Topical Use of Saussurea costus (Falc.) Lipsch. (Qost) Oil in Pediatric Nocturnal Enuresis in Comparison with Sesame Oil, A Randomized Double-Blind Clinical Trial

Nocturnal enuresis is one of the most common chronic problems of childhood. It has a significant effect on health and quality of life of children and their families. Despite pharmacological treatments, enuresis in most children relapses after the medication is discontinued. Also available drugs have many side effects that limited their uses. So, we compared the effect of topical use of Saussurea costus (Falc.) Lipsch. (Qost) oil as a Persian Medicine product on pediatric nocturnal enuresis in a parallel randomized double blinded study. Eighty-two patients aged 5 to 15 years who were diagnosed as monosymptomatic nocturnal enuresis were allocated to receive costus oil or sesame oil topically below the navel twice a day for 4 weeks. Patients were evaluated prior to and following end of the study in terms of frequency of enuresis and any observed adverse events. The results were evaluated with valid PLUTSS questionnaire. For evaluation, Chi-square and Fisher's exact tests, Mann-Whitney and Wilcoxon tests were used. Significant p value was < 0.05. A significant decrease in mean scores of the questionnaires was noted in both groups. The results before and after the intervention were significantly different in both groups, but there was no statistically significant difference between the intervention and control groups. At the end of the 4th week, the frequency and volume of enuresis showed a 46.2 percent reduction in costus oil group and a 25.5 percent reduction in sesame oil group. According to this study, the response rate based on PLUTSS questionnaire in costus oil group is 74.5%; while in the sesame oil group is 69%. No drug side effect was noticed in this study. Based on the results of this study, costus oil is effective in children with monosymptomatic nocturnal enuresis; however, there is no significant difference between costus oil and sesame oil.

Using mHealth to promote parents’ brushing of preschool children’s teeth: a protocol for a randomized factorial trial using the Multi-phase Optimization Strategy (MOST)

Background Early childhood caries is a highly prevalent disease affecting young children. Parental brushing of children’s teeth is recommended during preschool years. Interventions to promote parental brushing of children’s teeth are assessed as a package in randomized clinical trials and the efficacy of separate components is not known. Methods and analysis The aim of this study is to develop an optimized behavior modification intervention to increase parents’ brushing of their pre-school children’s teeth using the multi-phase optimization strategy (MOST) guided by the Theory of Planned Behavior. Behavior change will be assessed by the percent reduction in children’s dental plaque index after 6 months and parents reporting of toothbrushing frequency. Two phases of MOST will be carried out. First, the preparation phase comprises the development of a conceptual framework, identifying candidate components, conducting a feasibility pilot study to assess the acceptability and the design features of three intervention components (motivational interviewing (MI), and two mobile health (mHealth) components: oral health promotion messages and storytelling videos delivered using WhatsApp messenger) in addition to setting an optimization objective. Second, the optimization phase constitutes a factorial trial assessing the three intervention components and developing the intervention by selecting the most effective components within the optimization constraint. Each component will be set at two levels: yes (the intervention is applied) and no (the intervention is not applied). A linear regression model will be used to assess the effect of the intervention components on the percent reduction in dental plaque index (primary outcome measure). The secondary outcome measure is the change in the frequency of parents’ brushing of the child’s teeth. The combination of components making up the new optimized intervention will be selected. Discussion This will be the first study to apply the MOST framework in the field of dentistry. The results of this study can guide the development of an optimized behavior modification interventions using mHealth and MI. Trial registration ClinicalTrials.gov, NCT04923581, Registered 11 June 2021.

LYMPHEDEMA DURATION AS A PREDICTIVE FACTOR OF EFFICACY OF COMPLETE DECONGESTIVE THERAPY

Lymphedema is a common condition with global impact and a multitude of complications, however, only a few professionals specialize in its management. A retrospective analysis of 105 subjects with unilateral lymphedema upper or lower limb was performed to investigate whether the duration of lymphedema constitutes an important factor associated with the efficacy of complete decongestive therapy (CDT). Subjects were classified into two groups according to the duration of lymphedema, prior to CDT: group A (≤1 year) and group B (>1 year). Both groups were treated daily according to the same CDT protocol for four weeks. The CDT efficacy was determined based on the percent reduction of excess volume (PREV) measurements. Lymphedema was significantly reduced in both groups of subjects, but significantly more in group A (p<0.001). In subjects with upper limb lymphedema, median value of PREV was 80.8% (interquartile range, 79.1-105.0%) in group A and 62.0% (interquartile range, 56.7-66.5%) in group B (p<0.001). In subjects with lower limb lymphedema PREV was 80.7% (interquartile range, 74.9-85.2%) and 64.5% (interquartile range, 56.0-68.1%) for groups A and B, respectively (p<0.001). Duration of lymphedema was found to be a strong predictive factor that may significantly impact CDT efficacy. Therapeutic effects were increased in subjects who were detected and treated earlier for lymphedema.

Covid-19 Pandemic: Financial Impact and Intention to Stay in Current Business of Sabah Tamu Operators

In Sabah, Malaysia, a traditional market known as Tamu (means meeting) acts as a hub for local business activity, especially indigenous people. This paper presents an exploratory study whose goal is to investigate the Covid-19 pandemic financial impact and intention to stay in the current business of Tamu operators. Using purposive and snowballing sampling, survey data were collected from 125 Tamu business operators in Sabah. Among the respondents, 61.6 percent indicated Tamu business as their primary income and main entrepreneurial platform. The Covid-19 pandemic Movement Control Order (MCO) enforcement resulted in the Tamu entrepreneurs experiencing 34.2 percent decrease in weekly sales revenue and a 25.7 percent reduction in weekly gross profit. Furthermore, the overall mean score for the Tamu operators' intention to remain in the Tamu business is high at 4.37 based on 5-point likert scale. Thus, the Sabah Tamu operators are more likely to sustain their Tamu business despite the adverse financial impact of the Covid-19 MCO enforcement. This study outcome may guide the relevant government agencies to mitigate the financial impact by formulating and implementing appropriate policies and support programs specifically targeted for the Tamu business operators, who are mostly informal entrepreneurs.

Uji Aktivitas Antikolesterol Ekstrak Etanol Daun Jambu Air(Syzygium aqueum (Burm.f.)Alston) SecaraIn Vitro

Cholesterol is a natural substance that has physical properties similar to fat but has the formula steroids. Cholesterol belongs to the non-hydrolyzed lipid group and is the main sterol in body tissues. When cholesterol levels increase, it can cause blockages in blood vessels. Several studies have explained that one of the compounds that can reduce cholesterol is flavonoid compounds, one of the plants containing flavonoid compounds is guava leaf (Syzygium aqueum (Burm.f.) Alston). The purpose of this study was to determine the activity and percent reduction in cholesterol levels and the EC50 value of the ethanol extract of guava leaves (Syzygium aqueum (Burm.f.) Alston) in vitro using UV-Vis spectrophotometry with a wavelength of 665 nm. Anticholesterol activity analysis was carried out using Lieberman-Burchard reagent with a test solution series of 150; 300; 450; 600; and 750 ppm. The results showed that the greater the concentration, the lower the absorbance produced and the higher the percent reduction in cholesterol levels. At a concentration of 750 ppm cholesterol decreased by 58.74%. And the obtained EC50 value of 462 ppm, which means at that concentration the ethanol extract of guava leaves (Syzygium aqueum (Burm.f.) Alston) can reduce 50% of the initial cholesterol.Keywords:Cholesterol, Guava leaf, In Vitro, Spectrophotometry UV-Vis, Syzygium aqueum (Burm.f.)Alston. AbstrakKolesterol merupakan suatu zat alami yang memiliki sifat fisik hampir sama dengan lemak tetapi memiliki rumus steroida. Kolesterol adalah sterol utama yang ada pada jaringan tubuh dan termasuk dalam golongan lipid yang tidak terhidrolisis. Apabila kadar kolesterol mengalami kenaikan, dapat menyebabkan penyumbatan pada pembuluh darah. Dari beberapa penelitian dijelaskan bahwa salah satu senyawa yang dapat menurunkan kolesterol adalah flavonoid, salah satu tanaman yang mengandung senyawa flavonoid adalah daun jambu air (Syzygium aqueum (Burm.f.)Alston). Tujuan dari penelitian ini adalah untuk mengetahui aktivitas dan persen penurunan kadar kolesterol serta nilai EC50 dari ekstrak etanol daun jambu air (Syzygium aqueum (Burm.f.)Alston) secara in vitro menggunakan spektrofotometri UV-Vis dengan panjang gelombang 665 nm. Analisis aktivitas antikolesterol dilakukan dengan menggunakan pereaksi Lieberman-Burchard dengan seri larutan sampeli 150; 300; 450; 600; dan 750 ppm. Hasil penelitian menunjukkan semakin besar konsentrasi, absorbansi yang dihasilkan adalah semakin rendah dan persen penurunan kadar kolesterolnya semakin tinggi. Pada konsentrasi 750 ppm terjadi penurunan kolesterol sebesar 58,74%. Dan diperoleh nilai EC50 sebesar 462 ppm yang artinya pada konsentrasi tersebut ekstrak etanol daun jambu air (Syzygium aqueum (Burm.f.)Alston) dapat menurunkan 50% dari kolesterol awal.Kata kunci: Daun jambu air;Kolesterol;In Vitro;Spektrofotometri UV-Vis;Syzygium aqueum (Burm.f.)Alston

Team-Specific Human Capital and Team Performance: Evidence from Doctors

This paper studies whether team members’ past collaboration creates team-specific human capital and influences current team performance. Using administrative Medicare claims for two heart procedures, I find that shared work experience between the doctor who performs the procedure (“proceduralist”) and the doctors who provide care to the patient during the hospital stay for the procedure (“physicians”) reduces patient mortality rates. A one standard deviation increase in proceduralist-physician shared work experience leads to a 10–14 percent reduction in patient 30-day mortality. Patient medical resource use also declines with shared work experience, even as survival improves. (JEL I10, J24, M12, M54)

Sensitivity analysis of a reduced model of thrombosis under flow: Roles of Factor IX, Factor XI, and γ‘-Fibrin

A highly reduced extrinsic pathway coagulation model (8 ODEs) under flow considered a thin 15-micron platelet layer where transport limitations were largely negligible (except for fibrinogen) and where cofactors (FVIIa, FV, FVIII) were not rate-limiting. By including thrombin feedback activation of FXI and the antithrombin-I activities of fibrin, the model accurately simulated measured fibrin formation and thrombin fluxes. Using this reduced model, we conducted 10,000 Monte Carlo (MC) simulations for ±50% variation of 5 plasma zymogens and 2 fibrin binding sites for thrombin. A sensitivity analysis of zymogen concentrations indicated that FIX activity most influenced thrombin generation, a result expected from hemophilia A and B. Averaging all MC simulations confirmed both the mean and standard deviation of measured fibrin generation on 1 tissue factor (TF) molecule per μm2. Across all simulations, free thrombin in the layer ranged from 20 to 300 nM (mean: 50 nM). The top 2% of simulations that produced maximal fibrin were dominated by conditions with low antithrombin-I activity (decreased weak and strong sites) and high FIX concentration. In contrast, the bottom 2% of simulations that produced minimal fibrin were dominated by low FIX and FX. The percent reduction of fibrin by an ideal FXIa inhibitor (FXI = 0) ranged from 71% fibrin reduction in the top 2% of MC simulations to only 34% fibrin reduction in the bottom 2% of MC simulations. Thus, the antithrombotic potency of FXIa inhibitors may vary depending on normal ranges of zymogen concentrations. This reduced model allowed efficient multivariable sensitivity analysis.

Drying kinetics on mass reduction with natural operation of potatoes as simulation model

The increase in cases of coronavirus infection causes research to be carried out at home. This is due to the rapid mutation of the coronavirus. So far, WHO has confirmed 4 variants of the coronavirus. The research carried out this time is to make a kinetic model and the percent reduction in mass in potato samples by drying using sunlight as a form of research effort carried out at home. This drying has been done before and this time it is compared with previous research data. The results obtained are that there is a difference, namely the percent reduction in sample mass before and after drying. In the sample carried out this time, the percent mass reduction on the first day was very large, but when tested on the last day it was superior to the previous research, which means that the surface area of the sample accelerates the drying process.

Using mHealth to Promote Mothers’ Brushing of Preschool Children’s Teeth: A Study Protocol using the Multi-phase Optimization Strategy (MOST)

BackgroundEarly childhood caries is a highly prevalent disease affecting young children. Parental brushing of children’s teeth is recommended during preschool years. Interventions to promote parental brushing of children’s teeth are assessed as a package in randomized clinical trials and the efficacy of separate components is not known. Methods and AnalysisThe aim of this study is to develop an optimized behavior modification intervention to increase mothers’ brushing of their pre-school children’s teeth using the Multi-phase Optimization Strategy (MOST) guided by the Theory of Planned Behavior. Behavior change will be assessed by the percent reduction in children’s dental plaque index after 6 months and mothers’ reporting of toothbrushing frequency. Two phases of MOST will be carried out. First: the preparation phase comprises the development of a conceptual framework, identifying candidate components, conducting a feasibility pilot study to assess the acceptability and the design features of three intervention components (motivational interviewing (MI), and two mobile health (mHealth) components: oral health promotion messages, and storytelling videos delivered using WhatsApp messenger) in addition to setting an optimization objective. Second: the optimization phase constitutes a factorial trial assessing the three intervention components and developing the intervention by selecting the most effective components within the optimization constraint. Each component will be set at two levels: yes (the intervention is applied) and no (the intervention is not applied). A linear regression model will be used to assess the effect of the intervention components on the percent reduction in dental plaque index (primary outcome measure). The secondary outcome measure is the change in the frequency of mother’s brushing of the child’s teeth. The combination of components making up the new optimized intervention will be selected.DiscussionThis will be the first study to apply the MOST framework in the field of dentistry. The results of this study can guide to the development of an optimized behaviour modification interventions using mHealth and MI. Trial Registration This trial was registered on June 11th, 2021, in Clinical trials.gov. Registration number: NCT04923581.

Mitigation of Particulate Matter and Airborne Pathogens in Swine Barn Emissions with Filtration and UV-A Photocatalysis

This study evaluated the use of filtration and UV-A photocatalysis for the reduction of particulate matter (PM) and airborne bacterial pathogens in swine barns. Two MERV filters (8 and 15) were used to mitigate PM concentrations measured at the PM 1, PM 2.5, respirable PM, and PM 10 ranges. Filtration was also used to generate different levels of airborne pathogens to be treated by UV-A. Results show that MERV 8 and 15 filters effectively reduced PM concentrations (96-98%) in air exhausted from a swine barn (p ranged from &lt; 0.01 to 0.04). UV-A photocatalysis did not mitigate PM concentrations. UV-A photocatalysis treatment reduced measured colony-forming units (CFUs) by 15-95%. The CFU percent reduction was higher when airborne PM concentration was low. The numeric results suggested a real mitigation effect despite p-values that did not meet the usual statistical cut-off of &lt;0.05 for significance due to the large variability of the CFU control samples. Normalization of measured airborne pathogen concentrations by smaller PM size range concentrations led to emerging significant treatment differences for CFUs. A significant decrease (~60% reduction; p &lt; 0.03) in the concentration of viable airborne bacteria was shown for all PM below the 10-micron range.