Impact of computer game and computer assisted type instruction on inattention and impulsivity of children suffering from attention deficit hyperactivity disorder

زمینه و هدف: بهبود کاهش توجه و تکانشگری مبتلایان به اختلال نقص توجه- بیش فعالی یکی از مهمترین اهداف درمان این بیماران و از دشوارترین مسائل بالینی در آنها محسوب می شود. مطالعه حاضر با هدف مقایسه تأثیر بازی های کامپیوتری و آموزش تایپ کامپیوتری بر توجه و تکانشگری در کودکان مبتلا با اختلال نقص توجه- بیش فعالی انجام گرفت. روش بررسی: در این تحقیق که به صورت کارآزمایی بالینی یک سوکور انجام شد، 37 کودک دبستانی مبتلا به اختلال نقص توجه- بیش فعالی به دو گروه وارد شدند. گروه 1 (17 نفر) 8 جلسه یک ساعته به مدت یک ماه بازی کامپیوتری انجام دادند، گروه 2 (20 نفر) طی یک ماه تحت هشت جلسه یک ساعته آموزش تایپ کامپیوتری قرار گرفتند و با استفاده از تست عملکرد مداوم شامل بی توجهی (خطای حذف)، تکانشگری (خطای ارتکاب و زمان واکنش) و زمان واکنش قبل و پس از مداخله مقایسه شدند و نتایج با استفاده از آزمون های آماری مجذور کا، t مستقل و t جفت تجزیه و تحلیل گردید. یافته ها: دو گروه از نظر سن، مقطع تحصیلی، جنس، بهره هوشی، داروهای مصرفی، نمرات پرسشنامه کانرز والدین و معلمین، دارا بودن کامپیوتر در منزل و سابقه کار با کامپیوتر همسان بودند. تفاوت تعداد خطای ارتکاب قبل و پس از مداخله در گروه اول معنی دار نبود، اما در گروه دوم، پس از مداخله (44/20±64/11) در مقایسه با قبل از مداخله (18/10±10/14) کاهش معنی داری را نشان داد (05/0

Social Inclusion-Based Library Transformation: a National Library of Indonesia’s Role to Support Sustainable Development Goals (SDGs)

Since 2015, all countries that are members of the United Nations have participated in one of the programs to support human and environmental benefit, Sustainable Development Goals (SDGs). Indonesia as a member of the United Nations supports the course of the program with the release of Presidential Regulation No. 59 year 2017 in which all institutions and ministers follow tpb in accordance with their respective basic duties. The National Library of Indonesia is one of the institutions affected by the regulation. As a building library and network between libraries in accordance with Law No. 43 year 2007 on Libraries, Perpusnas RI has a program to support SDGs named “Social Inclusion-Based Library Transfomation” which is the revitalization of all public libraries of cities / districts and villages in order to implement social inclusion. This research method uses a qualitative approach with case study method. Data retrieval is done by interview techniques and documentation. The results of this study show that Perpusnas RI has carried out activities in accordance with its role in Law No.43 year 2007 and realized a social inclusion-based public library. Attention to all layer of society goes to those who are potentially marginalized, such as diffable people, women, and low-income communities. However, there are some impact that have not been reviewed further, such as to PLWHA, former drug sufferers, as well as minorities like ethnic, racial, and interstellar. Related to SDGs, there are 6 Goals that relevant National Library of Indonesia’s program

Estimated risk of pheochromocytoma recurrence after adrenal sparing surgery in patients with multiple endocrine neoplasia type 2a

Hypothesis Adrenal-sparing adrenalectomy is considered the treatment of choice for hereditary bilateral pheochromocytoma in patients with multiple endocrine neoplasia type 2A (MEN 2A). Design Retrospective analysis of prospectively documented data with a mean \ub1 SD follow-up of 81.5 \ub1 85.3 months. The PubMed database was searched for articles published between 1975 and 2004 to identify published series and/or case reports. Setting University hospital referral center. Patients In 17 (22%) of 77 patients with various mutations of the RET proto-oncogene, unilateral (n =3D 12) or bilateral (n =3D 5) pheochromocytomas were documented at the time of diagnosis or during the course of MEN 2A. Adrenal-sparing surgery was performed in 13 patients (group 1), synchronous bilateral total adrenalectomy in 4 patients (group 2A), and metachronous bilateral total adrenalectomy in 5 patients after adrenal-sparing adrenalectomy (group 2B). Main Outcome Measures Measurement of 24-hour urinary catecholamine levels (noradrenaline, adrenaline, and dopamine) and, in case of high catecholamine levels, imaging studies to localize the tumors in 1 or both adrenal glands to determine the size and exclude extra-adrenal tumors and distant metastasis. Results The mean\ub1SD estimated 5- and 10-year cumulative risk of developing recurrence in both groups was 38.5% \ub1 15.7%. Five (38%) of 13 patients in group 1 developed recurrence in the contralateral gland. Two (22%) of 9 patients in groups 2A and 2B developed several episodes of an addisonian crisis, 1 of whom died. Conclusions Substantial morbidity and mortality are associated with addisonian crisis after bilateral adrenalectomy. Adrenal-sparing adrenalectomy and close monitoring of the remnant may be the treatment of choice for hereditary bilateral pheochromocytoma in MEN 2A, since overall recurrence is low

Scientific Reports / External validation of the NUn score for predicting anastomotic leakage after oesophageal resection

Early detection of anastomotic leakage (AL) after oesophageal resection for malignancy is crucial. This retrospective study validates a risk score, predicting AL, which includes C-reactive protein, albumin and white cell count in patients undergoing oesophageal resection between 2003 and 2014. For validation of the NUn score a receiver operating characteristic (ROC) curve is estimated. Area under the ROC curve (AUC) is reported with 95% confidence interval (CI). Among 258 patients (79.5% male) 32 patients showed signs of anastomotic leakage (12.4%). NUn score in our data has a median of 9.3 (range 6.217.6). The odds ratio for AL was 1.31 (CI 1.031.67; p=0.028). AUC for AL was 0.59 (CI 0.470.72). Using the original cutoff value of 10, the sensitivity was 45.2% an the specificity was 73.8%. This results in a positive predictive value of 19.4% and a negative predictive value of 90.6%. The proportion of variation in AL occurrence, which is explained by the NUn score, was 2.5% (PEV=0.025). This study provides evidence for an external validation of a simple risk score for AL after oesophageal resection. In this cohort, the NUn score is not useful due to its poor discrimination.(VLID)461590

Dissecting molecular mechanisms underlying salt tolerance in rice: a comparative transcriptional profiling of the contrasting genotypes

Abstract Background Salinity expansion in arable land is a threat to crop plants. Rice is the staple food crop across several countries worldwide; however, its salt sensitive nature severely affects its growth under excessive salinity. FL478 is a salt tolerant indica recombinant inbred line, which can be a good source of salt tolerance at the seedling stage in rice. To learn about the genetic basis of its tolerance to salinity, we compared transcriptome profiles of FL478 and its sensitive parent (IR29) using RNA-seq technique. Results A total of 1714 and 2670 genes were found differentially expressed (DEGs) under salt stress compared to normal conditions in FL478 and IR29, respectively. Gene ontology analysis revealed the enrichment of transcripts involved in salinity response, regulation of gene expression, and transport in both genotypes. Comparative transcriptome analysis revealed that 1063 DEGs were co-expressed, while 338/252 and 572/908 DEGs were exclusively up/down-regulated in FL478 and IR29, respectively. Further, some biological processes (e.g. iron ion transport, response to abiotic stimulus, and oxidative stress) and molecular function terms (e.g. zinc ion binding and cation transmembrane transporter activity) were specifically enriched in FL478 up-regulated transcripts. Based on the metabolic pathways analysis, genes encoding transport and major intrinsic proteins transporter superfamily comprising aquaporin subfamilies and genes involved in MAPK signaling and signaling receptor kinases were specifically enriched in FL478. A total of 1135 and 1894 alternative splicing events were identified in transcripts of FL478 and IR29, respectively. Transcripts encoding two potassium transporters and two major facilitator family transporters were specifically up-regulated in FL478 under salt stress but not in the salt sensitive genotype. Remarkably, 11 DEGs were conversely regulated in the studied genotypes; for example, OsZIFL, OsNAAT, OsGDSL, and OsELIP genes were up-regulated in FL478, while they were down-regulated in IR29. Conclusions The achieved results suggest that FL478 employs more efficient mechanisms (especially in signal transduction of salt stress, influx and transport of k+, ionic and osmotic homeostasis, as well as ROS inhibition) to respond to the salt stress compared to its susceptible parent

Surgical Endoscopy / Electrical lower esophageal sphincter augmentation in patients with GERD and severe ineffective esophageal motility : a safety and efficacy study

Background Laparoscopic fundoplication (LF), even if performed in specialized centers, can be followed by long-term side effects such as dysphagia, gas bloating or inability to belch. Patients with an ineffective esophageal motility (IEM) and concurrent GERD are prone to postoperative dysphagia after LF. The aim of this study is to evaluate the safety and efficacy of electrical lower esophageal sphincter stimulation in patients with IEM and GERD. Methods This is a prospective, open-label single center study. Patients with PPI-refractory GERD and ineffective esophageal motility were included for lower esophageal sphincter electrical stimulation (LES-EST). Patients underwent prospective follow-up including physical examination, interrogation of the device and were surveyed for changes in the health-related quality of life score. Results According to power analysis, 17 patients were included in this study. Median distal contractile integral (DCI) was 64 mmHg s cm (quartiles 11.5301). Median total % pH<4 was 8.9 (quartiles 421.6). Twelve patients (70.6%) underwent additional hiatal repair. At 1-month follow-up, none of the patients showed any clinical or radiological signs of dysphagia. There were no procedure related severe adverse events. Mean total HQRL improved from baseline 37.53 (SD 15.07) to 10.93 (SD 9.18) at follow-up (FUP) (mean difference 24.0 CI 15.9332.07) p<0.001. Conclusions LES-EST was introduced as a potential technique to avoid side effects of LF. LES-EST significantly improved health related quality of life and does not impair swallowing in patients with GERD and ineffective esophageal motility.(VLID)365980

European Surgery / Morbidity in open versus minimally invasive hybrid esophagectomy (MIOMIE) : Long-term results of a randomized controlled clinical study

Background The minimally invasive esophagectomy (MIE) for esophageal cancer was introduced assuming a reduction of morbidity and operation time. After implementation of MIE at our institution, a randomized controlled trial was designed. Methods This is a prospective randomized controlled study comparing open (OE) and laparoscopic gastric tube (MIE) formation in Ivor Lewis esophagectomy. Primary endpoints were morbidity and 30-day mortality. Secondary endpoints included the duration of intensive care unit stay, length of hospital stay, operative time as well as relapse-free and overall survival. Results Twenty patients (76.9%) were male, median age was 63 years (4077). Median operation time was 290 (215385) minutes in OE and 292.5 (200450) minutes in MIE group, p = 0.421. Major complications occurred in 4 (33.3%) patients in the OE group and in 6 (35.7%) patients in the MIE group. Anastomotic leakage was seen in 2 (16.6%) and 3 (21.4%) patients, respectively (OR 1.364; CI = 0.1889.912; p = 0.759). Due to an alarming number of consecutive anastomotic leakages, the trial was stopped after inclusion of 26 patients. Median follow-up was 41.5 (162.6) months. 5year survival rate was 50%. Thirty-eight percent developed recurrence of disease in the study period. There was no significant difference in overall and relapse-free survival regarding the type of surgery. Conclusion This study shows that hybrid MIE is a feasible alternative for esophageal resection. Morbidity, mortality, and oncological long-term results were equal in both groups, but the interpretation has to be done carefully due to premature termination of the trial. Interrupting a trial because of patient benefit should not be a reason to discard results but rather to improve technical aspects and strive for novel studies.(VLID)361607