bluuebunny/crossref_metadata_2025 huggingface dataset:
“This is an illness. No one is supposed to be treated badly”: Community-based stigma assessments in South Africa to inform TB stigma intervention design
Authors: Foster Isabel , Biewer Amanda , Vanqa Nosivuyile , Makanda Goodman , Tisile Phumeza , Hayward Sally E. , Wademan Dillon T. , Anthony Michaile G. , Mbuyamba Rachel , Galloway Michelle , Human Wieda , Westhuizen Helene-Mari , Friedland Jon S. , Marino-Medina Andrew , Schoeman Ingrid , Hoddinott Graeme , Nathavitharana Ruvandhi R.
Published: December 2023

Background
Though TB-related stigma is a recognized barrier to care, interventions are lacking and gaps remain in understanding the drivers and experiences of TB-related stigma. We undertook community-based mixed methods stigma assessments to inform stigma intervention design.
Methods
We adapted the Stop TB Partnership stigma assessment tool, and trained three peer research associates (PRAs; two TB survivors, one community health worker) to conduct surveys with people with TB (PWTB, n=93) and caregivers of children with TB (n=24) at peri-urban and rural clinic sites in Khayelitsha, Western Cape, and Hammanskraal, Gauteng Province, South Africa. We descriptively analyzed responses for each stigma experience (anticipated, internal, and enacted), calculated stigma scores, and undertook generalized linear regression analysis. We further conducted 25 in-depth interviews with PWTB (n=22) and caregivers TB (n=3). Using inductive thematic analysis, we performed open coding to identify emergent themes, and selective coding to identify relevant quotes. Themes were organised using the CARD (Constraints, Actions, Risks and Desires) framework.
Results
Surveys revealed at least one-third of PWTB and one-quarter of caregivers report experiences of anticipated, internal, and/or enacted stigma, which affected engagement throughout the care cascade. Participants in rural locations (compared to peri-urban) reported higher anticipated, internal, and enacted stigma (β-coefficient 0.72, 0.71, and 0.74). Interview participants described how stigma experiences, including HIV intersectional stigma, act individually and in concert as key constraints to impede care, and underpins failure to disclose a TB diagnosis, isolation, and exclusion. Stigma resilience arose through understanding that TB can affect anyone and should not diminish self-worth. Risks of stigma, driven by fears related to disease severity and infectiousness, led to care disengagement and impaired psychological wellbeing. Participants desired counselling, identifying a specific role for TB survivors as peer counsellors, and community education.
Conclusions
Stigma is highly prevalent and negatively impacts TB care and the well-being of PWTB, warranting its assessment as a primary outcome indicator rather than intermediary contributor to poor cascade outcomes. Multicomponent stigma interventions are needed, including counselling for PWTB and education for health workers and communities. Such interventions must incorporate contextual differences based on gender or setting, and use survivor-guided messaging to foster stigma resilience.
Comparing the effect of radial extracorporeal shock waves with different energy flux densities on forearm spasticity after stroke: A randomized controlled trial
Authors: Li Li , Huang Chuchu , Wu Dengxuan , Yang Guifen
Published: December 2023

Background
To explore the effect of radial extracorporeal shock wave therapy (rESWT) on forearm spasticity in stroke patients and to compare the effect of low energy flux density (EFD) and medium EFD rESWT on forearm spasticity after stroke.
Methods
Ninety stroke patients who met the inclusion criteria of this study were randomly divided into a control group, intervention group A and intervention group B, with 30 patients in each group. The control group received placebo rESWT. Group A received a low EFD (energy flux density of 0.08 mJ/mm2); Group B received a medium EFD (energy flux density of 0.16 mJ/mm2). The interventions continued for 4 weeks, once a week. Muscle tension and muscle stiffness were evaluated by the modified Ashworth scale (MAS), and shear wave velocity (SWV) was measured by ultrasound elastography before and after treatment.
Results
① MAS: After treatment, the MAS scores of muscle groups in intervention groups A and B were lower than those before treatment, and the differences were statistically significant (P < 0.01). After treatment, the MAS scores of the wrist flexor muscle group in groups A and B were significantly lower than that in the control group (P < 0.05). ② SWV: After treatment, the SWV of the flexor digitorum superficialis (FDS), flexor digitorum profundus (FDP), flexor carpi radialis (FCR), and pronator teres (PT) in group A were significantly lower than those before treatment (P < 0.05), and the SWV of FDS, FDP, flexor carpi ulnaris (FCU), FCR, and PT in group B were significantly lower than those before treatment (P < 0.05). The SWVs of FDS, FDP and FCR in group A were significantly lower than those in the control group (P < 0.05). The SWVs of the FDS, FDP, FCR and PT in group B were significantly lower than those in the control group (P < 0.05).
Conclusion
Both low- and medium-EFD rESWT are effective for forearm spasticity in stroke patients. The effect of medium EFD rESWT is slightly better than that of low EFD rESWT, but the difference is not significant.
Trial registration:
Clinical trial registration numbers and date of registration: ChiCTR2300075610, Registered 11 September 2023.
Noise-tolerant NMF-based parallel algorithm for respiratory rate estimation
Authors: Revuelta-Sanz Pablo , Muñoz-Montoro Antonio J. , Torre-Cruz Juan , Canadas-Quesada Francisco J. , Ranilla José
Published: December 2023

The accurate estimation of respiratory rate (RR) is crucial for assessing the respiratory system's health in humans, particularly during auscultation processes. Despite numerous automated RR estimation approaches proposed in the literature, challenges persist in accurately estimating RR in noisy environments, typical of real-life situations. This becomes especially critical when periodic noise patterns interfere with the target signal. In this study, we present a parallel driver designed to address the challenges of RR estimation in real-world environments, combining multi-core architectures with parallel and high-performance techniques. The proposed system employs a non-negative matrix factorization (NMF) approach to mitigate the impact of noise interference in the input signal. This NMF approach is guided by pre-trained bases of respiratory sounds and incorporates an orthogonal constraint to enhance accuracy. The proposed solution is tailored for real-time processing on low-power hardware. Experimental results across various scenarios demonstrate promising outcomes in terms of accuracy and computational efficiency.
The Rothman Index predicts unplanned readmissions to intensive care associated with increased mortality and hospital length of stay: a propensity-matched cohort study
Authors: Stahel Philip F. , Belk Kathy W. , McInnis Samantha J. , Holland Kathryn , Nanz Roy , Beals Joseph , Gosnell Jaclyn , Ogundele Olufunmilayo , Mastriani Katherine S.
Published: December 2023

Background
Patients with unplanned readmissions to the intensive care unit (ICU) are at high risk of preventable adverse events. The Rothman Index represents an objective real-time grading system of a patient’s clinical condition and a predictive tool of clinical deterioration over time. This study was designed to test the hypothesis that the Rothman Index represents a sensitive predictor of unanticipated ICU readmissions.
Methods
A retrospective propensity-matched cohort study was performed at a tertiary referral academic medical center in the United States from January 1, 2022, to December 31, 2022. Inclusion criteria were adult patients admitted to an ICU and readmitted within seven days of transfer to a lower level of care. The control group consisted of patients who were downgraded from ICU without a subsequent readmission. The primary outcome measure was in-hospital mortality or discharge to hospice for end-of-life care. Secondary outcome measures were overall hospital length of stay, ICU length of stay, and 30-day readmission rates. Propensity matching was used to control for differences between the study cohorts. Regression analyses were performed to determine independent risk factors of an unplanned readmission to ICU.
Results
A total of 5,261 ICU patients met the inclusion criteria, of which 212 patients (4%) had an unanticipated readmission to the ICU within 7 days. The study cohort and control group were stratified by propensity matching into equal group sizes of n = 181. Lower Rothman Index scores (reflecting higher physiologic acuity) at the time of downgrade from the ICU were significantly associated with an unplanned readmission to the ICU (p < 0.0001). Patients readmitted to ICU had a lower mean Rothman Index score (p < 0.0001) and significantly increased rates of mortality (19.3% vs. 2.2%, p < 0.0001) and discharge to hospice (14.4% vs. 6.1%, p = 0.0073) compared to the control group of patients without ICU readmission. The overall length of ICU stay (mean 8.0 vs. 2.2 days, p < 0.0001) and total length of hospital stay (mean 15.8 vs. 7.3 days, p < 0.0001) were significantly increased in patients readmitted to ICU, compared to the control group.
Conclusion
The Rothman Index represents a sensitive predictor of unanticipated readmissions to ICU, associated with a significantly increased mortality and overall ICU and hospital length of stay. The Rothman Index should be considered as a real-time objective measure for prediction of a safe downgrade from ICU to a lower level of care.
Barriers and Facilitators to Collaborative Care Implementation within the New York State Collaborative Care Medicaid Program
Authors: LePoire Erin , Heald Ashley , Russo Joan , Bowen Deborah J , Joseph Molly , Gadbois Danielle , Jones Amy
Published: December 2023

Background
Since 2015, the New York State Office of Mental Health has provided state primary care clinics with outreach, free training and technical assistance, and the opportunity to bill Medicaid for the Collaborative Care Model (CoCM) as part of its Collaborative Care Medicaid Program. This study aims to describe the characteristics of New York State primary care clinics at each step of CoCM implementation, and the barriers and facilitators to CoCM implementation for the New York State Collaborative Care Medicaid Program.
Methods
In this mixed-methods study, clinics were categorized into RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) steps. Clinics were sent a survey, which included questions related to payer mix, funding sources, billing codes used, and patient population demographics. Qualitative interviews were conducted with clinic representatives, focusing on barriers or facilitators clinics experienced affecting their progression to the next RE-AIM step.
Results
1,099 surveys were sent to primary care clinics across New York State, with 107 (9.7%) completing a survey. Significant differences were observed among the different RE-AIM steps for multiple demographic variables including primary payer, percentage of patients with a diagnose of depression or anxiety, and percent of behavioral health services that are reimbursed, in addition to others. Three main themes regarding barriers and facilitators to implementing CoCM for New York State Medicaid billing emerged from 31 qualitative interviews: (1) Billing requirements, (2) Reimbursement rates, and (3) Buy-in to CoCM.
Conclusions
Survey data align with what we would expect to see demographically in NYS primary care clinics. Qualitative data illuminated a disconnect between what clinics can bill for and the reimbursed amount that clinics receive, illustrating the need for stronger billing workflows and continued refinement of billing options across different payers.
Prognostic value of myositis-specific antibodies in patients with idiopathic interstitial pneumonia
Authors: Wakabayashi Hiroki , Iwasaki Kotaro , Murakami Yu , Takashima Keata , Kaneko Kaichi , Matsuzawa Yasuo
Published: December 2023

Background
Patients with idiopathic interstitial pneumonias (IIP) often exhibit positivity for myositis-specific antibodies (MSA). However, the significance of MSA remains unclear. In this study, we investigated the association of MSA with the prognosis and risk of acute exacerbation in patients with IIP.
Methods
We retrospectively reviewed the medical records of patients with IIP and examined the impact of each MSA subtype on survival and acute exacerbation.
Results
Of 240 patients with IIP, 48 (20%) exhibited positivity for MSA. The MSA subtypes included: PL-7 (antithreonyl; n = 16, 6.7%); signal recognition particle (n = 13, 5.4%); PL-12 (antialanyl; n = 9, 3.8%); Mi-2 (n = 8, 3.3%); OJ (anti-isoleucyl; n = 7, 2.9%). During the 382 days (382 ± 281 days) of observation, 32 (13%) patients expired and 27 (11%) experienced an acute exacerbation. Cox proportional hazards regression analysis demonstrated that age at initial visit (hazard ratio [HR]: 1.072; 95% confidence interval [CI]: 1.017–1.131; P = 0.01), PL-7 (HR: 4.785; 95% CI: 1.528–14.925; P = 0.007), and PL-12 (HR: 3.922; 95% CI: 1.198–12.82; P = 0.024) were independent predictors of survival time. PL-7 (HR: 3.268; 95% CI: 1.064–10; P = 0.039) and PL-12 (HR: 5.747; 95% CI: 1.894–7.544; P = 0.002) were independent predictors of time from first visit to acute exacerbation.
Conclusion
The detection of MSA in patients with interstitial lung disease may be useful in predicting prognosis and providing a rationale for intensive treatment.
Case Report: Complete Remission of a Patient with Acute-on-chronic Liver Failure with Rare Hepatic Encephalopathy and Fever of Unknown Origin Treated with Anti-infective Therapy Combined with Psychotherapy After Artificial Liver Support System
Authors: Bo Yan , Li Beilei , Sha Ren , Yu Haodong , Miao Chuhan
Published: December 2023

The theme of this report is the inspiration of incredible psychological therapy for fever of unknown origin (FUO). We analysed this remarkable phenomenon through psychological immunity, liver immunity, inflammation, aetiology, diagnostic methods, and treatment strategies. A man, 44 years old, was dyed for more than 40 days due to abdominal distension with skin and scleral yellow, and feathers accompanied him for four days to enter the hospital. Hepatitis virus test shows HBV infection. HBV DNA detection offers negative. The detection of the respiratory tract nine-fold, tuberculosis, anaemia, and gut-to-club ratio all show negative. Due to the weakness of the patient's body, we cannot cooperate with more examinations. We use blood specimens to monitor and analyse for 25 days. In short, this is a case of chronic-acute liver failure, manic, and fever, likely to be an FUO cause in terms of the treatment plan, general treatment, artificial liver treatment, surgical treatment, anti-infection therapy, and psychotherapy. The patient reached the common treatment goal after 25 days of treatment. This report aims to provide psychotherapy programs and clinical characteristics for patients with chronic, acute liver failure, manic, and FUO and inspirational thinking strategies for long-term blood specimen examination. The potential mechanism of psychological fever is immune disorders, and the decline in the concentration of immunoglobulin A and E may be a direct factor.
Advancing NCAA March Madness Forecasts Through Deep Learning and Combinatorial Fusion Analysis
Authors: Alfatemi Ali , Rahouti Mohamed , Hsu Frank , Schweikert Christina
Published: December 2023

This paper presents a novel methodology for accurately predicting game outcomes in the NCAA Men's Basketball Tournament, known as March Madness. The high variance inherent to this tournament poses challenges that often exceed traditional forecasting methods. We implement a rigorous data preprocessing and feature engineering pipeline tailored to this problem using a historical NCAA Men's Tournament dataset. Four diverse neural network architectures, including convolutional, recurrent, feedforward, and residual networks, are developed to model team statistics and sequential game information. We formulate a robust forecasting approach by leveraging combinatorial fusion analysis (CFA) to merge predictions from these heterogeneous models. Our methodology synergistically integrates deep learning, CFA techniques, and domain-specific feature engineering to push the boundaries of state-of-the-art March Madness forecasting. This enables basketball enthusiasts to gain strategic advantages in tournament contests while advancing sports outcome prediction research.
The effects of economic policy uncertainty and large investment project on leverage
Authors: Sung Suk Kim  , Rita Juliana  , Liza Handoko
Published: December 2023

The dominant view on firms’ financial leverage suggests a stable, long-term leverage ratio, while previous studies recognise that factors like macroeconomic fluctuations and unanticipated financing needs can cause deviations from this target leverage. This study seeks to explore the joint effect of economic policy uncertainty (EPU) and large long-term investments on firms’ leverage decisions, specifically focusing on how these factors influence target leverage dynamics and financial flexibility. This study uses 2,865 listed firms in NYSE, NASDAQ, and AMEX from 1990 to 2019. The data is analysed through fixed effect panel regression model. The results show that EPU negatively affects firms’ leverage, which are reduced through joint effects with large investment for five years. This study also demonstrates firms’ financial flexibility motive to protect the debt capacity of large investments and enhance their capabilities.
Diálogos entre biologia e educação física para compreensão do corpo humano integrado
Authors: De Souza Guilherme Orsolon , De Castro Jeimis Nogueira
Published: December 2023

Nossa motivação emergiu de como o corpo humano é abordado no ensino escolar formal pelas disciplinas de Biologia e de Educação Física que, historicamente, o restringiram às áreas anatômica e fisiológica. Este texto explorou a elaboração e a aplicação de uma sequência didática a partir de uma abordagem metodológica qualitativa em uma turma do segundo ano do Ensino Médio Técnico Integrado em Química do CEFET/RJ, Valença, RJ, Brasil. Como objetivo, apresentamos uma sequência didática para construção de uma percepção integrada e dinâmica do corpo dividida em três momentos pedagógicos: problematização inicial, organização do conhecimento e aplicação do conhecimento. Os dados foram registrados a partir de atividades teórico-práticas desenvolvidas na plataforma Microsoft Teams®. Os resultados e as discussões foram apresentados em três tópicos: saberes prévios dos/as estudantes; atividades práticas sobre sensações internas e externas corporais por meio das variações nos ritmos respiratório e cardíaco; e análise dos/as estudantes de seu entorno e suas proposições interventoras para um corpo humano integrado e coletivo. Os dados mostraram que os/as estudantes tenderam inicialmente a um afastamento da percepção integrada do corpo e que, conforme desenvolveram as atividades, agregaram outras percepções para além da dimensão biológica, como atividades de autoconhecimento, de bem-estar psicológico, de cuidado ambiental e de saúde coletiva.
Effect of Lipolytic Enzymes on Sensory Properties of Low-Fat Cheeses
Authors: Mordvinova Valentina , Delitskaya Irina , Sviridenko Galina , Vakhrusheva Dar'ya
Published: December 2023

Lipolytic enzymes can improve the sensory profile of low-fat cheeses. In this study, bovine lipase improved the flavor of semi-hard cheese with a 30.0% fat mass fraction.
New Technology for Functional Cream Cheese Fortified with Cryopowders
Authors: Dunchenko Nina , Yankovskaya Valentina , Kuptsova Svetlana
Published: December 2023

The research tested the conformity of a new cream cheese formulation to consumer expectations as an organic and functional product. A qualimetric modeling made it possible to introduce turnip cryopowder into the traditional cream cheese formulation. The turnip cryopowder proved to be an effective multifunctional component. Not only is it a natural flavor and thickener, but it is also a source of vitamin C, silicon, vanadium, and cobalt. The research revealed the combined effect of the mass fraction of protein and fat in the curd base and the share of turnip cryopowder on the consistency of the finished product. The mathematical dependences obtained made it possible to program a particular viscosity. The sensory evaluation demonstrated the high consumer properties of the new cream cheese fortified with turnip cryopowder. The research broadens the range of domestic organic dairy products fortified with vitamins and macro- and micronutrients.
Forms of Terms of Contract for Maintenance of Public Buildings
Authors: Olanrewaju AbdulLateef , Tan Rui Hong , Nizam Akbar Anis Rosniza , Preece Christopher Nigel
Published: December 2023

Housing is essential to the development and progress of a country. In Malaysia, the government has implemented numerous programmes to promote home ownership in response to the housing shortage. However, problems with building performance and condition continue to increase due to defects in the housing stock. This study examined the forms of procurement for building maintenance management for public housing by interviewing eight maintenance managers. According to the data, specialised contracts, repair and maintenance and fixed-term contracts are the most common forms of maintenance contracts.
Operating room and communication study: A reflection of non-technical surgical skills in a regional setting
Authors: Clark Molly , Dooreemeah Dilshad , Cogger Lisa , Miller Francis
Published: December 2023

Health care is multifaceted. This study aimed to examine situational awareness and how measures like name recognition can be a hurdle to operational safety. The results were that an inability to recall staff members’ names exists even with introductions. Perhaps there needs to be more training centred on these “non-surgical” skills.
Results of Gensingen Bracing in Patients With Adolescent Idiopathic Scoliosis: Retrospective Cross-Sectional Feasibility Study
Authors: Nan Xiaofeng , Kuru Çolak Tuğba , Akçay Burçin , Xie Hua , Zhao Liwei , Borysov Maksym
Published: December 2023

Background

Bracing is an essential part of scoliosis treatment. The standard of brace treatment for patients with scoliosis today is still very variable in terms of brace quality and outcome. The Gensingen brace is a further developed Chêneau brace derivative with individual design, which can be adapted through computer-aided design.

Objective

This study aims to generate a template to obtain a database for prospective multicenter studies study to analyze the results of high-corrective asymmetric Gensingen brace treatment for patients with adolescent idiopathic scoliosis (AIS).

Methods

A template for the database was created, which contains the patients' basic data (age, menarcheal status, Risser Sign, curve pattern, and daily brace wearing time), the Cobb angles of curvature, and the cosmetically relevant angles of trunk rotation (ATR). A retrospective review of medical records of patients with AIS, who met the Scoliosis Research Society’s inclusion criteria for brace studies, was performed to test the feasibility of the template. Template items were filled in by the researchers.

Results

Out of 115 patients between 2014 and 2018, the complete data of 33 patients followed up at least 3 months after complete Gensingen brace weaning could be analyzed. The mean age was 12 years, the mean Cobb angle was 33.6°, and the mean Risser value was 0.7 at the beginning of the treatment. The mean improvement in the Cobb angle on in-brace x-ray imaging was –26.1० (80% of in-brace correction). The Cobb angle of the major curvature changed as follows: curve stabilization was achieved in 7 (21.2%) cases, and curve improvement was achieved in 26 (78.8%) cases. None of the patients showed a curve progression. The Cobb angle was significantly reduced in the brace at the end of treatment and at follow-up evaluation (P<.001). ATR improved significantly for thoracic (P<.001) and lumbar curves (P<.001).

Conclusions

The database proved to be informative in the assessment of radiological and clinical outcome parameters. The example data set we have generated can be a helpful tool for professionals who work in clinics but do not store regular patient data. Especially with regard to different patient collectives worldwide, different results may be achieved with the same standards of care. In addition, the results of this study suggest that above-average correction effects with a full-time brace application lead to significant improvements in the Cobb angle after brace treatment has been completed.
Management of human factors in aviation and health: potential for patient safety (Preprint)
Authors: Bicu Fernandes Sr Iulia , Corrêa Sr Vanessa de Almeida Ferreira , Henrique Sr Danielle de Mendonça , Fassarella Sr Cintia Silva , Silva Sr Renata Flavia Abreu da
Published: December 2023

BACKGROUND

The human factor is one of the contributors to the error. However, health services cannot be organized without considering that professionals can make mistakes. There are mechanisms to avoid them, and aviation is an example of a complex system in managing human factors.

OBJECTIVE

Characterize management practices to minimize human factors’ influence on incidents in aviation and health areas.

METHODS

Exploratory field research with a qualitative approach, whose participants were aviators and health professionals with experience in patient safety management, was recruited using snowball sampling. Data collection took place through semi-structured interviews online through the virtual platform Zoom®, and data processing took place through the analysis of categorical thematic content.

RESULTS

The aviation area proved to be more sensitive to human factors concerning the health area and presented specific human factors management practices to mitigate its influence.

CONCLUSIONS

Articulating the practices of the two areas is a pillar to enhance patient safety and bring recognition/awareness of the human factors necessary in health. It is necessary to bring aviation as an example of health and learn how they apply safe practices in everyday life.
The Power of Rapid Reviews for Bridging the Knowledge-to-Action Gap in Evidence-Based Virtual Health Care (Preprint)
Authors: MacPherson Megan , Rourke Sarah
Published: December 2023

UNSTRUCTURED

Despite the surge in popularity of virtual health care services as a means of delivering health care through technology, the integration of research evidence into practice remains a challenge. Rapid reviews, a type of time-efficient evidence synthesis, offer a potential solution to bridge the gap between knowledge and action. This paper aims to highlight the experiences of the Fraser Health Authority’s Virtual Health team in conducting rapid reviews. This paper discusses the experiences of the Virtual Health team in conducting 15 rapid reviews over the course of 1.5 years and the benefit of involving diverse stakeholders including researchers, project and clinical leads, and students for the creation of user-friendly knowledge products to summarize results. The Virtual Health team found rapid reviews to be a valuable tool for evidence-informed decision-making in virtual health care. Involving stakeholders and focusing on implementation considerations are crucial for maximizing the impact of rapid reviews. Health care decision makers are encouraged to consider implementing rapid review processes to improve the translation of research evidence into practice, ultimately enhancing patient outcomes and promoting a culture of evidence-informed care.
Development and Validation of a Universal Multi-Module Health Education Web Platform for University Students: A Randomized Controlled Trial of HIV/AIDS Prevention (Preprint)
Authors: Liu Guangnan , Pei Runyuan , Ma Haoming , Chen Bin , Liu Chenming , Shen Yiru , Yu Chengjie , Sheng Yu
Published: December 2023

BACKGROUND

Information platforms have become a major avenue for public knowledge acquisition. However, the current framework of web platforms is not fully developed, and the needs of university students are not well understood by developers. Moreover, despite the low prevalence of HIV/AIDS in China, the situation remains critical for university student groups.

OBJECTIVE

The aim is to develop and establish a comprehensive, multi-module health education web platform tailored for university students. Specifically, to use HIV/AIDS prevention among university students as a case study to validate the effectiveness of the platform's educational modules.

METHODS

The web platform was developed following the behavioural guidelines of American medical and health websites. The modules were designed around “the three parts of a medical health education module course,” encompassing video learning, gaming, virtual community, and a question bank. Following development, experts were invited to test and refine the platform's modules. A preliminary experiment was conducted at the School of Nursing, Peking Union Medical College with nine participants, three from each grade. The platform was further refined based on these results. The study involved 146 non-medical undergraduate students from three different types of universities in Beijing, randomly divided into control (n=63) and intervention (n=63) groups. A web-based survey on Knowledge, Belief, and Practices (KBP) concerning AIDS, covering knowledge, belief, and high-risk behaviours with 36 items, was used. Baseline measurements for both groups were initially taken. The intervention group then used the web platform for three consecutive weeks, with a minimum usage of 120 minutes per week, sequentially accessing the video, gaming, and virtual community modules. The control group engaged in self-learning. Post-intervention, the total scores for knowledge, belief, and behaviour were measured for both groups.

RESULTS

The intervention group's baseline mean score was 22.34±1.668, and the control group's was 22.77±1.736, with no significant statistical difference in baseline data (P>0.05). After three weeks, the intervention group's average total score was 38.19±4.865, compared to 29.84±5.742 for the control group, indicating a statistically significant difference in AIDS KBP levels between the groups (P<0.05).

CONCLUSIONS

The web platform significantly positively impacted the AIDS KBP level among university students, suggesting that it has a significant positive effect on the health education of this demographic. It is recommended to continue developing modules for diseases beyond HIV/AIDS in the future.

CLINICALTRIAL

Approval:No.2022zglc06017
Breast Cancer Screening on Instagram: Understanding Narratives (Preprint)
Authors: Chowdhry Angad , Banerjee Anurag
Published: December 2023

BACKGROUND

Social media platforms have permeated different aspects of everyday life, including healthcare. While much of the scholarship has focused on Twitter, fewer have been concerned with Instagram and its impact on healthcare related awareness. As a platform, Instagram is distinctive in the sense of its format, privileging in equal measure both visual and textual narratives. Due to its popularity and reach among young people, it is important to study how health-related issues and especially breast cancer screening is being discussed on this platform.

OBJECTIVE

This paper seeks to analyse narratives of breast cancer screening practices on Instagram and what users seek from or how they look to contribute to these narratives. The paper also analyses these narratives within the framework of kinship and community of that public health practitioners, healthcare professionals, and healthcare organisations that emerges from these interactions.

METHODS

Using machine learning technology (Sphere Ai), we identify thematic areas and a range of emotions associated with public participation around breast cancer screening on Instagram. We analysed over a 1000 posts and its interaction using Sphere to deduce how users on social media disseminate, receive and interact with information on breast cancer screening.

RESULTS

The analysis unpacks six prominent themes within Instagram posts associated with breast cancer screening practices, including Awareness and Education, Tips for Well-being and Campaigns and Events. In addition, the analysis also reveals four main emotions underpinning the textual components of the Instagram posts associated with breast cancer screening: optimism, joy, sadness and anger.

CONCLUSIONS

We conclude that understanding narratives of cancer screening on Instagram helps foster a more inclusive conversation among healthcare professionals, organisations and patients.
A qualitative exploration of Doctor of pharmacy students’ readiness to the rapid transition to virtual placement amid the COVID-19 pandemic using the framework of readiness to change (Preprint)
Authors: El-Awaisi Alla , El Chami Rula , Al-Jayyousi Ghadir , Diab Mohammad , Abdul Rahim Hanan , Al-Moslih Ayad , Du Xiangyun , Du Xiangyun
Published: December 2023

BACKGROUND

The Covid-19 pandemic has caused a sudden unprecedented disruption to education with a significant impact on experiential education.

OBJECTIVE

This study aimed to examine the readiness of the PharmD students to change to a virtual internship during the start of the COVID19 pandemic, from the perspectives of both the students and faculty preceptors.

METHODS

The qualitative study was conducted online based on focus group discussions with PharmD students and semi-structured interviews with their faculty preceptors. Interviews were conducted in June 2020. They were online recorded, transcribed, and independently analyzed using the framework of readiness to change which was also used to construct the interview schedule.

RESULTS

Results were mapped to the framework of readiness to change with five themes emerging: understanding the necessity to shift to virtual internship; appropriateness of virtual internship; efficacy and confidence in one’s own and the institution’s ability to conduct online training; sufficient support and finally valence and benefits gained.

CONCLUSIONS

The results of this study showed that the PharmD students exhibited readiness for shifting to virtual internships and identified several aspects that shaped this readiness. Several student and faculty needs emerged including integration of new interactive learning methods and improving the level of preceptors’ communication with students, in order to optimize the students’ experience of virtual internship. Our results can also set baseline evidence for future research that can suggest what improvements should be implemented in the design of the VI program, and evaluate the impact of such improvements.
Improving the Electrical Conductivity of the Composite Comprising Bismuth Oxide, Activated Carbon, and Graphite for Use as a Battery Anode
Authors: Astuti Yayuk , Zaqia Faradina Azahra , Ekaningsih Aulia Zahra , Gunawan Gunawan , Darmawan Adi
Published: December 2023

This research is concerned with the synthesis and characterization of a composite material that may be used as a battery electrode. Bismuth oxide (Bi2O3) was synthesized from Bi(NO3)3·5H2O, Na2SO4, and NaOH mixed with commercial activated carbon and graphite. The composite formation process was carried out using the hydrothermal method at 110 °C for 5 h. The characterization data indicated the composites produced contained Bi2O3 with a monoclinic crystal system, and Bi2O3 particles were evenly distributed in the composite. The composites were characterized to be mesoporous, with the electrical conductivity reaching 10−1 S m−1. The development of this composite material has potential applications in the field of energy storage, particularly in the development of battery anode.
Sonochemical and Mechanochemical Synthesis of Alcohols from Aldehydes and Ketones
Authors: Putri Indah Mutiara , Dachi Ferlana Debbora , Fitriastuti Dhina , Mardjan Muhammad Idham Darussalam
Published: December 2023

A green, convenient, and scalable synthesis of alcohols through the reduction of aldehydes and ketones has been developed. The green reduction was conducted using two different methods, namely sonochemistry and mechanochemistry. In the former method, the solution of aldehydes or ketones and sodium borohydride was irradiated under ultrasound irradiation. In the latter technique, the reaction mixture was ground under solvent-free conditions. The reduction reaction was performed at room temperature and completed in only 10 min using both protocols. The results showed that aldehydes and ketones with aromatic, heteroaromatic, and aliphatic motifs were tolerated under the reaction conditions, allowing the formation of the corresponding alcohols with the synthetic yields of 75–98% and 77–95% for grinding and sonication methods, respectively. In addition, the reaction can be carried out on a multigram scale.
The Comparative of α- and β-Cyclodextrin as Stabilizing Agents on AuNPs and Application as Colorimetric Sensors for Fe3+ in Tap Water
Authors: Yusuf Adhi Maulana , Kuntolaksono Satrio , Andreani Agustina Sus
Published: December 2023

In this study, AuNPs were reduced using ortho-hydroxybenzoic acid (o-HBA) and various stabilizing agents (α-CDs and β-CDs). The stability, shape, size, and sensitivity of the Fe3+ detection of AuNPs α-CDs and AuNP β-CDs are compared. Both nanomaterials were characterized using ultraviolet-visible (UV-vis) spectroscopy, Fourier transform infrared (FTIR) spectroscopy, and transmission electron microscopes (TEM). After the addition of Fe3+, the absorption rate of surface plasma resonance (SPR) increased to 524 nm, and the color of AuNPs α-CDs and AuNPs β-CDs was changed from pink to red and purple, respectively. AuNPs α-CDs are more uniform in shape and size than AuNPs β-CDs with a size of 23.34 nm. Further, AuNPs α-CDs are more stable, and the absorption rate at 524 nm wavelength decreases by 17.76%. AuNPs α-CDs have a good linear relationship with a linear regression coefficient of 0.996. The sensitivity of AuNPs α-CDs was good with LoD and LoQ both with 1.21 and 4.02 ppm, respectively. These results show that the sensor is superior in determining Fe3+. In addition, AuNPs α-CDs were used to detect Fe3+ in the tap water in South Tangerang, Banten, Indonesia.
Fisiologi Pemberian Larutan Oral Karbohidrat pada Pasien yang Akan Menjalani Operasi Elektif
Authors: Sar Djayanti , Kurniawati Juni , Sunantara I Gusti Ngurah Putu Mandela Agatha
Published: December 2023

Pembedahan merupakan gabungan anestesi, obat-obatan, trauma, kehilangan darah. Selain itu persiapan pasien sebelum operasi yang rutin dijalankan seperti puasa 6-8 jam juga merupakan bagian dari operasi. Kondisi tersebut dapat mengganggu keseimbangan dalam tubuh. Keadaan metabolik pasien pra operasi harus dioptimalkan untuk persiapan operasi. Pasien harus berada dalam keadaan anabolik yang cukup daripada dalam keadaan kelaparan dan katabolik. Periode puasa khas 8 jam sebelum operasi memaksa metabolisme ke dalam keadaan katabolik. Pemberian larutan oral karbohidrat sebelum operasi membantu menjaga tubuh dalam keadaan anabolik yang diinginkan. Pemberian yang biasa dilakukan adalah 2-3 jam sebelum operasi pasien akan diberikan larutan oral karbohidrat tersebut. Oleh karena itu penulisan ini dibuat untuk mengetahui fisiologi pemberian larutan oral karbohidrat sebagai manajemen preoperatif pada pasien yang akan menjalankan operasi.
MANAJEMEN ANESTESI PADA PASIEN HAMIL G1P0 UK 26 MINGGU YANGMENJALANI CRANIOTOMY REMOVAL TUMOR FOSSA POSTERIOR
Authors: Sudadi  , Kurniawaty Juni , Utomo F uad Cipto
Published: December 2023

Tumor otak selama kehamilan sangat jarang terjadi dan kejadiannya menjadikan tantangan bagi dokter bedah saraf, dokter obsgyn dan dokter anestesi tidak hanya untuk diagnosis akan tetapi manajemen perioperative yang membutuhkan persiapan yang baik untuk ibu dan janin. Kami laporkan kasus perempuan usia kehamilan 26 minggu dengan tumor meningioma.Dengan usia kehamilan 26 minggu yang disertai tanda dan gejala peningkatan tekanan intracranial (TIK), deficit neurologi yang bertambah yang tidak membaik dengan obat-obatan, maka tindakan craniotomy dekompresi pengambilan tumor diperlukan. Kami melakukan pertemuan multidisiplin sebelum operasi dan merencanakan secara detail prosedur operasi. Selama operasi, tim memastikan monitoring intensive, oksigen yang adekuat dan menghasilkan hemodinamik yang stabil. Obat anestesi seperti fentanil, rocuronium, propofol dan sevoflurane dipilih untuk memastikan keamanan ibu dan janin. Dibawah prosedur manajemen anestesi yang aman dan sukses, pasien dapat dilakukan tindakan operasi secara baik tanpa komplikasi terhadap ibu dan janin, baik sebelum dan setelah operasi. Tindakan bedah saraf selama kehamilan jarang dilakukan, dan perencanaan yang baik antar multi-disiplin diperlukan untuk mendapat hasil yang baik selama operasi. Keamanan bagi ibu dan janin merupakan sebuah tantangan yang penting.
Hubungan Kadar Awal D-Dimer Terhadap Mortalitas pada Pasien COVID-19 Di RSUP Dr. Sardjito
Authors: Alqustar Adam , Kurniawaty Juni , Widyastuti Yunita
Published: December 2023

Pada pasien COVID-19 berat, respon imun dapat berlebihan dan menyebabkan badai sitokin sistemik yang mencetuskan terjadinya systemic inflammatory response syndrome (SIRS). Respon inflamasi sistemik berlebihan dapat menyebabkan terjadinya jejas endotel (endoteliopati) sistemik dan keadaan hiperkoagulasi yang meningkatkan risiko terjadinya makrotrombosis dan mikrotrombosis sistemik. D- dimer dilepaskan ketika plasmin, enzim fibrinolitik, memecah fibrin dan sebagai cerminan dari proses trombosis endovaskular. Penilaian konsentrasi D-dimer dalam sirkulasi merupakan tes yang sensitif untuk mendiagnosis status trombosis (termasuk emboli paru dan disseminated intravascular coagulation (DIC)) serta prediksi terhadap kejadian mortalitas.
MANAJEMEN NUTRISI PADA PASIEN ICU YANG MENJALANI PROSEDUR ESOFAGEKTOMI
Authors: Widodo Untung , Jufan Akhmad Yun , Adrin Olga Elenska
Published: December 2023

Pasien dalam perawatan intensif pada umumnya terpapar pada keadaan stress katabolik dengan komplikasi peningkatan morbiditas dan mortalitas, serta berpengaruh pada lamanya perawatan di unit intensif. Manajemen nutrisi yang optimal dapat membantu meningkatkan respon metabolik terhadap stress, mencegah cedera seluler oksidatif, dan memodulasi respon imun. Kami melaporkan pasien laki-laki berusia 30 tahun yang menjalani prosedur esofagektomi oleh karena tumor esophagus. Pasca operasi hari ketiga pasien diberikan nutrisi enteral namun terdapat residu kecoklatan, sehingga diberikan nutrisi parenteral sampai dengan perawatan hari kesepuluh. Nutrisi enteral dilanjutkan di hari perawatan kesepuluh sampai dengan pasien pindah bangsal pada hari perawatan ketigabelas di unit intensif.
Angka Mortalitas Perioperatif yang Terkait Anestesi di RSUP Dr Sardjito Yogyakarta Tahun 2010 – 2011
Authors: Heri Pujiono  , Untung Widodo  , Djajanti Sari
Published: December 2023

Pendahuluan. Angka kematian merupakan jumlah kematian secara umum atau oleh sebab khusus dalam suatu populasi, berskala sesuai dengan besarnya populasi per unit waktu. Angka kematian yang terkait anestesi merupakan pengukuran dasar atau utama dari kualitas dan keselamatan pelayanan anestesi. Pencegahan mortalitas terkait dengan tindakan anestesi adalah bagian dari rangkaian pelayanan anestesi termasuk optimalisasi preoperatif, penatalaksanaan anestesi yang baik, bahkan hingga penanganan postoperasinya. Penelitian tentang mortalitas terkait anestesi yang cukup intens dapat meningkatkan perbaikan keselamatan pasien yang dianestesi. Tujuan penelitian ini adalah untuk mengetahui angka mortalitas terkait anestesi di RSUP Dr Sardjito tahun 2010-2011.

Subyek dan Metode. Penelitian ini menggunakan rancangan observasional kohort retrospektif dengan membandingkan dua macam kelompok subyek yang mempunyai variabel yang berbeda. Semua data pasien yang mendapatkan anestesi tahun 2010 sampai 2011 di RSUP Dr Sardjito diambil dari rekam medis RSUP Dr Sardjito kemudian dihitung angka kematiannya dengan kriteria meninggal < 24 jam setelah operasi/anestesi selesai dengan k ategori 1 apabila penyebab kematian disebabkan oleh faktor anestesi atau penyebab lain dibawah kendali anestesi, kategori 2 apabila ada keraguan penyebab kematian apakah faktor anestesi ataukah faktor lain yang masih dibawah kendali ahli anestesi dan kategori 3 apabila kematian disebabkan faktor operasi maupun anestesinya . Analisis dilakukan dengan analisa deskriptif, analisa bivariat menggunakan Chi- square dan analisa multivariat menggunakan uji regresi logistik. Hasil dianggap bermakna bila p<0,0 5.

Hasil. Delapan belas ribu tujuh pasien telah menjalani pembiusan di tahun 2010- 2011. Sebanyak 17 pasien meninggal perioperatif dan 9 diantaranya terkait anestesi. Angka kematian per 10.000 pembiusan di RSUP Dr Sardjito untuk perioperatif (9,44) lebih rendah dibanding rata-rata negara maju (17,68) maupun negara berkembang (44,17), sedangkan kematian yang terkait anestesi (5) lebih tinggi dibanding rata-rata negara maju (2,813) maupun negara berkembang (3,645).

Kesimpulan. Berdasarkan karakteristik variabel penelitian tidak ditemukan perbedaan yang bermakna terhadap kematian yang terkait anestesi sehingga analisis regresi logistik tidak dapat dilakukan.
Manajemen Anestesi pada Pasien Mitral Stenosis Berat yang Menjalani Operasi STSG
Authors: Asep Indah Wuddi Arief  , Bhirowo Yudo Pratomo  , IG Ngurah Rai Artika
Published: December 2023

Telah dilakukan anestesi pada pasien dengan diagnosis Combutio gr III 29% disertai dengan stenosis mitral berat yang menjalani operasi debridement dan skin traction skin graft (STSG). Pasien dinilai status fisik ASA II. Anestesi dilakukan dengan general anestesi tehnik semi close, ET no 7, napas kontrol dengan pelumpuh otot. Premedikasi dengan midazolam 3 mg dan fentanil 100 mcg, induksi dengan Etomidate 16 mg, dan fasilitas intubasi dengan rokuronium 30 mg. Pemeliharan anestesi dengan O2, Isofluran dan Fentanil kontinyu. Tindakan pembedahan berlangsung selama kira-kira 4 jam. Selama pembedahan hemodinamik relatif stabil dengan tekanan darah sistol 100-120 mmHg, tekanan darah diastol 45-70 mmHg, laju jantung (HR) antara 60-75 x/menit dan saturasi oksigen antara 98-100%, perdarahan selama operasi kira-kira 200 cc, dan urine output ± 200 cc. Pasca operasi pasien dirawat di Unit Luka Bakar.
Optimizing Post Discharge Pain Management in Pediatric
Authors: Elizeus Hanindito
Published: December 2023

Nyeri adalah masalah yang paling sering dan paling bermakna bagi pasien pediatrik walaupun pada prosedur operasi minor dan masalah ini dapat diterapi dengan efektif. Penilaian keparahan nyeri secara berkala menggunakan beberapa teknik seperti numeric rating scales atau faces scale of Bieri untuk anak yang lebih besar dan behaviour pain scale seperti FLACC untuk usia ‘non-verbal’ dapat membantu mengoptimalkan penanganan nyeri. Penilaian nyeri post operasi untuk orang tua dapat digunakan jika pasien pediatrik sudah keluar dari ruang pemulihan. Nonsteroidal anti-inflammatory drug (NSAID) memberikan analgesia yang baik setelah prosedur operasi minor dan dapat menurunkan jumlah analgesi opioid yang dibutuhkan setelah prosedur yang lebih ekstensif apabila waktu pemberian obat diberikan secara benar. Meskipun kontrol nyeri yang baik umumnya diperoleh setelah operasi, perbaikan dari management nyeri post keluar dari ruang pemulihan seharusnya dioptimakan dengan meningkatkan penggunaan analgesi multimodal seperti standar perawatan, pemberian instruksi post operasi standard yang tertulis, penggunaan guideline analgesia pediatrik khusus untuk masing-masing prosedur operasi, karena laporan dan skor nyeri secara bermakna lebih tinggi pada perawatan di rumah dibandingkan di Rumah Sakit.