bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge of Nurses Regarding Essential Newborn Care in Special Care Neonatal Units (SCANU) of Different Hospitals of Chattogram, Bangladesh
Authors: Sharmin Tasnuva , Chowdhury Pranab Kumar , Khan Tafazzal Hossain , Hoque Md Obidul 
Published: June 2021

Background: The advancements in intensive care in recent decades have enabled better survival of newborn. Knowledge of essential newborn care is important for the survival, growth, and development of a newborn. In spite of its essentiality, most health-care professionals do not know and follow the World Health Organization recommendation.
Aim and objectives: The aim of this study was to assess the knowledge of nurses regarding essential newborn Care in Special Care Neonatal Units (SCANU).
Materials and methods: This observational study was conducted among the nurses working in SCANU of Chattogram Medical College and Hospital, Chattogram Maa- O- Shishu Hospital and Bangabandu memorial hospital of University of Science and Technology, Chattogram (USTC) for 6 months. Purposive sampling technique were applied for selecting the sample. A structured data sheet was predesigned to collect data. Knowledge regarding Essential Newborn Care among the nurses graded as satisfactory or not satisfactory.
Results: In this study it was observed that 69.0% nurses had completed diploma in nursing and midwife education, B. Sc in nursing 11.0%, diploma in nursing 7.0%. 56.0% nurses attended special courses/training in neonatology. 94.75% of the nurses had satisfactory knowledge regarding essential newborn care. 58.0% of nurses washed their hands with disinfectant solution before handling the baby, 99.0% mentioned that the baby must be breast feeding within 1st hour of delivery, 92.0% mentioned that baby must be fed 6 months of exclusive breast feed, 91.0% knew how to stabilize body temperature of low birth weight newborn. The knowledge regarding essential newborn care were almost similar with age, gender, religion, marital status, educational level, working place and attending special courses/training in neonatology.
Conclusion: Most of the nurses working in SCANU of both Government and non-government hospitals of Chattogram have good knowledge regarding ENC. This knowledge appeared irrespective of their age, gender, religion, marital status, working place and special courses/training in neonatology.
J Bangladesh Coll Phys Surg 2021; 39(3): 185-192
Outcome of Varus Derotation Osteotomy for Containment of Femoral Head in Advanced Perthes Disease
Authors: Rana Mohammad Masud , Datta Nokul Kumar , Bhuiyan Mohammad Ishaq , Ripon Md Asadullah , Mohammad Salim Abu Zihad 
Published: June 2021

Background: Legg-Calve-Perthes (LCP) disease, or idiopathic avascular necrosis of the femoral head occurs during early childhood and is caused by impaired circulation in the femoral head. Varus derotation osteotomy (VDO) was described over half a century ago, and is now a popular method for the operative treatment of Perthes disease.
Objective: To find out the clinical and radiological outcome of varus derotation osteotomy for containment of femoral head in advanced Perthes disease.
Materials and Methods: This observational study was conducted in the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from March 2015 to September 2017. Total 20 cases of advanced Perthes disease were enrolled. Pre- and post-operative period were evaluated by interview and clinical examination by using a semi-structured questionnaire. Demographic and clinical information were recorded. All patients had a pre- and post-operative x-rays. We used visual analog scales (VAS) for scoring pain; Wiberg’s central edge angle, epiphyseal extraction index, neck shaft angle and Larson (Iowa) hip score were used to assess the outcome of VDO. Comparison of continuous variables between the two groups was made with Student’s t-tests. Comparison of proportions between Herring groups B and C were made with chi-square tests. p<0.05 was considered as significant. All the data were compiled and sorted properly and the quantitative data were analyzed statistically by using Statistical Package for Social Sciences (SPSS 22.0).
Results: In the present study, mean visual analog scale (VAS) score and epiphyseal extraction index (EEI) were significantly (p<0.001) lower in Herring Group B in comparison to that of Group C, but mean WCEA, NSA and HLS were significantly (p<0.001) higher in Herring Group B in comparison to that of Group C.
Conclusion: Varus osteotomy gives good results in children aged 6–12 years who do not exhibit any femoral head deformity or flattening, especially those with good containment in abduction in advance Perthes disease.
J Enam Med Col 2020; 10(2): 79-85
An Unusual Cause of Efferent Loop Obstruction
Authors: Sarker Ashok Kumar 
Published: June 2021

Efferent loop obstruction is a very rare post-gastrectomy obstruction that can occur following Billroth-II or Roux-en-Y reconstruction. Here we report a case who underwent gastrojejunostomy for gastric outlet obstruction 30 years back and now developed efferent loop obstruction due to phytobezoar. The efferent loop obstruction was successfully resolved by laparotomy.
J Enam Med Col 2020; 10(2): 118-121
Model Orientasi Kewirausahaan dan Strategi Bisnis Guna Meningkatkan Kinerja Wirausaha Perempuan di Bogor
Authors: Primadhita Yuridistya , Ayuningtyas Eka Avianti , Primatami Anggraita 
Published: July 2021

Penelitian ini bertujuan untuk menguji pengaruh langsung orientasi kewirausahaan dan strategi bisnis serta pengaruh tidak langsung orientasi kewirausahaan yang dimediasi oleh strategi bisnis terhadap kinerja wirausaha perempuan di Bogor. Penelitian ini menggunakan data primer dari 50 wirausaha perempuan di Bogor. Analisis data dilakukan dengan menggunakan analisis jalur. Hasil penelitian menunjukkan bahwa orientasi kewirausahaan tidak berpengaruh secara langsung terhadap kinerja wirausaha perempuan. Hasil penelitian juga menunjukkan bahwa orientasi kewirausahaan yang dimediasi oleh strategi bisnis berpengaruh lebih besar terhadap peningkatan kinerja wirausaha perempuan. Orientasi kewirausahaan yang kuat diiringi dengan strategi efisiensi biaya, strategi diferensiasi produk, dan strategi segmen pasar spesifik akan memberikan kemungkinan yang lebih besar bagi wirausaha perempuan untuk meningkatkan kinerjanya dan menjadi lebih kompetitif.Kata kunci: kinerja; orientasi kewirausahaan; strategi bisnis; UMKM; wirausaha perempuan ABSTRACTThis study aims to examine the direct effect of entrepreneurial orientation and business strategy and also the indirect effect of entrepreneurial orientation, mediates by business strategy, on the performance of women entrepreneurs in Bogor. This study used the primary data of 50 women entrepreneurs in Bogor. The data was analyzed using path analysis. The results showed that entrepreneurial orientation has no directly effect on the performance of women entrepreneurs. The results also showed that entrepreneurial orientation that is mediated by business strategy has a greater effect on improving the performance of women entrepreneurs. Strong entrepreneurial orientation that accompanied by cost efficiency strategy, product differentiation strategy, and specific market segment strategy will provide more possibilities for women entrepreneurs to improve their performance and become more competitive.Keywords: business strategy; entrepreneurial orientation; performance; SMEs; women entrepreneurship
Development and Validation of Willingness to Communicate, Language Use, and Motivation Questionnaires
Authors: Ubaid Ubaid Ullah , Rethinasamy Soubakeavathi , Ramanair Joseph 
Published: June 2021

The main goal of modern second language (L2) pedagogy is to engender appropriate communication skills among its learners. Hence, willingness to communicate (WTC) in L2 emerged as an important variable in recent years. Several factors have been found to influence students’ L2 WTC directly or indirectly. For this purpose, many scales and questionnaires have been developed so far to examine the factors influencing WTC among L2 students. However, a comprehensive questionnaire on WTC inside ESL classroom is still lacking. Likewise, WTC in relation to language use and motivational orientations in a single study has yet to be investigated. Thus, this study was aimed to develop and validate questionnaires on WTC, language use and motivational orientations. For this purpose, a five-phase model was used. After an extensive literature review, questionnaires on WTC, language use and motivational orientations were framed. Operational definitions of the three constructs were established and the items of the questionnaires were finalised. Two experts in the field of applied linguistics determined the content validity of the questionnaires. At the end, the questionnaires were piloted on 50 undergraduates and 10 ESL teachers. The results revealed that all the instruments were valid and highly reliable.
The Effects of Dapagliflozin in Patients With Heart Failure Complicated With Type 2 Diabetes: A Meta-Analysis of Placebo-Controlled Randomized Trials
Authors: Zhai Miaobo , Du Xin , Liu Changmei , Xu Huipu 
Published: June 2021

BackgroundCardiovascular disease threatens the health and quality of life of individuals, particularly those with type II diabetes. Recently, some studies have reported the effect of sodium-glucose cotransporter 2 (SGLT2) inhibitors in reducing the rates of hospitalization or urgent visits, resulting in IV therapy for heart failure in patients with type 2 diabetes mellitus (T2DM).MethodsWe did a comprehensive search in electronic databases from inception through July 2020 for randomized-controlled trials, using the keywords “sodium-glucose cotransporter-2 inhibitor”, “dapagliflozin”, “heart failure”, “cardiovascular outcomes”, “major adverse cardiovascular events”, “all-cause mortality”, and “cardiovascular death”. Random-effects summary odds ratios (OR) were constructed using M-L heterogeneity model.ResultsFive trials with 5,252 patients were ultimately included. The incidence of hospitalization for heart failure (HHF) (n=4, OR=0.74; 95% CI, 0.61 to 0.88; I2 = 0%) and all-cause mortality (ACM, n=4, OR=0.76; 95% CI, 0.66 to 0.94; I2 = 0%); was reduced by dapagliflozin, respectively, in all heart failure patients, without obvious heterogeneity. The incidence of cardiovascular death in dapagliflozin was lower than that in placebo without statistically significant (CVD, n=5, OR=0.84; 95% CI, 0.69 to 1.03; I2 = 0%). In HFrEF subgroup, dapagliflozin was associated with a reduced incidence of hospitalization for heart failure (n=4, OR=0.74; 95% CI, 0.60 to 0.91; I2 = 0%), cardiovascular death (n=4, OR=0.72; 95% CI, 0.58 to 0.91; I2 = 8%), and all-cause mortality (n=3, OR=0.70; 95% CI, 0.50 to 0.99; I2 = 43%) without significant heterogeneity. In contrast, in the HFpEF subgroup, there was no difference in the incidence of cardiovascular death (n=2, OR=1.45; 95% CI, 0.95 to 2.22; I2 = 0%) and all-cause mortality (n=2, OR=1.04; 95% CI, 0.76 to 1.43; I2 = 0%) between dapagliflozin and placebo.ConclusionIn our study, dapagliflozin performed a statistical reduction in the rate of heart failure hospitalization, cardiovascular death, and all-cause mortality in patients with HFrEF and diabetes. However, in the HFpEF subgroup, dapagliflozin did not show a significant cardiovascular protective effect.
Ultrasound-Guided Regional Anesthesia Under Sedation for Radical Mastectomy in an SAS Patient: A Case Report
Authors: Zhang Na , Wang Tingting , Wei Penghui , Zhou Jinfeng , Li Jianjun 
Published: June 2021

Radical mastectomy is commonly performed under general anesthesia, and regional block is often used as assisted or postoperative analgesia. We herein report a case of successful radical mastectomy with severe aortic stenosis (SAS) by using ultrasound-guided regional anesthesia under sedation. A 66-year-old female with an American Society of Anesthesiology physical status IV; limited functional capacity with &lt;4 metabolic equivalents; a lump (10 cm × 8 cm) in the right breast with skin breakage and infection; and a history of hypertension, diabetes, atrial fibrillation, and SAS, underwent lump-resection and rapid pathological examination by biopsy. Considering a high-risk of significant mortality, we used ultrasound-guided regional block to avoid general anesthesia. We performed the right thoracic paravertebral nerve block (TPVB), subclavicular brachial plexus block, and pectoralis plane block (PECS 1). Patient tolerated the procedure well with no significant hemodynamic changes. Nevertheless, when the axillary lymph nodes were wiped, discharge was observed from the patient’s upper limbs. We inserted the laryngeal mask airway combined with low-dose sevoflurane inhalation sedation. The operation was successfully completed, and the patient was revived with steady hemodynamics and good prognosis. In the present case, radical mastectomy with SAS was performed successfully using ultrasound-guided regional anesthesia under sevoflurane sedation. Despite some potential limitations, this case report can serve as a reference for other anesthetists.
Short-Interval Sequential CAR-T Cell Infusion May Enhance Prior CAR-T Cell Expansion to Augment Anti-Lymphoma Response in B-NHL
Authors: Meng Yuan , Deng Biping , Rong Luan , Li Chuo , Song Weiliang , Ling Zhuojun , Xu Jinlong , Duan Jiajia , Wang Zelin , Chang Alex H. , Feng Xiaoming , Xiong Xiujuan , Chen Xiaoli , Pan Jing 
Published: June 2021

Chimeric antigen receptor (CAR)-T cell therapy emerges as a new treatment for refractory or relapsed (r/r) B-cell non-Hodgkin lymphoma (B-NHL); however, the overall response rate (ORR) of which in the B-NHL patients is much lower compared to the patients with r/r B acute lymphoblastic leukemia (B-ALL). We previously confirmed that sequential infusions of CD20 and CD22 CAR-T cells significantly improved the prognosis of the B-NHL patients, while some advanced patients still progressed to death during these CAR-T cell treatments. In this study, we showed that timely sequential administration of the second CAR-T cells could enhance expansion of prior CAR-T cells with stronger tumor-killing capacity in vitro and in vivo. We further conducted compassionate treatments on two advanced B-NHL patients with short-interval sequential infusions of CD19/22/20 CAR-T cells. Disease progression was observed in both patients after primary CAR-T cell infusion but robust re-expansion of prior CAR-T cells and anti-tumor effects was induced by infusion of a secondary CAR-T cells. These results indicate sequential infusions of CAR-T cells with a short interval may improve therapeutic efficacy in the B-NHL patients by promoting expansion of prior CAR-T cells.
Clinical Features and Risk Factors of Fungal Peritonitis in Children on Peritoneal Dialysis
Authors: Fang Xiaoyan , Cui Jingyi , Zhai Yihui , Liu Jiaojiao , Rao Jia , Zhang Zhiqing , Chen Jing , Liu Jialu , Miao Qianfan , Shen Qian , Xu Hong 
Published: June 2021

Objective: To analyse the clinical manifestations, aetiology, prognosis, and risk factors of fungal peritonitis (FP) in children on peritoneal dialysis (PD).Methods: Among 322 children undergoing PD at Children's Hospital of Fudan University, between January 2001 and December 2019, FP cases were retrospectively analysed and compared with those of bacterial peritonitis (BP) to analyse the risk factors of FP.Results: A total of 124 cases of peritonitis were treated, including 11 FP cases in 11 children (0.0019 episodes/patient*month) and 113 BP cases in 64 children (0.02 episodes/patient*month). Among the 11 FP cases, 7 cases (63.64%) were caused by Candida and Candida parapsilosis (5/7) was the most common pathogen of Candida. All FP patients were converted to haemodialysis (HD) and did not resume PD during follow-up. Two patients (18.2%) died after 6 months of HD due to heart failure, 2 patients underwent kidney transplant after 2 years of infection, and the other 7 patients were still on HD. The univariate analysis showed the usage rate of antibiotics in the month before the onset of peritonitis was higher (45.45 vs. 15.93%) and the mean serum albumin was lower (31.4 vs. 34.4 g/L) in the FP group when compared with BP group (P &lt; 0.05), while multivariate analysis showed that serum albumin ≤ 30 g/L was an independent risk factor for FP (odds ratio 4.896, 95% confidence interval 1.335–17.961).Conclusion: FP is a rare complication of PD in children, but it is associated with high technique failure. Attention should be paid to hypoproteinaemia and antibiotic use in children on PD.
A Good Way to Reduce Screening for Retinopathy of Prematurity: Development of the ROP Model in a China Preterm Population
Authors: Ding Wenqian , Luo Chenghan , Cheng Xinru , Shi Zanyang , Lei Mengyuan , Rong Junbo , Song Min , Cao Wenjun , Zhang Jingdi , Ge Jian , Wang Mengmeng , Zhang Yixia , Xia Peige , Wang Li , Liu Yufeng , Zhang Qian 
Published: June 2021

Importance:Retinopathy of prematurity (ROP) is a preventable cause of blindness in children. Without treatment, more than 45% of eyes may suffer permanent vision loss. Current ROP screening guidelines, which include a range of birth weights (BWs) and gestational ages (GAs), may require screening many low-risk preemies who might develop severe ROP.Method:All high-risk infants in the neonatal intensive care unit (NICU) of the First Affiliated Hospital of Zhengzhou University from 2017 to 2021 were included in this retrospective cohort study. Each of the 27 candidate risk factors was evaluated in univariate analysis and adjusted for known risk factors (i.e., GA and BW). The significant results were analyzed in a backward selection multivariate logistic regression model. Receiver operating characteristic (ROC) curves and a nomogram were drawn.Results:The study included 2,040 infants who underwent ROP screening. The weight gain rate [OR, 2.65; 95% confidence interval (CI), 1.49–1.21 ≤ 12 g/d vs. &gt; 18 g/d;P= 0.001], blood transfusion (OR, 2.03; 95% CI, 1.14–3.64;P= 0.017), invasive mechanical ventilation (OR, 1.74; 95% CI, 1.15–2.66;P= 0.009) and N-terminal segment of pro-B-type natriuretic peptide (NT-proBNP) ≥ 25,000 ng/L (OR, 1.51; 95% CI, 1.00–2.28;P= 0.048) were four new statistically independent risk factors in addition to GA and BW. The area under the curve (AUC) of the final multivariate model was 0.90 (95% CI, 0.88–0.92;P&lt; 0.001).Conclusions and Relevance:These findings add to our understanding of ROP screening because they include all eligible infants rather than only high-risk infants, as in previous studies. Under the control of BW and GA, low weight gain rate, increased number of blood transfusion, invasive mechanical ventilation and NT-proBNP ≥ 25,000 ng/L were “new” statistically independent risk factors for ROP. The ROP risk can be calculated manually or represented by a nomogram for clinical use.
Developing and Maintaining a Healthy Family Today
Authors: Moral Manuel , Chimpén Carlos 
Published: July 2021

This article on health families is specific regarding the key aspects about how to develop and to maintain a healthy family in today’s world. These key aspects are theoretically reframed in different words and applied to the growth of a consistent family in current times. Other topics are new entries to complete the picture of a strong and vigorous family. To better understand this complex objective, this article first reviews the concepts and theories about family and love, and then review the different theoretical reviews to better understand the contemporary family. These great definitions and foundations will allow making practical applications in the areas of growth, development and maintenance of a healthy family today.
A Non-purine Xanthine Oxidoreductase Inhibitor Reduces Albuminuria in Patients with DKD: A Randomized Controlled Trial
Authors: Bakris George L. , Mikami Hidetaka , Hirata Masayuki , Nakajima Akihiro , Cressman Michael D. 
Published: June 2021

Abstract

Key Points

Whether xanthine oxidoreductase inhibitors (XORIs) can be renoprotective for type 2 diabetic kidney disease (T2DKD) is unclear.In this randomized trial, a novel XORI, TMX-049 200 mg, reduced albuminuria by 35% in patients with T2DKD, without any relevant safety concerns.Aside from lowering uric acid levels, xanthine oxidoreductase inhibition in the kidney may play a key role for the management of T2DKD.

Background
Diabetic kidney disease (DKD) is characterized by albuminuria and reduced renal function. Whether xanthine oxidoreductase inhibitors (XORIs) have a renoprotective effect in DKD patients with type 2 diabetes remains controversial. We conducted a proof-of-concept study to investigate the renal effects of a novel XORI, TMX-049, in patients with DKD and type 2 diabetes.

Methods
This is a multicenter, 12-week, randomized, double-blind, placebo-controlled phase 2a trial conducted at 49 centers across the United States between April 2018 and June 2019. In total, 130 patients with type 2 diabetes, urine albumin-creatinine ratio (UACR) 200 − 3000 mg/g, eGFR ≥30 ml/min per 1.73 m2, and serum uric acid (sUA) 4 − 10 mg/dl were randomized 1:1:1 to TMX-049 200 mg (n=44) or 40 mg (n=44), or placebo (n=42). The primary end point was change in log-transformed UACR at week 12 from baseline. The secondary end points included changes in UACR, eGFR, and sUA from baseline.

Results
The least squares mean differences for changes in log-transformed UACR from baseline to week 12 compared with placebo were −0.43 (95% confidence interval [95% CI], −0.82 to −0.04, P=0.03) for TMX-049 200 mg and −0.05 (95% CI, −0.44 to 0.34, P=0.80) for 40 mg; a 35% reduction in UACR was observed with TMX-049 200 mg (ratio versus placebo, 0.65; 95% CI, 0.44 to 0.96) but not 40 mg (0.95; 95% CI, 0.64 to 1.41). Throughout the treatment period, marked reductions in sUA levels but no changes in eGFR were observed with both TMX-049 doses. TMX-049 was generally well tolerated, although two patients with TMX-049 200 mg developed gout.

Conclusions
TMX-049 200 mg reduced albuminuria at 12 weeks in patients with DKD and type 2 diabetes. TMX-049 may exert a renoprotective effect independent of its sUA-lowering effect.