Search

Guided bone regeneration (GBR) has been shown to be an optimal technique to accelerate the bone regeneration process thanks to the action of membrane barriers that promote tissue healing through the process of osteogenesis, inducing the repopulation with osteoprogenitor cells that prevent the invasion of non-osteogenic tissue. However, current membranes, such as expanded polytetrafluoroethylene or rubber dam, have some disadvantages that could potentially reduce the effectiveness of GBR. Recently, some scaffolds with magnetic properties have been tested to promote rapid osteogenesis. The aim of this laboratory study was to evaluate the intensity of the magnetic field generated by a custom-made rubber dam magnetised with neodymium-iron-boron (Nd2F14B) (three layers of latex filled with Nd2F14B powder on the inner surface) and to understand the effects of such a membrane on cell viability. A magnetic field of 750 G, 400 G, and 900 G was generated on the surface and on the long and wide sides of 3 and 2 cm in contact with the rubber dam. At a distance of 1 mm from the magnetic dam, a magnetic field of 300 G, 150 G, and 400 G was measured on the surface and on the long and wide sides of the rubber dam, respectively. After 72 h, the MG-63 osteoblast-like line showed a slight decrease in cell proliferation (85 ± 10) compared with the unmodified dam (95 ± 6) and the cell control population. According to our findings, this magnetic cofferdam is able to generate a static magnetic field and significantly affect cell proliferation in contrast to other nonabsorbable membranes. Further laboratory studies and subsequent clinical trials are needed to evaluate the significant improvements that can be achieved by using this type of magnetic rubber dam in GBR.

Objetivo: identificar as dificuldades vivenciadas nas Unidades Básicas de Saúde pela equipe multiprofissional no atendimento ao usuário queimado. Método: estudo qualitativo, descritivo, realizado com 14 profissionais atuantes em três unidades básicas de saúde no Sul do Rio Grande do Sul. A coleta de dados ocorreu em junho de 2018, por meio de entrevista semiestruturada. Os dados foram tratados por análise temática. Resultados: os multiprofissionais relataram que consideram sua formação insuficiente e que se sentem despreparados para o primeiro atendimento e manejo, repercutindo em estresse e ansiedade, quando surgem queimaduras mais específicas. Identificaram-se relato de discordâncias nas condutas adotadas e a ausência de um protocolo para o manejo apropriado. Pontuaram que a estrutura física e insumos são inadequados. Conclusão: diante das dificuldades vivenciadas para o atendimento ao queimado, é necessário capacitação profissional e um olhar mais próximo pela gestão, para investir em recursos físicos, materiais e protocolos que possibilitem esse atendimento. ABSTRACT Objective: to identify difficulties experienced in Basic Health Units by multiprofessional teams providing care for burn patients. Method: in this qualitative, descriptive study with 14 health personnel working in three basic health units in southern Rio Grande do Sul state, data were collected in June 2018 by semi-structured interview, and treated by thematic analysis. Results: the multiprofessionals reported that they considered their training insufficient and that they felt unprepared to provide first care and management when more specific burns presented, which was reflected in stress and anxiety. There were reports of divergences in procedures adopted and no protocol for appropriate burn management was in place. They pointed out that the physical structure and materials were unsuitable. Conclusion: the difficulties experienced in providing care to burn victims pose a need for training, and closer attention by management with a view to investing in physical resources, materials and protocols to enable this service. RESUMEN Objetivo: identificar las dificultades vividas en las Unidades Básicas de Salud por el equipo multiprofesional en la atención al usuario quemado. Método: estudio cualitativo, descriptivo, realizado junto a 14 profesionales que trabajan en tres unidades básicas de salud en el sur de Rio Grande do Sul. La recolección de los datos se realizó en junio de 2018, mediante entrevista semiestructurada. Los datos fueron tratados por análisis temático. Resultados: los multiprofesionales refirieron que consideraron su formación insuficiente y que no se sentían preparados para el primer cuidado y manejo, lo que reflejaba en estrés y ansiedad, cuando surgían quemaduras más específicas. Se identificaron diferencias en las conductas adoptadas y ausencia de un protocolo para el manejo adecuados. Apuntaron que la estructura física y los insumos son inadecuados. Conclusión: ante las dificultades vividas en la atención de personas quemadas, hace falta una formación profesional y una mirada más cercana por parte de la gestión, en el sentido de invertir en recursos físicos, materiales y protocolos que hagan posible esa atención.

As increasing literature emerges to address text comprehension deficits for students with autism spectrum disorder (ASD), educators often struggle to design interventions resulting in successful generalization of comprehension skills. This evaluative review of literature explored the inclusion of and methods used in generalization of text comprehension research for students with ASD. Authors examined 32 studies across content areas (e.g., English language arts [ELA], math, science) to investigate the following questions: (a) To what extent is generalization addressed across content areas for students with ASD? (b) How did the studies program for generalization? (c) What conclusions can be inferred about effective generalization methods? and (d) Can quality indicators be recommended for generalization methods for text comprehension? Recommendations for quality indicators for generalization measures and strategies are suggested based on the findings from the current review. Implications for future research and instructional practice are also discussed.

Both scripted lessons and unscripted task analyzed lessons have been used effectively to teach science content to students with intellectual disability and autism spectrum disorder. This study evaluated the efficacy, efficiency, and teacher preference of scripted and unscripted task analyzed lesson plans from an elementary science curriculum designed for students with intellectual disability and autism spectrum disorder by evaluating both lesson formats for (a) student outcomes on a science comprehension assessment, (b) sessions to criterion, and (c) average duration of lessons. Findings propose both lesson types were equally effective, but unscripted task analyzed versions may be more efficient and were preferred by teachers to scripted lessons. Implications, limitations, and suggestions for future research are also discussed.

Increased accountability for quality instruction leading to higher achievement for all students has made it essential for identification and implementation of evidence-based practices. The Council for Exceptional Children's development of quality indicators (QI) has provided measures for researchers to apply to a body of literature to determine if a strategy or intervention meets criteria to be considered evidence based. This literature review expands and updates previous findings from research on response cards against specific QI to determine the evidence base for use during classroom instruction in educational contexts. The results of the review suggest response cards meet the specifications of an evidence-based practice for increasing active responding. Findings for potentially increasing achievement levels for students while having a positive impact on social behaviors is discussed.

Euplotin C is a sesquiterpene of marine origin endowed with significant anti-microbial and anti-tumor properties. Despite the promising functional profile, its progress as a novel drug candidate has failed so far, due to its scarce solubility and poor stability in aqueous media, such as biological fluids. Therefore, overcoming these limits is an intriguing challenge for the scientific community. In this work, we synthesized β-cyclodextrin-based nanosponges and investigated their use as colloidal carriers for stably complex euplotin C. Results obtained proved the ability of the carrier to include the natural compound, showing remarkable values of both loading efficiency and capacity. Moreover, it also allowed us to preserve the chemical structure of the loaded compound, which was recovered unaltered once extracted from the complex. Therefore, the use of β-cyclodextrin-based nanosponges represents a viable option to vehiculate euplotin C, thus opening up its possible use as pharmacologically active compound.

Bacterial resistance represents a major health problem worldwide and there is an urgent need to develop first-in-class compounds directed against new therapeutic targets. We previously developed a drug-discovery platform to identify new antimicrobials able to disrupt the protein–protein interaction between the β’ subunit and the σ70 initiation factor of bacterial RNA polymerase, which is essential for transcription. As a follow-up to such work, we have improved the discovery strategy to make it less time-consuming and more cost-effective. This involves three sequential assays, easily scalable to a high-throughput format, and a subsequent in-depth characterization only limited to hits that passed the three tests. This optimized workflow, applied to the screening of 5360 small molecules from three synthetic and natural compound libraries, led to the identification of six compounds interfering with the β’–σ70 interaction, and thus was capable of inhibiting promoter-specific RNA transcription and bacterial growth. Upon supplementation with a permeability adjuvant, the two most potent transcription-inhibiting compounds displayed a strong antibacterial activity against Escherichia coli with minimum inhibitory concentration (MIC) values among the lowest (0.87–1.56 μM) thus far reported for β’–σ PPI inhibitors. The newly identified hit compounds share structural feature similarities with those of a pharmacophore model previously developed from known inhibitors.

Spices, widely used to improve the sensory characteristics of food, contain several bioactive compounds as well, including polyphenols, carotenoids, and glucosynolates. Acting through multiple pathways, these bioactive molecules affect a wide variety of cellular processes involved in molecular mechanisms important in the onset and progress of human diseases. Capparis spinosa L. is an aromatic plant characteristic of the Mediterranean diet. Previous studies have reported that different parts (aerial parts, roots, and seeds) of C. spinosa exert various pharmacological activities. Flower buds of C. spinosa contain several bioactive compounds, including polyphenols and glucosinolates. Two different subspecies of C. spinosa L., namely, C. spinosa L. subsp. spinosa, and C. spinosa L. subsp. rupestris, have been reported. Few studies have been carried out in C. spinosa L. subsp. rupestris. The aim of our study was to investigate the phytochemical profile of floral buds of the less investigated species C. spinosa subsp. rupestris. Moreover, we investigated the effect of the extract from buds of C. spinosa subsp. rupestris (CSE) on cell proliferation, intracellular ROS levels, and expression of the antioxidant and anti-apoptotic enzyme paraoxonase-2 (PON2) in normal and cancer cells. T24 cells and Caco-2 cells were selected as models of advanced-stage human bladder cancer and human colorectal adenocarcinoma, respectively. The immortalized human urothelial cell line (UROtsa) and human dermal fibroblast (HuDe) were chosen as normal cell models. Through an untargeted metabolomic approach based on ultra-high-performance liquid chromatography quadrupole-time-of-flight mass spectrometry (UHPLC-QTOF-MS), our results demonstrate that C. spinosa subsp. rupestris flower buds contain polyphenols and glucosinolates able to exert a higher cytotoxic effect and higher intracellular reactive oxygen species (ROS) production in cancer cells compared to normal cells. Moreover, upregulation of the expression of the enzyme PON2 was observed in cancer cells. In conclusion, our data demonstrate that normal and cancer cells are differentially sensitive to CSE, which has different effects on PON2 gene expression as well. The overexpression of PON2 in T24 cells treated with CSE could represent a mechanism by which tumor cells protect themselves from the apoptotic process induced by glucosinolates and polyphenols.

Introduction: The professional self is often hindered by a lack of self-care and poor work-life balance, and cannot be considered an unlimited resource. Given this, the reflexive team is an important organizational tool for protecting workers' well-being. The non-profit organization Maestri di Strada (MdS) (“Street Teachers”) conducts action research (AR) in the area of socio-education. The main tool used by the group to protect the well-being of its members is a guided reflexivity group, inspired by the Balint Group and termed the Multi-Vision Group (MG). In March 2020, because of the COVID-19 lockdown, the MdS team had to quickly revamp its working model, and MGs were held online for the first time.Aim: Through qualitative research that takes a longitudinal approach, the aim of this study is to evaluate the efficacy of the MG in supporting the team's reflexivity in this new online format.Methods: This article considers MGs during two different time periods: pre-pandemic (T1) and early pandemic (T2). During T1, the MdS team met 18 times in person, while during T2 the team met 12 times through an online platform (always under the guidance of a psychotherapist). During all sessions in both time periods, a silent observer was present in the meetings, and they subsequently compiled narrative reports. The textual corpora of the reports were submitted for a Thematic Analysis of Elementary Contexts through T-Lab Plus, in order to examine the main content of the groups' discourse.Results: The results (five clusters in T1; and five in T2) show that, during T2, the group devoted considerable time to experiences tied to the pandemic (T21: schools facing the pandemic crisis; T2.2: the pandemic: death, inner worlds, and thought resistance; T2.3: kids' stories involving physical distancing and emotional proximity). The group also came up with innovative educational initiatives that defied the lockdown (T2.4: fieldwork: the delivery of “packages of food for thought”; T2.5: the MdS group: identity and separation). Based on these findings, the MG most likely contributed to the emergence of MdS as a “resilient community,” capable of absorbing the shock of the pandemic and realizing a fast recovery response.

Abstract Sub-macular hemorrhage (SMH) is a hematic collection between the neurosensory retina and the retinal pigment epithelium; one of its causes is ocular blunt trauma, that usually affects young patients. Persisting SMH leads to a damage of photoreceptors mediated by three main mechanisms: iron-related toxicity, impairment of diffusion of oxygen and nutriment, mechanical damage due to clot contraction. Since early photoreceptors’ damage has been reported within 24 h, it is suggested to provide an early treatment, although there are no guidelines or consensus between authors regarding treatment strategies. The aim of this review was to present and compare available treatment options, like intravitreal tissue plasminogen activator (tPA) associated with pneumatic displacement, pneumatic displacement alone, subretinal tPA injection with pneumatic displacement, and intravitreal anti-vascular endothelial growth factor (VEGF) injection. All procedures obtained consistent results, though the most effective seemed to be pars plana vitrectomy, subretinal tPA and gas tamponade, probably due to a quicker liquefaction and displacement of the clot. Limitations concern the greater invasiveness and the higher incidence of complications. Alternatively, intravitreal injection of tPA and gas may represent a less invasive option with fewer complications. Intravitreal injection of gas and prone position could be preferred in young patients without coexisting ocular pathology, being a minimally invasive treatment, with lower risk of complications and a good visual recovery. Anti-VEGF agent have found, to date, limited employment in cases of traumatic SMH even though they may be useful as alternative or adjuvant therapy. Most of the published literature consists of small studies and case reports, therefore further investigations and larger clinical trials are required to fully understand safety and efficacy of the procedures. A preoperative comprehensive evaluation may be helpful to realize a surgical plan tailored on patient.

Marine litter is one of the main sources of anthropogenic pollution in the marine ecosystem, with plastic representing a global threat. This paper aims to assess the spatial distribution of plastic macro-litter on the seafloor, identifying accumulation hotspots at a northern Mediterranean scale. Density indices (items km–2) from the MEDITS trawl surveys (years 2013-2015) were modelled by generalized additive models using a Delta-type approach and several covariates: latitude, longitude, depth, seafloor slope, surface oceanographic currents and distances from main ports. To set thresholds for the identification of accumulation areas, the percentiles (85th, 90th and 95th) of the plastic spatial density distribution were computed on the raster data. In the northern Mediterranean marine macro-litter was widespread (90.13% of the 1279 surveyed stations), with plastic by far the most recurrent category. The prediction map of the plastic density highlighted accumulation areas (85th, 90th and 95th percentiles of the distribution, respectively, corresponding to 147, 196 and 316 items km–2) in the Gulf of Lions, eastern Corsica, the eastern Adriatic Sea, the Argo-Saronic region and waters around southern Cyprus. Maximum densities were predicted in correspondence to the shallower depths and in proximity to populated areas (distance from the ports). Surface currents and local water circulation with cyclonic and anticyclonic eddies were identified as drivers likely facilitating the sinking to the bottoms of floating debris.

A new approach to recruitment overfishing diagnosis is presented. We hypothesize that condition of recruits should increase when recruitment failures are caused by fishing activity. This would be a consequence of the increase in trophic resource availability, because the population is smaller than that which the ecosystem could support. Temporal series of hake recruit condition were calculated from MEDITS survey data collected in Mediterranean geographical sub-areas (GSAs) 1, 6, 17 and 19 from 1994 to 2015. Multiple linear regressions were used to analyse the relationship between mean annual condition and abundance of recruits and climatic indices in each GSA. Significant correlations were only detected in GSA 6, where 69% of condition variability was explained by the negative correlation with recruit abundance, and with two climatic indices, the Western Mediterranean Oscillation and the standardized air temperature anomaly at surface from the Gulf of Lions. Despite the differences in recruit abundance among GSAs, their mean annual condition oscillated around the same basal value during most of the time series, pointing to density-dependent mortality rates as an important mechanism stabilizing hake recruitment to levels close to the carrying capacity when populations do not suffer recruitment overfishing. This pattern changed when the decreasing recruit abundance trend drove GSA 6 condition values persistently above those of the rest of the GSAs. According to our hypothesis, hake in GSA 6 is in recruitment overfishing.

Fraud actions at institutions can catapult health costs. Globally, the potential loss due to fraud is estimated at 7,29% every year. Increasing the number of referrals in advanced health facilities FKTL is an indication of fraud behavior. In Southeast Sulawesi, the referral rate is high, reaching 17% with the maximum ideal standard for the average referral rate of first level health facilities(FKTP) to advanced health facilities(FKTL), not more than 5%. While in Kendari City in 2015, the referral rate from Puskesmas to Abunawas General Hospital was also still high at around 9.5% in 2015 and an increase of 15.3% in 2016. One of the puskesmas that provided referrals was Abeli ​​Community Health Center. This study aims to analyze the potential for fraud prevention in the implementation of National health insurance(JKN) at Abeli ​​Health Center. This study using observational analytic using one group pre test and post test design. Research was conducted at Abeli ​​Health Center and technique used was cluster random sampling with 28 respondents. From the statatistic test results obtained, there were differences in knowledge before and after the intervention with a mean gap value of 0, 21429 with a lower limit of 0.05226 and an upper limit of 37631 and a p value

Filamentous fungi were isolated from ten spices collected from markets in Indonesia. The aim was to enumerate fungal contamination and to determine the toxigenicity of Aspergillus flavus strains on each of the spices. Viable fungal populations were determined using a dilution method. Toxigenicity of Aspergillus flavus was determined by culture on a quick screening coconut agar and by PCR using four sets of primers specific for aflatoxin pathway genes. All the tested spices were contaminated by storage fungi, Species of Aspergillus was the most commonly isolated moulds followed by species of Fusarium, Mucor, Penicillium and Rhizopus. The greatest number of Aspergillus flavus isolates were found on white pepper, followed by nutmeg, cardamom, and black pepper. The greatest number of Aspergillus chevalieri isolates were found on coriander, followed by nutmeg. Fifty strains of A. flavus were isolated, all of the strains produced large sclerotia and biseriate conidiophores. Their toxigenicity was assayed by the presence of yellow pigment on a quick screening coconut agar medium and PCR amplification of regulatory and structural genes in the aflatoxin pathway.

First-line drugs (Isoniazid and Rifampicin) for the treatment of tuberculosis are known to have experienced resistance to Mycobacterium tuberculosis. The aim of this study was to determine the minimum inhibitory concentration (MIC) of maltodextrin encapsulated rosella calyx extract and its ability to provide a synergistic effect with Isoniazid (INH) and Rifampicin (RIF) on M. tuberculosis R37rv. Rosella calyxs were macerated using 50% ethanol and encapsulated using maltodextrin. Antibacterial activity was carried out by determining MIC value using Microscopic Observation and Direct Susceptibility (MODS) method. The synergistic effect was carried out by calculating the Fractional Inhibition Concentration Index (FICI). The results showed that this extract was able to inhibit M. tuberculosis H37rv with MIC of 10 mg/ ml. The FICI value of the combination of extract with INH and rifampicin was obtained 1.25. This showed that rosella calyx extract is not synergistic with INH and rifampicin, might be due to rosella calyx extract has an antibacterial effect with a different mechanism with INH and Rifampicin.

Fungi endofit merupakan mikroba yang hidup di dalam jaringan tanaman tanpa menimbulkan efek negatif serta mampu menghasilkan senyawa yang sama dengan yang dihasilkan oleh tanaman inangnya. Secang (Caesalpinia sappan L) merupakan salah satu tanaman obat yang telah diketahui memiliki kandungan senyawa dengan aktivitas antioksidan sehingga mendorong hipotesis bahwa fungi endofit yang ada di dalamnya dapat menghasilkan efek antioksidan yang serupa. Pada penelitian ini, isolasi fungi endofit dari kayu secang sebagai penghasil senyawa antioksidan telah dilakukan. Pada tahap awal, isolasi fungi endofit dari akar, batang, ranting dan daun dilakukan dengan metode agar cawan. Isolat murni selanjutnya diproses melalui proses fermentasi menggunakan media PDB+Ekstrak Yeast dan dishaker selama 12 hari pada kecepatan 200 rpm untuk memproduksi senyawa metabolit sekunder. Fermentat yang diperoleh kemudian diekstraksi dengan etyl asetat untuk memperoleh ekstrak yang akan diuji aktivitas antioksidannya. Dalam penelitian ini diperoleh 19 isolat dari empat bagian tanaman dimana lima isolat fungi, dengan kode IFA01, IFA02, IFD01, IFD04, dan IFR05 diketahui memiliki aktivitas antioksidan yang terlihat dengan adanya spot kuning pada kromatografi. Isolat dengan kode IFA 1 dan IFD4 memiliki aktivitas antioksidan yang paling baik.

Introduction: The emergence of antibiotic-resistant Staphylococcus aureus is a major threat for worldwide communities. To overcome such serious problem, the discovery of novel antibacterial agents through exploration of diverse potential sources is essential. The aim of this research was to investigate the in vivo anti-staphylococcal activity of roselle (Hibiscus sabdariffa L.) calyx extract against S. aureus in fruit flies (Drosophila melanogaster) model of infection. Methods: Roselle calyces were dried and extracted with ethanol using maceration method. Wildtype fruit flies were infected with S. aureus and subjected to survival assay, bacterial load examination, and gene expression analysis, in the presence or absence of roselle calyx extract. Survival and bacterial load analysis were subsequently performed on immunodeficient fruit flies using similar protocols. Results: Reduction of host survivorship accompanied by increasing level of bacterial proliferation was observed in group of wildtype fruit flies infected with S. aureus. These phenotypic events were further augmented in mutant flies devoid of component for antibacterial immune responses. Nevertheless, reduction of bacterial load and improvement of host survival were demonstrated in either wildtype or immunodeficient fruit flies upon treatment with roselle calyx extract after bacterial challenge, irrespective of immune status. Conclusion: Collectively, our results demonstrated the in vivo antibacterial activity of roselle calyx extract against S. aureus in Drosophila model of infection and this was not due to induction of immune response in the host.

Background: Percutaneous left atrial appendage occlusion (LAAO) is indicated in subjects with atrial fibrillation who cannot receive oral anticoagulants. This procedure requires transesophageal echocardiography guidance and is usually performed under general anesthesia. The Janus Mask is a new device designed to allow upper endoscopic procedures during noninvasive ventilation (NIV). Aims: This study aims to assess the possibility of performing LAAO under sedation and NIV. Setting: Cardiac electrophysiology laboratory. Design: Case–control study. Materials and Methods: Data from 11 subjects undergoing LAAO under sedation and NIV with the Janus Mask were retrospectively collected. Procedure duration, outcomes, and physicians' satisfaction were compared with those of 11 subjects who underwent LAAO under general anesthesia in the same period. Statistical Analysis: Univariate analysis and analysis of variance for between-groups comparison. Results: The 11 subjects treated with sedation experienced a good outcome, with a high degree of satisfaction from the medical team. An increase in arterial partial pressure of carbon dioxide in the Janus group (45 [43–62] mmHg vs. 33 [30–35] mmHg in the general anesthesia group, P < 0.001) led to a transient pH decrease 45 min after the beginning of the procedure (7.30 [7.18–7.36] vs. 7.40 [7.39–7.46], P = 0.014). No differences in arterial partial pressure of oxygen, FiO2, and hemodynamic parameters were observed. The subjects' conditions at discharge from the recovery room were comparable. No difference in procedure duration was registered. Conclusions: LAAO procedure under sedation and NIV through the Janus Mask is safe and feasible. This strategy might represent a valuable alternative to manage such a compromised and fragile population.

Gastrointestinal (GI) neoplasms include esophageal, gastric, colorectal, hepatic, and pancreatic cancers. They are characterized by asymptomatic behavior, being responsible for diagnostic delay. Substantial refractoriness to chemo- and radiotherapy, exhibited by late-stage tumors, contribute to determine poor patient outcome. Therefore, it is of outmost importance to identify new molecular targets for the development of effective therapeutic strategies. In this study, we focused on the enzyme nicotinamide N-methyltransferase (NNMT), which catalyzes the N-methylation reaction of nicotinamide and whose overexpression has been reported in numerous neoplasms, including GI cancers. The aim of this review was to report data illustrating NNMT involvement in these tumors, highlighting its contribution to tumor cell phenotype. Cited works clearly demonstrate the interesting potential use of enzyme level determination for both diagnostic and prognostic purposes. NNMT was also found to positively affect cell viability, proliferation, migration, and invasiveness, contributing to sustain in vitro and in vivo tumor growth and metastatic spread. Moreover, enzyme upregulation featuring tumor cells was significantly associated with enhancement of resistance to treatment with chemotherapeutic drugs. Taken together, these results strongly suggest the possibility to target NNMT for setup of molecular-based strategies to effectively treat GI cancers.

Objective: The purpose of this study will be to review several studies regarding the repair or treatment of perineal tears after vaginal delivery. This is expected to be an update for a midwife in daily caring. Methods: Two electronic databases (PubMed and Sciencedirect) were searched to locate relevant literature about perineal tears/wound/laceration/trauma that is published in 2016–2021. 124 Pubmed articles and 452 ScienceDirect articles filtered successfully. The articles that have been obtained will be evaluated based on the inclusion criteria in this study. We summarize place and date, objective, design, samples, the measurement used, and research results. Results: 9 articles were found that matched the inclusion criteria. Three articles examined the effect of the type of suture on perineal pain, and another 6 discussed therapy to reduce the adverse effects of perineal tears. The therapies used are far-infrared radiation therapy, capacitive-resistive radiofrequency therapy, pelvic floor muscle training in early postpartum, cold therapy, and treatment with TheresienOl (natural oil). Conclusion: Sutures and technique/suturing second-degree perineal tears or a postpartum episiotomy can affect perineal pain. Cold gel pad therapy and treatment with natural oil on perineal wounds can affect perineal pain and wound healing.

Objective: The results of the self-assessment assessment at the Lalolae Public Health Center which was the target of the 2017–2019 accreditation assessment in East Kolaka Regency showed that most of the low scores were in the administration and management group. This study aims to determine the relations between the readiness of accreditation documents in the Administration and Management Working Group on the accreditation results of the Lalolae Public Health Center in East Kolaka Regency. Methods: This type of research is quantitative using a cross sectional design. The number of samples in this study were all people in charge of the administrative and management working group at the Lalolae Public Health Center who were determined by the purposive sampling method. This research was carried out from May 1 to July 20, 2020 and took place at the Lalolae Health Center. The sample in this study is 30 respondents. Results: There are 3 documents in chapter I that have unfulfilled categories, there are 4 documents in chapter ii that have unfulfilled categories, and there are 4 documents in chapter III that have unfulfilled categories. Conclusion: There is a relation between the readiness of accreditation documents in the administration and management groups to the results of accreditation of Public Health Center.

Recently researchers have begun exploring the efficacy of interventions designed to improve text comprehension skills for students with developmental disabilities (DD). Text comprehension is essential for understanding academic content as students with disabilities make progress in the general education curriculum. This article focuses on single case design (SCD) studies of interventions and supports for improving text comprehension skills for students with DD. Specifically, the article examines elements essential for rigorous single case design research in this area. After reviewing the research, we provide recommendations for improving rigor of research in this area.

Background: Total mesorectal excision (TME) is the gold standard to treat locally advanced rectal cancer. This monocentric retrospective study evaluates the results of laparotomic, laparoscopic and robotic surgery in “COMRE GROUP” (REctalCOMmittee). Methods: 327 selected stage I-II-III patients (pts) underwent TME between November 2005 and April 2020 for low or middle rectal cancer; 91 pts underwent open, 200 laparoscopic and 36 robotic TME. Of these, we analyzed the anthropomorphic, intraoperative, anatomopathological parameters and outcome during the follow up. Results: The length of hospital stay was significantly different between robotic TME and the other two groups (8.47 ± 3.54 days robotic vs. 11.93 ± 5.71 laparotomic, p < 0.001; 8.47 ± 3.54 robotic vs. 11.10 ± 7.99 laparoscopic, p < 0.05). The mean number of harvested nodes was higher in the laparotomic group compared to the other two groups (19 ± 9 laparotomic vs. 15 ± 8 laparoscopic, p < 0.001; 19 ± 9 laparotomic vs. 15 ± 7 robotic, p < 0.05). Median follow-up was 52 months (range: 1–169). Overall survival was significantly shorter in the open TME group compared with the laparoscopic one (Chi2 = 13.36, p < 0.001). Conclusions: In the experience of the “COMRE” group, laparoscopic TME for rectal cancer is a better choice than laparotomy in a multidisciplinary context. Robotic TME has a significant difference in terms of hospital stay compared to the other two groups.

In Mexico, as part of the historical and political context, race heavily influences a person’s opportunities. Moreover, the data refer to a scenario of normalized gender-based violence caused by sociocultural practices, the lack of application of the laws, and structural discrimination. Given this precedent, the purpose of this study is to analyze the social and physical dimensions of gender-based violence in an Afro-Mexican community in the south of Mexico. The techniques used to gather data for this study consist of a variety of styles of interviews with a group of Afro-Mexican women from the Costa Chica of Oaxaca, who are survivors of gender-based violence, and participant observation obtained through conducting ethnographic fieldwork in Oaxaca. The social phenomena of emigration and alcohol and drug consumption, in combination with the cultural dimensions of the machista practices in this region of Mexico, are the material and immaterial spaces where GBV is produced and reproduced daily. An intersectional perspective of the context can be helpful when collecting data for effective and well-grounded public policies and intervention projects established on a feminist and women-centered perspective.

The source of Islamic banking capital must avoid interest as the vision and mission that relies on al-Quran and hadith. The capital structure is important for financial institutions, including Sharia Rural Bank (BPRS). However, BPRS has a problem that is the limited capital owned so that it affects performance. This paper's main objective is to investigate the relationship between capital structure and performance of the Islamic Rural Banks (BPRS) in Indonesia. The study using panel data regression to measure the capital structure on performance. The research sample used 164 BPRS that operate in 33 provinces from 2010 until 2017. The results show that capital structure affects DER (debt to equity ratio) and DAR (debt to asset ratio) but negatively affects ETA (equity to total Asset ratio). These findings indicate an increase in the capital structure of the performance of the BPRS in Indonesia. Hence, bank managers must reach a trade-off between the advantages and disadvantages of creating liquidity and consider the negative relationship between liquidity creation and bank performance when making decisions.

The rise of antibiotic-resistant Staphylococcus aureus-related clinical cases is an alarming chronicle for global communities. This research was conducted to examine the antistaphylococcal effect of roselle (Hibiscus sabdariffa L.) calyx fractions in the Drosophila model. In the infection experiment, wild-type and immunodeficient Drosophila were pricked with S. aureus and subsequently subjected to fly survivorship and colony-forming assays, in the presence or absence of roselle calyx fractions. The Involvement of immune stimulation in the host antibacterial protection was assessed in vitro using cell-based luciferase reporter assay and in vivo using RT-qPCR analysis on adult flies. A declining rate of fly survivorship and augmentation of bacterial growth were observable in S. aureus-infected wild-type flies but subject to improvement in the presence of roselle calyx fractions. Cell-based analysis revealed the absence of host immune stimulation via Drosophila Toll pathway and roselle calyx fractions-treated immune-deficient flies lacking for components in the Toll pathway were protected from infection-induced early death phenotype and harbored reduced number of S. aureus colonies. Overall, our data confirmed the in vivo anti-staphylococcal activity of roselle calyx fractions in Drosophila infection model and such protective signature was devoid of host immune stimulation.

This study investigates the dispersion of atmospheric pollutants over a coastal region of north-western Italy by means of modelling techniques. A series of annual air quality model simulations corresponding to different emission reduction scenarios has been performed with a three-dimensional chemical transport modelling chain running at 3 km resolution. The emission reduction scenarios were used to develop bottom-up (locally produced) source-receptor relationships to perform a local source allocation analysis of the main atmospheric pollutants in a few polluted cities within the domain of interest. Results were compared with default top-down (EU-wide) source-receptor relationships, at roughly 7 km resolution. The results show the benefit of using the two sources of information in an integrated way. The analysis of the impacts of local emission reductions on concentrations and of the source allocation results reveals that nitrogen oxides concentrations are mostly affected by local emission sources, especially road transport and harbour related activities while the contribution of non-local sources is important for particulate matter (especially from industry and agriculture sources). For PM, larger scale modelling approaches (top-down) are necessary. Ideally, both a bottom-up approach for the characterisation of the local emission sources and a top-down larger scale approach to capture the impact of non-local sources would be necessary to perform an accurate source allocation, and provide support to the design of local air quality plans.

Abstract Introduction To prevent the shrinkage stresses produced during polymerization, composite resins of low polymerization shrinkage were developed. Objective To evaluate the microtensile bond strength in class I cavities restored by acid-etching the cavosurface angle and with composite resins indicated for posterior teeth. Material and method 48 healthy molars were selected and divided into six groups (n = 8), considering that the cavosurface enamel of three groups was etched with 35% phosphoric acid. The teeth were restored with the Clearfil SE Bond adhesive system and Filtek Z350 XT, Empress Direct, and Charisma Diamond composite resins, which were light-cured for 40 seconds. After 24 hours, the teeth were taken to a cutting machine, which produced sections in the buccolingual and mesiodistal directions. This resulted in toothpicks of 0.9×0.9 mm that were taken to the universal testing machine for the microtensile bond strength test. Statistical analysis was performed with ANOVA and Tukey’s test (p < 0.05). Result There was no statistically significant difference between the groups evaluated. Conclusion Acid-etching the cavosurface angle did not affect the performance of restorations, probably due to the adhesive system used.

Abstract Objective To clinically assess the effect of desensitizing gels and dentifrices on the reduction in pain sensitivity and color variation during tooth bleaching. Methodology A total of 108 volunteers were randomly separated into the following groups of n=12: GT/S-glycerine and thickener/sucralose; NF/S-potassium nitrate and sodium fluoride/sucralose; NA/S-potassium nitrate and arginine/sucralose; GT/AC-glycerine and thickener/arginine and calcium carbonate; NF/AC-potassium nitrate and sodium fluoride/arginine and calcium carbonate; NA/AC-potassium nitrate and arginine/arginine and calcium carbonate; GT/PN-glycerine and thickener/potassium nitrate; NF/PN-potassium nitrate and sodium fluoride/potassium nitrate; and NA/PN-potassium nitrate and arginine/potassium nitrate. Sensitivity was assessed with the numerical analogue scale, and color variation (ΔE) was measured with a spectrophotometer. The sensitivity values obtained were subjected to a multivariate analysis of variance (MANOVA) and color variation values were subjected to a randomized analysis of variance (p

This type of research was Participatory Action Research using the Denzin and Lincoln (2005) model which consists of the Kahoot pre-action cycle and post-action cycle. This study aimed to examine the use of Kahoot Platform in Maritime English learning. It improved the speaking skill of nautical science cadets by the increasing number of maritime vocabularies as an indication. The results of this study described that the use of Kahoot quiz made learning experienced in the classroom very interactive, interesting, and effective, because of the two cycles carried out increased from the beginning of the cycle to the next cycle marked by the increasing number of correct answers done by the cadets. Thus, their vocabulary mastery increased as well. Kahoot not only increased vocabularies that supported cadet’s speaking skill initiated by the correct oral reproduction, but also increased cadet’s enthusiasm in learning Maritime English. In conclusion, the use of online gamification-based Kahoot quiz toward nautical science cadets at Sekolah Tinggi Maritim Yogyakarta had a significant impact on vocabulary mastery for effective communication skills.

Background and aims We evaluated a naturalistic language intervention (NLI) targeting expanded forms of expressive communication (e.g., two-word phrases) for elementary-aged children with autism spectrum disorder (ASD) and/or intellectual disability (ID). This study extends the findings of a previous study that evaluated an NLI for preschool-aged children who displayed social communication delays. In the previous study, one child was considered a non-responder to the original intervention; children with similar pre-intervention profiles to the non-responder were recruited for this study to evaluate a modified version of the NLI with a new participant group. Methods The NLI was evaluated within the context of a multiple probe design across children, with sessions conducted in a public school classroom. The modifications to the NLI resulted in varying dosages of the intervention provided across sessions and children. To analyze the moderating influence of the variation in dosage, we graphed each dosage variable to allow for a formative analysis of changes within and across study conditions. Results Results indicated increases in the target behavior for all three children when compared to probe sessions; however, for one child the consistency of changes were variable and, as such, may not be socially significant. Conclusions and implications This study extends the literature on conducting NLIs with minimally verbal children with ASD and ID in dynamic settings, like classrooms. Educators and related professionals can capitalize on natural opportunities for social communication in children who are minimally verbal but imitative by using naturalistic procedures to promote verbalizations during age-appropriate activities.

The skin is constantly exposed to exogenous and endogenous sources of reactive oxygen species (ROS). An adequate balance between ROS levels and antioxidant defenses is necessary for the optimal cell and tissue functions, especially for the skin, since it must face additional ROS sources that do not affect other tissues, including UV radiation. Melanocytes are more exposed to oxidative stress than other cells, also due to the melanin production process, which itself contributes to generating ROS. There is an increasing amount of evidence that oxidative stress may play a role in many skin diseases, including melanoma, being the primary cause or being a cofactor that aggravates the primary condition. Indeed, oxidative stress is emerging as another major force involved in all the phases of melanoma development, not only in the arising of the malignancy but also in the progression toward the metastatic phenotype. Furthermore, oxidative stress seems to play a role also in chemoresistance and thus has become a target for therapy. In this review, we discuss the existing knowledge on oxidative stress in the skin, examining sources and defenses, giving particular consideration to melanocytes. Therefore, we focus on the significance of oxidative stress in melanoma, thus analyzing the possibility to exploit the induction of oxidative stress as a therapeutic strategy to improve the effectiveness of therapeutic management of melanoma.

The most common type of skin cancer is melanoma. While significant advances in chemotherapy have occurred in a few instances, only marginal progress has been made in treating metastatic melanoma. Natural medicine has traditionally been used to treat various illnesses, including cancer. The purpose of this study was to identify the active compound in Kaempferia galanga, which could be used to treat melanoma as an anti-metastasis and chemosensitizer agent. The active compound in K. galanga was isolated and identified using chromatography and spectroscopy techniques, and given six compounds. Inhibitory activity on NFκB activation and cell viability was determined using reporter assay methods. Among the isolated compounds, ethyl p-methoxycinnamate (EPMC) demonstrated potent NFκB inhibitory activity against melanoma cell B16F10- NFκB Luc2 with an IC50 of 88.7 μM. Further investigation was conducted by evaluating the anti-metastasis effect of EPMC in vitro by using wound-healing assays, invasion tests, and molecular mechanism assays using Western blotting. NFκB has been implicated in tumorigenesis through the PI3K/Akt/NFκB pathway. The results of this study indicated that EPMCs act as inhibitors of p38 and thereby Akt phosphorylation inhibitors at serine 473, inhibiting NFκB-dependent transcription. Further analysis with paclitaxel demonstrated that the combinations could sensitize to apoptosis in response to well-known chemotherapy agents. Additional studies were conducted using the human melanoma cancer cell line SK-Mel 28. Along with the induction of apoptosis, we observed an increase in p-γH2AX expression (a molecular marker for double strand breaks in DNA damage) in response to treatment with paclitaxel and EPMC. The result showed EPMC to be a potential, viable adjuvant for improving the clinical efficacy of anti-metastatic and cancer chemotherapy.

Drug discovery is a complex process, and the use of a comprehensive approach is deemed necessary to discover new chemical entities with novel mechanisms of action. This research was carried out to determine whether Drosophila melanogaster can serve as an appropriate model organism in the initial screening of drug candidates with immunomodulatory activities. To test this, we performed phenotypic assay and molecular analysis to investigate the immunomodulatory activities of aspirin, dexamethasone, curcumin, and epigallocatechin gallate (EGCG), that have been reported to yield such effects in the mammalian model system. In vivo survival analysis demonstrated that all drugs/compounds were relatively safe at the tested concentrations. In the infection assay, curcumin and EGCG showed a protective signature to bacterial infection in flies lacking Toll-mediated immune responses. Furthermore, dexamethasone and aspirin, drugs with immunosuppressive activity, could improve the survival of PGRP-LBΔ mutant flies with hyperactivated immune system. These phenotypes were supported by RT-qPCR-based molecular analysis, revealing that drugs/compounds used in this study could modulate the expression level of genes related to the immune system. In conclusion, while curcumin and EGCG could promote the improvement of fly survival against infection, aspirin and dexamethasone were able to suppress overactivation of immune responses in D. melanogaster. These results are in line with the ones observed in the mammalian model system, further emphasizing the notion that flies would serve as a prospective model organism in the initial screening of drug candidates for their immunomodulatory activities prior to further checking in the mammalian animal models. In the end, this will reduce the use of mammalian animal models for preliminary experiments in an effort to discover/repurpose drugs with immunomodulatory activity.