Group B2 Research Articles

CHANGES IN CIRCADIAN CHARACTERISTICS OF PATIENTS WITH PARKINSON DISEASE AFTER CORRECTION OF POOR SLEEP QUALITY USING MELATONIN: AN OPEN-LABEL CONTROLLED RANDOMISED TRIAL

Introduction. Recent studies are increasing the amount of evidence suggesting that the circadian system is disrupted in Parkinson's disease that can lead to poor sleep. Currently, international guidelines for managing non-motor symptoms of Parkinson's disease do not have recommendations with proven efficacy, but only methods with potential benefit. Two of the most widely available methods for correcting poor sleep quality in patients with Parkinson's disease in Ukraine are sleep hygiene training, also known as somnoeducation, and melatonin administration. The aim of the study is to compare the state of circadian characteristics before and after the correction of poor sleep quality in patients with Parkinson's disease in the context of sleep hygiene and an integrated approach with the implementation of chronotherapy using melatonin. Materials and methods. We conducted a clinical trial at the Centre for Patients with Parkinson's Disease and Other Neurodegenerative Diseases, which included 34 patients with poor sleep quality who were randomised into 2 groups: group 1a (n = 17) consisted of patients with Parkinson's disease who followed sleep hygiene rules and received chronotherapy; group 1b (n = 17) involved patients with Parkinson's disease who followed sleep hygiene rules but did not take any medications to improve sleep. Circadian characteristics were analysed using the Munich Chronotype Questionnaire. Results. Our study has found that the correction of poor sleep quality by introducing sleep hygiene into the treatment process of patients with Parkinson's disease demonstrates a shift in the time of sleep onset and mid-sleep to earlier, accompanied by a shift in chronotypes towards earlier, as well as an increase in sleep duration against a decrease in the time spent in bed, which led to an increase in the average actual sleep efficiency. At the same time, melatonin supplementation helps to reduce sleep latency in Parkinson's disease. Conclusions. Adherence to sleep hygiene recommendations contributes to changes in circadian characteristics and improves sleep efficiency in patients with Parkinson's disease, regardless of melatonin administration. Additional use of melatonin to correct the quality of sleep for 1 month is accompanied by a reduction in the sleep latency period.

Iron parameters analysis in dogs with myxomatous mitral valve disease.

Myxomatous mitral valve disease (MMVD) is the most common acquired cardiovascular disease in small breed dogs. In contrast to human patients with heart failure (HF), iron deficiency (ID) prevalence in dogs with MMVD is weakly known. The study aimed to assess the usability of ID markers in serum and reticulocyte parameters from whole blood of dogs with MMVD to evaluate early ID symptoms. Sixty-eight dogs (43 male and 25 female) were included in the study. MMVD dogs were assigned according to the 2019 ACVIM guidelines for groups B1 (n = 9), B2 (n = 10), C (n = 27) and D (n = 10). Groups were also combined into B1 and B2 as non-symptomatic HF and C with D as symptomatic HF. Healthy controls were 12 dogs. Serum iron concentration below the reference range in dogs with MMVD was 12.5%. Other ID indices, such as %SAT, UIBC, and TIBC were similar in the MMVD groups and healthy controls (p > 0.05 for all parameters). Statistical comparison between control group and 4 groups of different stages of MMVD showed that significant differences occur only in serum transferrin. The assessment of ferritin and soluble transferrin receptors using Western Blotting did not show differences between control (n = 7) and MMVD (n = 33) dogs. Study has shown positive correlation between ID parameters and echocardiographic indices such as LA/Ao and LVIDdN, and some biochemical parameters. A significant increase in reticulocytes percentage, assessed manually, was observed in the HF group of animals (p = 0.027) compared to the control group. Studies have shown that ID parameters in serum are not significantly different in dogs with MMVD compared to healthy dogs. However, there is a clear correlation between atrial size and normalised left ventricular size to body size and some biochemical parameters, including ID parameters and therefore the severity of MMVD.

Intratubular Penetration Depth of Ultrasound Activated Bioceramic Sealant Cements at the Dentin-Radicular Cement Interface

To evaluate the intratubular penetration depth of ultrasound-activated bioceramic sealant cements into root dentin, specifically at the dentin-cement interface. This in vitro experimental study was conducted with samples that were randomly divided based on the type of sealer used and whether ultrasound activation was applied prior to obturation. This resulted in four experimental groups (n=40). Groups A1 and B1 utilized the Eighteeth Ultra X ultrasonic activator with a blue tip #20 featuring a 2% taper at low power for activation, while groups A2 and B2 did not employ any form of activation. The symbol (+) denotes groups with ultrasonic activation, while (-) represents groups without ultrasonic activation. In the middle third, it was observed that BioC Sealer (+) had a mean sealing value of 0.66±0.17, while MTA Fillapex (+) showed a mean value of 0.38±0.07. It was found that BioC Sealer (-) had a mean sealing value of 0.24±0.04 in the middle third, while MTA Fillapex (-) showed a mean value of 0.16±0.04. These differences were not statistically significant (p=0.569). In the apical third, the BioC Sealer (-) presented a mean sealing value of 0.44±0.17, while the MTA Fillapex (-) obtained a mean value of 0.30±0.04. However, this difference did not reach statistical significance (p=0.0745), suggesting that both materials can provide a similar seal in the apical third. The results suggest that both BioC Sealer and MTA Fillapex provide a comparable seal in the middle and apical thirds of the root canal system, however, this was not statistically significant. This indicates their potential efficacy in both endodontic sealing procedures.

Best anticoagulation strategy with and without appendage occlusion for stroke-prophylaxis in postablation atrial fibrillation patients with cardiac amyloidosis.

Both atrial fibrillation (AF) and amyloidosis increase stroke risk. We evaluated the best anticoagulation strategy in AF patients with coexistent amyloidosis. Consecutive AF patients with concomitant amyloidosis were divided into two groups based on the postablation stroke-prophylaxis approach; group 1: left atrial appendage occlusion (LAAO) in eligible patients and group 2: oral anticoagulation (OAC). Group 1 patients were further divided into Gr. 1A: LAAO + half-does NOAC (HD-NOAC) for 6 months followed by aspirin 81 mg/day and Gr. 1B: LAAO + HD-NOAC. In group 1 patients, with complete occlusion at the 45-day transesophageal echocardiogram, patients were switched to aspirin, 81 mg/day at 6 months. In case of leak, or dense "smoke"in the left atrium (LA) or enlarged LA, they were placed on long-term half-dose (HD)NOAC. Group 2 patients remained on full-dose NOAC during the whole study period. A total of 92 patients were included in the analysis; group 1: 56 and group 2: 36. After the 45-day TEE, 31 patients from group 1 remained on baby-aspirin and 25 on HDNOAC. At 1-year follow-up, four stroke, oneTIA and six device-thrombus were reported in group 1A, compared to none in patients in group 1B (5/31 vs. 0/25, p = .03). No bleeding events were reported in group 1, whereas group 2 had five bleeding events (one subdural hematoma, one retinal hemorrhage, and fourGI bleedings). Additionally, one stroke was reported in group 2 that happened during brief discontinuation of OAC. In patients with coexistent AF and amyloidosis, half-dose NOAC following LAAO was observed to be the safest stroke-prophylaxis strategy.

Complicated pregnancy and perinatal outcomes in women with type 1 and type 2 diabetes mellitus

Complicated pregnancy and perinatal outcomes in women with type 1 and type 2 diabetes mellitus

Effects of oral dexmedetomidine on incidence of anxiety and emergence delirium in surgical and non-surgical anesthesia in preschool children

ABSTRACT Background Anxiety and emergence delirium (ED) are common complications of anesthesia in preschool children. Several causes had been attributed to them. Emergence delirium might be related to preoperative anxiety. We aimed to detect the incidence of anxiety and emergence delirium in anesthesia for surgical and non-surgical procedures, also to detect if oral dexmedetomidine as a premedication affects the incidence and severity of them in these procedures. Methods The study involved 180 children undergoing anesthesia who were randomly assigned to one of four groups, with each group containing 45 children. The study was clinical, controlled, comparative, and prospective. Groups A1&A2 had surgical intervention, while groups B1&B2 had MRI scanning. Groups A1&B1 were given 20 ml plain apple juice (Placebo) and groups A2&B2 received oral Dexmedetomidine (4 µg/kg) inserted in 20 ml apple juice 45 minutes prior to anesthesia induction. Anxiety was assessed pre-procedural, emergence delirium and pain at different intervals post-anesthesia. Results Incidence of anxiety and emergence delirium showed no difference between surgical and non-surgical procedures. Patients who received oral dexmedetomidine in groups A2 and B2 had significantly lower Parental Separation Anxiety scores than corresponding control groups A1 and B1 (p = 0.001). Occurrence of emergence delirium and severe pain were much decreased in groups received dexmedetomidine. PAED and FLACC exhibited significantly reduced scores in groups received dexmedetomidine than groups received Placebo drug (p < 0.05) in both surgical and non-surgical procedures. Rescue analgesia was needed more significantly for patients in groups A1 and B1 relative to other groups (p = 0.002). The incidence of complications revealed no statistical significance. Conclusion Anxiety and emergence delirium were similar in surgical and non-surgical procedures. Premedication of preschool children with oral dexmedetomidine lowered the frequency and intensity of anxiety, emergence delirium and severe pain. Emergence delirium was correlated to pain, especially in surgical procedures.

Synthesis, antidiabetic activity and in silico studies of benzo[b]thiophene based small molecule α-amylase inhibitors

Benzo[b]thiophene has been implicated as molecular framework in the drug discovery against broad spectrum of biological targets. In the antidiabetic drug regime, benzo[b]thiophene based SGLT2 and ALR2 inhibitors have been recently developed but their potential towards α-amylase inhibition remained unexplored to date. In this context, a series of novel small molecule benzo[b]thiophene-2-carboxylic acid derivatives (3a-p) was synthesized, characterized, and evaluated for antidiabetic activity as α-amylase inhibitors. We found that, all benzo[b]thiophene derivatives exhibited significant α-amylase inhibition with IC50 value ranging from 5.37 ± 0.25 μM to 29.89 ± 0.68 μM. The SAR studies showed benzo[b]thiophene carboxylate bearing bis(2-hydroxyethyl)amino group (3b) was most potent with IC50 of 5.37 ± 0.25 μM compared to standard drug Acarbose (IC50 = 6.40 ± 0.14 μM). Further, the enzyme inhibition mechanism study regarded 3b as competitive inhibitor of α-amylase with Ki value of 1.76 μM. A detailed in silico study was also performed in order to estimate binding properties, drug likeness and predict toxicity profile of these agents. It was demonstrated that novel small molecule benzo[b]thiophene derivative (3b) can effectively bind through H-bonding, hydrophobic and π-stacking interactions within α-amylase active site. Moreover, drug likeness and toxicity prediction studies suggested compound 3b as potential & safter α-amylase inhibitor. Overall, our present study disclosed a novel class of benzo[b]thiophene based α-amylase inhibitors and opened a template for further lead optimization and development.

Diagnostic value of cytokines in severe childhood Mycoplasma pneumoniae pneumonia combined with Adenovirus infection

BackgroundTo explore the alterations of inflammatory markers and immune-related cytokines in children infected with Mycoplasma pneumoniae (MP) combined with Adenovirus (ADV).MethodsThe study population consisted of 201 children with MPP, and they were grouped according to whether they were coinfected with ADV infection and critically ill. Additionally, comparative analyses were performed. The diagnostic value of different indicators and combined indicators for SMPP combined with ADV was assessed using ROC curves.ResultsThere was no difference between group A1 and group A2, group B1 and group B2 in terms of age, gender, duration of hospitalisation and fever. The levels of calcitoninogen(PCT), lactate dehydrogenase concentration(LDH), interleukin(IL)-6, IL-8, IL-10, IL-4, IL-12P70, and IFN-γ in group A were higher than group B. The severe group (A1, B1) was significantly higher than the mild group (A2, B2) in terms of D-dimer, CRP, PCT, LDH, IL-6, IL-8, IL-10, IL-17a and number of patients with pleural effusion, solid lung changes. Among the individual indexes of D-dimer, CRP, N%,LDH, and PCT, the AUC of the combined test was 0.977, which was higher than that of the individual indicators. Among IL-6, IL-8, IL-10, and IL-17a, the AUC of the combined assay was 0.802, which was higher than that of the individual indicators.ConclusionMP combined with ADV infection was associated with increased expression levels of IL-6, IL-8, IL-10, IL-4, IL-12P70, IFN-γ, and LDH. IL-6, IL-8, IL-10, IL-17a, LDH, PCT, CRP, and D-dimer could be used as predictors of SMPP and the combined test can improve the diagnostic value.

Penicillin or cephalosporin antibiotic allergy label: Influence on length of stay and hospital readmission

A penicillin or cephalosporin antibiotic (PCA) allergy label (PCAAL) has negative implications for both the patient and health care alike. A retrospective study was undertaken to evaluate the influence of a PCAAL on length of stay (LOS) and hospital readmissions. Over 4 weeks, inpatients with a PCAAL who were referred to the allergy service or opportunistically reviewed were grouped in the categories delabeled (group 1a) or advice not followed (ie, label carriage) (group 1b). Comparator groups without a PCAAL were identified, those either on a PCA (the PCA group [group 2]) or on a non-PCA (the non-PCA group [group 3]). The study population comprised 77 patients as follows: group 1a (n= 19), group 1b (n= 6), group 2 (n= 36), and group 3 (n= 16). Those in group 1a were significantly older (median age 78 years) than those in group 1b (median age 53 years [P= .013]) or group 3 (median age 59 years [P= .013]).There was a trend toward lower LOS in group 1a (10 days) than in group 1b (11.5 days [P= not significant]). Group 2 had a significantly lower LOS (6 days) than either both group 1a (10 days [P= .043]) or group 3 (15 days [P= .002]). Group 3 had the highest rate of patients readmitted within 30 days (n= 5 [71.4%]). A PCAAL carries influence on both LOS and readmissions, thus identifying the prompt need for allergy review to provide specific recommendations: delabeling and transition to an appropriate antibiotic. The significantly older group of those with a PCAAL who received a PCA after delabeling (ie, a 20-year age difference) may also be a signal that more elderly and comorbid patients benefit from this intervention the most.

Shaping the Character of Early Childhood: Teacher Strategies for Improving Emotional Regulation in Early Childhood at Tunas Pancasila Krasakageng Kindergarten

This research is motivated by the problems faced by children who basically have varying emotional levels. Early childhood is faced with the demand to learn to control their own emotions from an early age. The aim of this research is to understand how emotional regulation occurs in young children in Group B1 at the Tunas Pancasila Krasakageng Kindergarten and why emotional regulation can occur in children. This research also aims to identify the strategies used by teachers to improve emotional regulation abilities in early childhood. This research uses a qualitative method with a case study type of research. This research was conducted on 23-24 November 2023 at the Tunas Pancasila Krasakageng Kindergarten in Group B1. The subjects of this research were the school principal, homeroom teacher and Group B1 children. Data collection techniques were carried out using observation, interviews and documentation methods. Data analysis was carried out by condensing data, presenting data, and drawing conclusions. Meanwhile, the data validity test used is triangulation of techniques and sources. The results of this research are that there are still children who have not implemented emotional regulation well and have not been able to control their emotions independently. The teacher's strategy for improving emotional regulation in young children in Group B1 of the Tunas Pancasila Krasakageng Kindergarten is: (1) The teacher calms the child if the child shows emotion, 2) Provides examples of how to overcome disappointment and tension in the child. (3) Provides positive rewards. in children when they are able to behave well. (4) The teacher provides a calm and comfortable atmosphere for learning activities. (5) Teaches children to play supportively. (6) Teachers establish good communication with children without discriminating, (7) Introduce students to an attitude of tolerance

МЕТОДИКА МЕДИЦИНСКОГО СОПРОВОЖДЕНИЯ ПАЦИЕНТОВ ПОСЛЕ ПРОВЕДЕНИЯ ДЕНТАЛЬНОЙ РЕПЛАНТАЦИИ

Modern dentistry is aimed at using minimally invasive interventions to preserve dentition. This fact determines the need for wider use of various types of tooth-preserving operations. In modern conditions, tooth-preserving operations are increasingly being carried out with a predictable successful outcome. Treatment of dental trauma involves complex endodontic or surgical treatment protocols. An important aspect in the rehabilitation of dental injuries is the development of clear diagnostic tactics both at the initial appointment and at all stages of treatment. We observed 127 patients from 2012 to 2022 with diagnoses: complete, incomplete tooth dislocation, uncomplicated or complicated by fractures of the coronal part of the teeth, men and women aged 18 to 40 years. The first group consisted of 66 people with traumatic dislocations of teeth, who sought medical help within 24 hours after the injury, who underwent tooth replantation surgery, endodontic treatment, a complex treatment developed aimed at stopping an acute inflammatory reaction of a post-traumatic nature, and carrying out the necessary splinting measures. The second group consisted of 61 people with traumatic dislocations of teeth who sought medical help after 24 hours or later. Patients in each group were divided into subgroups; in the control subgroups, traditional treatment and rehabilitation after dental replantation were carried out; in the main subgroups, the technique we developed using M-Chip nanomatrices and LED radiation was used. All patients underwent macrohistochemical examination and measurement of dentogingival attachment using a periodontal probe. The results of a macrohistochemical study 7 days after replantation showed that in groups 1b and 2b, whose patients received complex treatment according to the developed method, the area of inflammation of the mucogingival complex was smaller than in patients in groups 1a and 2a, who were treated according to the traditional method. Results of probing of the dentogingival attachment found that in groups 1b and 2b, whose patients received complex treatment using the developed method, the dentogingival attachment corresponds to normal indicators of a healthy periodontal complex than in patients in groups 1a and 2a, who were treated using the traditional method. The inclusion in the complex of rehabilitation measures after dental replantation surgery of drugs that have antiseptic, reparative, hemostatic and immunoadjuvant effects, using LED radiation, increases the effectiveness of these measures by 2-3 times.

The Impact of Gadget Use on Early Childhood Religious Value Development

Globalization has diverse interpretations depending on various fields of expertise, but generally implies a borderless world where interactions can occur freely. Official NET News highlights the influence of gadgets on children, particularly in relation to gaming habits and parental management of potential addictions. This study aims to explore the impact of gadget use on the religious development of children aged 4-6 at TK Negeri Pembina Samporoa Vatutela Tondo. A mixed-method approach, incorporating both quantitative and qualitative methods, was used over a three-week period. Observations covered various religious aspects including knowledge of Prophets and Messengers, Hajj rituals, and prayer movements. The findings indicate that gadget use can positively influence the development of religious values in children aged 4-6. The aspects of naming Prophets and Messengers, understanding Hajj rituals, and performing prayer movements show development as expected. In Group B1, gadget usage also varies, with some children engaging in online/offline games, watching YouTube, or using TikTok. Gadget use can be multifaceted, serving as a means for both entertainment and educational development, particularly in the religious sphere. The balance between these uses and potential influences on children's development warrants further investigation.

Pulmonary-vein-to-pulmonary-artery ratio can be utilized to evaluate myxomatous mitral valve disease progression in dogs.

To evaluate the diagnostic value of pulmonary-vein-to-pulmonary-artery ratio (PV:PA) in dogs with myxomatous mitral valve degeneration (MMVD), classified according to the American College of Veterinary Internal Medicine (ACVIM) consensus guidelines. 80 client-owned dogs with either MMVD (n = 65) or no cardiovascular disease (control group; n = 15) between August 5, 2020, and July 19, 2023. This is a retrospective study. Dogs with MMVD were classified according to ACVIM consensus guidelines. Echocardiograms, thoracic radiographs, and other measurements needed in this study were reviewed in all dogs. Spearman correlation was used to determine the correlation between the PV:PA and the following variables: vertebral heart size, vertebral left atrial size, left-atrium-to-aorta ratio, normalized left ventricular internal diameter, and peak transmitral early diastolic velocity. Receiver operating characteristic (ROC) curve analysis was used to evaluate the value of PV:PA in distinguishing between stages B1 and B2 and stages B2 and C. All conventional indices showed correlations with PV:PA. The area under the ROC curve (AUC) for stages B1 and B2 was 0.83, and the cutoff value for differentiating stage B2 was 1.52. The AUC for stages B2 and C was 0.81, and the cutoff value for differentiating stage C was 2.09. PV:PA was significantly different between control and the stage B1 group, stage B1 and B2 group, and stage B2 and C group. PV:PA can be an index that can be used in evaluating MMVD dogs.

Design of a Computer Technology-Based Teaching System for College Students Mental Health Course

The hypothetical discussion describes the design of a personal computer innovation-based display structure tailored specifically for subordinates enrolled in an educational well-being course. Using a sophisticated approach, this structure intends to raise understudy devotion, urge dynamic studying, and enhance profitability. The displaying framework promotes reflective thinking, resolute thinking, and the acquisition of practical qualities associated with psychological wellness through the use of intuitive multimedia, competitive elements, and tailored input. This innovative displaying structure allows students to grow a more substantial grasp of mental health concerns while growing their personal psychic flourishing in a consistent and enticing teaching environment through the integration of cutting-edge technology with informative content. Modern instructional tactics stay frequently grounded in scheduled exam-based schooling besides infrequently actually caring about the root cause of pupils' questions, although flipping psychological training methods have emerged in some sectors. The primary goal of this concept is to combine digital intelligence with flipping laboratory brain studies. This essay focuses on the characteristics of fraudulent learning as well as the symbolic significance of flipping their house. What exactly are the advantages of the smart display stage over traditional learning? The following piece chooses crucial 1, the classroom, important 2, the school, main 3, the group, and key 4, from our institution's undergraduates. The A1 and B1 groups guide an academic year of artificial intellect, along with the concept of inverted classrooms for neuroscience. Bundles A2 and B2 depict the under study in accordance with normal training. According to the study data, the size of gatherings A1 and B1 increased respectively. Gatherings A1 and B1 had higher midterm and final normal scores respectively, than assemblages A2 and B2, and their scores have increased by a rate. The influence of artificial intelligence and flipping residence mind study on mental health in education programs may additionally energize subordinates' benefit and forward the advancement of understudy's display throughout autonomous education.

Effect of Cigarette Smoking on Selected Coagulation Parameters in Apparently Healthy Male Smokers

Background: Smoking is a significant global health concern associated with increased mortality and morbidity, including cancer development. Tobacco smoke contains carcinogens that can disrupt cellular processes and immune function, potentially affecting coagulation parameters. Objective: This study aimed to investigate the impact of smoking on selected coagulation parameters in apparently healthy male smokers compared to non-smokers. Method: A cross-sectional analytical study was conducted at the Department of Physiology, Sir Salimullah Medical College (SSMC) in Dhaka, Bangladesh, from July 1, 2018, to June 30, 2019. Seventy male participants aged 20 to 40 years were enrolled, comprising 35 healthy non-smokers (Group A) and 35 male smokers (Group B). Smokers (Group B) were further categorized into two groups based on pack-years of smoking (group B1 and group B2). Coagulation parameters including prothrombin time (PT), activated partial thromboplastin time (APTT), bleeding time (BT), and clotting time (CT) were assessed. Results: In this study, age and BMI were almost similar between groups A (healthy non-smokers) and B (smokers), with mean (± SD) ages of 33.17 ± 2.91 and 34.11 ± 3.18 years, and mean (± SD) BMI values of 24.36 ± 2.28 and 24.68 ± 2.33 kg/m2, respectively. There was no statistically significant disparity between the two groups, indicating successful age and BMI matching. Smokers (group B) exhibited significantly lower mean (± SD) prothrombin time (PT) values (11.56 ± 0.87 seconds) compared to non-smokers (13.07 ± 0.77 seconds), with a statistically significant difference (p &lt; 0.001). Similarly, activated partial thromboplastin time (APTT) was significantly decreased in smokers (28.42 ± 2.00 seconds) compared to non-smokers (31.50 ± 1.00 seconds) (p &lt; 0.001). Bleeding time (BT) and clotting time (CT) were also significantly reduced in smokers (2.40 ± 0.24 minutes and 5.35 ± 0.29 minutes, respectively) compared to non-smokers (3.48 ± 0.36 minutes .....

Usefulness of serum amyloid A for the diagnosis of pyelonephritis in cats: A prospective evaluation.

The diagnosis of pyelonephritis in cats is challenging and development of a noninvasive and accurate biomarker is needed. Serum amyloid A (SAA) is increased in cats with pyelonephritis, but not in cats with other urinary tract diseases. A cohort of 125 cats (149 observations). This was a prospective study. Group 1 included cats with a diagnosis of pyelonephritis either confirmed by bacterial culture of pelvic urine (Group 1a) or presumed (1b). Group 2 included cats for which pyelonephritis was ruled out (with certainty: Group 2a or judged unlikely: Group 2b). SAA concentration was compared between groups, and accuracy of SAA for the diagnosis of pyelonephritis was calculated using a Receiver Operating Characteristic (ROC) curve analysis. Median SAA concentration was significantly higher in Group 1a (86.8 mg/L [73.3; 161.5]; n = 8) than in Group 2a (4 mg/L [1.8; 5.6], n = 19; P < .001) and in Group 2b (5.4 mg/L [3.1; 9.7], n = 113; P < .001). It was also significantly higher in Group 1b (98.8 mg/L [83.1; 147.3]; n = 9) than in Group 2b (P < .001) and Group 2a (P < .001). Optimal diagnostic cut-off for SAA concentration was 51.3 mg/L. yielding a sensitivity of 88% (95% confidence interval: [64%; 99%]) and a specificity of 94% (95% confidence interval: [88%; 97%]). Measurement of SAA could be used to rule out pyelonephritis in the case of low suspicion of the disease. Increased SAA concentration is suggestive of pyelonephritis despite a lack of specificity.

Implementasi Metode Single Minute Exchange of Dies Untuk Optimasi Setting Time Mesin Flexo B1 Grup C Pada Carton Box Departement PT. A

PT. A is a company engaged in the production and sale of paper, cardboard boxes, and other similar products in Indonesia. The products it offers include paper, tissue, packaging, and other products. The Carton Box Department, from the results of observations made, the average actual setting time on the Flexo B1 Group C machine is 47 minutes/order, this is one of the weaknesses that causes a 32-minute gap from the target set by the company which is 15 minutes/order. The research objectives are to analyze, improve, and obtain improved setting time results on the Flexo B1 Group C machine and the production process time carried out. The SMED (Single Minute Exchange of Dies) method is one approach that can be pursued in improving setting time. The influence of the SMED (Single Minute Exchange of Dies) method in optimizing the setting time of the Flexo B1 Group C machine results in a decrease in setting time with a setup duration of 49.11 minutes, normal time of 59 minutes, and standard time 66 minutes to a setup duration 25.36 minutes, normal time 27 minutes and standard time 34 minutes and the percentage obtained is 51.8%. Keywords: Lean Manufacturing, Productivity, Single Minute Exchange of Dies

Antimicrobial Resistance and Molecular Characterization of Escherichia coli from Healthy Chickens in Shandong, China from 2009 to 2014.

Antimicrobial resistance (AMR) is a great threat to animal and public health. Here, we conducted a surveillance of Escherichia coli isolated from healthy chickens during 2009-2014 to identify the characteristics of AMR. A total of 351 (95.64%) E. coli isolates were obtained from 367 healthy chicken fecal samples collected from 6 farms located in Shandong Province, China. The susceptibility to 10 antimicrobials, the prevalence of antibiotic resistance genes (ARGs), phylogenetic clustering, and multilocus sequence typing were evaluated. The isolates exhibited high resistant rates (>95%) to ampicillin, cefotaxime, ciprofloxacin, ceftiofur, and enrofloxacin. The most prevalent ARGs were blaCTX-M (36.36%), aac(6')-Ib-cr (30.79%), qnrS (29.62%), oqxAB (27%), mcr-1 (15.83%), blaTEM (9.09%), qnrC (3.52%), qnrD (0.88%), and qepA (0.29%). Phylogenetic clustering analysis indicated that the most prevalent group was group D (37.89%), followed by group B1 (34.76%), A (24.22%), and B2 (3.13%). Fifty-seven sequence types (STs) were identified among the 124 blaCTX-M-positive strains, and the dominant STs were ST354 (13.71%), ST117 (5.65%), ST155, ST2309, and ST2505 (4.84% each). There was a significant association between 17 pairs of AMR phenotypes, 14 pairs of ARGs, and 11 pairs of AMR-ARGs. The strongest association was found between ST602 and qnrC (odds ratios: 22.2). This study implied that E. coli isolated from healthy chickens could potentially serve as a reservoir of AMR and ARGs, and significant associations exist among AMR, ARGs, phylogenetic groups, and STs. Our study highlighted the need for routine surveillance of AMR in healthy chickens, and promoting appropriate antibiotic use and implementing regular monitoring of resistance in broilers are crucial for fostering the development of the poultry industry and safeguarding public health.

High prevalence of plasmid-mediated quinolone resistance in escherichia coli strains producing extended-spectrum beta-lactamases isolated from faeces and urine of pregnant women with acute cystitis.

Escherichia coli is the most common etiological agent of urinary tract infections (UTIs). Meanwhile, plasmid-mediated quinolone resistance (PMQR) is reported in E. coli isolates producing extended-spectrum β-lactamases (ESBLs). Furthermore, the reservoirs and mechanisms of acquisition of uropathogenic Escherichia coli (UPEC) strains are poorly understood. On the other hand, UTIs are common in pregnant women and the treatment challenge is alarming. In the present study, 54 pregnant women with acute cystitis were included. A total of 108 E. coli isolates, 54 isolates from UTI and 54 isolates from faeces of pregnant women (same host) were collected. In the antimicrobial susceptibility test, the highest rate of antibiotic resistance was to nalidixic acid (77%, 83/108) and the lowest rate was to imipenem (9%, 10/108). Among the isolates, 44% (48/108) were ESBLs producers. A high frequency of PMQR genes was observed in the isolates. The frequency of PMQR genes qnrS, qnrB, aac(6')-Ib-cr, and qnrA was 58% (63/108), 21% (23/108), 9% (10/108), and 4% (4/108), respectively. Meanwhile, PMQR genes were not detected in 24% (20/85) of isolates resistant to nalidixic acid and/or fluoroquinolone, indicating that other mechanisms, i.e. chromosomal mutations, are involved in resistance to quinolones, which were not detected in the present study. In ESBL-producing isolates, the frequency of PMQR genes was higher than that of non-ESBL-producing isolates (81% vs. 53%). Meanwhile, UTI and faeces isolates mainly belonged to phylogenetic group B2 (36/54, 67% and 25/54, 46%, respectively) compared to other phylogenetic groups. In addition, virulence factors and multidrug-resistant (MDR) were mainly associated with phylogenetic group B2. However, predominant clones in faeces were not found in UTIs. Rep-PCR revealed the presence of 85 clones in patients. Among the clones, 40 clones were detected only in faeces (faeces-only), 35 clones only in UTI (UTI-only) and 10 clones in both faeces and UTI (faeces-UTI). We found that out of 10 faeces-UTI clones, 5 clones were present in the host's faeces flora. This study revealed a high rate of resistance to the quinolone nalidixic acid and a widespread distribution of PMQR genes in MDR E. coli strains producing ESBLs. The strains represented virulence factors and phylogenetic group B2 are closely associated with abundance in UTI and faeces. However, the predominant clones in faeces were not found in UTIs and it is possible that rep-PCR is not sufficiently discriminating clones.

EFFECT OF 4 wt% HYDROXYAPATITE PASTA ON DENTAL EMAIL HARDNESS

Introduction: Dental erosion can affect the dental demineralization due to the pH level that is below the critical pH of 5,5 resulting a decrease in dental enamel hardness. Remineralization is needed to bring back the mineral loss. Hydroxyapatite is similar to inorganic components in dental enamel dan have biocompatible properties. Hydroxyapatite with 4 wt% concentration has a Ca/P molar ratio close to 1,67, which is similar to the human enamel and can regenerate enamel. This study is aimed to analyze the effects of 4 wt% hydroxyapatite paste on dental enamel hardness for 7 and 14 days. Material and Methods: 20 maxillary premolars were divided into 4 groups. Group A1 were applied with 4 wt% hydroxyapatite paste for 30 minutes each day for 7 days, group A2 were applied with 4 wt% hydroxyapatite paste for 30 minutes each day for 14 days, group B1 were immersed with artificial saliva for 7 days, and group B2 were immersed with artificial saliva for 14 days. All groups were immersed with artificial saliva and was incubated for 24 hours at 37°C. Hardness measurements were carried out at the start, after erosion, and at the end of the experiment. Dental enamel hardness was measured with Vickers Hardness Tester (Shimadzu HMV G-21 Series). Dental enamel hardness data were analysed with GLM Repeated Measure ANOVA test (p&lt;0,05) and One-way ANOVA test (p&lt;0,05). Results and Discussions: The result showed dental enamel hardness number after 4 wt% hydroxyapatite paste application showed significant difference than untreated group, which was immersed in artificial saliva. Dental enamel hardness number after 4 wt% hydroxyapatite paste application for 14 days showed significant difference than 7 days. Conclusion: It can be concluded that 4 wt% hydroxyapatite paste application for 14 days resulted in an increase of dental enamel hardness as in normal condition of dental enamel before erosion