Top Category Research Articles

The Leading Causes of Recurrent Hospitalization of Neurologically Impaired & Disabled Pediatric Patients in King Abdulaziz Medical City- Jeddah from 2013 to 2017

Background: Disabilities are a major issue, affecting 15% of the world’s population. They are mostly caused by NI such as GDD, CP, hydrocephalus, and HIE. Patients of such conditions, especially children, are more likely to require admission and healthcare. Therefore, it is necessary to investigate the causes that may lead these children to have multiple admissions Methods: A cross-sectional study was conducted by reviewing medical records of patients who were admitted to the pediatric ward of King Khalid National Guard Hospital, Jeddah, Saudi Arabia from 2013-2017 with any underlying NI. These impairments included any previous diagnosis of GD, CP, HIE, encephalitis, hydrocephalus, or corpus callosum agenesis. A non-probability convenience sampling technique was used to recruit patients who were under 15 years of age with the mentioned diagnoses, and all of the identified 265 patients were included in this study. Results: Analysis of a total of 635 admissions reports that the most common causes of admission in of patients with the mentioned included underlying conditions are other neurological conditions with (n=222, 35%) admissions, mainly due to seizures (n= 64, 10%), hydrocephalus (n=39, 6.1%), and delayed milestones (n=29, 4.6%). The second top category was respiratory conditions and infections (n=164, 25%). Aspiration pneumonia was documented (n=66, 10.4%), making it the top diagnosis in all admission, followed by seizures. The second top documented infection was pneumonia (n=40, 6.3%). The third top category was gastrointestinal infections and conditions. Leading that category is gastroenteritis (n=22, 3.4%) and GER (n=15, 2.4%). There was no There was a statistically significant relationship between NI and the gender of patients (p = 0.170). There was, however, a statistically significant relationship with the age group, feeding rout, home oxygen, documented disability, admission cause, and patient management (p < 0.001). Conclusion: Specific NI are more associated with certain conditions that are more likely to lead to hospitalization. Recognition of these conditions can be of future help in early detection and prevention of serious complications and morbidity.

Association between dietary fat intake and odds of Gastro-esophageal Reflux Disorder. (GERD) in Iranian adults

Background:Most information on the association of dietary fat intake and gastro-esophageal reflux disorder (GERD) came from developed countries, where lifestyle and other dietary components might be different from those in developing countries. This cross-sectional study was, therefore, conducted to investigate the association between dietary fat intake and odds of having GERD in a large group of Iranian population.Study Design:This cross-sectional study was done among 3362 adult population in Isfahan, Iran. Dietary intakes were collected by the use of a validated semi-quantitative food frequency questionnaire.Methods:Assessment of GERD was done using a validated self-administered questionnaire examining the frequency of heartburn in the last 3 months. Individuals with the presence of heartburn symptoms sometimes, often or always during the last 3 months were defined as having GERD.Results:Participants in the top category of dietary fat intake had higher daily intakes of energy, macronutrients and micronutrients. Dietary intakes of all food groups were also significantly higher among those in the top quintile as compared with those in the bottom category of dietary fat intake (P < 0.001 for all). There were no significant associations between dietary fat intake and incidence of GERD in general population. Crude and multivariable-adjusted models revealed no significant associations between dietary fat intake and having GERD in either gender.Conclusions:We found no significant association between dietary fat intake and odds of having GERD in this population. Further studies, in particular of prospective designs, are warranted to clarify this association.

Relationship between cardiac biomarker concentrations and long-term mortality in subjects with osteoarthritis.

Osteoarthritis (OA) is associated with adverse cardio-metabolic features. N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponins T and I (hs-cTnT and hs-cTnI) are well-characterized cardiac markers and provide prognostic information. The objective was to assess the association of cardiac biomarker concentrations with long-term mortality in subjects with OA. In a cohort of 679 OA subjects, undergoing hip or knee replacement during 1995/1996, cardiac biomarkers were measured and subjects were followed over 20 years. During a median follow-up of 18.4 years, 332 (48.9%) subjects died. Median of hs-cTnT, hs-cTnI, and NT-proBNP at baseline was 3.2 ng/L, 3.9 ng/L, and 96.8 ng/L. The top quartile of NT-proBNP was associated with increased risk of mortality (Hazard Ratio (HR) 1.79, 95% confidence interval (CI) 1.17–2.73) after adjustment for covariates including troponins (hs-cTnT HR 1.30 (95% CI 0.90–1.89), hs-cTnI HR 1.32 (95% CI 0.87–2.00) for top category). When biomarker associations were evaluated as continuous variables, only NT-proBNP (HR per log-unit increment 1.34, 95% CI 1.16–1.54) and hs-cTnI (HR 1.38, 95% CI 1.11–1.72) showed robust results. Elevated cardiac biomarker concentrations predicted an increased risk of long-term mortality and strongest for NT-proBNP and hs-cTnI. These results might help to identify subjects at risk and target preventive efforts early.

Abstract PO-146: Multiethnic GWAS meta-analysis identifies novel variants and informs genetic risk prediction for prostate cancer across populations

Abstract Prostate cancer (PCa) is a highly heritable disease with large disparities in incidence rates across racial and ethnic populations. The inadequate representation of diverse populations in current genome-wide association studies (GWAS) limits the translational potential of findings to the world’s populations and could result in biased risk prediction, further exacerbating health disparities. To improve our understanding of genetic risk of PCa, we conducted a multiethnic meta-analysis of PCa GWAS using 107,247 cases and 127,006 controls from the Prostate Cancer Association Group to Investigate Cancer-Associated Alterations in the Genome (PRACTICAL) consortium, including 85,554 cases and 91,972 controls of European ancestry, 10,368 cases and 10,986 controls of African ancestry, 8,611 cases and 18,809 controls of Asian ancestry, and 2,714 cases and 5,239 controls of Hispanic ancestry. We identified 269 genetic risk variants independently associated with PCa risk, 86 of which were novel. To understand the aggregate effect of the 269 variants, we constructed a genetic risk score (GRS) using the multiethnic weights of the risk variants. Compared to men in the average 40-60% GRS category, the estimated OR for men in the top GRS decile (90-100%) was 5.06 [95% CI 4.84-5.29] for men of European ancestry, 3.74 [95% CI 3.36-4.17] for men of African ancestry, 4.47 [95% CI 3.52-5.68] for men of Asian ancestry, and 4.15 [95% CI 3.33-5.17] for men of Hispanic ancestry. Men of African ancestry were estimated to have a 2.18-times higher mean GRS [95% CI 2.14-2.22], and men of Asian ancestry 0.73-times lower [95% CI 0.71- 0.76], than men of European ancestry. Age significantly modified the GRS association with PCa risk, such that in men of European ancestry, the top decile GRS category was associated with an OR of 6.71 [95 % CI 5.99-7.52] for men ages 55 years or younger and 4.39 [95% CI 4.19-4.60] for men older than 55 years. Similarly, in men of African ancestry, the top decile GRS category was associated with an OR of 4.70 [95% CI 3.65-6.07] for men ages 55 years or younger and 3.37 [95% CI 2.99-3.80] for men older than 55 years. We found that 51% of aggressive cases of European ancestry and 45% of aggressive cases of African ancestry were within the top 20% of the GRS. The lifetime absolute risk of PCa for men in the top decile of the GRS reached 38% for both African Americans [95% CI 36-41%] and Whites [95% CI 37-39%], 31% [95% CI 27-36%] for Hispanics and 26% [95% CI 22-30%] for Asians. For comparison, we constructed a genome-wide GRS, including the 269 variants and variants associated with PCa with P&amp;lt;1.0 × 10-5. ORs calculated with genome-wide GRS were similar and had nearly identical discriminative ability as the 269 GRS in independent samples of 6,852 cases and 193,117 controls of European ancestry and 1,586 cases and 1,047 controls of African ancestry. These findings support the role of germline variation contributing to racial and ethnic disparities in PCa risk, with the GRS offering an approach for personalized risk prediction across populations. Citation Format: David V. Conti, Burcu F. Darst, Lilit Moss, Edward J. Saunders, Xin Sheng, Alisha Chou, Tokhir Dadaev, Sonja I. Berndt, Stephen K. Van Den Eeden, Stephen J. Chanock, Michael B. Cook, Hidewaki Nakagawa, John S. Witte, Rosalind A. Eeles, Zsofia Kote-Jarai, Christopher A. Haiman. Multiethnic GWAS meta-analysis identifies novel variants and informs genetic risk prediction for prostate cancer across populations [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-146.

Histamine-4 receptor antagonist ameliorates Parkinson-like pathology in the striatum

Growing evidence indicates that microglia activation and a neuroinflammatory trigger contribute to dopaminergic cell loss in Parkinson’s disease (PD). Furthermore, increased density of histaminergic fibers and enhanced histamine levels have been observed in the substantia nigra of PD-postmortem brains. Histamine-induced microglial activation is mediated by the histamine-4 receptor (H4R). In the current study, gene set enrichment and pathway analyses of a PD basal ganglia RNA-sequencing dataset revealed that upregulation of H4R was in the top functional category for PD treatment targets. Interestingly, the H4R antagonist JNJ7777120 normalized the number of nigrostriatal dopaminergic fibers and striatal dopamine levels in a rotenone-induced PD rat model. These improvements were accompanied by a reduction of α-synuclein-positive inclusions in the striatum. In addition, intracerebroventricular infusion of JNJ7777120 alleviated the morphological changes in Iba-1-positive microglia and resulted in a lower tumor necrosis factor-α release from this brain region, as well as in ameliorated apomorphine-induced rotation behaviour. Finally, JNJ7777120 also restored basal ganglia function by decreasing the levels of γ-aminobutyric acid (GABA) and the 5-hydroxyindoleactic acid to serotonin (5-HIAA/5-HT) concentration ratios in the striatum of the PD model. Our results highlight H4R inhibition in microglia as a promising and specific therapeutic target to reduce or prevent neuroinflammation, and as such the development of PD pathology.

Identification of Appropriate Agri-technologies Minimizing Yield Gaps in Different Sugarcane-Growing States of India

In India, five states, viz., Uttar Pradesh, Maharashtra, Karnataka, Tamil Nadu and Bihar, contribute about 84.64% sugarcane production of the country and occupy about 82.46% cropped area. The mean productivity of these states is also higher as compared to remaining states. However, the yield gap up to 33.0 t ha−1 prevails among these states. The performance of technologies in different states also varies depending on constrains and potentials of the region. Thus, the objectives of our study were (1) to assess the yield gap between attainable yield and farmers yield in potential sugarcane-growing states of the country and (2) to determine the long-term relationship between improved technologies and sugarcane yields at various levels. Yield gap analysis revealed that Uttar Pradesh recorded the highest positive correlation between period and sugarcane yield (R2 = 0.917/r = 0.96) and showed that technological advancements caused linear increase in sugarcane yield. Out of eight technologies, five technologies, i.e. improved variety, pit method of planting, intercropping, drip irrigation and ratoon management, enhanced sugarcane yield by > 20% and could be placed as top rankers. In Maharashtra, improved variety, ratoon management, intercropping and integrated nutrient management were recorded as top rankers and improved sugarcane yields in the range of 20.44–31.29%, individually. In Karnataka, drip irrigation, intercropping, ratoon management and improved varieties increased > 20% sugarcane yield as compared to state average sugarcane yield. However, wide row spacing and INM could increase yield level in the range of 15.17% and 17.65%, respectively. In Tamil Nadu, the various technologies could increase about 4.35–35.87% higher sugarcane yields as compared to farmers practice. Pit method planting showed the highest improvement in yield (35.87%). Improved varieties, integrated weed management, intercropping and ratoon management showed positive effect in the range of 13.28–19.0% as compared to mean of technologies demonstrated in five states. In Bihar, the improved variety contributed 40.2% yield increase as compared to state average yield (59.25 t ha−1). Ratoon management (35.14%) and intercropping in sugarcane (31.76%) could also be ranked in the top category in increasing sugarcane yields. Thus, it could be recorded that improved variety in Maharashtra and Bihar, pit/trench method of planting in Uttar Pradesh and Tamil Nadu drip irrigation and ratoon management in Karnataka are the major technologies contributing in sugarcane yield. Therefore, these technologies need to be promoted in the potential sugarcane-growing states to improve the national average.

The relationship between protein domains and homopeptides in the Plasmodium falciparum proteome.

The proteome of the malaria parasite Plasmodium falciparum is notable for the pervasive occurrence of homopeptides or low-complexity regions (i.e., regions that are made from a small subset of amino-acid residue types). The most prevalent of these are made from residues encoded by adenine/thymidine (AT)-rich codons, in particular asparagine. We examined homopeptide occurrences within protein domains in P. falciparum. Homopeptide enrichments occur for hydrophobic (e.g., valine), or small residues (alanine or glycine) in short spans (<5 residues), but these enrichments disappear for longer lengths. We observe that short asparagine homopeptides (<10 residues long) have a dramatic relative depletion inside protein domains, indicating some selective constraint to keep them from forming. We surmise that this is possibly linked to co-translational protein folding, although there are specific protein domains that are enriched in longer asparagine homopeptides (≥10 residues) indicating a functional linkage for specific poly-asparagine tracts. Top gene ontology functional category enrichments for homopeptides associated with diverse protein domains include “vesicle-mediated transport”, and “DNA-directed 5′-3′ RNA polymerase activity”, with various categories linked to “binding” evidencing significant homopeptide depletions. Also, in general homopeptides are substantially enriched in the parts of protein domains that are near/in IDRs. The implications of these findings are discussed.

LA OBSERVACIÓN EN CONTEXTO DE LOS NIVELES DE ACCIÓN EN BALONMANO

Esta investigación plantea como objetivo principal diseñar un instrumento de registro que permita describir y relacionar tres niveles de acción del balonmano (juego de equipo, juego grupal y juego individual), vinculándolos al contexto de competición y atendiendo a su eficacia. Siguiendo las directrices de la metodología observacional se opta por un sistema combinado de formatos de campo y sistema de categorías, utilizando un diseño de investigación de carácter ideográfico, puntual y multidimensional. Se utiliza como instrumento de registro el software Dartfish TeamPro V.4.5 para analizar siete partidos de categoría absoluta, y siete partidos de categoría infantil, generándose datos de tipo concurrente y de evento. Se aplican técnicas estadísticas descriptivas e inferenciales bivariadas para el análisis relacional de los datos. Destacamos los resultados que constatan la asociación entre sistemas de juego y procedimientos colectivos tanto ofensivos como defensivos, y la dificultad en establecer relaciones significativas entre el ataque y la defensa.

Top Food Category Contributors to Sodium and Potassium Intake — United States, 2015–2016

Most U.S. adults consume too much sodium and not enough potassium (1,2). For apparently healthy U.S. adults aged ≥19 years, guidelines recommend reducing sodium intake that exceeds 2,300 mg/day and consuming at least 3,400 mg/day of potassium for males and at least 2,600 mg/day for females* (1). Reducing population-level sodium intake can reduce blood pressure and prevent cardiovascular diseases, the leading causes of death in the United States (1,3). Adequate potassium intake might offset the hypertensive effects of excessive sodium intake (1). Data from the 2015-2016 What We Eat in America (WWEIA) dietary interview component of the National Health and Nutrition Examination Survey (NHANES)† were analyzed to identify top food categories contributing to sodium and potassium intake for U.S. residents aged ≥1 year. During 2015-2016, 40% of sodium consumed came from the top 10 food categories, which included prepared foods with sodium added (e.g., deli meat sandwiches and pizza). Approximately 43% of potassium consumed was from 10 food categories, which included foods naturally low in sodium (e.g., unflavored milk, fruit, vegetables) and prepared foods. These results can inform efforts to encourage consumption of foods naturally low in sodium, which might have the dual benefit of reducing sodium intake and increasing potassium intake, contributing to cardiovascular disease prevention.

Fruit and vegetable consumption in relation to primary headaches: the MEPHASOUS study.

Fruit and vegetable consumption may beneficially affect the odds of primary headaches due to their antioxidant contents. However, no study has examined the association between fruit and vegetable consumption and primary headaches among university students. To assess the relation between fruit and vegetable intakes and primary headaches among Iranian university students. Overall, 83,214 university students with an age range of ≥ 18years participated in the present study. Dietary intakes and also data on confounding variables were collected using validated questionnaires. Data on dietary intakes were collected using a validated dietary habits questionnaire. We used the International Classification of Headache Disorders-3 (ICHD-3) criteria to define primary headaches. Fruit consumption was negatively associated with primary headaches; such that after controlling for potential confounders, greater intake of fruits was associated with 30% lower odds of primary headaches (OR: 0.70, 95% CI 0.58-0.84). Such an inverse association was also found for vegetable consumption. In the fully adjusted model, students in the top category of vegetable consumption were 16% less likely to have primary headaches compared with those in the bottom category (OR: 0.84, 95% CI 0.74-0.95). Subgroup analysis revealed that fruit consumption was inversely associated with primary headaches in females, unlike males, and vegetable consumption was inversely associated with these headaches in males, as opposed to females. Moreover, fruit and vegetable consumption was related to lower odds of primary headaches in normal-weight students. Fruit and vegetable intakes were associated with reduced odds of primary headaches. Level III, cross-sectional analytic studies.

Global research trends and publications of insomnia: A bibliometric analysis

This study aimed to evaluate the tendency of insomnia articles in SCI-EXPANDED database. Data was obtained from the online version of Science Citation Index Expanded (SCI-EXPANDED) database in the Web of Science Core Collection of Clarivate Analytics within the publication year from 1991 to 2018. The publications were assessed regarding their document types, languages, and journals. We used three citation indicators such as C 2018, TC 2018, and CPP 2018 to determine the citation received by publications. We used the Y-index method formulated by Ho. The study found 16,478 insomnia documents within 15 document types indexed in the Web of Science, and articles type was used most constituting 66% (10,801) of the documents. Ninety-five percent of the articles were published in English. The journal of Sleep published most of the insomnia article then followed by Sleep Medicine. The 30% of 10,801 articles were published in the top category of clinical neurology. The G7 countries published most of the insomnia articles. The most productive country and institution was United States and Harvard University respectively. The article entitled “A new method for measuring daytime sleepiness: The Epworth sleepiness scale” published by Johns in 1991was the most cited article with TC 2018 of 7,191 and C 2018 of 661 citations. The most industrious and had more potential to published insomnia articles was M.M. Ohayon. Moreover, the study showed that most of the insomnia articles were related to depression, anxiety, cancer, and schizophrenia. Insomnia is a serious problem with synergistic effects for normal body health. Bibliometric method can help researchers to have comprehensive knowledge on insomnia and initiate an orientation for further research so as to solve a problem. Furthermore, it may also help researchers to determine the impact of insomnia publications as well as to identify relevant research groups in the field of insomnia.

Legume and Nuts Consumption in Relation to Glioma: A Case- Control Study

Data on the link between legume and nuts consumption and risk of glioma are controversial. The current study aimed to investigate the relation between legume and nuts consumption and glioma in a case-control study in Iranian adults. In this hospital-based case-control study, we enrolled 128 pathologically confirmed new cases of glioma and 256 age and sex-matched controls. Dietary intakes of study participants were assessed using the validated Block-format 123-item semi-quantitative FFQ. Data on potential confounders were also collected through the use of a pre-tested questionnaire. Mean age of cases and controls were 43.4 and 42.8 years, respectively. Individuals with the greatest legume and nuts consumption were less likely to have glioma compared with those with the lowest consumption (0.52; 95% CI: 0.30–0.88). This inverse association was not changed after controlling for age, sex and energy intake (0.46; 95% CI: 0.26–0.81). The association remained statistically significant even after taking other potential confounders, including dietary intakes into account (0.32; 95% CI: 0.14–0.72). Additional adjustments for BMI did not alter the association; such that individuals in the top category of legume and nuts consumption were 66% less likely to have glioma compared with those in the bottom category (0.34; 95% CI: 0.15–0.76). We found an inverse association between legume and nuts consumption and odds of glioma, even after controlling for a wide range of confounders.

Quantitative proteomic analysis to determine differentially expressed proteins in axenic amastigotes of Leishmania tropica and Leishmania major

Cutaneous leishmaniasis is commonly caused by Leishmania major and Leishmania tropica. In the present study, the differential expression of proteins was identified in the amastigote-like forms of L. tropica and L. major in Iranian isolates. Initially, the samples were cultured and identified using PCR-RFLP technique. The Leishmania isolates were then grown in host-free (axenic) culture and prepared to amastigote-like forms, followed by the extraction of their proteins. To identify significant differentially expressed proteins (DEPs) of two types of Leishmania, the label-free quantitative proteomic technique was used based on sequential window acquisition of all theoretical fragment ion spectra mass spectrometry. A total of 51 up/down-DEPs (fold change >2 and p-value <.05) were identified between the axenic amastigote forms of L. major and L. tropica. Of these, 34 and 17 proteins were up-regulated in L. major and L. tropica, respectively. Several enriched GO terms were identified via biological process analyses for DEPs; furthermore, the metabolic process and translation were disclosed as top category in the up-regulated proteins of both L. major and L. tropica species. Also, the KEGG analysis revealed carbon metabolism and metabolic pathways term as the top pathways in the proteins up-regulated in L. major and L. tropica, respectively. Taken together, the numerous novel DEPs identified between the studied species could help fully understand the molecular mechanisms of pathogenesis and provide potential drug targets and vaccine candidates.

Socio-demographic and maternal health indicators of inhibitory control in preschool age children: evidence from Growing Up in New Zealand

Inhibitory control is central to developmental trajectories of cognitive, emotional and social functioning in children. Here, inhibitory control was measured using the Luria hand clap task (an adapted version of the Luria pencil tap task). A sample of 5,448 children age 4½ years and their mothers from a longitudinal, population-based New Zealand cohort were included in this study. Antenatal maternal health indictors, child characteristics and performance on the Luria hand clap task were assessed using multivariate ordinal logistic regression. Seven covariates, including mother’s ethnicity and education, and child’s gender, age and birthweight were included. Based on Luria task performance scores that approximated the 25th and 50th percentiles, children were categorised into three groups (low, intermediate, high). High Luria task performance was associated with maternal relationship status, maternal education, first trimester folate supplementation, maternal BMI and smoking before pregnancy. In addition, children born heavier, and female, and older children were more likely to be in the top Luria score category relative to children born smaller, male and younger. A number of potentially modifiable maternal factors significantly predict Luria task performance in children age 4½ years. Identifying socio-demographic, child characteristics and maternal factors that are associated with inhibitory control is a crucial first step for identifying children at risk of atypical inhibition development and informing behavioural intervention strategies.

Phospho-proteomic discovery of novel signal transducers including thioredoxin-interacting protein as mediators of erythropoietin-dependent human erythropoiesis

Erythroid cell formation critically depends on signals transduced via erythropoietin (EPO)/EPO receptor (EPOR)/JAK2 complexes. This includes not only core response modules (e.g., JAK2/STAT5, RAS/MEK/ERK), but also specialized effectors (e.g., erythroferrone, ASCT2 glutamine transport, Spi2A). By using phospho-proteomics and a human erythroblastic cell model, we identify 121 new EPO target proteins, together with their EPO-modulated domains and phosphosites. Gene ontology (GO) enrichment for "Molecular Function" identified adaptor proteins as one top EPO target category. This includes a novel EPOR/JAK2-coupled network of actin assemblage modifiers, with adaptors DLG-1, DLG-3, WAS, WASL, and CD2AP as prime components. "Cellular Component" GO analysis further identified 19 new EPO-modulated cytoskeletal targets including the erythroid cytoskeletal targets spectrin A, spectrin B, adducin 2, and glycophorin C. In each, EPO-induced phosphorylation occurred at pY sites and subdomains, which suggests coordinated regulation by EPO of the erythroid cytoskeleton. GO analysis of "Biological Processes" further revealed metabolic regulators as a likewise unexpected EPO target set. Targets included aldolase A, pyruvate dehydrogenase α1, and thioredoxin-interacting protein (TXNIP), with EPO-modulated p-Y sites in each occurring within functional subdomains. In TXNIP, EPO-induced phosphorylation occurred at novel p-T349 and p-S358 sites, and was paralleled by rapid increases in TXNIP levels. In UT7epo-E and primary human stem cell (HSC)-derived erythroid progenitor cells, lentivirus-mediated short hairpin RNA knockdown studies revealed novel pro-erythropoietic roles for TXNIP. Specifically, TXNIP's knockdown sharply inhibited c-KIT expression; compromised EPO dose-dependent erythroblast proliferation and survival; and delayed late-stage erythroblast formation. Overall, new insight is provided into EPO's diverse action mechanisms and TXNIP's contributions to EPO-dependent human erythropoiesis.

A Study for Analysing Key Factors for Establishing the Omni-Channel Customer System in a Financial Enterprise Using ANP

The omni-channel customer system is the communication system between enterprise and customer via multiple channels such as mail, email, SMS, and mobile. The omni-channel customer system complements each other channel through the integration of each channel. The purpose of this research is to derive key factors and calculate the weights that a financial enterprise considers when adopting the omni-channel customer system. For this research, we analyzed the request for proposal documents used for the omni-channel customer system implementation projects in the financial enterprise. Also, we derived, classified, and stratified the key factors to be considered for the introduction of the omni-channel customer system in the financial enterprise. As a result of analyzing the key factors, customer experience, operations, and security were identified as the components of the top category in introducing the omni-channel customer system in the financial sector. Furthermore, the weight for each key factor was calculated by using ANP. As a result of ANP, operations, customer experience, and security were important in order. Also, the degree of easiness for connecting with other systems and the various abilities for representing the contents of the omni-channels were derived as the important key factors.

IMPROVE COGNITIVE ABILITIES AND LEARNING MOTIVATION STUDENT IN ELEMENTARY SCHOOL WITH SCIENTIFIC APPROACHES AND STORYTELLING ACTIVITIES

This research has been conducting to get a picture of improving cognitive abilities and learning motivation of students who get natural science subjects in elementary schools with a scientific approach and storytelling activities. The study has been conducting using quasi-experimental methods with a randomized one-group pretest-posttest design. The population is all grade IV students of SD Negeri 7 Jakarta. A sample of one class has been selecting by random cluster sampling. The sample of this research was class IV C, with 30 students. Test instruments in the form of essay tests were 15 items, and learning motivation questionnaires were 12 items with five options using the Likert Scale. The data has been processing with the help of SPSS 22 software. The results showed that there was an increase in students' cognitive abilities with a gain value of 0.55 in the medium category. Student learning motivation has been obtaining an increase of 85.76% in the top category.

Analysis of the Level of Critical Thinking Skills of Students in Biological Materials at Muhammadiyah High School in Palembang City

Critical thinking skills are competencies that must be trained in students because these skills are essential to compete in the life of the 21st century. The purpose of this study is to determine the level of critical thinking skills of students in biological material in Muhammadiyah High School throughout Palembang. This research is a qualitative descriptive study; the population and sample in this study were students of class XI IPA Muhammadiyah High School in Palembang. The research instrument used was a test of critical thinking skills as many as 20 multiple choice questions of semester XI biology material 1. The data obtained will be analyzed quantitatively. Quantitative analysis is used to analyze students' test results. The results showed the level of critical thinking skills of students in Muhammadiyah High Schools throughout Palembang City varied; the exceptionally high category was obtained at 1.85%, top category amounting to 14.5%, medium category 66.6%, low category 16.4% and category very low at 0.5%. The results of this study provide information on the profile of students 'critical thinking skills in Muhammadiyah High Schools throughout Palembang City with the highest moderate category so that teachers are expected to be able to design learning process activities that can empower students' critical thinking skills.

Patient Satisfaction With Medical Student Participation in a Longitudinal Integrated Clerkship: A Controlled Trial.

To determine whether longitudinal student involvement improves patient satisfaction with care. The authors conducted a satisfaction survey of patients followed by 10 University of Minnesota Medical School students enrolled in 2016-2017 in the Veterans Affairs Longitudinal Undergraduate Medical Education (VALUE) program, a longitudinal integrated clerkship at the Minneapolis Veterans Health Care System. Students were embedded in an ambulatory practice with primary preceptors who assigned students a panel of 14 to 32 patients to follow longitudinally in inpatient and outpatient settings. Control patients, matched on disease severity, were chosen from the preceptor's panel. Two to five months after the students completed the VALUE program, the authors conducted a phone survey of the VALUE and control patients using a validated, customized questionnaire. Results are reported from 97 VALUE patients (63% response rate) and 72 controls (47% response rate) who had similar baseline characteristics. Compared with control patients, VALUE patients reported greater satisfaction with explanations provided by their health care provider, their provider's knowledge of their personal history, and their provider's looking out for their best interests (P < .05). Patients in the VALUE panel selected the top category more often than control patients for overall satisfaction with their health care (65% vs 43%, P < .05). The results of this controlled trial demonstrate that VALUE student longitudinal participation in patient care improves patient satisfaction and patient-perceived quality of health care for VALUE patients compared with controls matched by primary care provider and disease severity. These findings may have implications outside the Veterans Administration population.

Apoptosis in porcine cumulus-oocyte complexes: Relationship with their morphology and the developmental competence.

The aim of this study was to assess the presence and distribution of apoptosis in porcine cumulus-oocyte complexes (COCs) and its relations with COC morphology and developmental competence. The COCs were obtained from slaughterhouse ovaries, classified into A1 (top category), A2, B1, B2, C, and D based on their morphology. A1, A2, and B1 were matured and fertilized in vitro, and blastocyst rate was compared among them. Before and after in vitro maturation (IVM), annexin-V staining, and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assays were performed to assess early and late apoptosis, respectively. There was a significant increase in both annexin-V (+) oocytes and TUNEL (+) cumulus cells as morphology further deteriorated. There were no statistical differences regarding annexin-V (+) oocytes within immature and post-IVM COCs, but TUNEL (+) oocytes were only observed in post-IVM COCs. Early and late apoptosis was detected in cumulus cells of all categories of immature and post-IVM COCs. However, the difference was only significant for annexin-V (+). There were no significant differences in embryo development. Therefore, apoptosis increases as the morphological features of the immature COCs decrease. In conclusion, the selection of COCs from Categories A1, A2, and B1 may be used as a selection criterion for in vitro development.