NEUROBIOLOGY RELATIONSHIP BETWEEN STUNTING AND THE RISK OF SPEECH DELAY: A NARRATIVE REVIEW

Stunting is a disorder of growth and development of children due to chronic malnutrition and recurrent infections, especially in the first 1000 days of life. The negative impact of stunting on children, especially on the development of fine motor skills and cognitive abilities, including speech delays, but how stunting is related to speech delay in children has yet to be clearly understood due to restricted existing research and studies. This narrative review explains possible biomechanisms on how stunting causes speech delays in children

Hubungan Pola Dermatoglifi Dengan Hipertensi Essensial

Hipertensi essensial adalah suatu keadaan dimana terjadi peningkatan tekanan darah yang belum bisa dijelaskan penyebabnya. Penelitian ini bertujuan untuk mengetahui hubungan pola dermatoglifi dengan hipertensi essensial. Studi kasus kontrol ini dilakukan di poliklinik rawat jalan penyakit dalam RSMH Palembang, pada bulan Februari 2014. Sampel penelitian berjumlah 93 orang dibagi menjadi dua kelompok, yaitu 31 orang kelompok kasus dan 62 orang kelompok kontrol. Sidik jari dan telapak tangan yang diambil kemudian dibandingkan antara kelompok kasus dan kelompok control. Hasilnya dianalisis dengan menggunakan uji Chi-Square dan t-test. Pola sidik jari paling banyak pada hipertensi essensial adalah pola loop ulnar (64,2%). Pada hipertensi essensial Indeks Furuhata 40,92% kemudian Indeks Dankmeijer 7,72%. Ada hubungan yang bermakna antara pola whorl terhadap pola loop ulnar dan pola whorl terhadap pola arch (p? 0,05 dan OR? 1). Pada uji T -independent didapatkan tidak ada perbedaan yang signifikan rata-rata sudut atd kanan dan sudut atd kiri, terdapat perbedaan yang bermakna pada triradius total (TTC) dan jumlah garis jari total (TRC) antara hipertensi essensial dan bukan hipertensi essensial. Dapat disimpulkan bahwa ada hubungan yang bermakna antara pola dermatoglifi dengan hipertensi essensia

Pengembangan prototipe sistem pencatatan waktu untuk pengukuran kecepatan secara otomatis pada sprint 60-meter

Abstrak: Saat ini sedang berkembang pencatatan waktu otomatis yang dijual oleh beberapa perusahan perlatan olahraga ternama seperti. Namun sayangnya, harga perangkat tersebut sangatlah mahal, dan membuat setiap pelatih ataupun praktisi olahraga terkendala untuk mendapatkannya. Karena fakta dan permasalahan tersebut, maka penelitian ini bertujuan untuk mengembangkan prototipe sistem pencatatan waktu untuk pengukuran kecepatan secara otomatis pada sprint 60-meter, dengan menggunakan perangkat sederhana dengan harga yang murah, namun memiliki tingkat presisi dan akurasi yang baik. Penelitian ini menggunakan metode penelitian research and development, dimana dalam proses pengembangan dan pembuatan pencatatan waktu otomatis, penelitian ini mengambil contoh dari timing gate yang sudah divalidasi sebelumnya. Dalam penelitian ini, kami juga sudah melakukan uji coba kepada 12 atlet sprinter (tinggi badan 172.8 ± 9.31, berat badan 61.05 ± 6.90, BMI 20.38 ± 0.87) terkait kegunaan alat tersebut. Rata�rata kecepatan lari seluruh subjek pada pos 10-meter adalah 2.44 ± 0.23 detik, pos 20-meter adalah 3.71 ± 0.18 detik, pos 30-meter adalah 4.75 ± 0.22 detik, pos 40-meter adalah 6.39 ± 0.31 detik, 50-meter adalah 7.65 ± 0.41 detik, dan 60-meter adalah 9.12 ± 0.49 detik. Penelitian research and development terkait pengembangan pencatatan waktu otomatis dalam penelitian ini, menunjukkan bahwa pencatatan waktu otomatis dapat dibuat dengan harga ekonomis, dan dapat digunakan untuk mengukur kecepatan lari 60-meter. Kata Kunci: kecepatan, peralatan olahraga, prototipe, sports science, sprinte

Heterogeneity in Reported Outcome Measures after Surgery in Superior Canal Dehiscence Syndrome—A Systematic Literature Review

BackgroundSuperior canal dehiscence syndrome (SCDS) can be treated surgically in patients with incapacitating symptoms. However, the ideal treatment has not been determined.ObjectivesThis systematic literature review aims to assess available evidence on the comparative effectiveness and risks of different surgical treatments regarding: (1) symptom improvement; (2) objectively measurable auditory and vestibular function; (3) adverse effects, and (4) length of hospitalization.Search method and data sourcesA systematic database search according to PRISMA statement was conducted on Pubmed, Embase, and Cochrane library. In addition, reference lists were searched. No correspondence with the authors was established. The last search was conducted on June 9, 2017.Study eligibility criteriaRetrospective and prospective cohort studies were held applicable under the condition that they investigated the association between a surgical treatment method and the relief of vestibular and/or auditory symptoms. Only studies including quantitative assessment of the pre- to postoperative success rate of a surgical treatment method were included. Case reports, reviews, meta-analysis, and studies not published in English, Dutch, or German were excluded.Data collection and analysisThe first author searched literature and extracted data; the first and last analyzed the data.Main resultsSeventeen studies (354 participants, 367 dehiscences) met the eligibility criteria and were grouped according to surgical approach. Seven combinations of surgical approaches and methods for addressing the dehiscence were identified: plugging, resurfacing, or a combination of both through the middle fossa (middle fossa approach); plugging, resurfacing, or a combination of both through the mastoid (transmastoid approach); round window reinforcement through the ear canal (transcanal approach). Several studies showed high internal validity, but quality was often downgraded due to study design (1). Outcome measures and timing of postsurgical assessment varied among studies, making it unfeasible to pool data to perform a meta-analysis.ConclusionA standardized protocol including outcome measures and timeframes is needed to compare the effectiveness and safety SCDS treatments. It should include symptom severity assessments and changes in vestibular and auditory function before and after treatment

Comprehensive molecular characterization of gastric adenocarcinoma

Gastric cancer is a leading cause of cancer deaths, but analysis of its molecular and clinical characteristics has been complicated by histological and aetiological heterogeneity. Here we describe a comprehensive molecular evaluation of 295 primary gastric adenocarcinomas as part of The Cancer Genome Atlas (TCGA) project. We propose a molecular classification dividing gastric cancer into four subtypes: tumours positive for Epstein–Barr virus, which display recurrent PIK3CA mutations, extreme DNA hypermethylation, and amplification of JAK2, CD274 (also known as PD-L1) and PDCD1LG2 (also knownasPD-L2); microsatellite unstable tumours, which show elevated mutation rates, including mutations of genes encoding targetable oncogenic signalling proteins; genomically stable tumours, which are enriched for the diffuse histological variant and mutations of RHOA or fusions involving RHO-family GTPase-activating proteins; and tumours with chromosomal instability, which show marked aneuploidy and focal amplification of receptor tyrosine kinases. Identification of these subtypes provides a roadmap for patient stratification and trials of targeted therapies

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Multiplatform Analysis of 12 Cancer Types Reveals Molecular Classification within and across Tissues of Origin

Recent genomic analyses of pathologically-defined tumor types identify “within-a-tissue” disease subtypes. However, the extent to which genomic signatures are shared across tissues is still unclear. We performed an integrative analysis using five genome-wide platforms and one proteomic platform on 3,527 specimens from 12 cancer types, revealing a unified classification into 11 major subtypes. Five subtypes were nearly identical to their tissue-of-origin counterparts, but several distinct cancer types were found to converge into common subtypes. Lung squamous, head & neck, and a subset of bladder cancers coalesced into one subtype typified by TP53 alterations, TP63 amplifications, and high expression of immune and proliferation pathway genes. Of note, bladder cancers split into three pan-cancer subtypes. The multi-platform classification, while correlated with tissue-of-origin, provides independent information for predicting clinical outcomes. All datasets are available for data-mining from a unified resource to support further biological discoveries and insights into novel therapeutic strategies

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries