bluuebunny/crossref_metadata_2025 huggingface dataset:
Music Therapy and Aromatherapy Interventions in Patients undergoing Hemodialysis: A Systematic Review
Authors: Sariati Sariati , Sholikhah Dwi Uswatun , Narendri Cahya Mustika , Sari Gevi Melliya , Yahya Qolbi Nur Qoidah
Published: March 2020

Introduction: The number of patients with chronic kidney disease (CKD) who undergo hemodialysis is increasing every year. Various attempts have been made to maximize the process of hemodialysis, one of which is by providing complementary therapy with music as therapy and through the administration of aromatherapy. The aim of this study was to identify the effectiveness of the use of music therapy and aromatherapy in a patient diagnosed with chronic kidney disease undergoing hemodialysis.Methods: The literature review followed on from the identification of the interventions then the studies were identified by keyword according to the topic and title. There were 15 articles that discussed the effect of music therapy and aromatherapy on patients undergoing hemodialysis. The design RCT was 7 articles, 3 quasi-experimental articles, and 5 clinical trial articles.Results: Music can raise the endorphin and serotonin levels and reduce the catecholamine levels, so it can change the respiratory rate and oxygen saturation, improve their quality of sleep and reduce fatigue.Conclusion: Our findings indicate that music therapy and aromatherapy have a positive effect on patients with chronic kidney disease undergoing hemodialysis.
Correlation of Picky Eating in Children’s Growth: A Systematic Review
Authors: Fitriana Dona Muji , Pradany Risna Nur , Rahmawati Apriana
Published: March 2020

Introduction: picky eating is a problem that is now common in children, characterized by not trying or limiting variations in food, especially vegetables and fruit. Picky eating has an important role in the development of children, both physically and emotionally, so that it becomes a concern for the parents.Method: this systematic review aims to explain the correlation of picky eating on a child's growth using PRISMA approach from two database: Scopus and Proquest limited to the last 5 years; from 2015-2019 and obtained 15 articles that selected. Identification of articles using keywords ('picky eating' AND 'children' AND 'weight' or 'growth').Result: according to the findings, it was found nine articles that mentioned picky eating had an effect on growth and six articles mentioned no effect. Limitation of this study is that there are other factors that influence picky eating in selected articles.Conclusion: the most of the result from the studies show the behavior of picky eating in children can affect the growth of both body weight and height, and can also affect nutritional status, emotional status, physical activity and health status. Nurses can provide education about the effects of picky eating behavior on children in parents.
The Effect of Ergonomic Gymnastics on Joint Pain in Community-Dwelling Elderly
Authors: Siagian Martha Lowrani , Syarif Anggi Hanafiah , Sukur Andreas Wojtyla , Baga Beatric Maria Dwijayanti , Rayuni Ni Ketut Emi
Published: March 2020

Background: The aging process that occurs in the elderly is characterized by a decreasing immune system and physical impairment. The most common complaint is joint pain. The aim was to determine the effect of ergonomic gymnastics on the elderly who experienced joint pain.Method: The samples totaled 110 respondents who had joint pain at Krembangan-Surabaya obtained through the total sampling technique. The data was collected through observation sheets with one group pre-post-test design, and it was analyzed through the Wilcoxon text. The result showed that after 9 sessions of 60 minutes each for two months found that ergonomic gymnastics could influence the reduction of joint pain with a significance level of 0.00 (p<0.05).Discussion: There were a decreasing number of respondents that felt moderate pain (82 to 44) and this automatically meant that there was an increasing number of mild pain respondents (28 to 66).Conclusion: Exercising regularly and with the correct methods could provide an excellent benefit to maintain bodily health, especially to reduce joint pain in the elderly. It is expected that all health care providers in primary health services or in a private clinics should know and be able to conduct ergonomic gymnastics using the correct methods.
Telerehabilitation System in Nursing Post Stroke - A Systematic Review
Authors: Prayoga Dimas Hadi , Aridamayanti Bernadetta Germia , Trisnawati Ida , Ronalia Maria Fransiska
Published: March 2020

Background: Stroke is currently the main cause of disability worldwide. Telerehabilitation is a rehabilitation approach that can be used to repair the damage to motor, sensory and cognitive functions. This can also substantially reduce the travel time for the health workers and therefore increase the number of patients who are consulted in a day.Method: A search using specific keywords was done in both the journal articles and in the database. In total, 119 articles were from Scopus, 45 articles were from PubMed, 87 articles were from Science Direct, 52 articles were from EBSCO and 97 articles were from Proquest. There were 15 articles that matched the inclusion criteria. Most of the available literature only refers to short-term results and most of the research is of low quality.Result: Evidence of the relative effectiveness was found in the types of videos, VR, cellphones and computer use. The location of the network support and technological progress are still obstacles that must be addressed immediately. Based on the current scientific evidence, only a few telerehabilitation methods can be recommended for wider use.Conclusion: The telerehabilitation system can provide long-term therapy, meet the patient needs and save the health resources needed to minimize the severity of the patients’ condition. The application of telerehabilitation is used by the nurses to optimize their role in improving patient health and telerehabilitation will answer the problem of penetrating the distance dimension.
The Impact of Independent of Activity Daily Living among Stroke Patients on Caregivers Burden
Authors: Fadilah Nikmatul , Rahariyani Loetfia Dwi
Published: March 2020

Introduction: Weakness among stroke patients causes obstacles when fulfilling their activities in daily living (ADL). This condition also has an impact on the caregivers who provide daily care at home. The purpose of this study was to analyze the effect of independent ADL among the stroke patients on caregiver burden.Methods: The study used an analytical design through a cross-sectional approach. The variables included independent ADL and caregiver burden. A sample of 120 caregivers was taken from 2 community health centers in Surabaya through simple random sampling. The instruments used were Zarit Burden's Interview Schedule and the Katz Index of Independent for ADL. Regression ordinal was used to analyze the influence of independent ADL among stroke patients on caregiver burden.Results: The results showed that the caregiver who take care of stroke patients with severe functional impairment will feel burdened 3 times more than no burden. Post-stroke care at home through a rehabilitation program plays an important role in improving the condition of patients and their families at home, especially the caregivers.Conclusion: Nurses in a community health center through the family health care pathway provide comprehensive bio-psycho-socio-spiritual care in the rehabilitation period as expected. They are expected to improve and maintain the fulfillment of human needs comprehensively for stroke patients and their caregivers, so the quality of life of stroke patients, caregivers and their families remains optimal.
Factors Affecting the Organizational Commitment of Nurses in Comprehensive Health Services: A Systematic Review
Authors: Rofiqi Erfan , Nuritasari Rahayu Tri , Wiliyanarti Pipit Festi
Published: March 2020

Introduction: Organization commitment is an important variable in understanding employee behavior that has a serious effect on organizational performance. Employees not only have to have expertise, empowerment and competence, but they also have to have organizational commitment. Therefore, the level of attachment and commitment of the nurses to their organization can influence their clinical competence. The research was conducted to identify the factors that influence nursing organizational commitment.Methods: The literature review employed the Scopus, ScienceDirect, Pubmed, Ebsco and CINAHL databases to retrieve original articles published between 1999 and 2017. The method used to arrange the literature review started with the topic selection and then the reviewer determined the following keywords: organization commitment, commitment, nursing, health and factors of commitment. Out of the 2.134 articles found, there were 15 journals with a cross-sectional study design that discussed the organizational commitment of nurses.Results: The organizational commitment of care is influenced by many factors, both internal and external. These factors include leadership style, compensation, career development, organizational culture /climate, spiritual health and learning organizations.Conclusion: The factors found above can increase the commitment of nurse organizations in comprehensive health services.
A Systematic Review of Excessive Social Media Use: Has It Really Affected Our Mental Health?
Authors: Rahmawati Apriana , Fitriana Dona Muji , Pradany Risna Nur
Published: March 2020

Introduction: Social media use has been rapidly increasing over the past few years. Research and practice have mostly focused on the positive impacts of social media, intending to understand and support the various opportunities afforded by this particular technology era. However, it is increasingly observable that social media also involves enormous risks for individuals, communities, firms and even for society as a whole. This systematic review aimed to establish the negative impacts on mental health related to the excessive use of social media.Methods: As many as 15 articles were generated from Scopus, ScienceDirect and Ebscohost. The reviewers independently screened the titles and abstracts in addition to assessing the studies. The study design varied in rigorousness over the quantitative as well as qualitative studies.Results: The result for this study are that having an average daily screen time (more than 2 hours a day) is positively associated with social media addiction. Avoidant attachment was associated with more problematic social media use.Conclusion: Avoidant attachment was associated with more problematic social media use. Thus, an abstinence of several days from social media consumption can caused a reduction in perceived stress.
The Role of the Nurse Unit Manager Function on Nursing Work Performance: A Systematic Review
Authors: Patarru' Fitriyanti , Weu Basilius Yosepfus , Handini Febrina Secsaria , Heryyanoor Heryyanoor
Published: March 2020

Introduction: The role of Nurse Unit Manager is to improve the nurses’ performance in the context of their professional services. This role consists of planning, organizing, actuating and controlling. The aim of this systematic review was to determine the influence of the nurse unit manager’s management functions related to the nurses’ performance.Methods: The literature search was conducted in the PubMed, Scopus, ProQuest, Science Direct and SAGE databases with the keywords ‘head nurses’, ‘management function’ and ‘nurse performance’. The articles were reviewed using the inclusion criteria, which was that the title and abstract was in accordance with the desired topic, that the article aimed to analyze the influence of the nurse unit manager’s management functions related to the nurses’ performance and that it was explained in English. The exclusion criteria were that the title, abstract and purpose of the article was not in accordance with the topic of focus. The search identified 15 relevant journals from the 276.303 articles published between 2014 and 2019.Results: The results indicate a significant relationship exists between the role of the nurse unit manager and nursing work performance.Conclusion: To improve the management function of the nurse unit manager, it is necessary to conduct training for the nurse unit manager to allow them to better understand the functions and role of the nurse unit manager.
Predictive Risk Factors of Smartphone Addiction in Adolescents: A Systematic Review
Authors: Fauzi Abdul , Yusuf Ah , Mundakir Mundakir
Published: March 2020

Introduction: Smartphone addiction often occurs in adolescents. The purpose of this systematic review was to identify the predictors of smartphone addiction in adolescents.Methods: The method used in this systematic review consisted of 5 stages: (1) the identification of the instruments used in the literature (database search); (2) the identification of the relevant literature based on the title and abstract; (3) the inclusion and exclusion criteria; (4) getting the full-text literature and (5) grading based on the literature component and the analysis of the selected instruments. The databases used in the literature search were Scopus, PubMed, Science Direct and Springer Link from 2013 - 2018. The criteria for the included articles were that they used a cross-sectional design and involved adolescents as the sample.Results: 17 of 829 articles met the inclusion criteria. The predictors of smartphone addiction were broadly divided into 3, namely personal factors, interpersonal factors and behavioral factors. These 3 factors are related to one another.Conclusion: It is necessary to do further research within a case-control study to strengthen this systematic review.
The Effect of Early Mobilization on Intestinal Peristaltics in Patients after a Cesarean Section in Kendari City Hospital
Authors: Herman Andi , Santoso Budi , Yunitasari Esty
Published: March 2020

Background: Cesarean section (CS) is the most significant surgical intervention that affects the central nervous system and that slows down the bowel movement after CS. Intervention in the early period after CS is needed to improve bowel function. This study aims to determine the effect of early mobilization on intestinal peristalsis after cesarean section.Method: This quasi-experimental study was conducted on 72 patients divided into two groups of 36 for the intervention group at Dewi Sartika Public Hospital and for the control group at Kendari Public Hospital. A paired T-test was used for the data analysis.Result: After the intervention, there was a significant improvement in intestinal peristalsis in the intervention group (P<0,05).Conclusion: Early mobilization is an effective intervention to improve intestinal peristalsis in patients after cesarean section.
Factors Related to Sleep Disorders in the Elderly in Tresna Werdha Madago Tentena
Authors: Lataima Nurmawati S , Pasaju Novrin S
Published: March 2020

Background: Sleep disorders are common things often experienced by the elderly. This will affect their quality of life. There are many factors that influence sleep needs in the elderly. The aim of this study was to determine the factors related to sleep disorders in the elderly.Method: This study used a cross-sectional design with accidental sampling. The population in this study was the elderly at Tresna Werdha Madago Tentena. The data retrieval for this research was conducted between June - July 2014. The analysis of the data was done using Chi-Square. The results from the 45 respondents showed that 61.3% had sleep disorders caused by their disease and that 65.6% had sleep disorders caused by an unconducive environment.Result: This result showed that disease and an unconducive environment influenced sleep needs.Conclusion: The recommendation for nurses and staff is to increase their attention span and the environmental comfort by dimming the lights when the patient is going to sleep and reducing noise. This means that the patient's sleep needs are fulfilled.
Factors Influencing the Incidence of Dengue Haemorrhagic Fever
Authors: Lestari Trijati Puspita , Sholikhah Siti , Qowi Nurul Hikmatul
Published: March 2020

Background: Dengue Hemorrhagic Fever (DHF) is a contagious disease that is still a community problem in Indonesia. The purpose of this study was to analyze the factors related to the incidence of dengue fever in Deket village.Method: This study was an observational analytical study with a case control design. The data that was collected used interviews and questionnaires. The sample consisted of 39 for the case group and 39 for the control group. The variables used were 3M behavior (covering the water container, draining the water container, burying unused things) and the incidence of DHF.  This study used the Chi-square test.Result: The results showed that there was a relationship between the habitual draining of the water reservoirs with dengue fever, where p=0.000 (p<0.005). There was a relationship between the habit of closing the water reservoirs with dengue fever; p=0.000 (p<0.005). There was a relationship between the habits of thrift burial with dengue hemorrhagic fever; p=0.000 (p<0.005).Conclusion: Based on these results, it is expected that the health cadres should control the implementation of 3M in the community.
Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-analysis
Authors: Rodriguez-Morales Alfonso J. , Cardona-Ospina Jaime A. , Gutiérrez-Ocampo Estefanía , Villamizar-Peña Rhuvi , Holguin-Rivera Yeimer , Escalera-Antezana Juan Pablo , Alvarado-Arnez Lucia Elena , Bonilla-Aldana D. Katterine , Franco-Paredes Carlos , Henao-Martinez Andrés F. , Paniz-Mondolfi Alberto , Lagos-Grisales Guillermo J. , Ramírez-Vallejo Eduardo , Suárez Jose A. , Zambrano Lysien I. , Villamil-Gómez Wilmer E. , Balbin-Ramon Graciela J. , Rabaan Ali A. , Harapan Harapan , Dhama Kuldeep , Nishiura Hiroshi , Kataoka Hiromitsu , Ahmad Tauseef , Sah Ranjit
Published: March 2020

Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) begun in December 2019 in China, causing a Public Health Emergency of International Concern. Among raised questions, clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews have been published on this matter. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases. Observational studies, and also case reports, were included and analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). Results: 660 articles were retrieved (1/1/2020-2/23/2020). After screening by abstract/title, 27 articles were selected for full-text assessment. Of them, 19 were finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 40.8-74.4%) and dyspnea (45.6%, 10.9-80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), with 32.8% presenting acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock and 13.9% (95%CI 6.2-21.5%) of hospitalized patients with fatal outcomes (case fatality rate, CFR).Conclusion: COVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected patients and this group was associated with a CFR of over 13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure, and facilities to treat severe COVID-19.
Data-Oriented Constitutive Modeling of Plasticity in Metals
Authors: Hartmaier Alexander
Published: March 2020

Constitutive models for plastic deformation of metals are typically based on flow rules determining the transition from elastic to plastic response of a material as function of the applied mechanical load. These flow rules are commonly formulated as a yield function, based on the equivalent stress and the yield strength of the material, and its derivatives. In this work, a novel mathematical formulation is developed that allows the efficient use of machine learning algorithms describing the elastic-plastic deformation of a solid under arbitrary mechanical loads and that can replace the standard yield functions with more flexible algorithms. By exploiting basic physical principles of elastic-plastic deformation, the dimensionality of the problem is reduced without loss of generality. The data-oriented approach inherently offers a great flexibility to handle different kinds of material anisotropy without the need for explicitly calculating a large number of model parameters. The applicability of this formulation in finite element analysis is demonstrated, and the results are compared to formulations based on Hill-like anisotropic plasticity as reference model. In future applications, the machine learning algorithm can be trained by hybrid experimental and numerical data, as for example obtained from fundamental micromechanical simulations based on crystal plasticity models. In this way, data-oriented constitutive modeling will also provide a new way to homogenize numerical results in a scale-bridging approach.
HIF-1beta Positively Regulates NF-kappaB Activity via Direct Control of TRAF6
Authors: D'Ignazio Laura , Shakir Dilem , Batie Michael , Muller H. Arno , Rocha Sonia
Published: March 2020

NF-B signalling is crucial for cellular responses to inflammation but has also been associated with the hypoxia response. NF-B and HIF transcription factors possess an intense molecular crosstalk. Although it is known that HIF-1beta modulates NF-kappaB transcriptional response, very little is understood regarding how HIF-1beta contributes to NF-kappaB signalling. Here, we demonstrate that HIF-1beta is required for full NF-kappaB activation in cells following canonical and non-canonical stimuli. We found that HIF-1beta specifically controls TRAF6 expression in human cells but also in Drosophila melanogaster. HIF-1beta binds to the TRAF6 gene and controls its expression independently of HIF-1alpha. Furthermore, exogenous TRAF6 expression is able to rescue all of the cellular phenotypes observed in the absence of HIF-1beta. These results indicate that HIF-1beta is an important regulator of NF-kappaB with consequences for homeostasis and human disease.
Serological Test is an Efficient Supplement of RNA Detection for Confirmation of SARS-CoV-2 Infection
Authors: Xia Ning-Shao , Wang Gui-Qiang , Gong Wen-Feng
Published: March 2020

Until now, viral RNA detection is almost the only way to confirm the infection of SARS-CoV-2 in practice. But varied reasons lead to the low sensitivity by RNA detection, which proposes serious challenge to disease control. We tested the performance of detecting total antibody(Ab) and IgM antibody in serum by the methods of chemiluminescence, Enzyme Linked Immunosorbent Assay(ELISA), and colloidal gold. Data showed that the sensitivity and specificity for total Ab and IgM detection were high by all the three methods, and compared with IgM, the sensitivity was higher for total Ab detection. Evidence from studies showed viral RNA testing combining with serological testing could increase the sensitivity of diagnosis, while remaining the high specificity. Specific serolody test for SARS-CoV-2 has great value for clinical practice and public health.
Evaluasi Program Pelaksanaan Knowledge Sharing Materi Legal Aspects di Perumda Pasar Jaya
Authors: Yudanti Tiara Putri , Mulyadi Mulyadi , Ariani Diana
Published: March 2020

This research aims to describe the program evaluation. Evaluation is needed to determine the level of implementation or success of a program by knowing the effectiveness of its component. This research used formative summative evaluation model by Michael Scriven's that focused on formative research programs. Formative evaluation is used when the program is being implemented with the aim of making improvements to the program. One of the implementations of the formative evaluation is to evaluate the Legal Aspects knowledge sharing at Perumda Pasar Jaya. Formative evaluation was used to assess the implementation of the Legal Aspects knowledge sharing program at Perumda Pasar Jaya. The method of this research is survey technique which consists of distributing questionnaires to 30 respondents participants sharing Legal Aspects and interviewing the organizers of sharing activities, the Pasar Jaya Training Center. The collected data is processed using a qualitative descriptive approach.
Pengembangan Program Pelatihan Teknik Penulisan Modul Untuk Widyaiswara BPSDM Provinsi DKI Jakarta
Authors: Purwaning Putri , Widyaningrum Retno , Kustandi Cecep
Published: March 2020

This development research aims to develop an appropriate training program about module writing which intended to the Instructors of BPSDM Jakarta in order to increase ones’ knowledge and competencies in module writing. The program development refers to the Instructional Development Model by M. Atwi Suparman. Basde on these models, research and developmenta has been through the stages of assess needs to identify instructional goal, conduct instructional analysis, analyze learners and contexts, write performance objectives, develop assessment instrument, develop instructional strategy, develop and select instructional, and design and conduct formative evaluation. This research also developed a book of training program for Instructors, training module, and presentation media, in order to assist the training process. The evaluation of the training program includes two phases which consist of expert review and one-to-one evaluation. The evaluation scores from expert review phase by Instructional Design Expert is 3.73 which considered as very good, also the scores from media expert for learning source module is 3.88 which considered as very good and for presentation media 3.17 which considered as very good either. The one-to-one evaluation phase involved 3 Instructors and the scores obtained is 3 which considered as good. Based on the results of evaluation, it can be concluded that this training program is appropriate to be implemented in order to increase the competencies of module writing for the Instructors of BPSDM DKI Jakarta.
Challenges in the cultural adaptation of the German Myeloma Patient Outcome Scale (MyPOS): an outcome measure to support routine symptom assessment in myeloma care
Authors: Gerlach Christina , Taylor Katherine , Ferner Marion , Munder Markus , Weber Martin , Ramsenthaler Christina
Published: March 2020

Background: Patients with multiple myeloma report more problems with quality of life (QoL) than other haematological malignancies over the course of their incurable illness. The patient-centred Myeloma Patient Outcome Scale (MyPOS) was developed to assess and monitor symptoms and supportive care factors in routine care. Our aim was to translate and culturally adapt the outcome measure to the German context, and to explore its face and content validity.Methods: Translation and cultural adaptation following established guidelines used an exploratory, sequential mixed method study design. Steps included: (1) forward translation to German; (2) backward translation to English; (3) expert review; (4) focus groups with the target population (patients, family members, healthcare professionals) to achieve conceptual equivalence; (5) cognitive interviews using Tourangeau’s model with think-aloud technique to evaluate comprehension and acceptability; (6) final review. Results were analysed using thematic analysis.Results: Cultural and linguistic differences were noted between the German and English original version. The focus groups (n = 11) and cognitive interviews (n = 9) both highlighted the need for adapting individual items and their answer options to the German healthcare context. Greater individuality regarding need for information with the right to not be informed was elaborated by patients. While the comprehensive nature of the tool was appreciated, item wording regarding satisfaction with healthcare was deemed not appropriate in the German context. Before implementation into routine care, patients‘ concerns about keeping their MyPOS data confidential need to be addressed as a barrier, whereas the MyPOS itself was perceived as a facilitator/prompt for a patient-centred discussion of QoL issues. Conclusion: With adaptations to answer options and certain items, the German version of the MyPOS can help monitor symptoms and problems afflicting myeloma patients over the course of the disease trajectory. It can help promote a model of comprehensive supportive and patient-centred care for these patients.
Outcome impact of individualized fluid management during spine surgery A before-after prospective comparison study
Authors: Che Lu , Zhang Xiu H , Li Xu , Zhang Yue L , Huang Yu G , Xu Li
Published: March 2020

Background

Individualized fluid management (IFM) has been shown to be useful to improve the postoperative outcome of patients undergoing major abdominal surgery. A limited number of clinical studies have been done in orthopaedic patients and have yielded conflicting results. We designed the present study to investigate the clinical impact of IFM in patients undergoing major spine surgery.

Methods

This is a before-after study done in 300 patients undergoing posterior spine arthrodesis. Postoperative outcomes were compared between control group implementing standard fluid management (n = 150) and IFM group (n = 150) guided by fluid protocol based on continuous stroke volume monitoring and optimization. The primary outcome measure was the proportion of patients who developed one or more complications within 30 days following surgery.

Results

During surgery, patients received on average the same volume of crystalloids (7.4 vs 7.2 ml/kg/h) and colloids (1.6 vs 1.6 ml/kg/h) before and after the implementation of IFM. During 30 days following surgery, the proportion of patients who developed one or more complications was lower in the IFM group (32 vs 48%, p<0.01). This difference was mainly explained by a significant decrease in post-operative nausea and vomiting (from 38 to 19%, p<0.01), urinary tract infections (from 9 to 1%, p<0.01) and surgical site infections (from 5 to 1%, p<0.05). Median hospital length of stay was not affected by the implementation of IFM.

Conclusions

In patients undergoing major spine surgery, the implementation of IFM was associated with a significant decrease in postoperative morbidity.
Relationship of endoscopic lesions of the renal papilla with type of renal stone and 24 h urine analysis
Authors: Arroyo Xavier Arnau Sabaté , Grases Felix , Quetglas Jose Luis Bauza , Garcia Jorge Guimera , Ayala Enrique Pieras
Published: March 2020

BACKGROUND:

Our purpose was to study the relationships of the 3 different types of endoscopic calcifications of the renal papilla (Randall’s plaque, intratubular calcification, papillary crater) with the type of stone and urine chemistry.

METHODS

This prospective study examined 41 patients (age range: 18 to 80 years) who received retrograde intrarenal surgery (RIRS) for renal lithiasis (mean stone size: 15.3 ± 7.2 mm). Endoscopic injuries of the renal papilla were classified as Randall’s plaque, intratubular calcification, or papillary crater. Calculi were classified as uric acid, calcium oxalate monohydrate (COM; papillary and cavity), calcium oxalate dihydrate (COD), or calcium phosphate (CP). A 24 h urine analysis of calcium, oxalate, citrate, phosphate, and pH was performed in all patients. The relationship of each type of papillary endoscopic injury with type of stone and urine chemistry was determined. Fisher’s exact test and Student’s t-test were used to determine the significance of relationships, and a p value below 0.05 was considered significant.

RESULTS

The most common endoscopic injury was tubular calcification (78%), followed by Randall’s plaque (58%), and papillary crater (39%). There was no significant relationship of Randall’s plaque with type of stone. However, endoscopic intratubular calcification (p = 0.025) and papillary crater (p = 0.041) were more common in patients with COD and CP stones. There were also significant relationships of papillary crater with hypercalciuria (p = 0.036) and hyperoxaluria (p = 0.024), and of Randall’s plaque with hypocitraturia (p = 0.005).

CONCLUSIONS

There are certain specific relationships between the different types of endoscopic papillary calcifications with stone chemistry and urine chemistry. COD and CP stones were associated with endoscopic tubular calcifications and papillary craters. Hypercalciuria was associated with tubular calcification, and hypocitraturia was associated with Randall’s plaque.
Serum soluble PD-1 plays a role in predicting infection complications in patients with acute pancreatitis
Authors: Yu Xingxing , Pan Yu , Fei Qinglin , Lin Xianchao , Chen Zhijiang , Huang Heguang
Published: March 2020

Background: Most of acute pancreatitis (AP) are mild and self-limiting, however, 15%-20% of patients develop severe AP (SAP) or moderately SAP (MSAP) with local or systemic complications. Infection complications (ICs) result in 40-70% morbidity and high mortality rates among SAP and MSAP patients. It’s require that early identification of SAP and MSAP patients at risk of developing ICs. Several studies have indicated that serum soluble programmed cell death protein (sPD-1) or programmed cell death 1 ligand (sPD-L1) levels were higher in patients with severe sepsis than in healthy volunteers, and have a predictive capacity for mortality. However, the role of serum soluble PD-1/PD-L1 in AP remains unclear. This study aimed to investigate whether the ICs of AP patients is associated with their sPD-1 and sPD-L1 levels, which were determined via enzyme-linked immunosorbent assay of peripheral blood samples from 63 MSAP and SAP patients and 30 healthy volunteers.Results: The serum sPD-1 levels in AP patients on days 1, 3 and 10 after onset were significantly increased in a time-dependent manner compared with that in healthy volunteers. Moreover, the AP patients with ICs had significantly higher serum sPD-1 levels than the AP patients without ICs. While serum sPD-L1 levels in AP patients were similar to that in healthy volunteers. Besides, serum levels of sPD-1/sPD-L1 10 were negatively correlated with circulating lymphocytes. Univariate and Multivariate regression analyses showed that the up-regulated serum sPD-1 level was an independent risk factor for ICs in AP. The area under the receiver operating characteristics (ROCs) curve indicated that combination with Acute Physiology and Chronic Health Evaluation II (APACHE II) score and serum sPD-1 level had a high accuracy in predicting ICs in AP patients.Conclusion: Serum sPD-1/sPD-L1 may be involved in the immunosuppressive process in AP. Moreover, the serum sPD-1 level may be an independent risk factor for predicting ICs in AP patients.
The safety and efficacy of SDLT-2 (Sodium-glucose co-transporter 2) inhibitor versus placebo in the treatment of heart failure in patients with or without T2DM (Type 2 diabetes mellitus): A Systemic Review and Meta-analysis.
Authors: Zhang Qian , Wang Xiaofei , Ge Peipei , Hu Aizhen , Li Xuexun
Published: March 2020

Background Sodium-glucose co-transporter 2 (SGLT2) inhibitor which is a type of drug used for the treatment of diabetes mellitus, has been reported by many trials that it could be beneficial for patients with established heart failure. A meta-analysis on this subject could obtain more reliable estimates of the efficacy and safety outcomes. Methods A systematic review and meta-analysis of randomized, placebo-controlled trials of SGLT2 inhibitor in patients with heart failure was conducted. We searched PubMed, Cochrane Library, and Web of Science for trials published from inception to March, 2018. PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used to conduct the review. For quality assessment of included studies. The methodological quality of the included trials was assessed using the Cochrane tool for assessing randomized clinical trials (RCT). Efficacy outcomes included hospitalization for heart failure and all-cause death. Safety outcomes consisted of serious adverse event (SAE) and volume depletion. Results We included data from 5 identified studies and 8775 patients (aged 64.9, female 29.8%). A total of 3930 (44.8%) patients were known to have diabetes mellitus. Compared with placebo, SGLT2 inhibitor decrease the incidence of hospitalization for heart failure (RR 0.692; 95%CI, 0.611-0.784 P<0.001), and all-cause death (RR 0.824; 95%CI, 0.736-0.922 P=0.001). The incidence of SAE in patients with a treatment of SGLT2 inhibitor was low (RR 0.869; 95%CI, 0.779-0.970 P=0.012). SGLT2 inhibitor didn’t increase the incidence of volume depletion (RR1.165, 95%CI, 0.977-1.390 P=0.089). Conclusion Our results confirm that SGLT2 inhibitor is effective and safe for patients with heart failure regardless of presence of diabetes mellitus.
Interleukin-6-knockdown of chimeric antigen receptor-modified T cells significantly reduces IL-6 release from monocytes
Authors: Kang Liqing , Tang Xiaowen , Zhang Jian , Li Minghao , Xu Nan , Qi Wei , Tan Jingwen , Lou Xiaoyan , Yu Zhou , Sun Juanjuan , Wang Zhenkun , Dai Haiping , Chen Jia , Wu Depei , Yu Lei
Published: March 2020

Background T cells expressing a chimeric antigen receptor (CAR) engineered to target CD19 can treat leukemia effectively but also increase the risk of complications such as cytokine release syndrome (CRS) and CAR T cell related encephalopathy (CRES) driven by interleukin-6 (IL-6). Here, we investigated whether IL-6 knockdown in CART-19 cells can reduce IL-6 secretion from monocytes, which may reduce the risk of adverse events. Methods Supernatants from cocultures of regular CART-19 cells and B lymphoma cells were added to monocytes in vitro, and the IL-6 levels in monocyte supernatants were measured 24 h later. IL-6 expression was knocked down in regular CART-19 cells by adding a short hairpin RNA (shRNA) (termed ssCART-19) expression cassette specific for IL-6 to the conventional CAR vector. Transduction efficiency and cell proliferation were measured by flow cytometry, and cytotoxicity was measured by evaluating the release of lactate dehydrogenase into the medium. Gene expression was assessed by qRT-PCR and RNA sequencing. A xenograft leukemia mouse model was established by injecting NOD/SCID/γc-/- mice with luciferase-expressing B lymphoma cells, and then the animals were treated with regular CART-19 cells or ssCART-19. Tumor growth was assessed by bioluminescence imaging. Results Both recombinant IL-6 and activated regular CART-19 cells expressing IL-6 triggered IL-6 release by monocytes. IL-6 knockdown in ssCART-19 cells dramatically reduced IL-6 release from monocytes without reducing cytotoxic activity. Mice treated with ssCART-19 cells showed lower IL-6 levels in the serum than mice treated with regular CART-19 cells, but tumor growth and survival were similar between the animal groups. Conclusion IL-6 released from activated CAR T cells may be one of the main initiators of the release of IL-6 from monocytes that can drive CRS. IL-6 knockdown in ssCART-19 cells reduces monocyte release of IL-6 both in vitro and in vivo without affecting antitumor efficacy. The IL-6 knockdown strategy may provide a useful and promising way to improve the safety of CAR T cell therapy.
Materno-fetal and neonatal outcomes associated with caesarean section delivery in private and public hospitals in low- and middle-income countries: a systematic review
Authors: Beogo Idrissa , Darboue Amadou , Marthias Tiara , Drissa Sia , Eric Tchouaket Nguemeleu , Savard Julie
Published: March 2020

Background: Advancement in medicine has improved birth assistance. As a result, caesarean section delivery (CSD) has become the most commonly performed surgical procedure. The exponential growth has now skewed toward low- and middle-income countries (LMICs) despite the well-established morbimortality risk and extra costs associated to this procedure. The expansion of private healthcare sector may be playing a significant role. The objective of this review synthesizes knowledge and investigates the difference in materno-fetal and neonatal outcomes of CSD in the perinatal period, between private and public hospitals. Methods: Medline, Embase, Cinhal, Cochrane Database, LILACS, and HINARI were screened for peer-reviewed published studies in English and French, from 1990 to 2019, in human subjects and supplemented by manual searches. The studies included were prospective and retrospective cohort studies, cross-sectional and Delphi studies comparing perinatal outcomes of women whose neonates were delivered by caesarean section and by vaginal delivery in public and private hospitals. In total, the searches yielded 7,762 studies, assessed independently by two assessors. Of these, 26 quantitative studies were included which risk of bias was considered fairly low.Results: Elective or not, CSD is associated with a variety of outcomes, including death for both the mother and the neonate. Low quality of life, postpartum depression, infections, and scars were burdens attributable to CSD in both sectors. CSD is associated with less urinary incontinence compared to vaginal delivery but no difference exists in early skin-to-skin contact or in early breastfeeding introduction. Finally, across continents, Africa leads in terms of adverse consequences.Discussion/Conclusion: Private facilities surpassed public ones in CSD rate but were associated with the least severe materno-neonatal outcomes. Countries like China are succeeding through robust policies interventions formulation to contain the CSD epidemic and the health issues associated thereto.
Perceptions And Challenges Of Healthcare Workers In Making Ethical Decisions Of Withholding And Withdrawing Life Support From Terminally Ill Patient In Tertiary Hospital, Mwanza Region- Northwestern Tanzania
Authors: MABEGA NDAKIBAE GABRIEL , Ruggajo Paschal
Published: March 2020

Background: Making ethical decisions in Withholding and withdrawing life support measures from terminally ill patients are challenges in clinical practice. Still there is no consensus around the world. In Tanzania, there is neither guideline nor legal frameworks governing the practice.Methods: Aim: The aim of the study was to explore the perceptions and ethical challenges of healthcare workers in making ethical decisions of withholding and withdrawing life supportive measures from terminally ill patients.Results: A healthcare workers perceptions varies in decisions of withholding and withdrawing life supportive measures from terminally ill patients.Conclusions: Decisions of withholding and withdrawing life support measures from terminally ill patients face many challenges. Lack of legal and ethical framework to guide the practices inhibits the ethical decisions of physicians and nurses.
Identifying Public stakeholders effective on mental health promotion in Iran
Authors: Damari Behzad , Esmaili Mohammad Reza Amir , Rafiee Noora , Hajebi Ahmad
Published: March 2020

Background: Adding mental health to the agenda of other sectors is not always easy, but it is now confirmed that the mental health promotion policies need innovations beyond the health sector to be efficient. Thus, in this study, it has been attempted to identify the most effective stakeholders of the public sector in the field of mental health promotion in Iran to help the policymakers of health sector and to encourage the inter-sectoral cooperation and further involvement of these effective sectors with the mental health promotion plans.Methods: This study was a mixed-methods. From the data of the first step (literature review and survey of relevant professors), the names of government agencies in the mental health were extracted. In the second step, a checklist was developed, the horizontal axis of which was the relevant organizations and the vertical axis was the effective social risk factors on the mental health promotion. In order to analyze the data of this step, the Simple Additive Weighting method was used. In the last step, in order to summarize the organizations affecting each risk factor, a table was plotted as institutional mapping.Results: The Islamic Consultative Assembly, the Ministry of Interior, the Islamic Republic of Iran Broadcasting, the Ministry of Cooperatives, Labor, and Social Welfare, and the Ministry of Education were identified as 5 organizations with the greatest impacts on the social determinants affecting the mental health promotion.Conclusions: The impact of institutions such as Islamic Consultative Assembly (as legislator), the Ministry of Interior and its subsidiary entities such as municipalities and governors (as the administrators of homeland security and support for safe and appropriate urban and local facilities), the Islamic Republic of Iran Broadcasting (as the national media), the Ministry of Cooperatives, Labor, and Social Welfare (as the administration of employment, job security and the provision of welfare to community members), and the Ministry of Education (as the educational institution of the society) are significant.
Significant effects of two pesticides on the bacteriostatic activity and antioxidant ability of green tea polyphenols
Authors: Zhang Jin , Tao Meng-ting , Huang Zi-yan , Hong Gui-yun , Zhu Shu-guang
Published: March 2020

Background: Green tea polyphenols (GTPs) have good bacteriostatic activity and antioxidant capacity, yet pesticide pollutants in tea may affect their functionality. This study aims to explore the effects of pesticide pollutants on the bacteriostasis and antioxidant ability of GTPs.Results: The bacteriostatic activity of GTPs and two pesticides (acetamiprid (ACE), diquat dibromide (DIQ)) shows some certain time characteristics. Two pesticides can affect the bacteriostatic activity of GTPs. The bacteriostatic activity of GTPs is enhanced or weakened by the two pesticides with time lengthening, i.e. time-dependent synergism or antagonism. The bacteriostatic mechanisms of the three substances and their mixtures is produced by affecting cell morphology or destroying cell structure, and the long-term antagonism of the three substances is may due to the competition of action site. In addition, the two pesticides can greatly reduce the antioxidant capacity of GTPs. ACE reduces the free radical scavenging ability of GTPs by 14%~24% and DIQ reduces the free radical scavenging ability of GTPs by 39%~63% at the experimental concentration ratios.Conclusions: Two pesticides has significant effects on the bacteriostatic activity and antioxidant ability of GTPs.