bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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.