Discordance between Liver Biopsy and FibroScan® in Assessing Liver Fibrosis in Chronic Hepatitis B: Risk Factors and Influence of Necroinflammation

BACKGROUND: Few studies have investigated predictors of discordance between liver biopsy (LB) and liver stiffness measurement (LSM) using FibroScan®. We assessed predictors of discordance between LB and LSM in chronic hepatitis B (CHB) and investigated the effects of necroinflammatory activity. METHODS: In total, 150 patients (107 men, 43 women) were prospectively enrolled. Only LSM with ≥ 10 valid measurements was considered reliable. Liver fibrosis was evaluated using the Laennec system. LB specimens <15 mm in length were considered ineligible. Reference cutoff LSM values to determine discordance were calculated from our cohort (6.0 kPa for ≥ F2, 7.5 kPa for ≥ F3, and 9.4 kPa for F4). RESULTS: A discordance, defined as a discordance of at least two stages between LB and LSM, was identified in 21 (14.0%) patients. In multivariate analyses, fibrosis stages F3-4 and F4 showed independent negative associations with discordance (P = 0.002; hazard ratio [HR], 0.073; 95% confidence interval [CI], 0.014-0.390 for F3-4 and P = 0.014; HR, 0.067; 95% CI, 0.008-0.574 for F4). LSM values were not significantly different between maximal activity grades 1-2 and 3-4 in F1 and F2 fibrosis stages, whereas LSM values were significantly higher in maximal activity grade 3-4 than 1-2 in F3 and F4 fibrosis stage (median 8.6 vs. 11.3 kPa in F3, P = 0.049; median 11.9 vs. 19.2 kPa in F4, P = 0.009). CONCLUSION: Advanced fibrosis stage (F3-4) or cirrhosis (F4) showed a negative correlation with discordance between LB and LSM in patients with CHB, and maximal activity grade 3-4 significantly influenced LSM values in F3 and F4

Politik Hukum Pertanahan Dibidang Hak Guna Usaha (Perkebunan) Yang Berkeadilan Dan Menyejahterakan Rakyat

Konflik agraria dalam skala luas muncul tatkala suatu wilayah dimasukkan ke dalam areal konsesi baik berupa hak (HGU misalnya) ataupun ijin konsesi. Pemberian HGU yang tidak selektif juga memberi peluang lebar bagi penelantaran tanah tatkala pihak penerima HGU tidak menggunakan sebagaimana peruntukaknya. Pemberian HGU tidak semata-mata terpenuhinya syarat administratif namun lebih karena didasarkan motif ekonomi, politik dan kepentingan pengambil kebijakan di pemerintahan daerah dan kepentingankepentingan lain. Pemberian HGU kepada perusahaan badan usaha maupun koperasi dengan saham kepemilikan kolektif, selain mempertimbangkan terpenuhinya syarat-syarat administratif sangatlah penting pula mempertimbangkan viabilitas pihak yang mengajukan, dan berbagai kejelasan klaim atas tanah. Hal ini penting agar di kemudian hari pemberian HGU tidak memunculkan masalah berupa korupsi sebab ditengarai sebagai kedok melakukan money laundry, penelantaran tanah dan konflik pertanahan yang lebih luas. Dalam perkembangannya hukum dan kebijakan pertanahan Indonesia malah melenggangkan pemberian HGU bahkan, dari catatan pemberian HGU dari masa pemerintahan Orde Lama tidak adanya pembatasan luas tanah untuk perusahaan (dalam bentuk HGU). Disertasi ini mengangkat permasalahan; 1) Mengapa Politik Hukum Pertanahan di Bidang HGU (Perkebunan) saat ini belum memberikan kesejahteraan pada rakyat? 2) Bagaimanakah Politik Hukum Pertanahan dibidang HGU (Perkebunan) yang berkeadilan dan menyejahterakan rakyat? Dengan demikian, Disertasi ini bertujuan untuk : 1) Mengetahui , menganalisis dan menjelaskan dengan menggunakan teori teori terhadap peraturan yang kabur, multi tafsir, dan lentur, yaitu Pasal 12 UU No 39 Tahun 2014 tentang Perkebunan untuk melindungan hak atas penduduk sekitar perkebunan. 2) Menemukan kejelasan norma Pasal 12 UU No. 39 Tahun 2014 tentang perkebunan yang berhubungan dengan politik hukum Pertanahan dalam perlindungan hak atas penduduk sekitar perkebunan. Metode penelitian yang digunakan dalam disertasi ini yaitu menggunakan metode penelitian secara normatif. Pendekatan yang digunakan yaitu pendekatan Undang-undang (Statute Approach), pendekatan kasus (case approach), pendekatan konseptual (conseptual approach), pendekanan sejarah (History Approach), dengan menggunakan bahan hukum primer, sekunder dan tertier. Adapun hasil penelitian ini diperoleh simpulan dan saran sebagai berikut: 1. Politik hukum pertаnаhаn di bidаng Hаk Gunа Usаhа (perkebunаn), belum mensejahterakan masyarakat karena pada masa Orde Lama, Orde Baru dan di Era Reformasi Hak Guna Usaha Perkebunan di Indonesia masih menempatkan konflik perkebunan pada tempat teratas, yaitu dengan angka 163 konflik 36,22%, konflik HGU (perkebunan) di Indonesia adalah merupakan model konflik yang berkepanjangan dan sulit terselesaikan, banyak korban yang sudah berjatuhan yaitu dari pihak Pemerintah, Pengusaha maupun dari pihak masyarakat, terkait Okupasi dan berlarutv larutnya proses ganti kerugian tanah hak masyarakat sekitar perkebunan yang di kuasai oleh perusahaan perkebunan. 2. Politik hukum pertanahan dibidang HGU (perkebunan) yang berkeadilan dan menyejahterakan rakyat yaitu politik hukum yang bisa mewujudkan kepastian hukum sehingga masyarakat sekitar HGU bisa mendapatkan kesejahteraan yaitu dengan cara mengikut sertakan masyarakat dalam sistem kemitraan Inti Plasma dan merekonstruksi UU No.39/2014 pasal 12 Ayat (1) yaitu menganti kata imbalan menjadi kata ganti kerugian. Rekomendasi kepada Dewan Perwakilan Rakyat dan pemerintah, agar UU No 39 Tahun 2014 tentang Perkebunan Pasal 12 Ayat (1) sepanjang berkaitan dengan kata “Imbalan” diganti dengan kata-kata yang mudah dipahami dan tidak multi tafsir yaitu kata ganti kerugian

Hormonal regulation of ovarian bursa fluid in mice and involvement of aquaporins.

In rodent species, the ovary and the end of oviduct are encapsulated by a thin membrane called ovarian bursa. The biological functions of ovarian bursa remain unexplored despite its structural arrangement in facilitating oocytes transport into oviduct. In the present study, we observed a rapid fluid accumulation and reabsorption within the ovarian bursa after ovarian stimulation (PMSG-primed hCG injection), suggesting that the ovarian bursa might play an active role in regulating local fluid homeostasis around the timing of ovulation. We hypothesized that the aquaporin proteins, which are specialized channels for water transport, might be involved in this process. By screening the expression of aquaporin family members (Aqp1-9) in the ovarian tissue and isolated ovarian bursa (0, 1, 2 and 5 h after hCG injection), we found that AQP2 and AQP5 mRNA showed dynamic changes after hCG treatment, showing upregulation at 1-2 h followed by gradually decrease at 5 h, which is closely related with the intra-bursa fluid dynamics. Further immunofluorescence examinations of AQP2 and AQP5 in the ovarian bursa revealed that AQP2 is specifically localized in the outer layer (peritoneal side) while AQP5 localized in the inner layer (ovarian side) of the bursa, such cell type specific and spatial-temporal expressions of AQP2 and 5 support our hypothesis that they might be involved in efficient water transport through ovarian bursa under ovulation related hormonal regulation. The physiological significance of aquaporin-mediated water transport in the context of ovarian bursa still awaits further clarification

Concurrent validity of self-rating scale of self-directed learning and self-directed learning instrument among Italian nursing students

BACKGROUND: Self-Directed Learning develops when students take the initiative for their learning, recognising needs, formulating goals, identifying resources, implementing appropriate strategies and evaluating learning outcomes. This should be seen as a collaborative process between the nurse educator and the learner. At the international level, various instruments have been used to measure Self-Directed Learning abilities (SDL), both in original and in culturally-adapted versions. However, few instruments have been subjected to full validation, and no gold standard reference has been established to date. In addition, few researchers have adopted the established tools to assess the concurrent validity of the emerging new tools. Therefore, the aim of this study was to measure the concurrent validity between the Self-Rating Scale of Self-Directed Learning (SRSSDL_Ita) - Italian version and the Self-Directed Learning Instruments (SDLI) in undergraduate nursing students. METHODS: A concurrent validity study design was conducted in a Bachelor level nursing degree programme located in Italy. All nursing students attending the first, second or third year (n=428) were the target sample. The SRSSDL_Ita, and the SDLI were used. The Pearson correlation was used to determine the concurrent validity between the instruments; the confidence of intervals (CI 95%) bias-corrected and accelerated bootstrap (BCa), were also calculated. RESULTS: The majority of participants were students attending their first year (47.9%), and were predominately female (78.5%). Their average age was 22.5\ub14.1. The SDL abilities scores, as measured with the SRSSDL_Ita (min 40, max 200), were, on average, 160.79 (95% CI 159.10-162.57; median 160); while with the SDLI (min 20, max 100), they were on average 82.57 (95% CI 81.79-83.38; median 83). The Pearson correlation between the SRSSDL_Ita and SDLI instruments was 0.815 (CI BCa 95% 0.774-0.848), (p=0.000). CONCLUSIONS: The findings confirm the concurrent validity of the SRSSDL_Ita with the SDLI. The SRSSDL_Ita instrument can be useful in the process of identifying Self-Directed Learning abilities, which are essential for students to achieve the expected learning goals and become lifelong learners

Enhanced heat transfer is dependent on thickness of graphene films: the heat dissipation during boiling

Boiling heat transfer (BHT) is a particularly efficient heat transport method because of the latent heat associated with the process. However, the efficiency of BHT decreases significantly with increasing wall temperature when the critical heat flux (CHF) is reached. Graphene has received much recent research attention for applications in thermal engineering due to its large thermal conductivity. In this study, graphene films of various thicknesses were deposited on a heated surface, and enhancements of BHT and CHF were investigated via pool-boiling experiments. In contrast to the well-known surface effects, including improved wettability and liquid spreading due to micron-and nanometer-scale structures, nanometer-scale folded edges of graphene films provided a clue of BHT improvement and only the thermal conductivity of the graphene layer could explain the dependence of the CHF on the thickness. The large thermal conductivity of the graphene films inhibited the formation of hot spots, thereby increasing the CHF. Finally, the provided empirical model could be suitable for prediction of CHF.open111522Nsciescopu

Efficacy of Electrocoagulation Treatment for the abatement of Heavy Metals: An Overview of Critical Processing Factors, Kinetic Models and Cost Analysis

The electrocoagulation (EC) process introduces coagulants by electrochemical means, and is widely adopted for removing heavy metals, besides other contaminants, such as organic pollutants, suspended and dissolved solids, colloidal materials, etc. However, its capability can vary significantly, depending on the operating conditions. Although most of the investigations so far are limited at the laboratory level with artificially prepared solutions or industrial effluent lacking full- and field-scale studies, the success of the process depends a lot on optimizing the process variable. It has been found that the current density (typically 1–20 mA/cm2), type of electrode (generally aluminum or iron) and minimum electrolysis time are the key process parameters that influence performance. Furthermore, key mechanisms involved in the EC process, including charge neutralization, reduction-oxidation and precipitation/co-precipitation, are crucial for pollutant abatement. This review presents a detailed study undertaking all significant parameters that play a crucial role in the EC process, its mechanism, and improving the efficiency of this process by optimization of these parameters, along with suitable kinetic models

Using social media to support small group learning

Abstract Background Medical curricula are increasingly using small group learning and less didactic lecture-based teaching. This creates new challenges and opportunities in how students are best supported with information technology. We explored how university-supported and external social media could support collaborative small group working on our new undergraduate medical curriculum. Methods We made available a curation platform (Scoop.it) and a wiki within our virtual learning environment as part of year 1 Case-Based Learning, and did not discourage the use of other tools such as Facebook. We undertook student surveys to capture perceptions of the tools and information on how they were used, and employed software user metrics to explore the extent to which they were used during the year. Results Student groups developed a preferred way of working early in the course. Most groups used Facebook to facilitate communication within the group, and to host documents and notes. There were more barriers to using the wiki and curation platform, although some groups did make extensive use of them. Staff engagement was variable, with some tutors reviewing the content posted on the wiki and curation platform in face-to-face sessions, but not outside these times. A small number of staff posted resources and reviewed student posts on the curation platform. Conclusions Optimum use of these tools depends on sufficient training of both staff and students, and an opportunity to practice using them, with ongoing support. The platforms can all support collaborative learning, and may help develop digital literacy, critical appraisal skills, and awareness of wider health issues in society

Quantum Correlations in NMR systems

In conventional NMR experiments, the Zeeman energy gaps of the nuclear spin ensembles are much lower than their thermal energies, and accordingly exhibit tiny polarizations. Generally such low-purity quantum states are devoid of quantum entanglement. However, there exist certain nonclassical correlations which can be observed even in such systems. In this chapter, we discuss three such quantum correlations, namely, quantum contextuality, Leggett-Garg temporal correlations, and quantum discord. In each case, we provide a brief theoretical background and then describe some results from NMR experiments.Comment: 21 pages, 7 figure