bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Abducens Nerve Palsy Following the Second Dose of the AstraZeneca COVID-19 Vaccine
Authors: Pereira Arpitha , Haslett Roger S.
Published: December 2021

The authors report the case of an otherwise healthy 65-year-old man who presented with an acute right abducens nerve palsy 3 days after receiving the second dose of the AstraZeneca coronavirus disease 2019 (COVID-19) vaccine. Abducens nerve palsies typically results from microvascular disease or compressive tumors, although they are known to arise following routine vaccinations. Given the lack of preexisting risk factors, normal computed tomography scan results, and the timing of the symptoms, the abducens nerve palsy was believed to be related to the vaccination. This report highlights the potential neurologic adverse effects associated with COVID-19 vaccines.

[
J Pediatr Ophthalmol Strabismus
. 2021;58(6):e49–e50.]
Nano-ecogel to maintain the physicochemical characteristics of fresh-cut mangosteen
Authors: Suriati Luh ,   Food Science and Technology Department, Agriculture Faculty, Warmadewa University, 80235, Denpasar, Bali, Indonesia, Utama I Made Supartha , Harsojuwono Bambang Admadi , Gunam Ida Bagus Wayan , Adnyana I Made , Fudholi Ahmad ,   Department of Agricultural Engineering, Agriculture Technology Faculty, Udayana University, 80234, Denpasar, Bali, Indonesia,   Technology of Agriculture Industry, Agriculture Technology Faculty, Udayana University 80234, Denpasar, Bali, Indonesia,   Department of Agricultural Sciences, Faculty of Agriculture, Udayana University, 80234, Denpasar, Bali Indonesia,   Research Centre for Electrical Power and Mechatronics, Indonesian Institute Science (LIPI), 15314, Jakarta Indonesia,   Solar Energy Research Institute, Universiti Kebangsaan Malaysia, 43600, Bangi Selangor, Malaysia
Published: December 2021

Fresh-cut mangosteen is a minimally processed product that is currently popular due to the requirement for fresh produce, quality, convenience, and minimal preparation. The process of skin removal causes fast deterioration in fresh-cut mangosteen. The nano edible coating of aloe vera gel or nano-ecogel can be applied to delay physicochemical changes in fresh-cut mangosteen. This study is intended to determine the effect of nano-ecogel concentration and immersion time to maintain the physicochemical characteristics of fresh-cut mangosteen. The effects of the concentration of nano-ecogel (100%, 75%, 50%, and 25%, v/v) and immersion time (1, 2, and 3 min) of fresh-cut mangosteen on acidity, vitamin C, water content, total dissolved solids, weight loss, texture and browning index were evaluated for nine days of cold storage. The concentration of nano-ecogel, immersion time, and interaction affected the acidity, water content, total dissolved solids, weight loss, and browning index of fresh-cut mangosteen. The best treatment was immersion in 50% nano-ecogel for 1 min.
Evaluating knowledge retention and perceived benefits of medical webinar for professional development among Indonesian physicians
Authors: Yo Edward Christopher , Witjaksono Anissa Nindhyatriayu , Fitriani Dewi Yunia , Werdhani Retno Asti , Parikesit Dyandra
Published: December 2021

Purpose: To assess knowledge retention of physicians after participating in a webinar series and its perceived benefits on daily practice and career development.Methods: The webinar series comprised six separate webinars about daily practice. Online questionnaires were sent to all participating physicians via email 3 months after the webinars. The questionnaire assessed knowledge retention through the difference between initial and follow-up post-test as well as the webinar series’ benefits on daily practice and career development. Participants’ demographic information, including their age, gender, education, year of graduation, and work details, were collected to compare outcomes between demographic groups.Results: A total of 689 responses were gathered, and 622 were analyzed. At follow-up, the median knowledge score was significantly lower than the initial median knowledge score (Z=-6.973, p<0.001). Participants’ perception of the webinar series’ benefits on daily practice and career development was very positive. A significant weak negative correlation was found between age and knowledge score at follow-up (rs=-0.157, p<0.001). Physicians who graduated more recently and worked for less than 3 years scored significantly higher on knowledge tests at follow-up. Meanwhile, perception score towards webinar series’ benefits on daily practice was significantly higher among physicians with more extended work history. Male physicians scored significantly higher on perception score towards webinar series’ benefits on career development.Conclusion: Online continuing medical education programs like webinars can encourage physicians to maintain their competence, but further research on improving knowledge retention over time is necessary. Overall, physicians perceived webinars to be beneficial for their professional development.
« Dieu vous exaucera en peu de temps » : Pontmain, une apparition en temps de guerre (17 janvier 1871)
Authors: Waché Brigitte
Published: December 2021

L’apparition mariale de Pontmain (17 janvier 1871) qui s’inscrit dans l’élan de dévotion mariale de la France du xixe siècle a la particularité de se situer à la fin de la guerre franco-prussienne. La concomitance entre les deux événements a nourri une tradition attribuant le repli prussien à l’intercession de la Vierge Marie. Après avoir rappelé l’événement de Pontmain (Mayenne), la communication montre dans quelle mesure ses liens avec le conflit ont d’abord donné une connotation nationale, voire nationaliste, au pèlerinage à l’origine duquel il a été. Cette tendance s’est estompée à partir de la fin des années 1930, notamment dans la période postérieure au concile Vatican II, au profit d’un approfondissement du message spirituel de Pontmain.
Que reste-t-il de 1870-1871 en 1920-1921 ? Le cinquantenaire de « l’année terrible » dans la presse bretonne
Authors: Le Gall Erwan
Published: December 2021

Dans son édition du 11 janvier 1920, le quotidien catholique rennais L’Ouest-Éclair rappelle que « depuis hier, 10 janvier 1920, 4 heures de l’après-midi, nous sommes en paix avec l’Allemagne ». D’un traité de Versailles à un autre, se referme donc un chapitre qui a débuté lors de l’été 1870 par une entrée en guerre précipitée par l’affaire de la dépêche d’Ems. Alors que le traumatisme né des tranchées de 1914-1918 constitue une plaie béante, on pourrait croire que cette mémoire de « l’Année terrible » est écrasée par le sacrifice tout récent de centaines de milliers d’hommes au cours de celle que l’on affirme être la « der des der ». Mais la presse bretonne montre que la réalité est plus complexe : le « poilu » n’a pas complètement effacé le « moblot », ne serait-ce parce que les vétérans de 1870 sont encore nombreux. Par ailleurs, la dimension politique de la séquence 1870-1871, de la proclamation de la République à la Commune de Paris, confère une certaine actualité à cette séquence chronologique. D’ailleurs, le 11 novembre 1920 est tout autant le deuxième anniversaire de l’Armistice que le cinquantième du 4 septembre 1870.
La carrière cancéreuse des enfants malades
Authors: Lecompte Hélène
Published: December 2021

Lorsque les enfants sont atteints d’un cancer, ils sont retirés durablement de leurs espaces sociaux habituels pour être soignés à l’hôpital, lieu dans lequel ils vivent et font de nouveaux apprentissages. Comment devient-on un enfant atteint de cancer ? Comment devient-on un enfant « guéri » ? Quel est le travail de transformation de soi entrepris par et dans l’hôpital et quelles sont les dispositions durablement acquises ? À partir d’une recherche ethnographique, cet article analyse l’expérience des enfants, des premiers symptômes à la vie après le cancer, en mobilisant le concept de carrière. Il décrit la carrière cancéreuse de l’enfant et ses différentes phases : l’entrée dans la carrière, la manière dont les enfants y sont engagés, la vie dans l’institution hospitalière et le maintien dans la carrière malgré la fin des traitements. En saisissant le processus, des premiers symptômes à l’après-cancer, nous analysons aussi comment l’expérience du cancer et de l’hôpital participe à la construction identitaire des anciens enfants malades.
Écrans, médiations et authenticité dans le concert pop : deux cas d’étude
Authors: Sarno Giulia
Published: December 2021

En recourant à des méthodologies d’analyse qualitative de contenu, l’essai examine certaines implications de l’utilisation de projections vidéo dans le concert de musique populaire avec deux études de cas : celui de Kraftwerk, qui développe un « double » visant à déshumaniser la performance, en phase avec la célébration de la machine et de l’androïde, cruciale dans leur esthétique ; et celui de Gorillaz, un groupe virtuel composé de personnages animés agissant sur des écrans ou comme des hologrammes, tandis que les musiciens « réel » restent cachés. Dans les deux cas, des choix spécifiques dans l’utilisation des vidéoprojections affectent le statut ontologique de l’auteur/performer, déclenchant une réflexion sur la nature de la performance musicale et problématisant les concepts de liveness et d’authenticité.
Online Detection and Prediction of Fused Deposition Modelled Parts Using Artificial Intelligence
Authors: Salunkhe Sachin , Kanagachidambaresan G. , Rajkumar C. , Jayanthi K.
Published: December 2021

Fused deposition modelling (FDM) is a technology used for filament deposition of heated plastic filaments by a given pattern by the melted extrusion process. Delamination is a critical issue of FDM's incredibly complex parts. In this chapter, the artificial intelligence (machine learning) model is used for online detections and prediction of FDM parts. The proposed machine learning and convolutional neural network model is capable of online detect delamination of FDM parts. The proposed model can also be applied for different types of additive manufacturing materials with less human interaction.
NRP Versus PALS for Infants Outside the Delivery Room: Not If, but When?
Authors: Doroba Jaime Esbensen
Published: December 2021

Background

Both the Neonatal Resuscitation Program and Pediatric Advanced Life Support guidelines can be used for infants requiring cardiopulmonary resuscitation outside the delivery room. Each set of guidelines has supporting algorithms for resuscitation; however, there are no current recommendations for transitioning older infants outside the delivery room.

Objective

To provide background information on the algorithms in the Neonatal Resuscitation Program and Pediatric Advanced Life Support guidelines and to discuss the role that nurses and advanced practice nurses play in advancing scientific research on resuscitation.

Content Covered

Summaries of both sets of guidelines, differences in practices, and recommendations for practice changes will be discussed.

Discussion

Provider preference and unit practice determine which guidelines are used for infants outside the delivery room. Providers in pediatric intensive care units and pediatric cardiac intensive care units often use the Pediatric Advanced Life Support guidelines, whereas providers in neonatal intensive care units use the Neonatal Resuscitation Program guidelines for infants of the same age. The variation in resuscitation practices for infants outside the delivery room can negatively affect resuscitation outcomes.
Afatinib Mediates Autophagic Degradation of ORAI1, STIM1, and SERCA2, Which Inhibits Proliferation of Non–Small Cell Lung Cancer Cells
Authors: Kim Mi Seong , Kim So Hui , Yang Sei-Hoon , Kim Min Seuk
Published: December 2021

Background: The expression of calcium signaling pathway molecules is altered in various carcinomas, which are related to the proliferation and altered characteristics of cancer cells. However, changes in calcium signaling in anti-cancer drugresistant cells (bearing a T790M mutation in epidermal growth factor receptor [EGFR]) remain unclear.Methods: Afatinib-mediated changes in the level of store-operated Ca2+ entry (SOCE)-related proteins and intracellular Ca2+ level in non–small cell lung cancer cells with T790M mutation in the EGFR gene were analyzed using western blot and ratiometric assays, respectively. Afatinib-mediated autophagic flux was evaluated by measuring the cleavage of LC3B-II. Flow cytometry and cell proliferation assays were conducted to assess cell apoptosis and proliferation.Results: The levels of SOCE-mediating proteins (ORAI calcium release-activated calcium modulator 1 [ORAI1], stromal interaction molecule 1 [STIM1], and sarco/endoplasmic reticulum Ca2+ ATPase [SERCA2]) decreased after afatinib treatment in non–small cell lung cancer cells, whereas the levels of SOCE-related proteins did not change in gefitinibresistant non–small cell lung cancer cells (PC-9/GR; bearing a T790M mutation in EGFR ). Notably, the expression level of SOCE-related proteins in PC-9/GR cells was reduced also responding to afatinib in the absence of extracellular Ca2+. Moreover, extracellular Ca2+ influx through the SOCE was significantly reduced in PC-9 cells pre-treated with afatinib than in the control group. Additionally, afatinib was found to decrease the level of SOCE-related proteins through autophagic degradation, and the proliferation of PC-9GR cells was significantly inhibited by a lack of extracellular Ca2+.Conclusion: Extracellular Ca2+ plays important role in afatinib-mediated autophagic degradation of SOCE-related proteins in cells with T790M mutation in the EGFR gene and extracellular Ca2+ is essential for determining anti-cancer drug efficacy.
Comparison of cuff inflation method with curvature control modification in thermosoftened endotracheal tubes during nasotracheal intubation – A prospective randomised controlled study
Authors: HT Prashant , Kerai Sukhyanti , Saxena Kirti Nath , Wadhwa Bharti , Gaba Prachi
Published: December 2021

Background and Aims:

Thermosoftening of endotracheal tube (ETT) is a simple method which reduces risk of epistaxis during nasotracheal intubation (NTI). This method, however, decreases the stiffness of ETT and necessitates frequent manipulation with Magill forceps. Cuff inflation technique has been found effective for navigating ETTs during NTI. Another method is using an ETT, modified with a silk thread which can be used to control its curvature. We conducted the present study to compare the ease of navigation of thermosoftened ETT using curvature control modificationwiththe cuff inflation technique.

Methods:

Depending on the method used for navigating thermosoftened ETT to glottis, 70 patients undergoing general anaesthesia with NTI were randomly divided into two groups. The primary outcome was ease of navigation of thermosoftened ETT. Secondary outcomes were time taken for moving tube from oropharynx to glottis and incidence of epistaxis during NTI.

Results:

Both techniques resulted in successful navigation of thermosoftened ETT in all patients with majority of cases resulting in smooth engagement to glottic inlet. The difference in ease of navigation between the groups was 7% [95% CI (−9.21% to 23.28%)] and it was not found to be statistically significant (P = 0.395). Cuff inflation method resulted in faster alignment to glottis compared to use of modified tube (12. 39 ± 7 Vs 18.73 ± 11.5 sec; P = 0.003).

Conclusion:

For thermosoftened ETT, both cuff inflation method and the technique of curvature controlled modified ETT can be used for navigation of tube to glottis with ease.
Use of a non-invasive biomarker salivary alpha-amylase to assess the role of probiotics in sleep regulation and stress attenuation in surgical patients
Authors: Kurdi Madhuri S , Ramaswamy Ashwini H , Kumar L Ajay , Choukimath Sharanabasava M , Jangi Aabidhussain A
Published: December 2021

Background and Aims:

The influence of gut microbiota on human behaviour, stress and sleep is currently a novel topic of research. A prospective double-blind randomised trial was planned to find out whether probiotics by alteration of the gut microbiome can allay surgery-related stress and improve sleep.

Methods:

A total of 160 elective surgical patients were randomised to receive either probiotic or placebo capsule twice daily for four and a half consecutive preoperative days. They were subjected to the Perceived Stress Scale (PSS) questionnaire, a psychomotor vigilance task (PVT) and estimation of salivary alpha-amylase (SAA), a well-known biomarker of stress on the evening of admission and on the evening just before the day of scheduled surgery. Data were analysed using Chi-square test, Student's t-test and Mann–Whitney test.

Results:

On comparing between the two groups, there was a significant difference in PSS scores, SAA levels and PVT scores after probiotic/placebo therapy. There was a decrease in the PSS scores by 11.38% (P < 0.05) and SAA levels by 11.38% (P < 0.05) and an increase in the PVT scores (12.13%, P < 0.05) following probiotic treatment.There was a mean difference of 52.85 in SAA levels in probiotic group and − 69.32 in placebo group with a definite fall in SAA levels in probiotic group, which showed that these patients had reduced stress levels and improved psychomotor vigilance implying improved sleep.

Conclusion:

Gut microbiome alteration with probiotics results in lowering of psychological stress and sleep improvement in the preoperative period in surgical patients.
The Role of c-myc and Adiponectin Receptors in Prostate Cancer Metastases
Authors: Safriadi Ferry , Sugandi Sugandi , Umbas Rainy , Hernowo Bethy Suryawati
Published: December 2021

Purpose:

This study aims to analyze the relationship between c-myc and adiponectin receptor expressions to prostate cancer staging and prove the role of c-myc and adiponectin receptors as risk factors of metastatic prostate cancer.

Materials and Methods:

This was a comparative study. The study sample consisted of 35 cases of metastatic prostate cancer and 35 cases of organ-confined prostate cancer. c-myc and adiponectin receptor expressions were examined by using immunohistochemistry and histoscore assessment with the cutoff point of 4. Chi-square and Mann–Whitney U-test were used to assess differences in c-myc and adiponectin receptor expressions. Stratification test and multiple logistic regressions were used to assess the correlation between the variables.

Results:

There were significant differences of c-myc expression (P = 0.000; odds ratio [OR]: 67.16 [95% confidence interval (CI): 3.820–180.50]) and adiponectin receptor expression (P = 0.001; OR: 6.0 [95% CI: 2.1–17.5]) between the two groups. The stratification test revealed that when c-myc and adiponectin receptor expressions were positive, the OR was 7.50 (95% CI: 1.827–30.783).

Conclusion:

c-myc and adiponectin receptors play an essential role in prostate cancer metastases. Positivity of both parameters will increase the probability of metastases.
Knowledge, Attitude, Confidence, and Barriers in the Practice of Erectile Dysfunction Screening among Primary Health-Care Providers in Taiping Perak, Malaysia
Authors: Tay Chai Li , Abdul Razak Abdul Rahim Bin , Tan Chun Khui , Tan Min Zin
Published: December 2021

Background:

Erectile dysfunction (ED) is a common health problem and has clinical importance. it is well documented that ED is associated with coronary heart disease. However, the practice of ED screening is poor in primary care settings.

Objectives:

To assess primary health-care providers' knowledge and attitude toward ED and to determine the confidence and barriers in the screening of ED.

Materials and Methods:

A cross-sectional study using self-administered questionnaires was conducted at 11 government health clinics in Taiping Perak in 2018 involving all health-care providers who run the outpatient and noncommunicable disease unit. SPSS (version 25) statistical package was used to analyze the data. Mann–Whitney U-test, Kruskal–Wallis test, and Chi-square test were employed.

Results:

A total of 77 primary health-care providers participated in this study. The median age of the participants was 31 years (interquartile range 7). A total of 38 (49.4%) participants scored above the median knowledge. Participants who were doctors, users of clinical practice guide in ED, confident in ED screening, and perceived adequate training scored higher in knowledge (P ≤ 0.05). Smoking as a cause of ED (98.7%) recorded the highest percentage of correct responses, whereas the prevalence of ED (18.2%) recorded the lowest. All participants perceived ED as an important health issue and felt that proper treatment is required. Only 16 (20.8%) participants had confidence in ED screening practice. Lack of training in ED screening and assessment was the barrier that significantly affects the confidence of practice (P = 0.012).

Conclusion:

The knowledge on ED and confidence in its screening were unsatisfactory among the primary health-care providers. Our work suggests the requirement to equip health-care professionals with adequate training on ED screening, assessment, and management for early prevention of cardiovascular disease and improvement of men's quality of life.
Histopathological Analysis and Scanning Electron Microscopic Study of Chlorpyrifos Exposed Kidney of Neonates in Pregnant Rats Exposed During Gestation Period
Authors: Upadhyay Jyoti , Tiwari Nidhi , Rana Mahendra , Bisht Satpal S.
Published: December 2021

Background:

Pesticide exposure has the potential for causing acute or chronic health effects at certain developmental stages of life. It can result in irreversible damage to structure and function of an organ. The exposure of females to pesticides before or after pregnancy is a matter of concern because of the possibility of having a child born with congenital disorders and developmental defects. Prenatal exposure of any toxicants can program the developing foetus to develop diseases that manifest in later life. Very few reports are available related to the pesticide exposure induced morphological changes in kidney which has prompted us to undertake this research study.

Aim:

The aim of this study is to evaluate the effect of pesticide, chlorpyrifos on the kidney development of rat neonates after being exposed prenatally to pesticides throughout their gestational period.

Materials and Methods:

Virgin female wistar rats weighing 200-250 gms were mated with adult males. It consisted of twelve, divided into two sub groups six rats per each were treated with selected pesticides, chlorpyrifos (insecticide) readily available commercially for various agricultural and non-agricultural settings. Insecticide chlorpyrifos was given at a dose of 10mg/kg per orally to the female rats throughout their gestation period. After gestation period rat neonates were sacrificed and their kidney section was processed for histopathological analysis. The SEM study of chlorpyrifos exposed kidney section of rat neonates was performed, investigating changes in morphometric and ultra-structural features of kidney in rat neonates.

Results:

The histopathological analysis shows morphological changes in the kidneys of prenatally pesticides exposed rat neonates markedly different from control group. Chlorpyrifos exposed neonates kidney shows damaged kidney corpuscles and glomeruli.

Conclusion:

This study concluded that pesticide exposure during gestation period to pregnant rats causes significant renal toxicity in their neonates.
Stented Foley's Catheter is a Versatile, Highly Useful, Easy-To-Use Way of Double J Stenting for a Short Time
Authors: Vartak Ketan P. , Raghuvanshi Kshitij , Raval Abid , Jain Devendra Kumar
Published: December 2021

Purpose:

A stented Foley's catheter was designed to combine two catheters into a single catheter to reduce the postureteroscopy (URS) pain and complications. This study evaluated the pain score and complications associated with the use of stented Foley's catheter in double J (DJ) stenting compared to the use of infant feeding tube (IFT) or a ureteric catheter in patients undergoing DJ stenting.

Materials and Methods:

A randomized parallel-group study was conducted in patients undergoing DJ stenting along with URS and stone fragmentation with pneumatic lithotripsy/LASER. The patients were randomized to be managed with either stented Foley's catheter or IFT along with Foley's catheter. The postoperative pain and complications were recorded.

Results:

A total of 200 patients were randomized (1:1) into Group A (100 patients with stented Foley's catheter) and Group B (100 patients with IFT). Male preponderance was observed in Group A (73%) and Group B (69%). A significantly higher number of patients from Group B (n = 20) had pericatheter leakage compared to Group A (n = 2). In Group B, the pericatheter leakage resolved in three males and three females, whereas six males and eight females continued to leak, which is managed by diapers. The number of patients with no pain was higher in Group A (52%) than Group B (36%), whereas none of the patients from both groups had severe pain scores (V or VI).

Conclusion:

The patients undergoing DJ stenting were tolerant to the use of stented Foley's catheter compared to those with the IFT.
How Safe Could Open Extravesical Bladder Cuff Resection Guarantee Complete Removal of Ipsilateral Ureteral Orifice?
Authors: Lin Yu-Chiao , Ou Chien-Hui , Yang Wen-Horng , Kao Yao-Lin
Published: December 2021

Objectives:

The aim of this study is to report our 8-year experience in terms of the success rate of complete bladder buff resection procedures bladder cuff resection (BCR) and further oncological outcomes in patients under open extravesical BCR for the management of primary upper tract urothelial carcinoma (UTUC).

Materials and Methods:

We retrospectively reviewed patients with primary UTUC who undergone laparoscopic nephroureterectomy and open extravesical BCR in our center. Complete BCR procedures were not defined by any ureteral orifice remnant noted in postoperative cystoscopy surveillance. The rate of complete BCR procedures was calculated. Patients were divided into residual ureteral orifice group (RUO) and nonRUO group (NRUO) and the intravesical and local recurrences and distant metastasis were analyzed and compared across the two groups.

Results:

A total of 105 patients were reviewed. After operation, 67 of them (63.8%) had ipsilateral strict criteria of complete BCR procedures defined on cystoscopy. Shorter mean operative time was noted in the RUO group comparing to the NRUO group (145 ± 73 vs. 192 ± 107 min, P = 0.03). Bladder recurrence was significantly higher in the RUO group (RUO vs. NRUO: 59.7% vs. 26%, P = 0.001) during a median of 39.7 months follow-up. Most of the intravesical recurrences were superficial (94%) and more prone to be found near the RUO/scar in the RUO group rather than the NRUO group (59.7% vs. 26.3%, P = 0.04). The RUO group strongly predicted superficial intravesical recurrence (odds ratio: 4.04, 95% confidence interval: 1.57–10.37, P = 0.004). No significant difference was recorded in muscle invasive bladder tumor, local recurrence, contralateral urinary tract recurrence, or distal metastasis across the groups.

Conclusions:

Open extravesical BCR does not guarantee the complete removal of ipsilateral ureteral orifice. Increased risk of superficial intravesical recurrence is noted in patients with RUO.
Comparison of Prophylactic Antibiotics in Patients without Pyuria Undergoing Ureterorenoscopic Surgery
Authors: Li Ming-Wei , Lee Yuan-Ju
Published: December 2021

Purpose:

The objective of this study was to evaluate the efficacy of antibiotic prophylaxis in patients with a tentative diagnosis of ureteral stones undergoing ureterorenoscopic surgery.

Materials and Methods:

This is a single-surgeon, open-label randomized controlled trial, which enrolled 109 patients from May 2014 to September 2018. The patients were equally randomized into three groups: a group with a single dose of intravenous cefazolin (1g), a group with oral cefuroxime (500 mg), and a control group with no prophylactic antibiotics. The primary end points were the rate of febrile urinary tract infections (UTIs) and postoperative pyuria.

Results:

The rate of postoperative fever was 9.4% in the cefazolin group (3 in 32), 0% in the cefuroxime group (0 in 29), and 6.9% in the control group (2 in 36). There was no statistically significant difference between the cefazolin and control groups (P = 0.1). The rate of postoperative pyuria was 64.3% in the cefazolin group, 58.3% in the cefuroxime group, and 33.3% in the control group, without statistically significant differences between the groups.

Conclusion:

Antibiotic prophylaxis could not reduce the incidence of postoperative febrile UTI and pyuria in ureterorenoscopic lithotripsy.
Conservative Management of Upper Tract Urothelial Carcinoma with Endoscopic Thulium Laser Ablation
Authors: Hsieh Yu-Che , Huang Steven K. , Su Chia-Cheng , Wang Jhih-Cheng , Feng I-Jung , Chiu Allen W. , Liu Chien-Liang
Published: December 2021

Purpose:

The gold standard treatment for upper tract urothelial carcinoma (UTUC) is radical nephroureterectomy. The combination of ureterorenoscopy and laser ablation has recently become more accepted. This study aims at investigating the risk factors of tumor recurrence associated with the thulium laser ablation of UTUC and reporting its clinical outcomes with subgroup analyses.

Materials and Methods:

Patients who underwent endoscopic thulium laser ablation of UTUC as the primary treatment from June 2012 to November 2018 were reviewed retrospectively. Sixty-eight patients were enrolled, of whom 34 had complete data for analysis after applying the exclusion criteria. Bivariate analysis was performed to compare patients with and without recurrence. Multivariable Cox regression models were applied. Kaplan–Meier survival estimates were presented, and three tumor characteristics were used for subgroup analyses.

Results:

Fifteen patients (44%) had local tumor recurrence. Four patients (12%) had cancer-specific death. In bivariate analysis, statistical significance was noted for age, tumor grade, and tumor size (P = 0.018, 0.047, and 0.014, respectively). In multivariate analysis, statistical significance was noted for age and tumor size (P = 0.017 and 0.042, respectively). In the Kaplan–Meier estimates for subgroup analysis, statistical significance was noted only in the tumor size and tumor grade group (P = 0.0275). The study limitations included the retrospective design and small sample size.

Conclusion:

Tumor size and tumor grade are influential recurrence factors. The tumor stage did not show statistical significance in recurrence analysis. In subgroup analyses, tumor size was more influential than tumor grade with respect to the prognosis of local recurrence.
Clinical Profile of Patients with Renal Trauma
Authors: Narendra J. B. , Ratkal C. S. , Keshavamurthy R. , Karthikeyan V. S.
Published: December 2021

Background:

Renal trauma is generally managed with conservative or surgical treatment. This study evaluated the clinicoradiological profile of renal trauma patients (Grades I–V) and their management to determine the association of grade of renal trauma with length of hospital stay and type of treatment.

Materials and Methods:

This cross-sectional prospective observational study included patients with renal trauma aged >18 years. All the study patients underwent computed tomography for identification and grading of renal injury (I–V).

Results:

A total of 121 patients with renal trauma were included in this study. The mean (standard deviation) age was 42.36 (17.95) years. The majority of the study patients (n = 101) were managed conservatively. Rib fracture (n = 15) was the most common associated injury, and the majority had unilateral renal injury (n = 117). The distribution of patients according to grades of renal trauma was 21 (17.35%) in Grade I; 32 (26.45%), Grade II; 25 (20.66%), Grade III; 38 (31.40%), Grade IV; and 5 (4.13%), Grade V. Length of hospital stay was ranging from 7 to 15 days, increasing with the severity of grades from Grade I to Grade V. Grade of renal trauma was positively correlated with length of hospital stay, respectively (r = 0.390, P = 0.003). Grade of renal injury (P = 0.019) and type of treatment (P = 0.028) significantly affected the variations in the length of hospital stay.

Conclusion:

Conservative treatment is the preferred management approach for renal trauma; grade of renal trauma and type of treatment are responsible for variation in the length of hospital stay.
Factors Affecting Hospital Stay in Patients Aged >65 Years who Underwent Urological Intervention
Authors: Bombaci Elif
Published: December 2021

Purpose:

The geriatric patient population is predominant in urologic surgeries. The perioperative period of geriatric patients is affected by several factors. This study aimed to investigate the factors affecting morbidity and hospital stay in patients aged >65 years, who underwent urological intervention.

Materials and Methods:

The data of patients aged >65 years, who underwent urological surgery, were retrospectively evaluated. Age; sex; the American Society of Anesthesiologists (ASA) physical status; type and method of surgical intervention; duration of surgery; anesthesia method; concomitant diseases; preoperative values of blood serum albumin, potassium, creatinine, and hemoglobin (Hb); presence of infection; admission to the intensive care unit; and duration of hospital stay were recorded. The effects of the data obtained on hospital stay were evaluated.P< 0.05 was considered statistically significant.

Results:

Surgical method, duration of surgery, anesthesia method, presence of a comorbid disease, ASA physical status, preoperative values of blood serum albumin and Hb, presence of infection, and intensive care hospitalization had a significant effect on hospital stay, and particularly, long duration of surgery, ASA physical status, and low serum albumin levels were found to be the most effective factors to prolong hospital stay.

Conclusion:

In older patients who undergo a urological intervention, advanced age is not the only risk factor. The length of hospital stay is affected by a number of interrelated factors. A detailed preoperative evaluation and preparation with a multidisciplinary approach in elderly patients may prevent additional problems that may occur, ensuring the determination of the most appropriate surgical and anesthetic method.
Robot-Assisted Radical Cystectomy with Intracorporeal Urinary Diversion
Authors: Romagnoli Daniele , Bianchi Federico Mineo , Giampaoli Marco , Corsi Paolo , D'agostino Daniele , Schiavina Riccardo , Brunocilla Eugenio , Artibani Walter , Porreca Angelo
Published: December 2021

Aim:

We report the oncological and functional outcomes of a population of elderly patients who underwent robotic-assisted radical cystectomy (RARC) with totally intracorporeal urinary diversion (IUD) at a single high-volume center with extensive experience in robotic surgery.

Patients and Methods:

Each procedure was performed by a single main surgeon, who previously attained a 30-day modified modular training program at a referring center. None technical variation was performed, and the surgical technique was performed exactly as taught. Demographics, intraoperative data, and postoperative complications were recorded for each patient of the aforementioned population.

Results:

From July 2015 to December 2018, we submitted to RARC with totally IUD at our institution 29 elderly patients (aged ≥75 years). Median age was 78 years (interquartile range [IQR]: 76–82). Eleven (37.9%), 12 (41.4%), and 6 (20.7%) patients received RARC with ureterocutaneostomy, ileal conduit, and orthotopic neobladder, respectively. Overall, median operative time was 360 min (IQR: 270–410). The median number of lymph node retrieved was 24 (17–34), the median intraoperative estimated blood loss (EBL) was 200 mL (150–300), with median hospitalization time of 7 days (IQR: 6–9). Each procedure was successfully completed without open conversion. A statistically significant reduction was found in the operative time, when compared to a population of younger patients (aged <75 years), probably reflecting the significant reduction in the choice of the nerve-sparing approach. Early (<30 days) and late (≥30 and <90 days) complication rates and cancer-specific mortality and overall mortality rates were not found statistically significant difference.

Conclusions:

In experienced hands, RARC with IUD can be safely applied to elderly patients, without a significant difference in terms of complication rates, cancer-specific survival, and overall survival.
Webbed Penis
Authors: Chao Tze-Chen , Yang Stephen Shei-Dei , Chang Shang-Jen , Lin Chia-Da
Published: December 2021

Webbed penis may be congenital or acquired in etiology. Treatments are indicated for reasons such as cosmetic concerns and erection pain. This study aims at reviewing the etiology, symptoms, types of surgical correction, and outcomes of webbed penis. We searched Medline/PubMed for “webbed penis” and “inconspicuous penis” from 1956 through 2019. In this study, we discuss the advantages, drawbacks, and outcomes of each surgical method. We also explain the postoperative cosmetic outcomes and complications of the previously proposed surgical methods. Since the isolated congenital webbed penis is uncommon, there is a paucity of large-scale studies for the treatment of webbed penis. A variety of methods are proposed to correct webbed penis, including traditional transverse incision and vertical closure, Z-plasty, V-Y advancement technique, Byars preputial flap method, and other methods. Preoperative design is essential and is based on not only the degree of penoscrotal fusion but also the surgeon's experience and preference of the surgical methods. Some methods call for elaborate skin flaps that may be technically complicated. The immediate outcomes of surgical correction for webbed penis are good. However, studies on long-term cosmetic results and patient satisfaction remain scarce. Hence, surgical correction of the webbed penis generally yields good results. Long-term follow-up of postoperative cosmetic outcomes, patient satisfaction, and the impact of surgery on the psychological development of children are indicated.
Dorsolateral Onlay Buccal Mucosal Urethroplasty for Anterior Urethral Strictures by Unilateral Urethral Mobilization
Authors: Murugan P. Puvai , Iyyan A. Bhalaguru , Selvathangam Akash
Published: December 2021

Purpose:

Complete urethral mobilization may endanger the lateral vascularity of the urethra in buccal mucosal graft (BMG) urethroplasty in stricture urethral disease. The present study aimed to evaluate the outcomes of BMG urethroplasty by dorsolateral onlay technique in patients with anterior urethral stricture.

Materials and Methods:

This was a prospective interventional study conducted at the Department of Urology at PSG Institute of Medical Sciences and Research between January 2015 and December 2018. Patients diagnosed with anterior urethral stricture who underwent dorsolateral onlay urethroplasty were included in this study. Results were considered satisfactory with the Qmax between 8 mL/s and 15 mL/s. Failed outcome was defined as persistent lower urinary tract symptoms, stricture on retrograde urethrogram, Qmax <8 mL/s, and requiring repeated urethra intervention.

Results:

A total of 54 patients underwent BMG urethroplasty by dorsolateral onlay graft with a mean age of 47.6 years. The patients with a range of stricture length 3–14 cm were included in this study. Short-term success rate (Qmax >15 mL/s) was achieved in 42 patients, while satisfactory results (Qmax 8–15 mL/s) were observed in nine patients and failure (Qmax <8 mL/s) occurred in three patients. Oral and perineal complications were treated conservatively with oral antibiotics and analgesia. None of the patients in this study had a postoperative perineal hematoma, graft infection, and scrotal swelling.

Conclusion:

Overall observations suggest that dorsolateral onlay BMG urethroplasty with unilateral urethral mobilization for an anterior urethral stricture is a feasible and effective option with favorable outcomes.
Modified Enhanced Recovery after Surgery Protocol Versus Nonenhanced Recovery after Surgery in Radical Cystectomy Surgery (Preliminary Study)
Authors: Pramod Sawkar Vijay , Safriadi Ferry , Hernowo Bethy S , Dwiyana Reiva Farah , Partogu Bernard
Published: December 2021

Purpose:

Enhanced recovery after surgery (ERAS) protocol has proven to lower both length of stay and recovery time, while being cost-effective at the same time. There are three ERAS protocols implemented for radical cystectomy (RC). All of those were published by different institutions, such as the European Association of Urology, the Société Internationale d'Urologie, and the American Urological Association. We modified and proposed ERAS components from preoperative care until postoperative care to evaluate the implementation of ERAS for RC. Standard ERAS protocol is not fully applicable in Hasan Sadikin General Hospital due to financial factors and the limited list of drugs available to choose from our universal health coverage prescription system; thus, we had to make some modifications. This study aims at evaluating the preliminary results of an implementation of modified ERAS protocol in RC at our hospital.

Materials and Methods:

A cohort retrospective study of 21 consecutive patients who underwent RC (9 ERAS vs. 12 non-ERAS). The primary outcomes were the reduced length of stay (LOS) and hospitalization cost. The secondary outcomes included less intraoperative blood loss, faster bowel movement, lower transfusion rates, and decreased readmission rates.

Results:

Patients with ERAS had lower blood loss (ERAS median [range]: 1100 [500–2000] ml vs. 1650 [100–3000] ml for non-ERAS, P = 0.219), lower transfusion rates (ERAS: 55.6% vs. 91.7% for non-ERAS, P = 0.119), and fewer readmissions (ERAS: 0% vs. 8.3% for non-ERAS, P = 1.000). Bowel movement was faster in ERAS group (ERAS mean [range]: 6.11 ± 2.977 [3.00–12.00] h vs. 12.50 ± 5.385 [6.00–24.00] h for non-ERAS, P = 0.005). Duration of hospitalization was shorter with ERAS (5 [3–7] days) than without ERAS (8 [5–20] days, P = 0.003). The total mean costs were significantly higher in the non-ERAS group compared to the ERAS group ($1529 ± 346 for ERAS vs. $2580 ± 1415 for non-ERAS, P=0.028).

Conclusion:

Modified ERAS protocols for RC at our institution reduced the LOS and hospitalization cost and lead to faster bowel movement and no readmission.
Autophagy Modulation by Dysregulated Micrornas in Human Bladder Cancer
Authors: Lin Ji-Fan , Chen Po-Chun , Hwang Thomas I-Sheng
Published: December 2021

The catabolic process of autophagy is an essential cellular function that directs the breakdown and recycling of cellular macromolecules. Increased autophagy causes various cancers, mainly bladder cancer (BC), to survive under microenvironmental stress and promotes cancer cell growth and aggressiveness. Cancer cells with rapid proliferation require a high basal level of autophagy to deal with the increased metabolic rate that generates reactive oxygen species, misfolded proteins, and damaged organelles. The regulation of autophagy by a class of small noncoding microRNAs (miRNAs) in human cancer has been discovered in recent years. In BC, a high basal level of autophagy plays critical roles in cancer survival and resistance to chemotherapy. Some studies have suggested that miRNAs participate in regulating these functions. In this review, we focused on recent key findings in the study of dysregulated miRNAs and their involvement in the regulation of autophagy in BC.
KINERJA KEUANGAN CREDIT UNION KELING KUMANG BRANCH OFFICE SAYAN KABUPATEN MELAWI BERDASARKAN PEARLS
Authors: Ahie Simon
Published: December 2021

Abstrak

Sistem penilaian kinerja keuangan yang lebih sesuai untuk mengukur kinerja keuangan Credit Union, berdasarkan PEARLS. Tujuan dari Penelitian ini dilakukan adalah untuk mengetahui kinerja keuangan Credit Union Keling Kumang Sayan. Metode pengumpulan data yang digunakan adalah Observasi langsung. Metode penelitian yang peneliti gunakan adalah metode penelitian deskriftif. Teknik analis data yang digunakan untuk menjawab kedua permasalahan tersebut adalah analisis PEARLS. Hasil penelitiaan dari perhitungan pada tahun 2016-2018 rasio Perlindungan untuk P1 dan P2 tidak ideal, Struktur Keuangan Efektif untuk E1 tidak ideal, E5, Kualitas Aset untuk A1 tidak ideal, Likuiditas untuk L1 tidak ideal, Tanda-tanda Pertumbuhan untuk S10 tidak ideal S11 tidak ideal. dengan nilai presentasenya yang berarti masuk dalam kategori buruk (tidak sehat), walaupun pada tahun 2016-2018 Untuk struktur keuangan yang efektif E5, E7, E8 ideal, nilai pengembalian dan biaya R7, R9 ideal, likuiditas L3 ideal, berarti nilai presentasenya sudah ideal / sehat karena mencapai keretria PEARLS.

Kata Kunci: Protection, Effectiv Financial Structure, Asset Quality, Rate of return and costs, Liquidity dan Signs of growth.
STRATEGI PEMASARAN SAYURAN HIDROPONIK SHANTI BHUANA
Authors: Falentia Tia Indana  , Beni Sabinus
Published: December 2021

Indonesia merupakan salah satu negara yang mengalami peningkatan begitu pesat dalam bidang wirausaha, didukung dengan adanya kemajuan teknologi dan ilmu pengetahuan yang semakin berkembang sehingga dapat mendorong pelaku wirausaha untuk menciptakan dan membuat inovasi baru sehingga dapat memenuhi kebutuhan dan keinginan konsumen. Penelitian ini bertujuan untuk mengetahui strategi pemasaran yang digunakan oleh pemilik usaha sayuran hidroponik Shanti Bhuana dalam meningkatkan volume penjualan, strategi pemasaran yang digunakan yaitu strategi pemasaran 4P (product, price, promotion dan place) namun masih belum efektif selain itu juga digunakan strategi pemasaran digital berbasis media sosial dan konvensional. Berdasarkan hasil penelitian menunjukkan bahwa strategi pemasaran yang tepat untuk meningkatkan volume penjualan sayuran hidroponik Shanti Bhuana yaitu strategi pemasaran digital berbatas media sosial perlu dikembangkan karena dengan kemajuan teknologi saat ini tidak sedikit masyarakat yang senang berbelanja secara online.
Optimalisasi Bimbingan Klien Pemasyarakatan Pada Masa Pandemi Covid-19 di Balai Pemasyarakatan (Studi di Balai Pemasyarakatan Kelas I Jakarta Selatan)
Authors: Tahamata Yuniati maryana
Published: December 2021

Pandemi Covid-19 dengan korban yang semakin menigkat, berdampak pada pelaksanaan proses peradilan yang ada di Indonesia.  Hal ini juga terjadi pada proses bimbingan klien pemasyarakatan. Penelitian bertujuan untuk mengetahui upaya mengoptimalkan pembimbingan oleh Pembimbing Kemasyarakatan  pada masa pandemi Covid-19 di Balai Pemasyarakatan Kelas I Jakarta Selatan sehingga hak klien pemasyarakatan bisa terpenuhi dengan tetap memperhatikan protokol kesehatan. Penelitian ini merupakan penelitian deskriptif dengan metode penelitian kualitatif. Teknik pengumpulan data yang digunakan adalah wawancara, observasi, dan studi kepustakaan. Pengambilan subyek penelitian menggunakan teknik purposive sampling yaitu ditetapkan atas dasar tujuan tertentu yang mempunyai hubungan erat dengan masalah yang diteliti, yaitu Kepala Subseksi Bimbingan Klien Dewasa, Pembimbing Kemasyarakatan dan Klien Pemasyarakatan. Teknik keabsahan data menggunakan cross check dari hasil wawancara dan studi kepustakaan. Analisis data yang digunakan menggunakan analisis induktif dengan tahap reduksi data, unitisasi dan kategorisasi, serta pengambilan kesimpulan. Hasil penelitian ini menunjukkan bahwa selama masa pandemi Covid-19 terdapat beberapa perubahan prosedur pelaksanaan bimbingan klien yang dulunya dilakukan secara tatap muka menjadi melalui daring. Pembimbingan klien difokuskan pada peningkatan ketaqwaan kepada Tuhan Yang Maha Esa, peningkatan kesadaran hukum serta penanaman pola hidup bersih dan sehat guna mencegah penyebaran Covid-19. Kesimpulan penelitan menemukan kendala yang muncul selama proses pembimbingan daring ini meliputi terbatasnya informasi untuk kebutuhan asesmen, keterbatasan pemahaman petugas akan pentingnya laporan perkembangan dan asesmen, serta partisipasi klien rendah. Saran untukmelakukan optimalisasi proses pembimbinngan tersebut adalah dengan meningkatkan koordinasi dengan Aparat Penegak Hukum dan Pemerintah Daerah, peningkatan kualitas Sumber Daya Manusia, serta meningkatkan kualitas dan intensitas bimbingan.