bluuebunny/crossref_metadata_2025_split huggingface dataset:
BACK-REFERRAL PROGRAM IN THE ERA OF NATIONAL HEALTH INSURANCE AT BALUNG DISTRICT GENERAL HOSPITAL OF JEMBER IN 2017
Authors: Sandra Christyana 
Published: June 2019

Background: In 2014, National Health Insurance Program (BPJS Kesehatan) implemented Back-Referral Program (BRP) to facilitate access to health care for patients with chronic diseases in stable conditions. However, the program did not run well at District General Hospital of Balung which had the lowest back-referral program (6 participants) in 2015-2016.Aim: The study aims to examine the BRP at Balung District General Hospital of Jember in 2017.Methods: This study is designed as qualitative case study. The informants consisted of head of treasury verification, secretary of JKN service controlling, officers of local government’s free care scheme, coordinator of internal and neurological disease, specialists in internal and neurological diseases, officers of Social Security Agency for Health, officers of patient eligibility verification, and participants of Back-Referral Program. The study was conducted from October to December 2017.Results: Results show that the attendance of BPJS Kesehatan officers has no contribution to the services of BPJS Kesehatan in the hospital. Participants also find it difficult to follow the steps of BRP due to unavailability of drugs at primary healthcare centers. Moreover, neurologists have not written any referral recommendation since 2016, so there was no patient admittance.Conclusions: The BRP at Balung District General Hospital did not achieve its target (<5 cases/week). In the contrary, the average number of patients referred to the hospital was 86 patients per week. Balung District General Hospital should implement Standard Operating Procedure for letters signed by responsible physician for patients and evaluate the BRP. Keywords: National Health Insurance, Back-referral program, Hospital, Social security.
IMPROVING THE PERFORMANCE OF PRIMARY HEALTHCARE CENTERS IN SURABAYA: A COMPARISON OF LEADERSHIP STYLE AND VERTICAL DYAD LINKAGE
Authors: Soesanto Danoe 
Published: June 2019

Background: Leadership style and Vertical Dyad Linkage have a significant influence on organization’s performance, especially public health service providers. Leadership style is one factor that will influence the performance and management of primary healthcare center (PHC).Aim: This study aims to investigate the influence of leadership style and leader-member exchange to the performance of PHC.Methods: The research is an observational study with a cross-sectional design. There were 27 PHCs involved in the study. Each PHC was represented by 11 respondents including the directors, five health program coordinators, and their five members. Data were collected with questionnaires and then analyzed using Multinomial Logistic Regression (α=0.05).Results: The results of the research show that (37.05%) of PHCs use supportive leadership style, and (33.33%) of them use participative leadership style. Most of the Vertical Dyad Linkage of PHC were imbalanced social overinvestment (40.7%), and the work performance showed enough performance (59.3%). Path-Goal leadership had the most influence on the performance of PHC.Conclusions: Excellent performance of PHC is related to achievement-oriented leadership style. Work performance of PHC can be improved by improving real neutral leader-member exchange. Furthermore, identifying employees’ maturity can be chosen as the leadership style. Employees’ self-esteem can be developed to improve the work performance of PHC. Keywords: Leadership style, Vertical Dyad Linkage, Performance of primary healthcare centre.
THE EQUITY OF ANTENATAL CARE STANDARD IN DIFFERENT AGES
Authors: Goemawati Efvina , Kristy Titis Widya 
Published: June 2019

Background: Antenatal care standard ensures the health of pregnant woman with early detection of risk factors, prevention and treatment provided by competent health practitioners. Health equality does not always mean improving the same service for everyone, but the services are provided according to everyone's needs.Aim: This research was to examine the antenatal standards based on patients’ needs in the Public Health Centre of Medokan Ayu.Methods: This research was observational by using cross-sectional design. The population in this study was 518 pregnant women who gave birth from June 2011 to May 2012 in the Primary Healthcare Center of Medokan Ayu. There were 88 mothers as samples obtained by a cluster random sampling.Results: This study determines the need for antenatal care standards can be fulfilled more for the age of <20 years and >30 years to avoid the high risk of maternal death and needs and equity based on the standards. There were no differences in the acceptance standard of antenatal care (5T and 7T) based on the age group between <20 years, 20-30 years, and> 30 years.Conclusions: Reproductive women need to recognize the importance of antenatal care. The availability and quality of antenatal care need to be further maintained by the healthcare providers, and they need to be more aware to the importance of antenatal care. Women in later reproductive period need to be aware of the prevailing risks in circumstances. Keywords: Equity, Antenatal care standard, Age.
OPPORTUNITY LOSS ANALYSIS OF DISCHARGE AGAINST MEDICAL ADVICE (DAMA) AT INPATIENT UNIT OF TYPE A HOSPITAL IN SURABAYA
Authors: Bilqis Nabilah , Prakoso Seta 
Published: June 2019

Background: Patients who Discharge Against Medical Advice (DAMA) will experience the opportunity loss. DAMA will result in opportunity loss for patients to get treatment and cure their illness. For hospitals, DAMA patients will cause the opportunity loss for hospitals to provide services to patients.Aim: The purpose of this research was to analyze the opportunity loss as the result of DAMA patient. Methods: The method used in this research was a descriptive research. The samples were chosen from the total sample of inpatient population who did DAMA as many as 77 medical records. The inclusive samples were doctors who were responsible for other doctors and dentists as well as inpatient medical records. Meanwhile, the exclusive samples were doctors who are not responsible for other doctors and dentists as well as inpatient medical records. Data analysis used Microsoft Excel to see the total and percentage of DAMA patients.Results: The number of DAMA patients was 77 patients. The highest number of DAMA patients was those in grade 3 as many as 25%. It happened because the grade 3 was cheaper than others. As many as 65% of DAMA patients paid hospital fees using general payments. Patients felt free to discharge themselves from the hospitals because they funded on their own. The majority of DAMA patients were type 2 DM patients amounted to 12% because they assumed they could carry out self-care at home.Conclusions: DAMA patients caused opportunity loss and no Social Security Agency for Health (BPJS Kesehatan) guarantees. Therefore, the hospital has to form a policy to prevent patients from DAMA, notify and ask patients’ reasons of doing DAMA, so the hospital can use these as information for hospital service evaluation. Keywords: Opportunity loss, DAMA, Hospital.
CD45+ Erythroid progenitor cell contribute to antiangiogenic drug resistance via regulating lipid metabolism in lymphoma
Authors: Wei Xia , Yang Sainan , Pu Xin , He Silian , Yang Zailin , Sheng Xiaomin , Jin Ling , Chen Wen , Zhang Yong 
Published: June 2019

Abstract
Background: More than half of lymphoma patients are complicated with anemia. Anemia often indicates a poor prognosis, but the mechanism is still unclear. Erythroid progenitor cells (EPCs) are precursors of erythrocytes and play an important role in maintaining the homeostasis of erythrocytes. Here we investigated the role and mechanism of EPCs in promoting lymphoma progression.

Methods: Ki-67, CD31, P-AMPK and CPT1A expression was detected by immunohistochemical staining. CD45+ EPCs were detected by flow cytometry. Animal experiments were used to detect the effect of CD45+ EPCs on lymphoma.

Results: Our study found that the proportion of CD45+ EPCs in anemic patients with diffuse large B-cell lymphoma (DLBCL) was significantly higher, which is positively correlated with the expressions of P-AMPK and CPT1A in lymphoma tissues. Interestingly, we found that in hypoxic conditions, CD45+ EPCs regulated lipid metabolism and enhanced energy metabolism of lymphoma cells through AMPK-ACC-CPT1A pathway, further promoted cell proliferation and inhibited apoptosis of lymphoma cells. Animal experiments showed that CD45+ EPCs combined transplantation significantly increased the resistance of antiangiogenic drugs. ROS played a key role in this process.

Conclusion: CD45+ EPCs contributed to antiangiogenic drug resistance via regulating lipid metabolism in lymphoma.
The Effect of Stress Management Training on Stigma and Social Phobia in HIV‐positive women
Authors: shamsaei Farshid , Tahour Neda , Sadeghian Efat 
Published: June 2019

Abstract
Objectives: This study was to investigate the effect of stress management training on the stigma and social phobia of HIV‐positive women.
Methods: This semi-experimental was conducted on 55 HIV‐positive using census sampling. The participants referred to Shohada Comprehensive Health Center in Hamadan, west of Iran, in 2017. Stress management training was conducted in 5 sessions for a group of 8-10 participants. The data collection tools were Berger HIV Stigma and Connor Social Phobia Scale. The questionnaires were filled before and 2 weeks after the intervention.
Results: The mean age of participants was 38.5 and the duration of HIV infection was 6.5 years. 55% of patients were married and 80% were infected by sexual intercourse. The findings showed that there was a significant difference between the mean scores of stigma and social phobia before and after the intervention (P<0.05).
Conclusions: Stress management training has been effective in the decrease of stigma and social phobia among HIV positive women.
Oxaliplatin resistance is enhanced by saracatinib via upregulation Wnt-ABCG1 signaling in hepatocellular carcinoma
Authors: Liao Xia , Song Ge , Xu Zihan , Bu Yang , Chang Fan , Jia Fengan , Xiao Xuelian , Ren Xuejiao , Zhang Mei , Jia Qingan 
Published: June 2019

Abstract
Background: Chemo-resistance in hepatocellular carcinoma (HCC) is a major problem, and acquired drug resistance prevents cancer therapies from achieving complete responses. Molecular targeting therapy presents an opportunity to impede tumor through combination or sequential therapy, while the accurate effect is vague.
Methods: The efficacy of combinations between oxaliplatin and anti-cancer molecular targeting drugs was screened. Strangely, the combined chemotherapy with oxaliplatin and saracatinib induced significantly antagonistic effects. Then the antitumor effects of combined treatment with saracatinib and oxaliplatin were confirmed in wide type HCC as well as in saracatinib- and oxaliplatin-resistant HCC. RNA sequencing was used to explore the resistance mechanism, and the roles of ABCG1 and Wnt signaling in oxaliplatin resistance were confirmed.
Results: Chemotherapy with oxaliplatin and saracatinib individually induced strong anti-HCC effects, while combined or sequential treatment of HCC cells with these two drugs exhibited reduced efficacy compared to treatment with the single drugs. And it was saracatinib treatment caused oxaliplatin resistance. RNA sequencing revealed 458 genes that were altered by treatment with saracatinib and oxaliplatin. Of these, the gene encoding the ATP-binding cassette transporter G1 ABCG1 and Wnt-associated genes were significantly upregulated. Upregulation of ABCG1 and oxaliplatin resistance were associated with activation of Wnt signaling. Interference with ABCG1 expression or inhibition of Wnt signaling resulted in reversal of the saracatinib-induced oxaliplatin resistance in HCC.
Conclusions: These studies demonstrated that combined or sequential chemotherapy with oxaliplatin and saracatinib reduced antitumor efficacy, and this antagonism was attributed to the activation of Wnt signaling and upregulation of ABCG1 by saracatinib.
Risk factors of primary open-angle glaucoma: the first case-control hospital-based study in Vietnam
Authors: Bui Anh Van , Hoang Tung Thanh , Nguyen Ngoc Bich , Le Anh Kim , Patnaik Jennifer L. 
Published: June 2019

Abstract
Purpose: To identify risk factors for primary open-angle glaucoma (POAG) in a Vietnamese population. Methods: A matched case-control study was conducted at Vietnam National Institute of Ophthalmology. Cases were patients clinically diagnosed with POAG. Controls were caregivers of patients with other eye diseases, free from any ocular and systemic abnormalities, and were selected and then matched with the cases by gender and age. Cases and controls were examined by a glaucoma specialist to confirm presence or absence of POAG. Data on demographic, ophthalmic and medical conditions were collected via interview at time of examination. Associations between POAG and potential factors were examined by univariate conditional logistic regression analysis (OR – Odd Ratios) and multivariate conditional logistic regression (AOR – Adjusted Odd Ratios) with level of significance is 0.05. Results: In total, 128 cases with POAG and 128 controls were recruited. Multivariate conditional (fixed-effects) logistic regression analysis resulted in several significant risk factors, including hypertension AOR =4.7 (95% CI: 1.8–12.0; p=0.002); family history of glaucoma AOR = 6.4 (95% CI: 1.3 – 32.2; p = 0.026); over–the–counter eye medication AOR = 3.1 (95% CI: 1.5 – 6.5; p = 0.006), and a protective role for marriage AOR = 0.2 (95% CI: 0.1 – 0.7; p = 0.006) and weekly exercise AOR = 0.3 (95% CI: 0.1 – 0.8; p = 0.021). Conclusions: Hypertension, family history of glaucoma and over–the–counter eye medication were risk factors while marriage and weekly exercise were protective factors for POAG in Vietnamese population.
Statistical analysis plan for Early mobilisation by head-up tilt with stepping versus standard care after severe traumatic brain injury – a randomised clinical feasibility trial
Authors: Riberholt Christian Gunge , Gluud Christian , Jakobsen Janus Christian , Ovesen Christian , Mehlsen Jesper , Møller Kirsten 
Published: June 2019

Abstract
Background: Early mobilisation on a tilt table with stepping versus standard care may be beneficial for patients with severe brain injury, but data from randomised clinical trials are lacking.

Methods: This statistical analysis plan describes the analyses of data collected in a randomised clinical feasibility trial for early mobilisation by head-up tilt with stepping versus standard care after severe traumatic brain injury. Primary feasibility outcomes are the proportion of included participants who were randomised out of all screened patients; the proportion of participants allocated to the experimental intervention who received at least 60% of the planned exercise sessions; and safety outcomes such as severe adverse events and reactions and adverse events and reactions. Exploratory clinical outcomes are suspected unexpected severe adverse reactions; and functional outcomes as assessed by Coma Recovery Scale – Revised at four weeks; Early Functional Ability Scale, and Functional Independence Measure at three months. Exploratory physiological outcomes are electrocardiographic data; mean arterial pressure; and middle cerebral artery blood flow velocity, all obtained during the head-up tilt test. From the first head-up tilt test and five days onwards, a heart rate was measured by continuous electrocardiography. The detailed description includes the statistical analysis including use of multiple imputation and Trial Sequential Analysis.

Conclusions: The present statistical analysis plan serves to minimise potential trial reporting bias and selective P hacking and to improve transparency. This feasibility trial will inform design and eventual launching of a larger multicentre randomised clinical trial.

Trial registration: ClinicalTrials.gov identifier: NCT02924649. Registered on 3 October 2016.
Göğüs Cerrahisi Sonrası Erken Dönemde Uygulanan Fizyoterapinin Hemodinamik Etkileri
Authors: PEHLİVAN Esra , BALCI Arif , CAGAY Feride Elçin , ULUKOL Z. Nilgün 
Published: June 2019

Amaç: Çalışmamızın amacı torokotomi sonrası yoğun bakım
ünitesinde yatmakta olan hastalarda erken dönemde uygulanan fizyoterapinin
hemodinamik etkilerinin belirlenmesidir.Gereç ve Yöntemler: Torokotomi yapılan ve cerrahi yoğun
bakımda 24 saatlerini tamamlayan hastalar çalışmaya dahil edildi. Hastalara
solunum egzersizleri, insentif spirometre çalışması, destekli öksürme ve
mobilizasyon içerikli fizyoterapi programı, cerrahi yoğun bakım ünitesinde
uygulandı. Hastaların tedavi öncesinde, sonrasında ve 5 dakika
toparlanmalarının ardından sistolik (SKB) ve diastolik kan basınçları (DKB),
kalp hızı (KH) ve oksijen saturasyonları (SpO2) kaydedildi. Ağrı seviyeleri ise vizüel analog
skalası (VAS, 0-10) kullanılarak değerlendirildi.Bulgular: Yirmiikisi (%30) kadın, 50 (%70)’si erkek, yaş ortalaması
59 olan 72 hasta çalışmaya alındı.
Tedavi öncesi ve sonrası karşılaştırılmasında DKB’de yükselme (p=,006),
tedavi sonrası ve 5 dakika toparlanma karşılaştırılmasında KH’de düşme
(p=,008), tedavi öncesi ve 5 dakika toparlanma karşılaştırmasında ise KH’deki
düşme (p=,026) ve DKB’deki yükselme (p=,014) istatistiksel olarak anlamlıydı.
Meydana gelen hemodinamik değişimler fizyolojik limitler içindeydi.

Sonuç: Çalışmamızdan
elde edilen sonuçlara göre cerrahi yoğun bakım ünitesinde uygulanan erken dönem
fizyoterapi güvenlidir. Fizyolojik yanıtları gözlemlemek ve hasta güvenliğini
sağlamak amacıyla fizyoterapi sırasında hemodinamik parametreler sürekli
monitorize edilmelidir.
Utilization of Tumor Markers in Adnexal Masses: A Review of Current Literature
Authors: Penick Emily , Olowu Victoria 
Published: June 2019

Background:
Adnexal masses are a common presenting concern among women of all
age groups. While the majority of adnexal masses are benign, the differentiation of a mass and diagnosis
of malignancy can present a dilemma. The use of laboratory studies and tumor markers,
which can be obtained through minimally invasive means, can aid in the diagnosis of a mass or the
decision to refer a patient to a specialist.

Objective:
This review provides information on current available tumor markers, their use in the
diagnosis of various adnexal masses and tumors, a review on current biomarker panels, and the role
these results play in treating pre- and postmenopausal patients with adnexal masses.

Results:
Many tumor markers exist; however, the majority of markers are not specific to one tumor
or cancer. Many benign conditions also cause elevations in tumor markers, which can make distinguishing
benign and malignant conditions difficult. In recent years, the development of biomarker
panels has served to improve diagnostic accuracy when dealing with an adnexal mass and algorithms
have been developed to aid with triaging a patient to continued observation versus referral to
a specialist.

Conclusion:
It is important to merge clinical and laboratory data together when diagnosing and
managing any patient with an adnexal mass given the many benign and malignant conditions that
can cause elevations in tumor markers.
Virtual Eye Simulation: An Aid in Evaluation of Capsular Block Syndrome
Authors: Hu Joseph L. , Hu Chao-Chien 
Published: June 2019

Objective:
To demonstrate the findings of three consecutive cases of postoperative Capsular Block Syndrome (CBS) diagnosed with the aid of Pentacam virtual eye simulation images.

Methods:
Observational case series report. Three patients underwent uneventful cataract removal and presented with blurry vision ranging from 4 days to 5 years after the surgeries were performed.

Results:
In a case of early-onset postoperative CBS, virtual eye simulation images clearly revealed a reduced posterior chamber depth caused by the accumulation of transparent fluid in the area between the intraocular lens and the posterior capsule. In two cases of late-onset postoperative CBS, virtual eye simulation images better visualized the alignment between intraocular lens (IOL) and iris than slit lamp examination and Schiemflug images. All three of the cases underwent neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy, and their capsular bag distensions were resolved immediately. The patients with misalignments between IOL and iris experienced more improvement in best-corrected visual acuity as opposed to the one who did not.

Conclusion:
Virtual eye simulation is found to be a useful way in visualizing misalignment between IOL and iris and assisting diagnoses of both early- and late-onset postoperative capsular block syndrome.
The Relationship between Nurses’ Recognition Regarding Elder Abuse and their Attitudes and Performance in Dealing with Elder Abuse Induced by Iranian Family Caregivers
Authors: Alipour Atefeh , Fotokian Zahra , Shamsalinia Abbas , Ghaffari Fatemeh , Hajiahmadi Mahmoud 
Published: June 2019

Introduction:Knowledge of nurses regarding elder abuse can be helpful in decisions about on-time and appropriate interventions. Our aim was to assess the relationship between recognition of nursing staff toward elder abuse and their attitudes, and performance in dealing with elder abuse induced by Iranian family caregivers.Methods:In this descriptive study, 400 nurses were selected, using cluster sampling, from nurses working in public or private hospitals in Iran. Data collection was performed using questionnaires measuring elder abuse symptom recognition, attitudes, and performance.Results:There is a significant relationship between the total scores for recognition of symptoms and elder abuse potential risk factors (p=0.05) and the nurses’ attitudes and performance scores (p = 0.001). There was no significant difference between the nurses’ performance and recognition scores (p = 0.14).Conclusion:Interventions to promote nurses’ recognitionviain-service educational programs can improve nurses’ performance in different levels of abuse prevention and the quality of nursing care for the elderly.
Harpin Proteins Improve Bioactive Compounds Content in Crimson Seedless Table Grape
Authors: Crupi Pasquale , Debiase Giambattista , Masi Gianvito , Mangione Francesca , Tarricone Luigi 
Published: June 2019

Background:Frequently, in warm climates such as Mediterranean areas, a red-pink table grape ‘Crimson Seedless’ does not reach a good berry skin color; and an acceptable anthocyanin bioactive compounds content, responsible for the red color of berries. Harpin proteins are biotechnologically developed bio-activators that, if applied on plants during the growing period, trigger the expression of hundreds of genes among which those associated with the biosynthesis of bioactive compounds (such as anthocyanins).Aim:This research aimed at using harpin proteins to test their suitability in improving the grape skin color.Methods and Materials:Beta-harpin protein 1% p.a. (400 g/Ha) was applied to ‘Crimson Seedless’ vines three times at the beginning of veraison. Six samplings were carried out for both the treated and control grapes until commercial harvest. In the skin extracts, total and individual anthocyanins content was determined by UV-Vis and RP-HPLC-DAD analyses, respectively.Results:The collected results confirmed that the application of harpin proteins effectively stimulated the anthocyanin biosynthesis leading to make peonidin-3O-glucoside, cyanidin-3O-glucoside, and malvidin-3O-glucoside values from 2 to almost 10 folds higher in treated grapes than in control grapes (P< 0.05).Conclusion:Actually, harpin proteins improved the color of the berry skin, leading to a significantly higher concentration of anthocyanins in treated than in control grapes.