tiredness and laziness start-ed to be felt among the participants. This is worried to affect nonoptimal learning outcomes. During lessons, teaching staff often focuses on learning materials without knowing the emotions of their learning participants. Indirect online learning becomes a new challenge in adaptation; teaching staff and learning participants are required to adapt to existing conditions. With the problems above, the writer has an idea in devel-oping a prototype system that is developed to be able to help teachers in evaluating manners and emotions of students in online learning. Facial detection is a technology for detecting facial features such as the nose, eyes, and mouth. Development of facial detection that has un-dergone upgrades until now can differentiate if something is a facial feature or not and detect more than one face. This research aims to help teaching staff in evaluating learning participants’ affective behavior online by applying a Convolutional Neural Network method that has been trained to be able to predict emotional extents through facial expression. Â

BackgroundOvarian reserve is an important factor determining female reproductive potential. The number and quality of oocytes in patients with diminished ovarian reserve (DOR) are reduced, and even if in vitro fertilization-embryo transfer (IVF-ET) is used to assist their pregnancy, the clinical pregnancy rate and live birth rate are still low. Infertility caused by reduced ovarian reserve is still one of the most difficult clinical problems in the field of reproduction. Follicular fluid is the microenvironment for oocyte survival, and the metabolic characteristics of follicular fluid can be obtained by metabolomics technology. By analyzing the metabolic status of follicular fluid, we hope to find the metabolic factors that affect the quality of oocytes and find new diagnostic markers to provide clues for early detection and intervention of patients with DOR.MethodsIn this research, 26 infertile women with DOR and 28 volunteers with normal ovarian reserve receiving IVF/ET were recruited, and their follicular fluid samples were collected for a nontargeted metabonomic study. The orthogonal partial least squares discriminant analysis model was used to understand the separation trend of the two groups, KEGG was used to analyze the possible metabolic pathways involved in differential metabolites, and the random forest algorithm was used to establish the diagnostic model.Results12 upregulated and 32 downregulated differential metabolites were detected by metabolic analysis, mainly including amino acids, indoles, nucleosides, organic acids, steroids, phospholipids, fatty acyls, and organic oxygen compounds. Through KEGG analysis, these metabolites were mainly involved in aminoacyl-tRNA biosynthesis, tryptophan metabolism, pantothenate and CoA biosynthesis, and purine metabolism. The AUC value of the diagnostic model based on the top 10 metabolites was 0.9936.ConclusionThe follicular fluid of patients with DOR shows unique metabolic characteristics. These data can provide us with rich biochemical information and a research basis for exploring the pathogenesis of DOR and predicting ovarian reserve function.

Objectives:The impact of a comprehensive therapeutic patient education (TPE) on the prognosis of diabetic foot ulcer (DFU) has not yet been evaluated in the literature. The purpose of this study was to determine whether TPE is a predictor of outcome in type 2 diabetes patients with DFU. Methods:We evaluated 583 consecutive individuals with a recent and single DFU. They were treated and followed for 42.8±23.3 months. Patients were divided into 2 groups. The TPE group included subjects who had been receiving regular sessions of a comprehensive TPE, including a specific foot care education (FCE), for at least 12 months before DFU occurred (n=129). The non-TPE group comprised the remaining subjects (n=454). All 583 patients received intensive FCE during the treatment period. Results:We identified a significantly higher percentage of healed DFUs (96.0% vs 74.9%; p Conclusion:A comprehensive TPE may have a positive impact on wound healing, ulcer recurrence and mortality in people with DFU.

Background Currently, there is no approved medication for non-alcoholic fatty liver disease management. Pre-clinical and clinical studies showed that several bioactive molecules in plants or foods (i.e., curcumin complex, bergamot polyphenol fraction, artichoke leaf extract, black seed oil, concentrate fish oil, picroliv root, glutathione, S-adenosyl-l-methionine and other natural ingredients) have been associated with improved fatty liver disease. Starting from these evidences, our purpose was to evaluate the effects of a novel combination of abovementioned nutraceuticals as a treatment for adults with fatty liver disease. Methods A total of 140 participants with liver steatosis were enrolled in a randomized, double-blind, placebo controlled clinical trial. The intervention group received six softgel capsules daily of a nutraceutical (namely Livogen Plus®) containing a combination of natural bioactive components for 12 weeks. The control group received six softgel capsules daily of a placebo containing maltodextrin for 12 weeks. The primary outcome measure was the change in liver fat content (CAP score). CAP score, by transient elastography, serum glucose, lipids, transaminases, and cytokines were measured at baseline and after intervention. Results After adjustment for confounding variables (i.e., CAP score and triglyceride at baseline, and changes of serum γGT, and vegetable and animal proteins, cholesterol intake at the follow-up), we found a greater CAP score reduction in the nutraceutical group rather than placebo (− 34 ± 5 dB/m vs. − 20 ± 5 dB/m, respectively; p = 0.045). The CAP score reduction (%) was even greater in those with aged 60 or less, low baseline HDL-C, AST reduction as well as in men. Conclusion Our results showed that a new combination of bioactive molecules as nutraceutical was safe and effective in reducing liver fat content over 12 weeks in individuals with hepatic steatosis. Trial registration ISRCTN, ISRCTN70887063. Registered 03 August 2021—retrospectively registered, https://doi.org/10.1186/ISRCTN70887063

Penelitian ini bertujuan untuk mengetahui : (1) validitas, (2) kepraktisan dan , (3) efektivitas pada media mobile learning berbasis android. Jenis penelitian ini adalah penelitian Research and Development. Pada penelitian ini menggunakan model pengembangan ADDIE. Subjek penelitian adalah guru, 25 siswa kelas X Akuntansi SMK Hassina dan para validator. Instrumen yang digunakan pada penelitian ini yaitu lembar validasi ahli materi dan ahli media untuk memperoleh hasil uji validitas media serta angket respon guru dan siswa untuk mengukur kepraktisan dari media dan tes kemampuan pemahaman konsep matematis siswa untuk memperoleh hasil efektif dari media. Hasil penilaian kelayakan oleh validator menunjukkan bahwa media mendapat penilaian sebesar 88,33 % dari ahli media dan 84,61 % dari ahli materi, sehingga sangat valid dan layak untuk diuji cobakan. Hasil uji coba diperoleh respon yaitu 84,615% dari guru dan 86,363% dari siswa, sehingga produk termasuk kedalam kategori sangat praktis. Kemudian hasil analisis tes siswa berdasarkan pedoman penskoran pemahaman konsep matematis diperoleh skor total awal sebesar 253 dan skor total akhir sebesar 574. Berdasarkan uji N-Gain diperoleh hasil rata-rata sebesar 72,55% dengan kategori tinggi.

Background Obesity is among the main determinants of nonalcoholic fatty liver disease progression towards severe liver disease (SLD). However, risk factors for SLD in individuals with obesity have not been examined. Objectives To identify the independent risk factors for SLD among participants with obesity from the UK Biobank. Methods A total of 80,224 UK Biobank participants with obesity (body mass index[BMI] > 30 kg/m2) and 242,822 without obesity, of European descent without clinical history of liver disease and liver cancer were prospectively followed for the onset of SLD, defined as a composite diagnosis of cirrhosis, decompensated liver disease, hepatocellular carcinoma and/or liver transplantation. Risk factors for incident SLD were assessed by Cox proportional hazards models. Different clinical phenotypes were derived by latent class analysis (LCA). Results Obesity conferred a 2.6-fold increased risk for SLD that was abolished after the inclusion of waist circumference (WC) in the model. Among individuals with obesity, age (adjusted hazard ratio [aHR] 1.05, 95%CI 1.03–1.07, p = 3.9 * 10−7), type 2 diabetes (aHR 2.18, 95%CI 1.55–3.05, p = 6.2 * 10−6), PNPLA3 rs738409 (aHR 1.59, 95%CI 1.33–1.9, p = 3.1 * 10−7) and WC (aHR 1.04, 95%CI 1.02–1.06, p = 8.5 * 10−6) were independent predictors of SLD. BMI category-specific WC thresholds allowed a better risk stratification compared to traditional ones. By LCA, the clinical phenotype at highest risk for SLD was that with BMI

The arid region in China with rich mineral resources are belongs to ecological fragile region with inadequate recovering capacity. Hundred years of continues mining of mineral resources for economic purposes, leads to the problem of land degradation caused by the spatial coupling of large-scale mining disturbance and arid fragile ecological environment. The environmental problems created by mining have not been addressed promptly, while at the same time, new problems have emerged. On the basis of our 20 years of practical experience on ecological restoration in mining areas, review and synthesis of selective literature, with interpretation and perspective, the mining situation and its ecological impacts, the factors impeding ecological restoration capability in the arid region in China were examined, the key challenges and promotion strategy were presented. The main findings of this study are as follows: Land degradation is the most prominent problem resulting in mining activities, and mainly reflected by immediate disturbance, long term effects and ecological degradation. The main challenges faced by mining area restoration in arid areas are unclear objectives of ecological restoration, lack of ecological water consumption, unreasonable selection of indigenous plants, serious land degradation and wide restoration area. Our restoration experiments in typical mining areas have proved that the micro-topography reconstruction measures can increase surface roughness, redistribute limited precipitation resources (especially snow), and make soil water and nutrients carried by surface runoff and collected in valleys to regulate soil infiltration and water supply, so as to achieve water-saving and non-irrigated vegetation restoration .The ideal restoration effects are the mitigation of geological hazards, the increase of available land resources, and the improvement of ecosystem services in mining areas. This study would be helpful to carried out related implementation on ecological restoration and could act as a valuable reference for the researchers involved in the ecological restoration.in arid region.

PT Ciptaunggul Karya Abadi (CKA) is a manufacturer active in the country, and part arm rear break KYEA broken are one of the parts that are produced every month, and product defects occur frequently. Substantially companies need to improve the quality of products manufactured according to standards and prescribed specification in order to reduce product defect levels. This study aims to use lean six sigma DMAIC (Define, Measurem Analyze, Improve, and Control) approach and kaizen analysis to identify the factors that cause defect levels and suggest improvements to reduce the number of defect. The capacity of sigma obtained from the production process part arm rear break KYEA is 4,6. There are three types of defects in the production process, restice dented 9%, blank minus 27%, blunt serration 64%. In addition, kaizen analysis was performed by 5W+1H analysis. The results of this survey are expected to contribute to improving product qualitu, satisfaction customer, dan maximizing profits.

Penelitian ini bertujuan untuk mendeskripsikan kemampuan pemecahan masalah matematis menggunakan soal cerita islami. Subjek penelitian yang digunakan yaitu 3 orang siswa kelas VII-B Mts Tarbiyatul Falah yang berada di Selabintana dan sudah mempelajari materi perbandingan. Jenis penelitian ini adalah studi kasus dengan metode deskriptif kualitatif dengan instrumen utama adalah peneliti sendiri dan didukung instrumen tes satu butir soal uraian dan wawancara. Soal uraian tersebut akan mengukur kemampuan pemecahan masalah matematis siswa berdasarkan indikator pemecahan masalah menurut Polya dan didukung kesimpulan hasil wawancara. Teknik pengumpulan data dalam penelitian ini berupa tes dan wawancara kepada subjek penelitian. Hasil penelitian menunjukkan bahwa (1) Siswa dengan kemampuan pemecahan masalah matematis tinggi mampu memenuhi keempat tahapan polya dalam menyelesaikan soal cerita islami, yaitu: memahami masalah, menyusun rencana, menyelesaikan perencanaan, dan memeriksa kembali. (2) Siswa dengan kemampuan pemecahan masalah matematis sedang mampu memenuhi ketiga tahapan polya dalam menyelesaikan soal cerita islami, yaitu: memahami masalah, menyelesaikan perencanaan, dan memeriksa kembali. (3) Siswa dengan kemampuan pemecahan masalah matematis rendah mampu memenuhi kedua tahapan polya dalam menyelesaikan soal cerita islami, yaitu: memahami masalah dan menyelesaikan perencanaan.

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Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are two gut hormones, defined incretins, responsible for the amplification of insulin secretion after oral glucose intake. Unlike GLP-1, GIP has little acute effect on insulin secretion and no effect on food intake; instead it seems that the GIP may be an obesity-promoting hormone. In patients with type2 diabetes mellitus (T2DM) some studies found a downregulation of GIP receptors on pancreatic β cells caused by hyperglycemic state, but the glucagonotropic effect persisted. Agonists of the receptor for the GLP-1 have proven successful for the treatment of diabetes, since they reduce the risk for cardiovascular and renal events, but the possible application of GIP as therapy for T2DM is discussed. Moreover, the latest evidence showed a synergetic effect when GIP was combined with GLP-1 in monomolecular co-agonists. In fact, compared with the separate infusion of each hormone, the combination increased both insulin response and glucagonostatic response. In accordance with theseconsiderations, a dual GIP/GLP-1receptor agonist, i.e., Tirzepatide, known as a “twincretin” had been developed. In the pre-clinical trials, as well as Phase 1–3 clinical trials, Tirzepatideshowedpotent glucose lowering and weight loss effects within an acceptable safety.

Background A growing number of functional foods have been proposed to reduce cholesterol levels and the Portfolio Diet, which includes a combination of plant sterols, fibres, nuts, and soy protein, reduces low density lipoprotein cholesterol (LDL-C) from 20% to 30% in individuals with hyperlipidaemia. In this pilot study, the aim was to investigate whether a Mediterranean Diet incorporating a new and simple combination of cholesterol-lowering foods, excluding soy and nuts (namely the Portfolio-Mediterranean Diet), would reduce LDL-C levels, in the short-term, better than a Mediterranean Diet plus a sterol-enriched yogurt or a Mediterranean Diet alone. Methods We retrospectively evaluated 24 individuals on a Portfolio-Mediterranean Diet and 48 matched individuals on a Mediterranean Diet with or without a sterol-enriched yogurt (24 each groups) as controls. Results At follow-up (after 48±12 days), we observed an LDL reduction of 21±4, 23±4, and 44±4 mg/dL in the Mediterranean Diet alone, Mediterranean Diet plus yogurt and Portfolio-Mediterranean Diet respectively (Pl0.001). Conclusion A Portfolio-Mediterranean Diet, incorporating a new combination of functional foods such as oats or barley, plant sterols, chitosan, and green tea but not soy and nuts, may reduce LDL of 25% in the short term in individuals with hypercholesterolemia.

In recent times, it has become evident that there are individuals who, from a metabolic point of view, are affected by obesity but have a normal body mass index. There are also metabolically healthy individuals with a high body mass index who are thus are considered as to be affected by obesity obese. Understanding that individuals with obesity are phenotypically heterogeneous is a relatively novel concept which, although present in the scientific literature, unfortunately has not yet had an impact in clinical practice. However, common dietary approaches are not effective in treating large numbers of obese patients with obesity. This narrative review, based on the material searched via PubMed and the Web of Science up to October 2021, proposes a downsizing of the role of the body mass index in identifying the individual with “true obesity” since it is only partially useful, and suggests a new approach which also integrates the body composition and assessment of metabolic parameters. This approach leads to personalized therapies that work best for each obesity phenotype in reducing the risk of non-communicable diseases.

Background Secondary prevention measures have strongly contributed to the reduction of incidence and mortality of cervical cancer (CC) identifying women at high risk of developing it. This cross-sectional study aimed to investigate the acceptability of a home-based self-sampling methodology for Human Papilloma Virus (HPV) testing and the factors that may influence women’s preference. Methods A random sample of women over the age of 50 years has been selected in Southern part of Italy. Data was collected through an anonymous self-administered questionnaire and included socio-demographic characteristics, knowledge of HPV infection and prevention measures, and attitudes towards the acceptability of self-collected cervico-vaginal sampling (CVS) and urine sampling (US). Results Among the 321 women who completed the survey, more than two-thirds (73.7%) knew that CC is caused by HPV, only 68.9% knew that the HPV screening is useful for an early detection and diagnosis of CC, and 17% never had Pap-test or HPV-DNA test. Of the respondents, 67.9% declared that they preferred self-collected US for future HPV testing compared with clinician-taken cervical samples (CCS). The most common reasons reported for preferring US included that it was easier (54.8%), more convenient (28.7%), and less embarrassing (21.7%). Among those women who showed negative attitude towards self-collected US, 8 out of 10 (77.3%) expressed scepticism about its diagnostic performance. Only 37% of the sample preferred CVS, and this attitude is mainly attributable to the fear of not carrying out a correct self-sampling (71.2%) and to its underrated diagnostic performance (33.7%). Conclusions The preliminary results suggest that US is more acceptable than CCS and CVS in Italy. Urinary HPV test presents similar accuracy of the latter tests to detect CC and its supply in the context of population-based screening programmes could improve adherence, reducing the cost and burden on physicians. Key messages • Urine self-sampling could represent an innovative early detection approach to increase adherence to cervical cancer screening programmes. • Further research is needed to assess whether the screening status and the strategy of self-samplers distribution could act as predictors of screening uptake.

Additional file 2: Table S2. Nutrient profile of the overall diet according to the treatments.

Additional file 6: Table S6. Nutrients intake assessment and dietary intake changes during the study (per-protocol analysis).

Additional file 7: Table S7. Changes in clinical parameters at follow-up according to the treatments (per-protocol analysis).

Additional file 11: Table S8. Antioxidant activity of nutraceutical and placebo extract.

Additional file 5: Table S5. Baseline and follow-up clinical characteristics of participants according to the treatments (per-protocol analysis).

Additional file 3: Table S3. Nutrients intake assessment and dietary intake changes during the study (intention to treat analysis).

Additional file 12: Table S9. Safety assessment of Livogen.

Additional file 1: Table S1. Dietary advice, servings of various food categories consumed daily, weekly, or monthly during the study according to the treatments.

We study the Anomaly flow on $2$-step nilmanifolds with respect to any Hermitian connection in the Gauduchon line. In the case of flat holomorphic bundle, the general solution to the Anomaly flow is given for any initial invariant Hermitian metric. The solutions depend on two constants $K_1$ and $K_2$, and we study the qualitative behaviour of the Anomaly flow in terms of their signs, as well as the convergence in Gromov-Hausdorff topology. The sign of $K_1$ is related to the conformal invariant introduced by Fu, Wang and Wu. In the non-flat case, we find the general evolution equations of the Anomaly flow under certain initial assumptions. This allows us to detect non-flat solutions to the Hull-Strominger-Ivanov system on a concrete nilmanifold, which appear as stationary points of the Anomaly flow with respect to the Bismut connection., Comment: 34 pages. Comments are welcome

Osteoarthritis is a type of degenerative joint disease that results from the breakdown of joint cartilage and underlying bone. Due to their antioxidants and anti-inflammatory action, the phytochemical constituents of many vegetable varieties could represent a new frontier for the treatment of patients with Osteoarthritis and are still being explored. The aim of this pilot human study was to investigate the effects of pasta enriched with hemp seed flour on osteoarticular pain and bone formation markers in patients in post-arthroplasty rehabilitation. Another purpose was to evaluate the effect of hemp seed extract on bone metabolism, in vitro. A pilot, controlled, clinical study was conducted to verify the feasibility of pain symptom reduction in patients with Osteoarthritis undergoing arthroplasty surgery. We also investigated the effect of hemp seed extract on the Wnt/β-catenin and ERK1/2 pathways, alkaline phosphatase, RANKL, RUNX-2, osteocalcin, and COL1A on Saos-2. After 6 weeks, the consumption of hemp seed pasta led to greater pain relief compared to the regular pasta control group (−2.9 ± 1.3 cm vs. −1.3 ± 1.3 cm; p = 0.02). A significant reduction in serum BALP was observed in the participants consuming the hemp seed pasta compared to control group (−2.8 ± 3.2 µg/L vs. 1.1 ± 4.3 µg/L; p = 0.04). In the Saos-2 cell line, hemp seed extract also upregulated Wnt/β-catenin and Erk1/2 pathways (p = 0.02 and p = 0.03) and osteoblast differentiation markers (e.g., ALP, OC, RUNX2, and COL1A) and downregulated RANKL (p = 0.02), compared to the control. Our study demonstrated that hemp seed can improve pain symptoms in patients with osteoarthritis undergoing arthroplasty surgery and also improves bone metabolism both in humans and in vitro. However, more clinical studies are needed to confirm our preliminary findings.

Aesthetic and cosmetic medical practices have attracted considerable consumer attention globally. However, possible complications vary and range from mild, self-resolving ecchymoses or edema to more persistent complications. The aim of this review is to identify the nutritional deficits or excesses associated with the major complications of reconstructive surgery, aesthetic surgery, and mini-invasive aesthetic procedures. An additional goal is to provide a bundle of actions for professionals working in the industry in order to reduce the risks of aesthetic procedures and improve the clinical outcomes. Granulomas, hypertrophic scars and keloids, seromas, infections and xerosis, hyperpigmentation, petechiae, livedo reticularis, slower wound healing, and other poor outcomes are frequently associated with nutritional deficiencies. Nutritional status can markedly affect wound healing and tissue repair following surgical interventions, as well as the outcomes of aesthetic and cosmetic medical practices. Professionals working in this industry, therefore, need to consider the nutritional aspects of their patients to obtain the best results.

Mass spectrometry (MS)-based lipidomic has become a powerful tool for studying lipids in biological systems. However, lipidome analysis at the single-cell level remains a challenge. Here, we report a highly sensitive lipidomic workflow based on nanoflow liquid chromatography and trapped ion mobility spectrometry (TIMS)-MS. This approach enables the high-coverage identification of lipidome landscape at the single-oocyte level. By using the proposed method, comprehensive lipid changes in porcine oocytes during their maturation were revealed. The results provide valuable insights into the structural changes of lipid molecules during porcine oocyte maturation, highlighting the significance of sphingolipids and glycerophospholipids. This study offers a new approach to the single-cell lipidomic.