bluuebunny/crossref_metadata_2025 huggingface dataset:
Anti‐Helicobacter pylori, Anti‐Inflammatory, Cytotoxic, and Antioxidant Activities of Mace Extracts from Myristica fragrans
Authors: Suthisamphat Naranpraphai , Dechayont Bhanuz , Phuaklee Pathompong , Prajuabjinda Onmanee , Vilaichone Ratha-Korn , Itharat Arunporn , Mokmued Khwanchanok , Prommee Nuntika
Published: March 2020

The aril (mace) of Myristica fragrans, known as Dok‐Chan, is a spice that has long been used for treating stomach discomfort, peptic ulcer, and nausea. It is an ingredient in many remedies in Thai traditional medicine, e.g., Ya‐Hom‐Thep‐Bha‐Jit, Ya‐Hom‐Nao‐Wa‐Kot, and Ya‐That‐Bun‐Job, which are used to treat dyspepsia and other gastrointestinal tract symptoms. The aqueous and ethanolic extracts of mace were used for all tests. Anti-H. pylori activities were determined by the disc diffusion method and agar dilution. Anti‐inflammatory activity was determined by the LPS‐induced nitric oxide (NO) inhibition in a RAW264.7 cell line, and cytotoxicity was determined against gastric cancer cell lines (Kato III) using the sulphorhodamine B (SRB) assay. The DPPH radical scavenging and ABTS radical cation decolorization assays were used to determine the antioxidant activities. The result found that the ethanolic extract of mace exhibited antimicrobial activity against H. pylori ATCC 43504 and six clinical strains with MIC values of 125–250 μg/ml. The aqueous extract MICs against H. pylori ATCC reference strain and six clinical strains were 500 μg/ml compared with 0.5 μg/ml for the positive control, clarithromycin. The inhibitory effect of LPS‐induced NO release and cytotoxic activity of the ethanolic extract had IC50 values of 82.19 μg/ml and 26.06 μg/ml, respectively, and the EC50 values for the DPPH and ABTS antioxidant assays were 13.41 μg/ml and 12.44 μg/ml, respectively. The mace extract also had anticancer properties. In conclusion, the ethanolic mace extract had anti‐H. pylori, anti‐inflammatory, antioxidant, and anticancer activities. These data support further preclinical and clinical investigation to see if the mace extract could have a role in treating patients with dyspepsia, peptic ulcers, and possibly gastric cancer.
Atmospheric Pollution and Hospitalization for Cardiovascular and Respiratory Diseases in the City of Manaus from 2008 to 2012
Authors: Sacramento Daniel S. , Martins Lourdes C. , Arbex Marcos A. , Pamplona Ysabely de A. P.
Published: April 2020

Introduction. Air pollution has been identified as a serious public health problem in the world’s major metropolises. Recent studies have shown that airborne particle concentrations are associated with a wide range of effects on human health, including increased hospital admissions for respiratory disease, enhanced asthma episodes, decreased lung function, and increased mortality. Objective. To relate the levels of air pollution and hospital admissions for cardiovascular and respiratory diseases in the city of Manaus in Brazil from 2008 to 2012. Method. This is an ecological time-series study among children (under 5 years of age) and elderly (above 60 years of age). Data on the daily number of hospitalizations for cardiovascular and respiratory diseases, pollutants (PM2.5), temperature, and humidity were used. Poisson generalized additive models were used to estimate the association between variables. Increases in hospitalizations for cardiovascular and respiratory diseases were estimated for the interquartile range (IQR) daily mean level of each variable studied, with a confidence interval of 95%. Results. Respiratory diseases and children: −0.40% (95% CI: −1.11, 0.30), 0.59% (95% CI: −0.35, 1.52), and 0.47% (95% CI: −3.28, 4.21) for PM2.5, temperature, and humidity, respectively. Respiratory diseases and elderly: 0.19% (95% CI: −0.93, 1.31), −0.10% (95% CI: −1.85, 1.65), and −6.17% (95% CI: −13.08, 0.74) for PM2.5, temperature, and humidity, respectively. Cardiovascular diseases and elderly: −0.18% (95% CI: −0.86, 0.50), −0.04% (95% CI: −1.10, 1.03), and −3.37% (95% CI: −7.59, 0.85) for PM2.5, temperature, and humidity, respectively. Conclusions. The time-series study found no significant association between PM2.5, temperature, humidity, and hospitalization, unlike the evidences provided by the present academic literature. Since there is no air quality monitoring network in Manaus and the option available in the present study was to reproduce some information obtained from remote sensing, there is a need for implementation of ground monitoring stations for health and environmental studies in the region.
Comparison of Low-Pass Filters for SPECT Imaging
Authors: Sayed Inayatullah S. , Ismail Siti S.
Published: April 2020

In single photon emission computed tomography (SPECT) imaging, the choice of a suitable filter and its parameters for noise reduction purposes is a big challenge. Adverse effects on image quality arise if an improper filter is selected. Filtered back projection (FBP) is the most popular technique for image reconstruction in SPECT. With this technique, different types of reconstruction filters are used, such as the Butterworth and the Hamming. In this study, the effects on the quality of reconstructed images of the Butterworth filter were compared with the ones of the Hamming filter. A Philips ADAC forte gamma camera was used. A low-energy, high-resolution collimator was installed on the gamma camera. SPECT data were acquired by scanning a phantom with an insert composed of hot and cold regions. A Technetium-99m radioactive solution was homogenously mixed into the phantom. Furthermore, a symmetrical energy window (20%) centered at 140 keV was adjusted. Images were reconstructed by the FBP method. Various cutoff frequency values, namely, 0.35, 0.40, 0.45, and 0.50 cycles/cm, were selected for both filters, whereas for the Butterworth filter, the order was set at 7. Images of hot and cold regions were analyzed in terms of detectability, contrast, and signal-to-noise ratio (SNR). The findings of our study indicate that the Butterworth filter was able to expose more hot and cold regions in reconstructed images. In addition, higher contrast values were recorded, as compared to the Hamming filter. However, with the Butterworth filter, the decrease in SNR for both types of regions with the increase in cutoff frequency as compared to the Hamming filter was obtained. Overall, the Butterworth filter under investigation provided superior results than the Hamming filter. Effects of both filters on the quality of hot and cold region images varied with the change in cutoff frequency.
Secretory IgA in Mucosa of Pharynx and Larynx Plays an Important Role against Influenza A Virus Infection in Kidney Yang Deficiency Syndrome Model
Authors: Zhao Shaozhe , Yuan Lei , Li Yi , Liu Longchan , Luo Zixin , Lv Qingtao , Rong Rong , Yang Yong
Published: March 2020

Objective. Influenza virus poses a major threat to human health and has serious morbidity and mortality which commonly occurs in high‐risk populations. Pharynx and larynx of the upper respiratory tract mucosa is the first defense line against influenza virus infection. However, the ability of the pharynx and larynx organ to eliminate the influenza pathogen is still not clear under different host conditions. Methods. In this study, a mouse model of kidney yang deficiency syndrome (KYDS) was used to mimic high‐risk peoples. Two different methods of influenza A (H1N1) virus infection by nasal dropping or tracheal intubation were applied to these mice, which were divided into four groups: normal intubation (NI) group, normal nasal dropping (ND) group, model intubation (MI) group, and model nasal dropping (MD) group. The normal control (NC) group was used as a negative control. Body weight, rectal temperature, and survival rate were observed every day. Histopathologic changes, visceral index, gene expressions of H1N1, cytokine expressions, secretory IgA (SIgA) antibodies of tracheal lavage fluids in the upper respiratory tract, and bronchoalveolar lavage fluids were analyzed by ELISA. Results. The MD group had an earlier serious morbidity and mortality than the others. MI and NI groups became severe only in the 6th to 7th day after infection. The index of the lung increased significantly in NI, MI, and MD groups. Conversely, indices of the thymus and spleen increased significantly in NC and ND groups. H&E staining showed severe tissue lesions in MD, MI, and NI groups. H1N1 gene expressions were higher in the MD group compared with the MI group on the 3rd day; however, the MD group decreased significantly on the 7th day. IL‐6 levels increased remarkably, and SIgA expressions decreased significantly in the MD group compared with the NC group. Conclusions. SIgA secretions are influenced directly by different conditions of the host in the pharynx and larynx in the upper respiratory tract mucosa. In the KYDS virus disease mode, SIgA expressions could be inhibited severely, which leads to serious morbidity and mortality after influenza A virus infection. The SIgA expressions of the pharynx and larynx would be an important target in high‐risk populations against the influenza A virus for vaccine or antiviral drugs research.
Environmental Quality and Invasive Breast Cancer
Authors: Gearhart-Serna Larisa M. , Hoffman Kate , Devi Gayathri R.
Published: April 2020

Background: Breast cancer is a complex and multifactorial disease, and environmental factors have been suggested to increase its risk. However, prior research has largely focused on studying exposures to one factor/contaminant at a time, which does not reflect the real-world environment.

Methods: Herein, we investigate associations between breast cancer and the environmental quality index (EQI), a comprehensive assessment of five domains of environmental quality (air, water, land, sociodemographic, and built environments) at the county level. Breast cancer diagnoses for North Carolina women were obtained from the North Carolina Central Cancer Registry (2009–2014) and the county of residence at the time of diagnosis was linked with the EQI. We evaluated the odds of localized, regional, or distant metastatic breast cancer in categories of environmental quality using women with carcinoma in situ as registry-based controls.

Results: Overall environmental quality was generally not associated with invasive breast cancer; however, all breast cancer types tended to be inversely associated with land quality, particularly in more rural communities [distant metastatic breast cancer was 5%–8% more likely (OR, 1.08; 95% confidence interval, 1.02–1.14; P = 0.02) compared with carcinoma in situ].

Conclusions: Cumulatively, our results suggest that some broad measures of environmental quality are associated with invasive breast cancer but that associations vary by environmental domain, cancer stage, subtype, and urbanicity.

Impact: Our findings suggest that components of land quality (e.g., pesticide applications and animal facilities) warrant additional investigation in relation to invasive breast cancer.

See all articles in this CEBP Focus section, “Environmental Carcinogenesis: Pathways to Prevention.”
Effect of Iatrogenic Traction during Macular Peeling Surgery on Postoperative Microperimetry
Authors: Leisser Christoph , Palkovits Stefan , Hienert Julius , Ullrich Marlies , Zwickl Hannah , Georgiev Stefan , Findl Oliver
Published: April 2020

Introduction: Vitrectomy with peeling of epiretinal membrane (ERM) and internal limiting membrane offers the chance for improvement of metamorphopsia and visual acuity. Microscope integrated intraoperative optical coherence tomography (iOCT) enables real-time imaging of retinal alterations during peeling, such as intraoperative transient retinal thickening owing to tractional forces during peeling. The aim of our study was to measure the amounts of transient retinal thickening due to tractional forces during membrane peeling, as documented with iOCT, and to analyze possible effects on postoperative retinal function. Methods: This prospective, monocenter study included patients scheduled for pars plana vitrectomy with membrane peeling due to an idiopathic ERM. During peeling, an iOCT device (ReScan700, Carl Zeiss Meditec AG) with continuous OCT-assistance during the peeling procedure, and video documentation of the peeling procedure, was used for the assessment of intraoperative transient retinal thickening owing to tractional forces during peeling. Directly before and 3 months after surgery, macular-OCT scans and microperimetry were performed. Results: Twenty-five eyes of 25 patients were included in the study. Microperimetry could be performed in all patients, while iOCT documentation could be analyzed in 22 patients. Transient retinal thickening owing to tractional forces during peeling could be observed in 14 patients (64%), with a median thickening to 143% of the normal (preoperative) retinal thickness at that location (IQR 132–163). Six patients (24%) developed new deep microscotomata as seen in microperimetry 3 months after surgery, among them were 2 patients who also had transient retinal thickening during peeling. Conclusion: New deep microscotomata developed only in a minority of patients with transient retinal thickening owing to tractional forces during peeling.
Validation of diabetes mellitus patient behavior questionnaire in primary health care service
Authors: Saputri Ginanjar Zukhruf , Akrom Akrom , Dania Haafizah , S Okta Muthia
Published: March 2020

This study aimed to develop and validation a questionnaire as measurement instrument for knowledge and adherence behavior of DM patients in primary health care. Cross sectional study design was conducted in diabetes mellitus patient. Inclusion criteria were patients in the age group 18-65 years, diagnosed with DM, receiving at least one oral antidiabetic medication. Questionnaire questions for behavioral item were developed based on Diabetes Mellitus management guidelines and references to previous studies. Evaluation and validation by expert was carried out on diabetes mellitus experts and clinical psychologists. The pilot study was conducted on 10 healthy patients and 10 patients with diabetes who enrolled inclusion criteria. Questionnaire validation test was conducted with 41 DM outpatient at PKU Muhammadiyah Hospital in Yogyakarta. Collecting data by interviewing patients based on questionnaire. Statistical analysis was performed using SPSS with Pearson correlation coefficients for validation test and Cronbach alpha coefficients for reliability test of the questionnaire. Adherence behavior questionnaire consists of 12 question items, which are divided into three domains: cognitive, affective, and psychomotor domains. Validation results showed 12 valid items where the pearson correlation value was>0.308 (n=41). Cronbach alpha as reliability test results showed 0.78. This result showed a questionnaire were valid and reliable in Diabetes Mellitus patients. This instrument would be use in primary health care for measuring adherence behavior of DM patients.
Spiritual wellbeing in breast and cervical cancer survivors: differences in each stage of survivorship
Authors: Sari Ni Putu Wulan Purnama
Published: March 2020

Spiritual needs in cancer survivors are underappreciated compared to physical and psychological needs. This study aimed to: 1) compare and analyze the differences in spiritual wellbeing (SWB) between breast and cervical cancer survivors (BCS and CCS) generally, and between stages of survivorship specifically, and 2) determine the best predictor of SWB in both cases. This cross-sectional study involved 58 BCS and 47 CCS (n=105). Questionnaire of QOL-CS part IV was used in data collection. Various statistical tests were used in data analysis (α<0.05). SWB was significantly different between BCS and CCS (p=0.002), which influenced by significant differences in religious activity, spiritual activity, uncertainty, positive life changes, life goals, and hope (all p<α). In BCS, overall SWB was not significantly different between survivorship stages (p=0.179); but religious activity, life goals, and hope were significantly different (p=0.043, p=0.022, and p=0.036 respectively) which indicate that these three aspects change overtime along with the survivorship stages. While in CCS, SWB and all of its aspects were not significantly different between survivorship stages (all p>α) which indicate that SWB is stable/stagnant across the survival life span in CCS. Spiritual life changes and religious activity are the best predictors of SWB in both cases and were accounted for 70.3% (R2=0.703) and 69.7% (R2=0.697) variance of SWB in BCS and CCS respectively.
The best predictor of anxiety, stress, and depression among institutionalized elderly
Authors: Sari Ni Putu Wulan Purnama , Manungkalit Maria
Published: March 2020

Anxiety, stress, and depression are the three most common negative emotional constructs found in the elderly. Evidences available worldwide about how psychological problem could be resulted in mental disorder, and there is significant difference in the context of living in the nursing home and in community setting. This study aimed to determine the best predictor of anxiety, stress, and depression in elderly living in the nursing home, useful for future modification and intervention development. This cross-sectional study involved 145 elderly in a private nursing home in Surabaya, Indonesia. HARS, SPST-20, and GDS were used in data collection. Linear regression and one way ANOVA tests were used in data analysis (α<0.05). Results showed that mostly in old individuals, mild anxiety and stress, and undepressed state were found. Sensory problems and concentration difficulties were the best predictor of anxiety and stress respectively, which were accounted for 61.2% and 65.6% variances of anxiety and stress in nursing home residents respectively. Spirits, life energy, happiness, and feeling wonderful to be alive could not predict depression significantly. Feeling inferior to others is the best predictor of depression, which was accounted for 25.9% variance of depression in this population. Low self-esteem leads to depression in nursing home residents.
Clinical conditions and history of illness among terminal chronic kidney disease patients
Authors: Hidayati Titiek , Adiningrat Arya , Akrom Akrom
Published: March 2020

End-stage renal disease (ESRD) is one of the public health problems in Indonesia. This study aimed to determine the clinical condition of premorbid and the incidence of ESRD. The study design is a case-control. The number of volunteers involved in this study was 100 patients. The cases were ESRD patients who were determined by the criteria of Pernefri and the controls were patients from the same hospital who were not ESRD by the requirements of ESRD Pernefri. Inclusion criteria of the study sample were ESRD sufferers need routine hemodialysis and doctor's diagnosis supported by laboratory data, 15-75 years old and willing to fill out inform consent. Exclusion criteria for the study sample were patients with congenital kidney disease, Have a history of kidney transplants, and mental disorder. We collected demographic data, and patient’s clinical and drug history from medical records. Chi-square analysis with 2x2 tables and the Fisher's exact test were used to determine the relationship of clinical conditions and history of disease with the incidence of ESRD. The results showed that anemia, hyperglycemia, and hypertriglyceridemia were related to the prevalence of ESRD. History of hypertension, diabetes mellitus, dyslipidemia, and family history of ESRD are associated with an increased incidence of ESRD.
Health education improve behavior and self-efficacy on personal hygiene among children with intellectual disability
Authors: Hidayati Titiek , Akrom Akrom , Nurasa Indri , Erviana Erviana
Published: March 2020

Personal hygiene is one of the basic human needs and must be kept clean, including scalp and hair, eyes, nose, ears, nails of hands and feet, skin and overall body care. Health education on personal hygiene is still concern not only for healthy children but also for children with disabilities. One of the ways is with audiovisual methods. This study aimed to analyze the effect of health education on personal hygiene with audiovisual methods. The study design used was pre-experiment without a control group. The number of samples was 30 using total sampling technique. Knowledge of personal hygiene before health education (pre-test) was mostly insufficient category, after being given health education (post-test) mainly was in proper group. The pre-test attitude was in low category, and the post-test was still the same. Pre-test and post-test of behavior were mostly being practiced. Pre-test and post-test of self-efficacy were in low category. There was an influence of health education on personal hygiene with audiovisual methods on the level of knowledge in intellectually disabled children (p<0.05), but there was no effect on attitudes, behaviors, and self-efficacy in intellectually disabled children.
Lifestyle profile of elderly living with non-communicable disease in Bangkok and Surabaya
Authors: Sari Ni Putu Wulan Purnama , Artsanthia Jintana
Published: March 2020

Lifestyle is one of the underlying risk factor of non-communicable disease (NCD). Dietary habit and exercise pattern are two indicators of lifestyle. Elderly are prone to NCD due to increased age which being independent risk factor. This study aimed to analyze and compare the lifestyle profile of elderly living with NCD between Bangkok and Surabaya, in term of dietary habit and exercise pattern, and to determine the best predictor of sedentary lifestyle among this population. This cross-sectional study involved 100 and 96 elderly with HT and/or DM in communities of Bangkok and Surabaya respectively (n=196). Self-developed instrument was used in data collection (r=0.178–0.715, Chronbach Alpha=0.644). Mann-Whitney U and regression tests were used in data analysis (α<0.05). There was a significant difference of lifestyle in elderly living with NCD between Bangkok and Surabaya (p=0.008), especially in term of eat variety food (p=0.002), oily food (p=0.015), and curry with coconut milk (p=0.026). Eat vegetable and fruit could not predict dietary habit in elderly living with NCD (p=0.064). Eat fermented food was came up as the best predictor of lifestyle (p=0.000). It was accounted for 52.1% variance in lifestyle score in this population.
Patient satisfaction and associated factors with services provided at outpatient departments
Authors: Mesfin Dereje , Gintamo Tadiwos
Published: March 2020

Asking patients what they think how they feel about the health service they have received is an important step towards improving the quality of care and, ensuring that local health services are meeting clients needs and expectations. Facility- based cross-sectional study was conducted from April 1-7, 2019 in randomly selected primary hospitals found in Guraghe zone. There were 266 randomly selected patients who attended the primary hospitals were participated in the study. Data was collected using a interviewer-administered structured questionnaire and analyzed using SPSS version 21. Multiple logistic regression analysis used to identify predictors of patient satisfaction. The overall of patient satisfaction level with the health service provided at the outpatient departments of the primary hospitals was 66.5% (95% C.I. 60.8%-72.2%). waiting time (AOR 3.65), informing patients about cause of illness (AOR, 2.46) and waiting area cleanliness (AOR 2.33) were among the significant predictors of patients satisfaction. Acknowledging the limitation of the cross-sectional study design findings of this study indicate that waiting time, telling the cause of illness, cleanliness of the waiting area are important predictors of patient satisfaction.
Emotional eating, snacking behavior and nutritional status among adolescents
Authors: Rachmawati Yulia , Anantanyu Sapja , Kusnandar Kusnandar
Published: March 2020

The tendency to eat in response to stress known as emotional eating (EmE). Individuals with EmE usually has been change their dietary pattern towards more unhealthy snacking which contribute to overweight. This study aims to examine the interrelationship between EmE, snacking behavior and nutritional status among adolescents. This was an analytic observational with a cross sectional design study. It was conducted in Surakarta, on August 2019. Total 140 adolescents aged 14-17 years were selected. The data ofEmE were measured by Emotional Eater Questionnaire (EEQ), data of snacking behaviour measured by food frequencies questionnaire (FFQ),and BMI were measured using weight scale and microtoice. Data wereanalyzed by descriptive, bivariate and binary logistic using SPSS v.23. There was significantly difference of EmE and snacking behavior in underweight, normal, and overweight adolescents. We found that underweight (4.17±3.16) and normal individuals (4.97±4.19) were not an emotional eater, and less sweet snacks and sweet drinks consumption while overweight individuals were an emotional eater (14.26±6.04) and eat more sweet snacks, and sweet drinks (p<0.001) during negative emotional states. It was shown that emotional eating and snacking behavior were found higher in overweight than underweight and normal individuals.
Health seeking behavior in Bulak Banteng, Surabaya
Authors: Larasati Fatati
Published: March 2020

Infant and under-five mortality rate in the world is still a major health problem that must be resolved immediately. Mother’s health seeking behavior very important to manage the health of his children. Purpose of this study was to investigate health seeking behavior among mothers when their children were sick. This study was descriptive quantitative involved 50 respondents. The results show majority mothers choose to take action when their children are sick with most choosing to take them to health care facilities and do their own treatment. Mothers are expected to always care for their children well and not too late for giving treatment when their children are sick.
Prevalence and associated factors of metabolic syndrome and its individual components among adolescents
Authors: Bekel Getabalew Endazenaw , Thupayagale-Tshweneagae Gloria
Published: March 2020

Metabolic syndrome is a growing health problem that affects the whole population including adolescents due to change in lifestyles. It is strongly associated with different lifestyle behavioral factors. The objective of the study was to investigate the magnitude and associated factors of metabolic syndrome in adolescents. School based cross-sectional study design was used. The sample size for this study was 844 and 8 high schools were randomly selected from Addis Ababa city Administration. Simple random sampling technique was used to select each participant. Data was analyzed using SPSS version 24 and descriptive summary statistics produced to present the findings. In this study among the components of metabolic syndrome, the highest prevalence was observed in high level of fasting blood glucose level 57.8%, followed by high waist circumference 32.2%. The overall prevalence of metabolic syndrome from the total study participants was 12.4%. Smoking, alcohol intake, performing vigorous or modern physical activity, body mass index and time spent for sedentary activities were factors which had significant association with individual metabolic abnormalities. In conclusions the magnitude of metabolic syndrome is common problem of adolescents in the study area.
Adherence to iron and folic acid supplementation and associated factors among antenatal care attendants in Northwest Ethiopia
Authors: Mekonnen Berhanu Abebaw , Dessie Yadeta , Baraki Negga , Oumer Abdu , Gebru Mehari
Published: March 2020

Iron and folic acid supplementation is the key approach for anemia prevention and control during pregnancy. In Ethiopia only <1% of pregnant mothers ingest the ideal number of tablets. Although, adherence is the most important challenge, literature is dearth and the predictors are undoubtedly recognized. Institution based quantitative cross sectional study design triangulated with qualitative methods was employed among 395 systematically selected pregnant mothers attending antenatal care in Debre Markos town, Ethiopia. Data were collected using interviewer administered structured questionnaire. Data were entered into Epi data and exported to SPSS software. Bivariate and multivariable Logistic regression with the 95% confidence interval was computed. P-value < 0.05 was declared as statistically significant. Eight in-depth interviews were conducted. The data were entered and analyzed using open code software. Adherence rate was 55.5% (95%CI, 50.5%-60.4%). Pregnant mothers who had; history of anemia during current pregnancy [AOR:7.9, 95%CI (4.44-14.01)], primary education (AOR:4.0, 95%CI (1.88-8.54)], secondary education and above (AOR:3.6, 95%CI (1.20-6.94)], good knowledge of iron and folic acid supplementation [AOR:2.1, 95%CI (1.24-3.56)], and early registration for antenatal care (AOR:1.8, 95%CI (1.06-3.11)] were predictors of iron and folic acid supplementation adherence. The rate of adherence was low. Getting medical advice and fear of illness if missed were the primary reasons that enforce mothers to take the tablets. Hence, improving mothers’ knowledge regarding overall aspects of the tablet through better advice, community teaching and the mass media at large, would improve adherence.
Midwife roles to decline maternal mortality rate
Authors: Erawati Ambar Dwi , Rinayati Rinayati , Wahyuning Sri
Published: March 2020

In order to reduce maternal mortality in Central Java, this Province has a superior program which is called 5Ng (Jateng Gayeng Nginceng Wong Meteng/Central Java Glad to See Pregnant Women). Implementation of childbirth assistance in Semarang and Kendal districts in order to reduce maternal mortality has its own model. Based on the preliminary survey, the maternal mortality rate in Semarang and Kendal regencies has decreased. This research aimed to explain the implementation of delivery assistance by midwives in the framework of accelerating reduction in maternal mortality. This study used a qualitative approach with descriptive analytical specifications. Research subjects were midwives in Semarang and Kendal Regencies. Data collection method was conducted by direct in-depth interview. Normal childbirth assistance in Semarang Regency is carried out at the Midwife Independent Practice, Village midwife practice, at the village public health center and public health center with delivery assistance of at least four hands (two midwives). In Kendal Regency normal delivery assistance is performed at first health facility.
Medical student career choice’s determinants in Asia: a systematic review
Authors: Syakurah Rizma Adlia , Rosyila Rosyila
Published: March 2020

Asian countries have distinctive cultural patterns and norms that influence one’s decision making process throughout their life, including career choice. This review was intended to explore factors influencing medical students’ career choice in Asia. This review was compiled based on guidelines from PRISMA (Preferred Reporting Items for systematic reviews and Meta-Analysis). Data was searched and collected from studies published from electronic databases such as Pubmed, Europe PMC, Cochrane Databases, Science Direct, BMC Medical Education, ACM, Wiley Online Library and Mendeley with the keyword "medical student" and "career choice's determinants" or "medical students" and "career determinant" and "Asia". Six studies were found to match the inclusion criteria for this review. Five cross-sectional and one prospective cohort studies involving a total of 1.862 participants that were published between January 1986 and December 2017 were included. Among the included studies, the main findings were grouped into five main determinants: personal interest, family influence, prestigious profession, secure profession, and financial reward. Personal interest was the most influential factor that contributed to Asian medical student career choice’s determinants. It also highlights clinical specialist as unanimous career choice.
Social wellbeing among women living with cancer
Authors: Sari Ni Putu Wulan Purnama
Published: March 2020

Women living with cancer are gradually increases in number due to the increase prevalence of breast and cervical cancer worldwide. The social impact of cancer is underappreciated compared to physical and psychological impacts. This study aimed to: 1) compare and analyze the social wellbeing (SWB) between women living with breast and cervical cancer, and 2) determine the best predictor of SWB in both groups. This cross-sectional study involved 58 and 47 women living wih breast and cervical cancer (n=105). Questionnaire of QOL-CS part III was used in data collection. Various statistical tests were used in data analysis (α<0.05). Sufficient SWB was mostly found in both cases. Family stress, work life, home activities, worriness, social support, personal relation, sexuality, social isolation, and financial burden were significantly different between cases (p=0.021, p=0.027, p=0.004, p=0.022, p=0.000, p=0.000, p=0.000, p=0.000, and p=0.001 respectively), resulted in significant difference in overall SWB between cases (p=0.000). Home activities were the best predictor of SWB in both cases (R2=0.680 and R2=0.840 respectively) with more influences on cervical cancer (84% of influence). SWB was better in women living with breast cancer.
The Effect of PCSK9 (Proprotein Convertase Subtilisin/Kexin Type 9) Inhibition on the Risk of Venous Thromboembolism
Authors: Marston Nicholas A. , Gurmu Yared , Melloni Giorgio E.M. , Bonaca Marc , Gencer Baris , Sever Peter S. , Pedersen Terje R. , Keech Anthony C. , Roselli Carolina , Lubitz Steven A. , Ellinor Patrick T. , O’Donoghue Michelle L. , Giugliano Robert P. , Ruff Christian T. , Sabatine Marc S.
Published: March 2020

Background:

The relationship between cholesterol levels and risk of venous thromboembolism (VTE) is uncertain. We set out to determine the effect of PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibition on the risk of VTE, explore potential mechanisms, and examine the efficacy in subgroups with clinically and genetically defined risk.

Methods:

We performed a post hoc analysis of the FOURIER trial (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk) testing whether evolocumab reduces the risk of VTE events (deep venous thrombosis or pulmonary embolism). Data from FOURIER and ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment with Alirocumab) were then combined in a meta-analysis to assess the class effect of PCSK9 inhibition on the risk of VTE. We also analyzed baseline lipids in FOURIER to investigate potential mechanisms explaining the reduction in VTE with evolocumab. Last, an exploratory genetic analysis was performed in FOURIER to determine whether a VTE polygenic risk score could identify high-risk patients who would derive the greatest VTE reduction from evolocumab.

Results:

In FOURIER, the hazard ratio (HR) for VTE with evolocumab was 0.71 (95% CI, 0.50–1.00;
P
=0.05), with no effect in the 1st year (HR, 0.96 [95% CI, 0.57–1.62]) but a 46% reduction (HR, 0.54 [95% CI, 0.33–0.88];
P
=0.014) beyond 1 year. A meta-analysis of FOURIER and ODYSSEY OUTCOMES demonstrated a 31% relative risk reduction in VTE with PCSK9 inhibition (HR, 0.69 [95% CI, 0.53–0.90];
P
=0.007). There was no relation between baseline low-density lipoprotein cholesterol levels and magnitude of VTE risk reduction. In contrast, in patients with higher baseline lipoprotein(a) (Lp[a]) levels, evolocumab reduced Lp(a) by 33 nmol/L and risk of VTE by 48% (HR, 0.52 [95% CI, 0.30–0.89];
P
=0.017), whereas, in patients with lower baseline Lp(a) levels, evolocumab reduced Lp(a) by only 7 nmol/L and had no effect on VTE risk (
P
interaction
0.087 for HR;
P
heterogeneity
0.037 for absolute risk reduction). Modeled as a continuous variable, there was a significant interaction between baseline Lp(a) concentration and magnitude of VTE risk reduction (
P
interaction
=0.04). A polygenic risk score identified patients who were at >2-fold increased risk for VTE and who derived greater relative (
P
interaction
=0.04) and absolute VTE reduction (
P
heterogeneity
=0.009) in comparison with those without high genetic risk.

Conclusions:

PCSK9 inhibition significantly reduces the risk of VTE. Lp(a) reduction may be an important mediator of this effect, a finding of particular interest given the ongoing development of potent Lp(a) inhibitors.
Peripheral Artery Disease and Venous Thromboembolic Events After Acute Coronary Syndrome
Authors: Schwartz Gregory G. , Steg Philippe Gabriel , Szarek Michael , Bittner Vera A. , Diaz Rafael , Goodman Shaun G. , Kim Yong-Un , Jukema J. Wouter , Pordy Robert , Roe Matthew T. , White Harvey D. , Bhatt Deepak L. ,   For the ODYSSEY OUTCOMES Committees and Investigators*
Published: March 2020

Background:

Patients with acute coronary syndrome are at risk for peripheral artery disease (PAD) events and venous thromboembolism (VTE). PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors reduce lipoprotein(a) and low-density lipoprotein cholesterol (LDL-C) levels. Our objective was to ascertain whether PCSK9 inhibition reduces the risk of PAD events or VTE after acute coronary syndrome, and if such effects are related to levels of lipoprotein(a) or LDL-C.

Methods:

This was a prespecified analysis of the ODYSSEY OUTCOMES randomized clinical trial (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome), which was conducted in 18 924 patients with recent acute coronary syndrome on intensive or maximum-tolerated statin treatment who were randomized to the PCSK9 inhibitor alirocumab or placebo. In a prespecified analysis, PAD events (critical limb ischemia, limb revascularization, or amputation for ischemia) and VTE (deep vein thrombosis or pulmonary embolism) were assessed. LDL-C was corrected (LDL-C
corrected
) for cholesterol content in lipoprotein(a).

Results:

At baseline, median lipoprotein(a) and LDL-C
corrected
were 21 and 75 mg/dL, respectively; with alirocumab, median relative reductions were 23.5% and 70.6%, respectively. PAD events and VTE occurred in 246 and 92 patients, respectively. In the placebo group, risk of PAD events was related to baseline quartile of lipoprotein(a) (
P
trend
=0.0021), and tended to associate with baseline quartile of LDL-C
corrected
(
P
trend
=0.06); VTE tended to associate with baseline quartile of lipoprotein(a) (
P
trend
=0.06), but not LDL-C
corrected
(
P
trend
=0.85). Alirocumab reduced risk of PAD events (hazard ratio [HR], 0.69 [95% CI, 0.54–0.89];
P
=0.004), with nonsignificantly fewer VTE events (HR, 0.67 [95% CI, 0.44–1.01];
P
=0.06). Reduction in PAD events with alirocumab was associated with baseline quartile of lipoprotein(a) (
P
trend
=0.03), but not LDL-C
corrected
(
P
trend
=0.50). With alirocumab, the change from baseline to Month 4 in lipoprotein(a), but not LDL-C
corrected
, was associated with the risk of VTE and the composite of VTE and PAD events.

Conclusions:

In statin-treated patients with recent acute coronary syndrome, risk of PAD events is related to lipoprotein(a) level and is reduced by alirocumab, particularly among those with high lipoprotein(a). Further study is required to confirm whether risk of VTE is related to lipoprotein(a) level and its reduction with alirocumab.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01663402.
Risk/Benefit Tradeoff of Antithrombotic Therapy in Patients With Atrial Fibrillation Early and Late After an Acute Coronary Syndrome or Percutaneous Coronary Intervention
Authors: Alexander John H. , Wojdyla Daniel , Vora Amit N. , Thomas Laine , Granger Christopher B. , Goodman Shaun G. , Aronson Ronald , Windecker Stephan , Mehran Roxana , Lopes Renato D.
Published: March 2020

Background:

In AUGUSTUS (Open-Label, 2×2 Factorial, Randomized, Controlled Clinical Trial to Evaluate the Safety of Apixaban vs Vitamin K Antagonist and Aspirin vs Aspirin Placebo in Patients With Atrial Fibrillation and Acute Coronary Syndrome and/or Percutaneous Coronary Intervention), patients with atrial fibrillation and a recent acute coronary syndrome and those undergoing percutaneous coronary intervention had less bleeding with apixaban than vitamin K antagonist (VKA) and with placebo than aspirin. However, the number of ischemic events was numerically higher with placebo. The aim of this analysis is to assess the tradeoff of risk (bleeding) and benefit (ischemic events) over time with apixaban versus VKA and aspirin versus placebo.

Methods:

In AUGUSTUS, 4614 patients with atrial fibrillation and recent acute coronary syndrome or percutaneous coronary intervention on a P2Y
12
inhibitor were randomized to blinded aspirin or placebo and to open-label apixaban or VKA for 6 months. In a post hoc analysis, we compared the risk of 3 composite bleeding outcomes and 3 composite ischemic outcomes from randomization through 30 days and from 30 days to 6 months with apixaban and VKA and with aspirin and placebo.

Results:

Compared with VKA, apixaban had either a lower or a similar risk of bleeding and ischemic outcomes from randomization to 30 days and from 30 days to 6 months. From randomization to 30 days, aspirin caused more severe bleeding (absolute risk difference, 0.97% [95% CI, 0.23–1.70]) and fewer severe ischemic events (absolute risk difference, −0.91% [95% CI, −1.74 to −0.08]) than placebo. From 30 days to 6 months, the risk of severe bleeding was higher with aspirin than placebo (absolute risk difference, 1.25% [95% CI, 0.23–2.27]), whereas the risk of severe ischemic events was similar (absolute risk difference, −0.17% [95% CI, −1.33 to 0.98]).

Conclusions:

In patients with atrial fibrillation and recent acute coronary syndrome or percutaneous coronary intervention receiving a P2Y
12
inhibitor, apixaban is preferred over VKA. Use of aspirin immediately and for up to 30 days results in an equal tradeoff between an increase in severe bleeding and a reduction in severe ischemic events. After 30 days, aspirin continues to increase bleeding without significantly reducing ischemic events. These results inform shared, patient-centric decision making on the ideal duration of the use of aspirin after an acute coronary syndrome or percutaneous coronary intervention in patients with atrial fibrillation receiving oral anticoagulation.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02415400.
Cartooning and Mind Mapping in the Doctoral Journey
Authors: King Fiona
Published: March 2020

This article is a commentary of the author’s experiences with visual representation as a doctoral candidate. It is an autobiographical reflection of her doctoral journey towards a PhD in education, a mixed methods study which explored teaching for creativity and creative processes for music educators. The author reflects on the experience of engaging with her own work visually via cartooning and mind mapping, and what this meant for her studies and her experience as a research student. The author hopes that this can offer a scope for reflection to readers who are doing similar types of studies or intend to engage more creatively with their doctoral studies. The article aims to demonstrate the benefit of cartooning as a self-expressive tool for the PhD candidate and to show the value of visual representation through mind mapping in the process of data analysis.
A new species of Cypris (Crustacea: Ostracoda) from the Iberian Peninsula and the Balearic Islands, with comments on the first ostracod named using the Linnean system
Authors: MESQUITA-JOANES FRANCESC , AGUILAR-ALBEROLA JOSEP A. , PALERO FERRAN , RUEDA JUAN
Published: April 2020

The genus Cypris, considered the oldest ostracod generic name erected using the Linnean system, comprises a reduced number of large-bodied species, mostly found in Africa and Asia. Only six of them are known to occur in Europe. Here we describe a new species, Cypris pretusi sp. nov., collected in small temporary streams and ponds along the Eastern Iberian Peninsula and Minorca (Balearic Islands). The new species is very close to the type species of the genus, Cypris pubera O.F. Müller, 1776, but differs from it in having a set of smaller subequal spines on the posterior edge of the valves, by the absence of conspicuous spines along the front edge, and by the beak-like frontal shape of its carapace in dorsal view, similar to Cypris decaryi Gauthier, 1933. Soft parts are very similar to the type species, but it differs in having shorter swimming setae on the second antennae. Molecular analyses of the COX1 region support its status as a species distinct from C. pubera and closer to Cypris bispinosa Lucas, 1849, also providing evidence for a separation of C. pubera s.l. in two clades, one of which is here considered to correspond to Cypris triaculeata Daday, 1892. We discuss the relationships of C. pretusi sp. nov. to other members of the genus and its possible origin from nearby biogeographic regions (probably Africa or Asia) and provide a key to species of Cypris found in Europe. We also discuss the relationship between Monoculus concha pedata (= M. conchaceus), the first ostracod named by Linnæus, and Cypris pubera, the type species of the genus, described by Müller in 1776 and considered by him the same species as the one first named by Linnæus.
Examining the Role of Principal Contributors to ‘Sectoral Carbon Emissions’: In the Indian Context
Authors: Jain Megha , Nagpal Aishwarya
Published: March 2020

In the light of impending global climatic risk due to different anthropogenic activities, the current article studies the sectoral carbon footprint of third generational alterations along with new emerging determinants like Information and Communication Technology (ICT), innovation and other related factors with a special reference to the Indian economy. The article concludes with the inclusion of possible way forwards that could contain the deleterious prospective influence with the help of the appropriate policies and programmes.
Workplace Spirituality: A Comparative Study of Various Models
Authors: Rathee Rupa , Rajain Pallavi
Published: March 2020

It is difficult to define the term “workplace spirituality” precisely as it means different things to different people. The confusion arises due to the use of the word spirituality and religion synonymously. But workplace spirituality is not the same as religion. Spirituality at workplace is as simple as having a sense of connection between own self and the workplace. In a fast-moving world, employees often face anxiety, fear, and depression. Working in an environment that supports the employees’ right to openly express their beliefs helps them to have better working relationships with colleagues, feel safer, and be more engaged in their work. Therefore, more and more organizations are inculcating spirituality in their environment, as the impact of a good environment is not only felt by the employees but can be measured through economic outputs, using measures such as quality, productivity, and profitability. In the current research, previous literature has been reviewed to study the rising interest in workplace spirituality as well as to understand its importance for the employees in an organization. It was found that workplace spirituality has a significant impact of work attitudes like organizational performance, job involvement, job commitment, and job satisfaction as a whole. Some of the models given by various authors over time were also studied. These models established relationship between the three aspects of workplace spirituality (inner self, meaningful work, and sense of community) and different work attitudes. The models are quite similar in most of the studies leading to positive results related to influence of workplace spirituality. Few models even suggest the role of spiritual leadership as well in influencing workplace spirituality. Overall, these models suggest that there is significant and positive impact on employees due to workplace spirituality as seen from both empirical and theoretical evidence. Finally, the managerial implications and some suggestions for future research in this area have been provided.