bluuebunny/crossref_metadata_2025 huggingface dataset:
Empyema Necessitans in the Setting of Methicillin-Susceptible Staphylococcus aureus Causing Pneumonia and Bacteremia
Authors: Bandaru Sindhura , Manthri Sukesh , Sundareshan Vidya , Prakash Vidhya
Published: April 2018

Empyema necessitans (EN) is a rare phenomenon that refers to an insidious extension of the empyema through parietal pleura and subsequent dissection into subcutaneous tissue of the chest wall. A 29-year-old man presented to the hospital with fever and chills a few days after an inadvertent needle stick while injecting heroin. His left forearm was warm with an area of fluctuance. He underwent incision and drainage of the left forearm abscess with fluid submitted for Gram stain and culture. His condition rapidly deteriorated due to sepsis, and he required transfer to the intensive care unit. A new 4 × 3 cm area over the left pectoralis muscle had become increasingly indurated, fluctuant, and erythematous. CT of the chest demonstrated extensive cavitary lung lesions and a large loculated left-sided pleural effusion with extension through the chest wall. TEE revealed a 3 cm complex lesion on the superior septal leaflet of the tricuspid valve. The patient underwent incision and drainage of the pectoralis major EN with placement of a drain. Blood and sputum cultures grew methicillin-susceptible Staphylococcus aureus (MSSA) at which time antibiotic therapy was tailored to oxacillin. Our case highlights a rare occurrence of EN due to MSSA in a patient with intravenous drug use (IDU) and underscores the importance of prompt diagnosis and treatment.
Complex Recanalization of Chronic Total Occluison Supported by Minimal Extracorporeal Circulation in a Patient with an Aortic Valve Bioprothesis in Extraanatomic Position
Authors: Jansen Ruben , Bathgate Brigitte , Bufe Alexander , Guelker Jan-Erik
Published: April 2018

Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. This case describes a complex PCI of the left main coronary artery and of a CTO of the right coronary artery using a minimal extracorporeal circulation system (MECC) in a patient with an aortic valve bioprothesis in extraanatomic position. It illustrates that complex recanalization strategies can be solved combining it with mechanical circulatory support technologies.
Impact of Different Serum Potassium Levels on Postresuscitation Heart Function and Hemodynamics in Patients with Nontraumatic Out-of-Hospital Cardiac Arrest
Authors: Lin Yan-Ren , Syue Yuan-Jhen , Lee Tsung-Han , Chou Chu-Chung , Chang Chin-Fu , Li Chao-Jui
Published: April 2018

Background. Sustained return of spontaneous circulation (ROSC) can be initially established in patients with out-of-hospital cardiac arrest (OHCA); however, the early postresuscitation hemodynamics can still be impaired by high levels of serum potassium (hyperkalemia). The impact of different potassium levels on early postresuscitation heart function has remained unclear. We aim to analyze the relationship between different levels of serum potassium and postresuscitation heart function during the early postresuscitation period (the first hour after achieving sustained ROSC).Methods. Information on 479 nontraumatic OHCA patients with sustained ROSC was retrospectively obtained. Measures of early postresuscitation heart function (rate, blood pressure, and rhythm), hemodynamics (urine output and blood pH), and the duration of survival were analyzed in the case of different serum potassium levels (low: <3.5; normal: 3.5–5; high: >5 mmol/L).Results. Most patients (59.9%, n = 287) had previously presented with high levels of potassium. Bradycardia, nonsinus rhythm, urine output <1 ml/kg/hr, and acidosis (pH < 7.35) were more common in patients with high levels of potassium (allp<0.05). Compared with hyperkalemia, a normal potassium level was more likely to be associated with a normal heart rate (OR: 2.97, 95% CI: 1.74–5.08) and sinus rhythm (OR: 2.28, 95% CI: 1.45–3.58). A low level of potassium was more likely to be associated with tachycardia (OR: 3.54, 95% CI: 1.32–9.51), urine output >1 ml/kg/hr (OR: 5.35, 95% CI: 2.58–11.10), and nonacidosis (blood pH >7.35, OR: 7.74, 95% CI: 3.78–15.58). The duration of survival was shorter in patients with hyperkalemia than that in patients whose potassium levels were low or normal (p<0.05).Conclusion. Early postresuscitation heart function and hemodynamics were associated with the serum potassium level. A high potassium level was more likely to be associated with bradycardia, nonsinus rhythm, urine output <1 ml/kg/hr, and acidosis. More importantly, a high potassium level decreased the duration of survival.
DFT Study for the Spectroscopic and Structural Analysis of p-Dimethylaminoazobenzene
Authors: Ali Majid , Mansha Asim , Asim Sadia , Zahid Muhammad , Usman Muhammad , Ali Narmeen
Published: April 2018

The study under consideration represents the computational calculations of Azo-based direct dye named p-(dimethylamino)azobenzene (DMAB) under the effect of solvents with different relative permittivities. A density functional theory (DFT) method at the B3LYP level with 6-311G++ was applied for the spectroscopic and structural analysis of the title compound. Calculations of geometric parameters (bond orders, bond lengths, and dihedral angles), electron densities, thermodynamic parameters, and orbital energies were performed for the title compound. Mulliken population analysis (MPA) as well as natural population analysis (NPA) was also performed at the B3LYP level with different solvents for finding solvent effects. In order to predict the reactivity of DMAB, molecular electrostatic potential (MESP) calculations were carried out for it. For vibrational analysis, the infrared (IR) spectra were computed for the title compound at the B3LYP/6-311G++ level in the gas phase and in different solvents with good agreement to the experimental FT-IR spectrum. The different modes of vibrations were assigned using potential energy distribution (PED). The computed Raman spectra also showed appreciable agreement with the experimental recorded Raman spectrum. The electronic absorption spectra of the title compound have been computed employing DFT/B3LYP with the 6-311G++ basis set in the gas phase and in four different solvents, that is, DMSO, ethanol, acetonitrile, and water which were compared with the experimental spectra with appreciable agreement. NBO analysis was carried out for understanding the intramolecular and intermolecular bonding of the compound and the density transfer from completely filled to unfilled orbital was found. The HOMO-LUMO energies were determined for analyzing the mechanism of intramolecular charge transfer.
Peripheral Retinal Imaging Biomarkers for Alzheimer’s Disease: A Pilot Study
Authors: Csincsik Lajos , MacGillivray Thomas J. , Flynn Erin , Pellegrini  Enrico , Papanastasiou Giorgos , Barzegar-Befroei Neda , Csutak Adrienne , Bird Alan C. , Ritchie Craig W. , Peto Tunde , Lengyel Imre
Published: April 2018

Purpose: To examine whether ultra-widefield (UWF) retinal imaging can identify biomarkers for Alzheimer’s disease (AD) and its progression. Methods: Images were taken using a UWF scanning laser ophthalmoscope (Optos P200C AF) to determine phenotypic variations in 59 patients with AD and 48 healthy controls at baseline (BL). All living participants were invited for a follow-up (FU) after 2 years and imaged again (if still able to participate). All participants had blood taken for genotyping at BL. Images were graded for the prevalence of age-related macular degeneration-like pathologies and retinal vascular parameters. Comparison between AD patients and controls was made using the Student t test and the χ2 test. Results: Analysis at BL revealed a significantly higher prevalence of a hard drusen phenotype in the periphery of AD patients (14/55; 25.4%) compared to controls (2/48; 4.2%) [χ2 = 9.9, df = 4, p = 0.04]. A markedly increased drusen number was observed at the 2-year FU in patients with AD compared to controls. There was a significant increase in venular width gradient at BL (zone C: 8.425 × 10–3 ± 2.865 × 10–3 vs. 6.375 × 10–3 ± 1.532 × 10–3, p = 0.008; entire image: 8.235 × 10–3 ± 2.839 × 10–3 vs. 6.050 × 10–3 ± 1.414 × 10–3, p = 0.004) and a significant decrease in arterial fractal dimension in AD at BL (entire image: 1.250 ± 0.086 vs. 1.304 ± 0.089, p = 0.049) with a trend for both at FU. Conclusions: UWF retinal imaging revealed a significant association between AD and peripheral hard drusen formation and changes to the vasculature beyond the posterior pole, at BL and after clinical progression over 2 years, suggesting that monitoring pathological changes in the peripheral retina might become a valuable tool in AD monitoring.
Enhanced Vascular Biocompatibility and Remodeling of Decellularized and Secured Xenogeneic/Allogeneic Matrices in a Porcine Model
Authors: van Steenberghe Mathieu , Schubert Thomas , Bouzin Caroline , Caravaggio Carlo , Guiot Yves , Xhema Daela , Gianello Pierre
Published: April 2018

Background/Purpose: Calcifications and absence of growth potential are the major drawbacks of glutaraldehyde-treated prosthesis. Decellularized and secured xeno-/allogeneic matrices were assessed in a preclinical porcine model for biocompatibility and vascular remodeling in comparison to glutaraldehyde-fixed bovine pericardium (GBP; control). Methods: Native human (fascia lata, pericardium) and porcine tissues (peritoneum) were used and treated. In vitro, biopsies were performed before and after treatment to assess decellularization (hematoxylin and eosin/DAPI). In vivo, each decellularized and control tissue sample was implanted subcutaneously in 4 mini-pigs. In addition, 9 mini-pigs received a patch or a tubularized prosthesis interposition on the carotid artery or abdominal aorta of decellularized (D) human fascia lata (DHFL; n = 4), human pericardium (DHP; n = 9), porcine peritoneum (DPPt; n = 7), and control tissue (GBP: n = 3). Arteries were harvested after 1 month and subcutaneous samples after 15–30 days. Tissues were processed for hematoxylin and eosin/von Kossa staining and immunohistochemistry for CD31, alpha-smooth muscle actin, CD3, and CD68. Histomorphometry was achieved by point counting. Results: A 95% decellularization was confirmed for DHP and DPPt, and to a lower degree for DHFL. In the subcutaneous protocol, CD3 infiltration was significantly higher at day 30 in GBP and DHFL, and CD68 infiltration was significantly higher for GBP (p < 0.05). In intravascular study, no deaths, aneurysms, or pseudoaneurysms were observed. Inflammatory reaction was significantly higher for DHFL and GBP (p < 0.05), while it was lower and comparable for DHP/DPPt. DHP and DPPt showed deeper recellularization, and a new arterial wall was characterized. Conclusions: In a preclinical model, DPPt and DHP offered better results than conventional commercialized GBP for biocompatibility and vascular remodeling.
Age, Loss Minimization, and the Role of Probability for Decision-Making
Authors: Best Ryan , Freund Alexandra M.
Published: April 2018

Background: Older adults are stereotypically considered to be risk averse compared to younger age groups, although meta-analyses on age and the influence of gain/loss framing on risky choices have not found empirical evidence for age differences in risk-taking. Objective: The current study extends the investigation of age differences in risk preference by including analyses on the effect of the probability of a risky option on choices in gain versus loss situations. Methods: Participants (n = 130 adults aged 19–80 years) chose between a certain option and a risky option of varying probability in gain- and loss-framed gambles with actual monetary outcomes. Results: Only younger adults displayed an overall framing effect. Younger and older adults responded differently to probability fluctuations depending on the framing condition. Older adults were more likely to choose the risky option as the likelihood of avoiding a larger loss increased and as the likelihood of a larger gain decreased. Younger adults responded with the opposite pattern: they were more likely to choose the risky option as the likelihood of a larger gain increased and as the likelihood of avoiding a (slightly) larger loss decreased. Conclusion: Results suggest that older adults are more willing to select a risky option when it increases the likelihood that larger losses be avoided, whereas younger adults are more willing to select a risky option when it allows for slightly larger gains. This finding supports expectations based on theoretical accounts of goal orientation shifting away from securing gains in younger adulthood towards maintenance and avoiding losses in older adulthood. Findings are also discussed in respect to the affective enhancement perspective and socioemotional selectivity theory.
A Complete Pathological Response to Pembrolizumab following ex vivo Liver Resection in a Patient with Colorectal Liver Metastases
Authors: Baimas-George Maria , Baker Erin , Kamionek Michal , Salmon J. Stuart , Sastry Amit , Levi David , Vrochides Dionisios
Published: April 2018

Advances in the systemic treatment of stage IV colorectal cancer with liver metastases has offered improved survival rates for patients who otherwise face a dismal prognosis. However, a pathologically complete response (PCR) to chemotherapy for colorectal liver metastases is still rare, and its significance is not fully understood. In this case report, we describe a patient who achieved PCR after neoadjuvant immunotherapy with pembrolizumab and a left hepatectomy using an ex vivo resection technique.
Tuberculous Meningitis during Chemotherapy for Advanced Gastric Cancer
Authors: Matsumoto Hiroshi , Sasaki Akinori , Nakamura Yoshiaki , Kawazoe Akihito , Kuboki Yasutoshi , Okinaka Keiji , Shitara Kohei
Published: April 2018

Introduction: Tuberculous meningitis is rare but one of the most severe forms of tuberculosis infection. Case Report: A 78-year-old woman was diagnosed with advanced gastric cancer with multiple lymph node metastases. Four months after the beginning of second-line chemotherapy with weekly paclitaxel, she was admitted to our hospital because of fever and mild drowsiness. She had no other symptoms and no abnormalities in physical examinations. Her blood tests, urinalysis, and blood culture revealed no remarkable abnormal findings. Although her symptoms relieved, her disturbance of consciousness gradually progressed during 2 weeks thereafter. Finally, we diagnosed tuberculous meningitis on the 22nd day of hospitalization by a positive acid-fast bacilli test of the cerebrospinal fluid and tuberculosis-polymerase chain reaction. Although anti-tuberculosis therapy was started, she died on the 37th day of hospitalization because of tumor bleeding. Conclusion: To the best of our knowledge, this is the first report of tuberculous meningitis during chemotherapy for advanced gastric cancer, suggesting that subacute onset of fever followed by disturbance of consciousness may indicate the possibility of tuberculous meningitis even without typical signs of meningitis including headache or meningeal irritation.
Diagnosis of Hyperacute and Acute Ischaemic Stroke: The Potential Utility of Exosomal MicroRNA-21-5p and MicroRNA-30a-5p
Authors: Wang Wei , Li Dong-Bin , Li Ru-Ying , Zhou Xia , Yu Dong-Ju , Lan Xiao-Yan , Li Jin-Pin , Liu Jing-Li
Published: April 2018

Background: Early and accurate diagnosis of ischaemic stroke (IS) requires the use of an optimized biomarker. Exosomal microRNAs have the potential to serve as biomarkers owing to their stability and specificity. We investigated the expression levels of plasma-derived exosomal microRNA-21-5p and microRNA-30a-5p in the different phases of IS. Methods: One hundred forty-three patients with IS and 24 non-stroke controls were enrolled. The patients were divided into the following 5 groups: 1 group for the hyperacute phase IS (HIS, within 6 h); two for the acute phase IS (AIS, including days 1–3 and days 4–7); one for the subacute phase IS (SIS, days 8–14); and one for the recovery phase IS (RIS, days >14). Plasma exosomes were isolated using a QIAGEN exoRNeasy kit and examined by transmission electron ­microscopy, nanoparticle tracking, and flow cytometry. The expression levels of miRNA-21-5p and miRNA-30a-5p were detected by quantitative real-time polymerase chain reaction. Results: The plasma exosomal miR-21-5p levels in SIS and RIS were significantly higher than that in controls (p < 0.05 and p < 0.01 respectively). The levels of miR-30a-5p in HIS were significantly higher (p < 0.05) and in AIS (days 1–3) were lower than that in controls (p < 0.05). In AIS (days 1–3), both miRNAs were decreased compared with the HIS group (p = 0.053 and 0.001, respectively). The area under the curve (AUC) of the miR-21-5p was 0.714 for SIS (95% CI 0.570–0.859, p = 0.007), 0.734 for RIS (95% CI 0.596–0.871, p = 0.003); the AUC of the miR-30a-5p was 0.826 for HIS (95% CI 0.665–0.988, p = 0.001), 0.438 for AIS (days 1–3; 95% CI 0.240–0.635, p = 0.516). Conclusions: The plasma-derived exosomal miR-21-5p and miRNA-30a-5p in combination are promising biomarkers for diagnosing IS and distinguishing among HIS, SIS, and RIS, especially miRNA-30a-5p for the diagnosis of the HIS phase. Our results provide a new reference for clinicians to apply in early-stage diagnosis and identifies the possible value of biomarkers for IS thrombolysis therapy.
Targeting mTOR by CZ415 Inhibits Head and Neck Squamous Cell Carcinoma Cells
Authors: Xie Jing , Li Quan , Ding Xi , Gao Yunyun
Published: April 2018

Background/Aims: mTOR is an important therapeutic target for human head and neck squamous cell carcinoma (HNSCC). The current study tested the anti-HNSCC cell activity by a mTOR kinase inhibitor CZ415. Methods: HNSCC cells were treated with CZ415. Cell death was tested by lactate dehydrogenase (LDH) assay and MTT assay. Cell proliferation was tested by BrdU ELISA assay and [H3] thymidine incorporation assay, with apoptosis assayed by the TUNEL staining. A Western blotting assay was applied to test autophagy-associated proteins, mTOR and signalings. The nude mice xenograft model was established to study CZ415-mediated anti-tumor activity. Results: In established (SCC-9, SQ20B and A253 lines) and primary human HNSCC cells, CZ415 efficiently inhibited cell survival and proliferation. CZ415 blocked mTORC1/2 activation and inhibited ERK in HNSCC cells. CZ415 provoked feedback autophagy activation. Conversely, autophagy inhibitors (3-methyladenine and chloroquine) or Beclin-1 shRNA sensitized CZ415-induced HNSCC cell death. In vivo, CZ415 gavage inhibited SCC-9 tumor growth in nude mice, showing higher efficiency against Beclin-1-silenced tumors. Conclusion: CZ415 inhibits HNSCC cell growth in vitro and in vivo. Inhibition of autophagy can further sensitize CZ415 against HNSCC cells.
Nrf2 Activation Induced by Sirt1 Ameliorates Acute Lung Injury After Intestinal Ischemia/Reperfusion Through NOX4-Mediated Gene Regulation
Authors: Chai DongDong , Zhang Lei , Xi SiWei , Cheng YanYong , Jiang Hong , Hu Rong
Published: April 2018

Background/Aims: Nuclear erythroid 2-related factor-2 (Nrf2) is a major stress-response transcription factor that has been implicated in regulating ischemic angiogenesis. We investigated the effects of Nrf2 in regulating revascularization and modulating acute lung injury. Methods: The expression of Nrf2 and sirtuin1 (Sirt1) was assessed in lung tissue by western blotting and immunofluorescence staining after intestinal ischemia/reperfusion (IIR) in Nrf2–/– and wild-type (WT) mice. The involvement of Nrf2 in angiogenesis, cell viability, and migration was investigated in human pulmonary microvascular endothelial cells (PMVECs). Additionally, the influence of Nrf2 expression on NOX pathway activation was measured in PMVECs after oxygen–glucose deprivation/reoxygenation. Results: We found activation and nuclear accumulation of Nrf2 in lung tissue after IIR. Compared to IIR in WT mice, IIR in Nrf2–/– mice significantly enhanced leukocyte infiltration and collagen deposit, and inhibited endothelial cell marker CD31 expression. Nrf2 upregulation and translocation into the nucleus stimulated by Sirt1 overexpression exhibited remission of histopathologic changes and enhanced CD31 expression. Nrf2 knockdown repressed non-phagocytic cell oxidase 4 (NOX4), hypoxia-inducible factor (HIF-1α) and vascular endothelial growth factor (VEGF) expression after IIR. Nrf2 upregulation by Sirt1 enhances NOX4, HIF-1α and VEGF expression after IIR in WT mice. Furthermore, Nrf2 knockdown suppressed cell viability, capillary tube formation and cell migration in PMVECs after oxygen–glucose deprivation/reoxygenation and also inhibited NOX4, HIF-1 and VEGF expression. Moreover, NOX4 knockdown in PMVECs decreased the levels of VEGF, HIF-1α and angiogenesis. Conclusion: Nrf2 stimulation by Sirt1 plays an important role in sustaining angiogenic potential through NOX4-mediated gene regulation.
Asepsis in Operative Dentistry and Endodontics
Authors: Sriraman Priyanka , Neelakantan Prasanna
Published: April 2018

Operative (Conservative) dentistry and endodontics are specialties of dentistry where the operator is exposed to various infectious agents either via contact with infected tissues, fluids or aerosol. The potential for cross infection to happen at the dental office is great and every dentist must have a thorough knowledge of the concepts of sterilization and disinfection. Disposables should be used wherever possible. Furthermore, the water supply to the dental chair units and water outlets can house biofilms of microbes and should be considered as possible sources of infection. This review discusses the importance of following strict aseptic protocols from the perspective of operative dentistry and endodontics.
Parity Early Stage of Marriage with Incidence of Postpartum Depression
Authors: Ambarwati Eny Retna , Listiyani Ria
Published: April 2018

Postpartum depression is a condition that may be experienced by women. If it is not addressed properly, it will have a negative impact. Determine the correlation between parity and the early stage of the marriage with the incidence of postpartum depression. This research used analytic observational method with cross sectional approach. The population in this research was postpartum mothers in Maternal Hospital Leonisa. The sampling was done using purposive sampling technique. The data analysis was done with univariate and bivariate analysis using Chi-square.The correlation between parity and the incidence of postpartum depression obtains the result of x2 count of 22.864 and p value of 0.000 with df2 and the significance level of (α) at 5% (0.05) x table at 5.591. Therefore, Ho is rejected and Ha is accepted. The correlation between the early stage of the marriage variable with the incidence of postpartum depression obtains a result of x2 count of 12.965 and p value of 0.000 with df 1, the significance level at 5% (0.05), x table at 3.481, therefore, Ho is rejected and Ha is accepted. There is a correlation between parity and the early stage of the marriage with the incidence of postpartum depression.
The Design of Intervention among Survivors of Disaster
Authors: Urbayatun Siti , Listyanti Widuri Erlina , Muttaqiyatun Ani , Eskawati Dewi
Published: April 2018

Indonesia is a region that is frequently hit by disasters, especially the earthquake because of geological factors. Earthquake in 2006 in the region of Yogyakarta and Central Java still has problems to this day, the basics of the economy has not fully recovered , disabled people coud not work as usual, people experience a variety of stressors such as income and material stress and emotional stress. The aimed of this study was to find out the effect of cognitive and religious intervention to cope with stress of disaster. The subjects of this study were people in Bantul who exposed to stress due to disasters such as disability and individuals who have low self-confidence because of disabilty. The method of the study was a responsive action research. Data were collected through observation, interviews, focus group discussions, psychoeducation and training. The study found that cognitive and religious intervention has positive impact on recovery of the subject, for example increase on self-confidence of individual and decrease in the mean of SUD (subjective unit disturbances) score of familie’s subject member. The interventions were usefull to improve the future intervention of disabled persons and people who experience stress of family member’s disability.
Forgiveness, Gratitude, and Happiness among College Students
Authors: Safaria Triantoro
Published: April 2018

Wellbeing is the ultimate goal for everyone, not only for adolescence. Present study explore the relationship between gratitude and forgiveness with happiness among college student. A total of 81 undergarduate psychology students were recruited in this study from a private university in Jogjakarta. 29.6% (24) of the sample were males and 70.4% (57) were females Regression analysis was used to predict the model. This model regression predict relationship between gratitude and forgiveness with happiness, explaining 28.9% of the variance (Adjusted R2= 0.289).Gratitude give the biggest contribution to happiness (b= .536 p= .000), but forgiveness has no significance relationship to happiness (b= .078, p= .414). This result means that gratitude is an important factor contribute to happiness among undergraduate student in this sample. The implication of study are discussing further.
Effect of Storage Containers on Quality of Household Drinking Water in Urban Communities in Ibadan, Nigeria
Authors: Onigbogi Olanrewaju , Ogunyemi Oluwatoyin
Published: April 2018

The method of storage is essential in maintaining water purity and safety for drinking purposes. This study assessed the effect of various storage containers on household drinking water quality in a resource-limited setting. A quasi-experimental design was adopted. Four communities using protected springs as household drinking water sources were purposively selected. Forty-four households were selected and randomly assigned to four treatment groups; namely Covered Buckets with Taps (CBT), Covered Buckets without Tap (CB), Covered Kegs with Taps (CKT) and Covered Kegs without Tap (CK).  Physicochemical analysis and bacteriological analysis were carried out on the water samples before and after they were put in the containers. Data was analyzed using SPSS version 12. At baseline, mean pH values of water samples from the springs and RSC were 6.4±0.6 and 7.1±0.7 respectively which were above the recommended. Mean chloride concentration of springs (14.3±7.4mg/l) and RSC (19.3±10.0 mg/l) samples were below recommended. Mean Total Coliform Count (TCC) of the springs in the four communities was 18.0±4.0 and mean TCC of RSC was 12.7±4.9. Five percent of water samples from RSC had mean E.coli count of 100/100ml. The mean TCC after introducing CB, CBT, CK and CKT in all the communities were 10.0±4.0, 8.5±4.2, 6.9±2.8 and 7.3±3.7 respectively (p<0.05). The use of covered kegs without tap was best in reducing contaminants in drinking water. Education on appropriate household drinking water storage and handling practices is recommended.
Effect of Indirect Advertising and Promotion Activities of Tobacco Products in Khulna
Authors: Azad-uz-zaman Qazi , Hossain Quazi Zahangir
Published: April 2018

Different forms of tobacco advertisement and promotional activities are the burden of tobacco epidemic in Bangladesh. A descriptive type of cross-sectional study was carried out on a total of 404 adults, randomly selected from urban and rural areas. Data were collected implementing both qualitative and quantitative methods from July to September 2013 and found 52% of the respondents were smoking cigarette or bidi, within them only 30% of the male adults were never user of tobacco of any kind. The respondents mainly noticed packet wall (52%), posters (65%), and big size packets (38%) as indirect advertisement as well as free sample (51%) and free gifts (43%) as promotional activities. A significant effect was identified of the activities on increasing consumption which tobacco control advocates and practitioners always argue. Existing laws do not allow giving free samples and free gift to persons, it should be enforced adequately as well as all tobacco control activists should be vigilant on unlawful activities of tobacco traders.
Body Mass Index can be a Good Predictor of Bone Mineral Density in Postmenopausal Women in India
Authors: Chowdhury Biplob , Kundu Brajanath
Published: April 2018

Risk factors for the prediction of osteoporosis are an important and cost effective method since osteoporosis is a silent disease. The purpose of the study was to evaluate the associations between weight, body mass index (BMI), the Osteoporosis Self-Assessment Tool (OST), and bone mineral density (BMD) in postmenopausal women in India. In this cross sectional study, 90 postmenopausal women aged 45–85 years who had given consent participated and the study was conducted between April, 2012 and May, 2013. BMD was measured by ultrasound bone densitometry at calcaneal site. Linear regression multivariate models were used to examine the associations with weight, BMI, OST, and BMD. Body weight, BMI, and OST had almost similar overall performance in their ability to classify women with BMD T-score ≤−2.5. Regression results showed that the linear combination of three independent variables BMI, OST and body weight. BMI predicted 65.7% of the variance in BMD, R2 = .657, R2 adjusted = .609, (F=21.295, p<.000). The strongest predictor of low BMD was BMI. BMI showed significant association with BMD with a correlation of .846. Low weight and BMI predict osteoporosis and are associated with increased risks in postmenopausal women. The negative impact of low body weight on bone health should be more widely recognized.
Contribution Factors on Early Initiation of Breastfeeding
Authors: Ariyani Dwi Fitria , Handayani Lina
Published: April 2018

One of the causes of high Infant Mortality Rate is the low coverage of exclusive breastfeeding. One of the supporting factors to exclusive breastfeeding is implementation of Early Initiation of Breastfeeding (EIB). Mother’s knowledge and understanding about the EIB, as well as the role of birth attendants, especially midwives can be strongly support it’s the EIB. The purpose of this research was to determine the relationship between mother's knowledge, mother’s attitudes and midwife role with the implementation of Early Initiation of Breastfeeding (EIB). The research was an observational analytic research employed cross sectional design. The subjects were maternity mothers who inpatient at Pulang Pisau Hospital in Central Kalimantan Province, Indonesia. The results showed that there were significant relationships between mother's knowledge, attitudes and midwife role with the Implementation of Early Initiation of Breastfeeding (EIB). Attitude was the most influenced variable to the EIB.
Developing Comprehensive Diabetes Education Materials for Structured Patient Education Programs in Primary Care Setting
Authors: Hilman Agrimon Oryzati , Street Jackie
Published: April 2018

Diabetes education is a key factor for a succesful diabetes care. Comprehensive diabetes education materials for conducting stuctured diabetes education programs were rarely found in primary care setting in Indonesia. There was a need for developing new, comprehensive diabetes education materials for low-literate readers. Developing these education materials followed standard steps in developing print materials, and took account tips for writing low literacy materials for poor readers. The new  diabetes education materials consisted of tenvarious leaflets, also printed as14 posters and 14 x-banners. The ten diabetes leaflets were pre-tested to 5 people with type 2 diabetes (T2D). After minor revisions, the leaflets were printed and distributed to 88 people with T2D attending two structured diabetes education programs in Yogyakarta City. These 88 people were requested to evaluate the leaflets using an evaluation form consisting of four items on language usage, font size,  use of pictures, and diabetes informationwith a 1-10 rating scale; and an open-ended question for improvement. Descriptive statistics were used to analyze the results. Most participants thought that the leaflets were easy to understand and read, interesting, and simple. Majority of participants (79.7%) gave favorable comments without providing suggestions for improvement, such as: “The diabetes leaflets are already good and easy to understand”. One third of the participants gave suggestions for improvement. The comprehensive diabetes leaflets developed were well received and highly appreciated by people with T2D attending diabetes education programs.
The Effort to Decrease Maternal and Child Mortality Rates through Cultural Transformation
Authors: Triratnawati Atik , Ditya Kristianti Rani , Putra Aldo Pandega , Bagas Setyaji Pandu
Published: April 2018

Maternal and infant mortality in Ende is still high, but research related a social science is rare. The cultural aspect and medical factors such as the lack of primary health care services are also play a role. This study aims are to identifying and formulate the local cultural transformation as a way to solve maternal and infant mortality. This ethnographic research was conducted in 2013. The study carried not only interviews, but also observation towards reproductive-age women, heads of family, traditional birth attendants, doctors, midwives, local leaders, adat leaders, pastors and sisters, local government officials, and head of health district at Ende. Data is analysed phenomenologically. The strong belief to adat and local tradition has implication to people’s attitude towards traditional birth attendants. Traditional birth attendants hold superior position in the community. They also have strong influence due to their ability to massage, correctly guess infant’s sex, reposition infant in the womb, and stop bleeding during labor. Maternal and/or infant mortality has nothing to do with traditional birth attendants because local people believe that such case happens as a result of hex or black magic called ru’u. Anemia, bleeding, food taboo, and incorrect diet pattern worsen the overall condition of pregnant women. Cultural transformation is done by alternating TBAs practices in massaging pregnant women. TBAs are encouraged to massage pregnant women’s back instead of stomach since pregnant women often have to deal with low back pain during pregnancy.
Social Capital Capacity as Prediction of Dengue Control
Authors: Subaris Heru , Subiyanto Subiyanto , Tri Kartono Drajat , Lestary Eny
Published: April 2018

The program of elimination of mosquito breeding places is still low since there is no public participation effort in vector control. Social capital is key factor for sustaining any health programs implemented. This study was aimed to analyze the effectiveness of social capital impact on participation and environmental based dengue prevention programs. Study design was cross sectional. Population study was community around Bantul district. Sample was collected as 600 house hold devide on two categories endemic and potential areas. Data was collected with interviews and observation. Data were analyzed with person corelation, confirmatory analyzed and path way analyzed. There were significantly relationships between social capital and family perseption, disease perception, individual perception, environment perception and larva density p < 0,05. Relationship between perception of counselling and family perception, dengue programs and family perception p < 0,05, and the strongest factor is environment participation (r=0.296). Based on the path analysis for potential areas, social capital was effectively for increased larvae free index through family perception. Theoretically, model for social capital is more efficient in increasing the number of free larvae index through community environment participation. In potential areas, social capital is concluded to be more effectively increase of larva index through participation of individuals. In endemic areas, that dengue programs increase larva index more effectively, compared with social capital does. Strengthening of social capital is important because it effectively the coverage of larva index through environment participation both areas.
Investigations of latrine coverage and associated factors among Debretabor town, Amhara Region North west Ethiopia
Authors: Tafere Yilkal , Woldie Mirkuzie , Assefa Henok
Published: April 2018

<span style="color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Background: Studies in a number of countries have shown that wherever inappropraite waste disposal morbidity and mortality rates are high. Although latrine coverage is an important indicator for measuring success of the health service program; data on latrine coverage scarce in the study area. Objective: To investigate latrine coverage and associated factors in among households of Debretabor town, Amhara region, Ethiopia. <span style="color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Methods: A community based cross sectional study was conducted in Debretabor town from September 1-30, 2013. A total of 422 households were included in the study using systematic sampling technique. Data were collected using structured questionnaire and analyzed using SPSS version 16.0. Degree of association between independent and dependent variables was assessed with a 95% confidence level and p-value less than 0.05 was used to detect statistical significance. Result: In this study. Ninety three point five percent of households have latrine. Graduated as model family was predictor for availability of latrine (AOR= 3.18,). Income and house ownership were also found to be predictors for availability of latrine (AOR=3.70), (AOR=8.46), respectively. Educational status of respondents was found to be predictors for availability of latrine (AOR= 2.65). Conclusion:  latrine coverage was relatively lower from the national target of 100%, still there are households that use open defication. Educational status, house owner shipe, income and graduated as model family were main factors affecting latrine availability. Improving socio economic status of households, provision of continuous advice and technical support at household level on the availability of latrine are recommended.
Periodontal Disease on Pregnant Women (Case Study: Pondok Labu Village, South Jakarta, Indonesia)
Authors: Rikawarastuti Rikawarastuti , Ngatemi Ngatemi , Harahap Nita Noviani
Published: April 2018

During preganancy, women periodically concern about ANC due to fetus growth, but ignore their own periodontal health. This research was conducted to acknowledge the effect of age, educational background, parity, body mass index (BMI), diabetes mellitus, smoking habit and oral hygiene with periodontal disease on pregnant women. Analytical observation study with cross sectional design was conducted to pregnant women in Pondok Labu Village (Kelurahan), South Jakarta. Purposive sampling was performed among 101 respondents. Chi Square and logistic regression were used for the analysis.  Results shown that periodontal disease on pregnant women were 73.2% (66.3% were calculus and 6.9% were having periodontal pocket of 4-5 mm). It is proven that there is relationship between age, educational background, parity, BMI, diabetes mellitus, and smoking habit to the periodontal disease. On the other hand, oral hygiene highly affected the periodontal disease on pregnant woman. Poor oral hygiene is the dominant factor of periodontal disease on pregnant women after being controlled by age (OR= 21.33, p value 0.005). It is advised for pregnant women to improve their knowledge on how to care for their oral hygiene prior to and during pregnancy, as well as, go through treatments with dentists.
Performance Model of Nurse Community Approach to Organizational Culture in Indonesia
Authors: Suhartono Suhartono , Sulistiawati Sulistiawati , Yunitasari Esty
Published: April 2018

National problem faced by Indonesia today is the handling of the low quality of Human Resources (HR). HR issues that need attention is the issue of performance. Performance is the rate of success in carrying out the task, as well as the ability to achieve the goals set. The aim of this study was to determine the influence of individual factors, organizational factors, organizational and cultural factors on the Performance of Nurses. This study used a cross sectional study approach. The population used in this study were nurses ponkesdes Tuban and Lamongan district in accordance with the inclusion criteria as much as 55, with a sample size of 48 respondents specified research using simple random sampling technique. The independent variable in this study is the individual factors (abilities and skills), organizational cultural factors and organizational factors, dependent variable is the performance of nurse ponkesdes. Instruments used in the collection of data in the form of questionnaires and performance evaluation sheet. Research analysis using simple linear regression test. Simple linear regression analysis showed variable organizational cultural factors were not statistically significant effect on the performance of the p-value (0.000), organizational factors also significantly influence the performance of the pvalue (0.027). While the variable factors of individual (skills and abilities) does not significantly influence the performance
of the p-value (0.103).
Knowledge and Attitude of Students on Antimicrobial Resistance at Debre Markos University, Ethiopia
Authors: Zelellw Desalegne Amare , Bizuayehu Habtamu Mellie
Published: April 2018

Irrational use of medicines is a key reason for the increase and spread of antimicrobial resistance and it is a global concern. It is a fast mounting universal crisis. The main of this study of this study was to assess knowledge, attitude and practice of university students on antimicrobial resistance at Debre Markos University. Institutional based comparative cross-sectional survey was conducted from June to July with total sample size of 670. Participants were selected using simple random sampling method using random number table. Data clerk double entered the data into Epi data version 3.1 and transferred to SPSS Windows software version 21.0. Those variables that had associations at binary stage with p-value < 0.1, not collinear and biologically important variables were entered in to multiple logistic regression models. The cut off point for association was p-value < 0.05. About 14.8% study participants had adequate knowledge towards drug resistance.  Rural residences of the participants were significantly associated with drug resistance as compared to urban residence. Knowledgeable participants were significantly protective to self- medication and drug resistance as compare to those who had inadequate knowledge and participants who had positive attitude were positively associated with self-medication as compare to those who had negative attitude. The overall knowledge of participants regarding to antimicrobial resistance was low. In the other hand, majority of participants had positive attitude. Those participants who had positive attitude were significantly associated with antimicrobial resistance as compared to who had negative attitude.
Knowledge about Obstetric Danger Signs and Associated Factors among Antenatal Care Attendants
Authors: Girum Tadele , Shegaze Mulugeta
Published: April 2018

Knowledge of mothers about obstetric danger sign is the basic influencing factor for utilization of skilled maternal and neonatal cares which reduce maternal and new born mortality and morbidity. Therefore this study intended to assess knowledge about obstetric danger sign and identify associated factors among antenatal care attendants. Institutional based cross- sectional study was conducted from April to June 2015 among 358 randomly selected antenatal care attendants. Epi Info version 7 and SPSS version 20 software were used for data entry and analysis respectively. Logistic regression was run to look for the association between dependent and explanatory variables; and using variables which have p-value ≤ 0.25 binary logistic regression was fitted. Association presented in Odds ratio with 95% confidence interval and significance determined at P-value less than 0.05. Most of the respondents able to name some of the accepted danger signs. Two hundred eight (58%), 182(51%) and, 161(45%) of mother were knowledgeable for obstetric danger sign which could occur during pregnancy, at child birth and post-partum period respectively. The most mentioned dander signs were bleeding, retained placenta and prolonged labor. The factors that associated with Knowledge of obstetric danger signs were urban residence (AOR=2.6; 95% CI: 1.8, 4.2), being literate (AOR=2.54; 95% CI: 1.14, 5.76), multiparity (AOR 1.5; 95% CI: 1.14, 2.3) and being informed (AOR=3; 95% CI: 1.6, 6.4). The study showed that attendant’s knowledge was low. This could be averted through strategies designed to address women’s through health extension workers and health professionals.
Ethnicity, Obesity, and Type 2 Diabetes of Adults in Urban Populations of Central America
Authors: Wuenstel William G , Johnson James A. , Humphries James , Samuel Cheryl
Published: April 2018

The purpose of this meta-analysis was to examine the impact of ethnicity and obesity as it relates to Type-2 Diabetes (T2D) in specific Central American countries. A meta-analysis was conducted to determine the association of ethnicity, obesity, and T2D.  Four studies that qualified for inclusion were identified by searching MEDLINE and PubMed databases. The studies on the association of ethnicity and T2D had a combined population resulted in 265,858 study participants.  Two studies on the association of obesity and T2D had 197,899 participants. An analysis of the data was conducted utilizing the relative risk ration, odds ratio, and forest plots. The comparison of the relative risk of T2D across ethnic categories by studies range for Blacks was 1.59 to 2.74, Asians was 1.43 to 2.08, and Hispanics .92 to 2.91. The ethnic difference in the prevalence of diabetes was almost two-fold higher in all ethnic groups than among the Caucasians with a significance level of 95%. A comparison of relative risk of T2D across weight categories was significantly higher among those with a diagnosed of diabetes in all reported areas. The odds ratio was very close to the risk ratio in both ethnicity and obesity to the development of T2D.The meta-analysis findings documented that an association does exist between ethnicity and obesity to the development of type 2 diabetes.