bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Anticancer Activity of a Bile Acid-Dihydroartemisinin Hybrid Ursodeoxycholic-Dihydroartemisinin in Hepatocellular Carcinoma Cells
Authors: Huang Tzu-En , Deng Yi-Ning , Hsu Jui-Ling , Leu Wohn-Jenn , Marchesi Elena , Capobianco Massimo L. , Marchetti Paolo , Navacchia Maria Luisa , Guh Jih-Hwa , Perrone Daniela , Hsu Lih-Ching 
Published: November 2020

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy in adults and accounts for 85–90% of all primary liver cancer. Based on the estimation by the International Agency for Research on Cancer in 2018, liver cancer is the fourth leading cause of cancer death globally. Dihydroartemisinin (DHA), the main active metabolite of artemisinin derivatives, is a well-known drug for the treatment of malaria. Previous studies have demonstrated that DHA exhibits antitumor effects toward a variety of human cancers and has a potential for repurposing as an anticancer drug. However, its short half-life is a concern and may limit the application in cancer therapy. We have reported that UDC-DHA, a hybrid of bile acid ursodeoxycholic acid (UDCA) and DHA, is ∼12 times more potent than DHA against a HCC cell line HepG2. In this study, we found that UDC-DHA was also effective against another HCC cell line Huh-7 with an IC50 of 2.16 μM, which was 18.5-fold better than DHA with an IC50 of 39.96 μM. UDC-DHA was much more potent than the combination of DHA and UDCA at 1:1 molar ratio, suggesting that the covalent linkage rather than a synergism between UDCA and DHA is critical for enhancing DHA potency in HepG2 cells. Importantly, UDC-DHA was much less toxic to normal cells than DHA. UDC-DHA induced G0/G1 arrest and apoptosis. Both DHA and UDC-DHA significantly elevated cellular reactive oxygen species generation but with different magnitude and timing in HepG2 cells; whereas only DHA but not UDC-DHA induced reactive oxygen species in Huh-7 cells. Depolarization of mitochondrial membrane potential was detected in both HepG2 and Huh-7 cells and may contribute to the anticancer effect of DHA and UDC-DHA. Furthermore, UDC-DHA was much more stable than DHA based on activity assays and high performance liquid chromatography-MS/MS analysis. In conclusion, UDC-DHA and DHA may exert anticancer actions via similar mechanisms but a much lower concentration of UDC-DHA was required, which could be attributed to a better stability of UDC-DHA. Thus, UDC-DHA could be a better drug candidate than DHA against HCC and further investigation is warranted.
Dutch GPs’ experience of burden by euthanasia requests from people with dementia: a quantitative survey
Authors: Schuurmans Jaap , Crol Chantalle , Olde Rikkert Marcel , Engels Yvonne 
Published: November 2020

BackgroundIn the Netherlands during the past decade, a growing number of people with dementia requested euthanasia, and each year more of such requests were granted.AimTo obtain quantitative insights into the problems and needs of GPs when confronted with a euthanasia request by a person with dementia.Design & settingA concept survey was composed for GPs in the Netherlands. Expert validity of the survey was achieved through pilot testing.MethodA postal survey was sent to a random sample of 900 Dutch GPs, regardless of their opinion on, or practical experience with, euthanasia. Collected data were analysed with descriptive statistics.ResultsOf 894 GPs, 423 (47.3%) completed the survey, of whom 176 (41.6%) had experience with euthanasia requests from people with dementia. Emotional burden was reported most frequently (n = 86; 52.8%), as well as feeling uncertain about the mental competence of the person with dementia (n = 77; 47.2%), pressure by relatives (n = 70; 42.9%) or the person with dementia (n = 56; 34.4%), and uncertainty about handling advance euthanasia directives (AEDs) (n = 43; 26.4%). GPs would appreciate more support from the following: a support and consultation in euthanasia in the Netherlands (SCEN) physician (an independent physician for support, information, and formal consultation around euthanasia) (n = 291; 68. 8%); a geriatric consultation team (n = 185; 43.7%); the end-of-life clinic (n = 184; 43.5%); or a palliative care consultation team (n = 179; 42.3%). Surprisingly the need for moral deliberation was hardly mentioned.ConclusionThe reported burden and the rise in numbers and complexity of euthanasia requests from people with dementia warrants primary care support. There needs to be easier access to colleagues with expertise, and training on end-of-life care needs of patients with dementia and their caregivers.
Lipid levels and major adverse cardiovascular events in patients initiated on statins for primary prevention: an international population-based cohort study protocol
Authors: Blais Joseph E , Akyea Ralph Kwame , Coetzee Annelize , Chan Amy HY , Lau Wallis CY , Man Kenneth KC , Harrison Jeff , Chan Esther W , Beyene Kebede A , Wong Ian CK , Weng Stephen 
Published: November 2020

BackgroundClinical guidelines recommend specific targets for low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) for primary prevention of cardiovascular disease (CVD). Furthermore, individual variability in lipid response to statin therapy requires assessment of the association in diverse populations.AimTo assess whether lower concentrations of LDL-C and non-HDL-C are associated with a reduced risk of major adverse cardiovascular events (MACE) in primary prevention of CVD.Design & settingAn international, new-user, cohort study will be undertaken. It will use data from three electronic health record databases from three global regions: Clinical Practice Research Datalink, UK; PREDICT-CVD, New Zealand (NZ); and the Clinical Data and Analysis Reporting System, Hong Kong (HK).MethodNew statin users without a history of atherosclerotic CVD, heart failure, or chronic kidney disease, with baseline and follow-up lipid levels will be eligible for inclusion. Patients will be classified according to LDL-C (<1.4, 1.4–1.7, 1.8–2.5, and ≥2.6 mmol/l) and non-HDL-C (<2.2, 2.2–2.5, 2.6–3.3, and ≥3.4 mmol/l) concentrations 24 months after initiating statin therapy. The primary outcome of interest is MACE, defined as the first occurrence of coronary heart disease, stroke, or cardiovascular death. Secondary outcomes include all-cause mortality and the individual components of MACE. Sensitivity analyses will be conducted using lipid levels at 3 and 12 months after starting statin therapy.ConclusionResults will inform clinicians about the benefits of achieving guideline recommended concentrations of LDL-C for primary prevention of CVD.
The Δ Anion Gap/Δ Bicarbonate Ratio in Early Lactic Acidosis: Time for Another Delta?
Authors: Rudkin Scott E. , Grogan Tristan R. , Treger Richard M. 
Published: November 2020

Background
The ratio of Δ anion gap and Δ bicarbonate (ΔAG/ΔHCO3) is used to detect coexisting acid-base disorders in patients with high anion gap metabolic acidosis. Classic teaching holds that, in lactic acidosis, the ΔAG/ΔHCO3 is 1:1 within the first few hours of onset and subsequently rises to 1.8:1. However, this classic 1:1 stoichiometry in early lactic acidosis was derived primarily from animal models and only limited human data. The objective of this study was to examine the ΔAG/ΔHCO3 within the first hours of the development of lactic acidosis.

Methods
Data were obtained prospectively from a convenience sample of adult (age >18 years) trauma-designated patients at a single level-1 trauma center. Venous samples, including a chemistry panel and serum lactate, were drawn before initiation of intravenous fluid resuscitation.

Results
A total of 108 patients were included. Of these, 63 patients had normal serum lactate levels (≤2.1 mmol/L) with a mean AG of 7.1 mEq/L, the value used to calculate subsequent ΔAG values. ΔAG/ΔHCO3 was calculated for 45 patients who had elevated serum lactate levels (>2.1 mmol/L). The mean ΔAG/ΔHCO3 for all patients with elevated serum lactate levels was 1.86 (SD, 1.40).

Conclusions
The mean ΔAG/ΔHCO3 was 1.86 within the first hours of the development of lactic acidosis due to hypovolemic shock, confirming a small prior human study. This contradicts the traditional belief that, in lactic acidosis, the ΔAG/ΔHCO3 is 1:1 within the first several hours. The classic 1:1 stoichiometry was determined on the basis of animal models in which lactic acid is infused into the extracellular space, facilitating extracellular buffering of protons by bicarbonate. In contrast, our results demonstrate a higher initial ΔAG/ΔHCO3 ratio in early endogenous lactic acidosis in humans. Our analysis indicates this is likely due to unmeasured anions contributing to an elevation in AG.
DA PROTEÇÃO À INTEGRIDADE DO PRESO
Authors: Das Neves Lícia Jocilene 
Published: November 2020

A presente comunicação visa analisar o direito à integridade física e moral do preso conforme os preceitos fundamentais previstos na Constituição Federal de 1988 e os previstos na Lei de Execução Penal. Tem-se por objetivo geral analisar as condições humanas de convivência e sobrevivência do preso e por objetivos específicos visa-se verificar as condições de salubridade adequadas à vida humana e pesquisar as condições exigidas nas dependências coletivas que atendam aos propósitos da individualização da pena. Pretende-se responder ao seguinte questionamento: como atender aos direitos à integridade física e moral dos presos e à dignidade da pessoa humana diante das condições caóticas observadas no sistema prisional brasileiro? Nesse sentido, a pesquisa será qualitativa, descritiva e bibliográfica, tendo como principais fontes a constituição brasileira, a Lei de Execução Penal, as doutrinas disponíveis sobre o assunto, utilizando como método de pesquisa o indutivo baseado em problemas como superlotação, insalubridade e violência observadas nos estabelecimentos prisionais nacionais. Apesar da sociedade brasileira e das autoridades governamentais entenderem que a prisão é uma medida justa de punição, representa, na verdade, um entrave à recuperação do preso.
RELATIONSHIP BETWEEN FRIENDSHIP QUALITY AND ANXIETY IN FACING PHYSICAL CHANGES DURING PUBERTY IN FEMALE STUDENTS OF ELEMENTARY SCHOOL
Authors: Rahmawati Ida , Masruroh Masruroh 
Published: November 2020

Background: Friends have the most influence in an individual's life. Friendship contains specific elements, such as trust, openness, sharing of ups and downs, and learning to deal with conflict. Puberty children try to have friends to share their feelings with others. Because with good friendship will reduce minimize the anxiety they experience at puberty (Wulandari, Kustriyani, & Fiyannti, 2018).Objectives: The Purpose of this study to determine the relationship between friendship quality and anxiety facing the physical changes of puberty in female students at SDIT Bakti Insani Sleman Yogyakarta.Methods: This study was a quantitative research with survey method, with a total sampling of 47 respondents. Research instruments with questionnaires, the questionnaire was adopted from Marvienda (2007), researchers used a measuring instrument in the form of a friendship quality scale and anxiety scale of female students during puberty. Data analysis using person product moment.Results: The result showed respondents age 100% at the early adolescent stage, 74.5% respondents had not yet menarche, 25.5% had menarche, the average value of friendship quality was 84.89 and the average anxiety value was 63.91. The results showed that there was no relationship between the quality of friendship with anxiety facing physical changes during puberty in female students at SDIT Bakti Insani Sleman Yogyakarta (r = -.38, p-value = .802).Conclusion: This study found that the majority of respondents were in their early teens and only a small proportion had experienced menarche. The average value of high friendship quality shows that the quality of friendship is also high and the average value of anxiety in the medium shows moderate anxiety. The implications of this study are as input or consideration in preparing adolescent reproductive health starting from the beginning of puberty at school. Keywords: Quality of Friendship, Anxiety, Puberty, Physical Changes
THE RELATIONSHIP BETWEEN JEAN WATSON'S THEORY OF HELPING TRUST WITH PATIENT SATISFACTION
Authors: Ahmad Shieva Nur Azizah , Yulianti Cicih Ayu , Hasan Roswita 
Published: November 2020

Background: Fostering a trusting relationship between nurses and patients is the development of one of the curative caring factors because it is closely related to the acceptance of positive and negative feelings of patients when receiving services from nurses. The quality of a person's relationship with others is an element that determines the caring behavior of a nurse (Sartika, 2011). Nurses must be patient, generous, willing to provide assistance to patients voluntarily and be able to communicate, work and be responsible for their duties and rights when acting (Nursalam, 2013).Objectives: The purpose of this study was to determine Jean Watson's theory of helping trust with patient satisfaction in the inpatient room in The Government Hospital of Tangerang Regency.Methods: The research design used in this study is descriptive correlation using the Cross-Sectional approach. The population used in this study were patients treated in the inpatient rooms of Government Hospital of Tangerang Regency amounting to 80 people. The sampling method used is the non-probability sampling method. The sampling technique in this research is purposive sampling. The sample used in this study were 65 respondents. This research instrument using a questionnaire. The analysis used the Chi square test with a significance level α < 0.05.Results: Jean Watson's helping trust relationship both 13 respondents (34.2%) and those who were not satisfied were 1 respondent (3.7%). the results of the analysis obtained OR = 25.35 means that patients who claim helping trust relationship Jean Watson have a 25.35 times chance expressed satisfied. Chi square test results obtained p value 0.001 so that it can be concluded that there is a significant relationship between Jean Watson’s theory of helping trust relationship with patient satisfaction in class III inpatient room at The Government Hospital of Tangerang Regency.Conclusion: Patient satisfaction depends on the quality of nursing services. Service is said to be good if in fact the nurse provides the needs according to the patient's condition and the patient's response to service can be disappointing or satisfying. Further research is expected that nurses can provide assistance to the relationship of trust to patients so that patients can feel safe and comfortable when nurses take nursing actions to patients. Further researchers can use other research methods either qualitatively or add other variables so that the helping trust relationship between nurses and patients can be well developed. Keywords: Helping Trust Relationship, Patient, Satisfaction, Jean Watson.
BARRIERS TO PHYSICAL ACTIVITY IN RECENTLY DIAGNOSED TYPE 2 DIABETES MELLITUS PATIENTS: A QUALITATIVE STUDY
Authors: Kurniawati Yulia , Kurniawati Ninuk Dian , Probowati Ririn 
Published: November 2020

Background: Physical activity as one of diabetes management plays important role in maintaining glycemic control. Not all diabetics are doing adequate physical activity. Especially for recently diagnosed type 2 Diabetes Mellitus patients with the characteristic haven’t adopt diabetes management properly.Objectives: The aim of this study to reveal the barriers in physical activity that faced by recently diagnosed type 2 Diabetes Mellitus patients.Methods: Qualitative study with phenomenological approach was conducted in 10 recently diagnosed type 2 Diabetes Mellitus patients in Primary Health Care Kedungdoro and Asemrowo, Surabaya. The participants were selected based on inclusion criteria, namely patients aged 25-45 years old, under 6 months diagnosed, spoke in Indonesian or Javanese well. The exclusion criteria were patients with complication. Semi-structured in-depth interviews guided by interview guideline was conducted to obtain the information about barrier in physical activity. There were six questions in interview guideline. Then data from interview was analyzed by Colaizzi method.Results: Two themes were emerged as barriers in physical activity namely time expenditure and health literacy. Participants’ time expenditure refers to the limited time in doing physical activity, namely obligation to others and lack of spare time. Health literacy refers to the ability in searching and using health information. The barrier in health literacy aspect namely physical activity substitute and different information that got from others.Conclusion: The barriers of physical activity were problem in time flexibility, activity substitute, and need for straightening various information. Using media technology and involving family to promote and remind the physical activity can be suggested. Keywords: Barriers, Diabetes Mellitus Type 2, Recently Diagnosed, Physical Activity
DISCHARGE PLANNING STANDARD IN IMPROVING MOTHER'S SKILLS IN CARING FOR NEWBORN
Authors: Munif Badrul , Indriani Ninis , Nanik Nanik 
Published: November 2020

Background: Primipara is a client who really needs discharge planning to support her baby care skills independently at home after returning from the hospital. Discharge planning is one of the important elements in nursing services to improve client skills independently to perform care after discharge.Objectives: This study aims to determine the effectiveness of discharge planning according to the standards of maternal skills in caring for newborns.Methods: The research design was a quasi experimental study with a pre and post-test design with a control group. This research was conducted at a hospital in Banyuwangi. The research sample was 30 spontaneous primiparous patients, then divided into two groups, namely the experimental group given discharge planning according to the standard n=15 and the control group given conventional discharge planning treatment n=15. Sampling using Consecutive Sampling and data collection using the observation sheet of maternal skills about baby care. Data analyzed using paired T test and unpaired T test.Results: The results showed that the skills of mothers in caring for newborns in the experimental group had a higher value than the control group with the difference in the skills of caring for the umbilical cord of 3.60, changing diapers by 3.33 and breastfeeding by 6.60. Further analysis obtained p value=0.000 (p> 0.05), which means that there is a significant difference between the experimental and control groups.Conclusion: Discharge planning in accordance with standards can improve the skills of mothers in caring for their babies. Discharge planning in accordance with the standards should be implemented in the hospital, because discharge planning is one of the important elements in nursing services which aims to make clients independent after discharge from the hospital. Keywords: discharge planning, mother’s skill, caring, newborns
THE RELATIONSHIP BETWEEN FAMILY CHARACTERISTICS WITH STUNTING INCIDENCE IN WORKING AREA OF PADANG SERAI PUBLIC HEALTH CENTER
Authors: Khairani Nurul , Pawiliyah Pawiliyah 
Published: November 2020

Background: Under-fives who have stunting have a risk of decreased intellectual ability, productivity, and increased risk of degenerative diseases in the future (Anugraheni & Kartasurya, 2012). Objective: to examine the relationship between family characteristics with stunting incidence of under five children who visited the Integrated Healthcare Center (Posyandu) in working area of Padang Serai Public Health Center (Puskesmas) of Bengkulu City. Methods: this study was conducted in June, 2016. The type of the study was Analytical Survey and the design was Cross Sectional. Sample was under five children aged 0-59 months (stunted and non-stunted) who visited the Integrated Healthcare Center in working area of Padang Serai Public Health Center of Bengkulu City with their mothers. The sampling technique was Accidental Sampling and the sample total was 92 under five children. The data were primary and secondary data. The primary data were length or height, age of children, and family characteristics (education and knowledge of mothers, number of family, income rate of household heads). The secondary data was collected from Health Department and Integrated Healthcare Center. The data was analyzed with univariate and bivariate analysis. Bivariate analysis used Chi-Square (χ2) test. Results: The prevalence of stunting incidence was 27.17%, no relationship between family characteristics [height of mother (p=0.054), education of mother (p=0.857), knowledge of mother (p=1.000), total of family members (p=0.934), and income rate of household head (p=1.000)] with stunting incidence of under five children who visited the Integrated Healthcare Center in working area of Padang Serai Public Health Center of Bengkulu City.Conclusion: Padang Serai Public Health Center should be able to overcome the stunting problem by doing more intensive nutrition program for the fertile women, pregnant, and lactating women, under five children, and also socialization of the nutritional status of stunting to the community. Keywords: Family Characteristics, Stunting, Under Five Children.
THE LEVEL OF KNOWLEDGE AND ATTITUDES OF MOTHERS IN COMPLEMENTARY FEEDING TO INFANTS AGED 0-12 MONTHS
Authors: Riesmiyatiningdyah Riesmiyatiningdyah , Putra Kusuma Wijaya Ridi , Annisa Faida , Diana Meli 
Published: November 2020

Background: Until now, there are still many mothers who give complementary foods to babies before the age of 6 months. This is due to the lack of knowledge of mothers about complementary foods, the benefits and methods of giving complementary foods correctly, and improper complementary feeding habits, as well as the support from families in providing complementary foods. These conditions affect the mother's attitude in giving complementary foods (Sulistijani & Herlianty, 2001).
Objective: This study aimed to determine the relationship between the level of knowledge and attitudes of mothers in providing complementary foods to infants aged 0-12 months.
Methods: The research design used correlational analytic with cross sectional approach. The population in this study were all mothers who had children aged 0-12 months in Balonggabus Village as many as 58 people. The sampling technique used was total sampling. The sample size in this study were 58 respondents. Data collection was obtained through demographic data and questionnaire sheets with a total of 26 questions. Data were analyzed using the Spearmen Rho test with a significance level of p ≤ 0.05.
Results: The results showed that the level of knowledge of mothers in giving complementary foods to infants aged 0-12 months in Balonggabus Village, Candi, Sidoarjo, almost half of them had a low level of knowledge of 28 respondents (48.3%), and attitudes of mothers in giving complementary foods to babies. Most of those aged 0-12 months had negative attitudes as many as 38 respondents (65.5%). The results of statistical tests show that there is a relationship between the level of knowledge and attitudes of mothers in providing complementary foods to babies aged 0-12 months in Balonggabus Village, Candi, Sidoarjo with a significance level of 0.000 (ρ ≤ 0.05).
Discussion: Based on the results of the study, it was found that the better the level of knowledge of a mother regarding complementary feeding, the mother has a positive attitude in complementary feeding.
Conclusion: The implication of this study shows that the level of knowledge of mothers in providing complementary foods needs to be improved by providing information by health workers and health cadres about complementary feeding, so that the mother's attitude will be positive.