bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevention and Treatment of Venous Thromboembolism in Pregnancy
Authors: Suparman Erna 
Published: July 2022

Abstract
Objective: To determine prevention and treatment of venous thromboembolism in pregnancy
Methode: Literature Review
Results: The diagnosis of TEV, both deep vein thrombosis (DVT) and pulmonary embolism (PE) was clinical and confirmed by imaging. D-dimers commonly used in the non-pregnant population are less useful in pregnant women. Prevention needs to be done by assessing the risk of TEV in pregnant women and giving thrombophylaxis according to risk. Treatment of TEV in pregnant women mainly uses heparin, either unfractionated heparin (UFH) or low molecular weight heparin (LMWH).
Conclusion: The ASH recommends the use of LMWH compared with UFH for the management of acute VTE in pregnancy, in once-daily or divided doses. The recommended method of delivery for pregnant women receiving anticoagulant therapy should be planned delivery
Key word : vein thromboemboli, deep vein thrombosis, pulmonary embolism, pregnancy

Abstrak
Tujuan: mengetahui bagaimana pencegahan dan tatalaksana tromboemboli vena pada kehamilan
Metode: Kajian Pusataka
Hasil: Diagnosis TEV, baik Deep vein thrombosis (DVT) dan pulmonary embolism (PE) berdasarkan klinis dan dikonfirmasi dengan pencitraan. D-dimer yang biasa digunakan pada populasi non-hamil kurang berguna pada ibu hamil. Pencegahan perlu dilakukan dengan menilai risiko TEV pada ibu hamil dan memberikan trombofilaksis sesuai dengan risiko. Tatalaksana TEV pada ibu hamil terutama menggunakan heparin, baik unfractionated heparin (UFH) maupun low molecular weight heparin (LMWH).
Kesimpulan: ASH merekomendasikan penggunaan LMWH dibandingkan dengan UFH untuk pengelolaan VTE akut pada kehamilan, dalam dosis sekali sehari atau terbagi. Metode persalinan yang direkomendasikan untuk ibu hamil yang menerima terapi antikoagulan harus direncanakan persalinan
Kata kunci : tromboemboli vena, deep vein thrombosis, pulmonary embolism, kehamilan
Diagnosis and Management of Severe Peripartum Cardiomyopathy
Authors: Laksono Sidhi , Prawara Ananta S. , Halomoan Reynaldo 
Published: July 2022

Objective: To describe the diagnosis and management of severe peripartum cardiomyopathyMethods: A case report.Case: A 35-year-old woman presented with dyspnea and leg edema. The patient gave birth 3 months ago. The hemodynamic was unstable and the physical examination showed a mild rhonchi in the basal of the lung and pansystolic murmur in the apex. Echocardiography showed a dilated heart chamber and reduced ejection fraction (30%). The patient was diagnosed as severe PPCM. The initial management was to stabilize the patient using furosemide, catecholamine, and vasopressor administration. After the patient’s condition was stable, ramipril, bisoprolol, and bromocriptine were given as heart failure therapy.Conclusions: Patient with suspicion of PPCM should be managed thoroughly from detailed history taking to proper diagnostic testing such as echocardiography. Prompt treatment of severe PPCM according to the guideline will improve the cardiac function.Key words: catecholamines, echocardiography, peripartum cardiomyopathy, pregnancy, vasopressor.

Abstrak
Tujuan: Untuk mendeskripsikan mengenai diagnosis dan manajemen pasien pada kasus kardiomiopati peripartum yang berat.Metode: Laporan kasus.Kasus: Seorang Perempuan 35 tahun datang dengan dispnea dan edema tungkai. Pasien melahirkan 3 bulan lalu. Hemodinamik tidak stabil dan pemeriksaan fisik menunjukkan ronki ringan di basal paru dan murmur pansistolik di apeks. Ekokardiografi menunjukkan dilatasi ruang jantung dan fraksi ejeksi berkurang (30%). Pasien didiagnosis dengan PPCM berat. Penatalaksanaan awal adalah menstabilkan pasien dengan pemberian furosemid, katekolamin, dan vasopresor. Setelah kondisi pasien stabil, diberikan ramipril, bisoprolol, dan bromokriptin sebagai terapi gagal jantung.Kesimpulan: Pasien dengan kecurigaan PPCM harus dikelola secara menyeluruh mulai dari anamnesa yang rinci hingga uji diagnostik yang tepat seperti ekokardiografi. Pengobatan segera untuk PPCM derajat berat yang sesuai dengan pedoman akan meningkatkan fungsi jantung.Kata kunci: ekokardiografi, kardiomiopati peripartum, katekolamin, kehamilan, vasopressor.
Akibat Hukum Penolakan Penandatanganan Perjanjian Kerjasama (Non-Disclosure Agreement) oleh Pekerja yang Mengundurkan Diri
Authors: Nugroho Kresno Adi , Djumadi Djumadi , Hafidah Noor 
Published: July 2022

Artikel ini membahas tentang Perjanjian Kerahasiaan (Non-Disclosure Agreement) ketika dalam melakukan sebuah perjanjian Kerahasiaan (Non-Disclosure Agreement) dan meminta mantan pekerja persuahaan tersebut menandatanganinya. Mantan pekerja tersebut merasa keberatan karena ada poin-poin yang didalam Perjanjian Kerahasiaan (Non-Disclosure Agreement) merasa dirugikan sehinga perlu dikaji akibat yang ditimbulkan jika mantan pekerja tersebut menolak untuk menandatangani Perjanjian Kerahasiaan (Non-Disclosure Agreement). Tujuan dari Penelitian ini untuk mengkaji menganalisis Perjanjian Kerahasiaan (Non-Disclosure Agreement) dari perusahaan dapat mengakomodir asas keadilan dan menganalisis akibat hukum yang ditimbulkan apabila pekerja yang mengundurkan diri menolak menandatangani Perjanjian Kerahasiaan (Non-Disclosure Agreement) dari perusahaan metode yang digunakan bersifat normatif yaitu mengkaji persoaln hukum dari sudut pandang ilmu hukum secara mendalam tipe penelitian yang digunakan yaitu penelitian Theoritical Research Hasil Penelitiannya adalah perlu adanya batasan yang jelas dalam Perjanjian Kerahasiaan (Non-Disclosure Agreement) agar suatu perjanjian yang dibuat antara perusahaan dan pekerja dapat memenuhi tujuan yang berlandaskan asas keadilan kedua Seharusnya si pekerja pada saat menandatangani perjanjian kerja pada awal memasuki perusahaan tersebut juga harus mempelajari apakah dalam isi perjanjian tersebut menyatakan bahwa mengharuskan si pekerja menandatangani Perjanjian Kerahasiaan (Non-Disclosure Agreement) dan Pengaturan mengenai Perjanjian Kerahasiaan (Non-Disclosure Agreement) sendiri belum diatur secara eksplisit dan perjanjian ini pun mengacu pada asas kebebasan berkontrak sehingga ketika seorang pekerja mengundurkan diri dan pindah ke perusahaan kompetitor, selama dalam perjanjian kerja tidak diatur demikian, maka hal itu tidak mengapa karena telah dijamin oleh ketentuan Pasal 38 ayat (2) Undang-Undang Nomor 39 Tahun 1999 tentang Hak Asasi Manusia
ВЗАЄМОЗВ’ЯЗОК МІЖ ПОКАЗНИКАМИ БІОЛОГІЧНОГО ВІКУ ТА ФІЗИЧНОЇ ПІДГОТОВЛЕНОСТІ КУРСАНТІВ ВВНЗ
Authors: Оленєв Дмитро , Присяжнюк Станіслав , Шемчук Вадим , Юденко Оксана , Старчук Олександр 
Published: July 2022

В статті розглянуто питання взаємозв’язку показників біологічного віку курсантів вищих військових навчальних закладів як одного із чинників, що характеризують стан здоров’я, з показниками рівня розвитку основних фізичних якостей як інтегральної оцінки їх загальної фізичної підготовленості. З’ясовано, що переважна більшість сучасних досліджень діагностування біологічного віку різних верств населення спрямована на визначення кількісної характеристики функціональних систем організму людини, що не відображає динаміки його показників в залежності від рівня фізичної підготовленості. Результати проведеного авторами дослідження дозволили зробити попередні висновки щодо залежності показників біологічного віку від рівня фізичної підготовленості курсантів.
TALENT MANAGEMENT В СИСТЕМІ ВІЙСЬКОВОЇ ОСВІТИ УКРАЇНИ
Authors: Цевельов Олег , Вітер Дмитро , Мітягін Олег , Шабатіна Надія 
Published: July 2022

Успіх розвитку військового колективу значною мірою залежить не тільки від високого рівня готовності й умінь діяти в бойовій обстановці, а й від ефективності використання особистих якостей військовослужбовців, які є рушійною силою будь-якого військового підрозділу та важливим складником досягнення їм високих позицій з виконання поставлених завдань та результативності підрозділу і військового колективу у цілому.
У сучасному світі, коли захист держави потребує нових підходів, процес прийняття рішення становиться динамічним і в органах військового управління виникає постійна потреба в пошуках нових рішень і підвищенні ефективності її процесів, виграють ті військові підрозділи, які формують новий вектор розвитку кадрової політики та зміцнюють свою конкурентну позицію за рахунок пошуку, залучення й утримання найбільш талановитих спеціалістів у військовому колективі.
Талановиті люди мають змогу переміщатися як усередині одного військового колективу, так і функціонувати в рамках збройних сил, а також проявляти більше можливостей розпочати кар’єру та зріст по службовій сходинці, що, своєю чергою, призводить до виникнення дефіциту необхідних спеціалістів, тому пошук, залучення та утримання справжніх лідерів є достатньо складною проблемою, у зв’язку з чим з’являється посилення конкурентної боротьби за талановитих співробітників. Отже, виникає потреба побудови нової системи управління персоналом, основою якої стане орієнтація на таланти.
Asuhan Kebidanan Ibu Bersalin dengan Lilitan Tali Pusat
Authors: Sinaga Elvalini Warnelis , Aulia Tasya Nur 
Published: July 2022

Kehamilan, persalinan, masa nifas, bayi baru lahir dan pemilihan alat kontrasepsi merupakan serangkaian proses fisiologis yang berkesinambungan. Lilitan tali pusat dapat mengakibatkan hal fatal yaitu kematian pada bayi, hal tersebut dikarenakan puntiran tali pusat yang berulang-ulang ke suatu arah dan dapat mengakibatkan aliran darah dari ibu ke janin terhambat total. Tujuan penelitian adalah melakukan Asuhan Kebidanan Berbasis Continuty of Care dilakukan dengan pendekatan manajemen 7 langkah Helen Varney dan SOAP. Metode penelitian dilakukan dengan studi kasus. Penatalaksanaan dilakukan dengan pendekatan Continiue Of Care yaitu asuhan kebidanan pada Ny. A G1P0A0. Asuhan kebidanan komperensif pada Ny ”A” di dapat keluhan yang di rasakan masih dalam hal fisiologis dan telah di lakukan penatalaksanan sesuai dengan keluhan dan sesuai dengan hasil fisiologis dan dilakukan penatalaksanaan sesuai dengan kondisi pada pasien pada masa hamil, bersalin, nifas, neonatus, dan KB. Kala I persalinan Ny”A” berjalan normal, dengan Kala II dilakukan dengan menunda pemotongan tali pusat dalam waktu 60 menit. Penatalaksaannya yang di lakukan yaitu melakukan mengobservasi kemajuan persalinan dan keadaan janin dan berjalan dengan baik dan tidak mengalami masalah. Masih banyaknya ibu yang melahirkan dengan tanpa menunda pemotongan tali pusat yang disebabkan masih sedikit pilihan tempat melahirkan dengan penundaan pemotongan tali pusat.
Effects of Hip Bracing on Gait Biomechanics, Pain and Function in Subjects With Mild to Moderate Hip Osteoarthritis
Authors: Steingrebe Hannah , Stetter Bernd J. , Sell Stefan , Stein Thorsten 
Published: July 2022

Hip Osteoarthritis (HOA) is a common joint disease with serious impact on the quality of life of the affected persons. Additionally, persons with HOA often show alterations in gait biomechanics. Developing effective conservative treatment strategies is of paramount importance, as joint replacement is only indicated for end-stage HOA. In contrast to knee osteoarthritis, little is known about the effectiveness of hip bracing for the management of HOA. Studies analysing mechanically unloading hip braces partly showed beneficial results. However, methodological limitations of these studies, such as small sample sizes or lack of control groups, limit the applicability of the results. Additionally, mechanically unloading braces might impose restrictions on motion and comfort and thus, might not be suitable for people with only mild or moderate symptoms. The aim of this study was to comprehensively quantify the effects of unilateral HOA as well as functional hip bracing on gait biomechanics, pain, proprioception and functional capacity in people with mild to moderate HOA. Hip and pelvis biomechanics during walking were analysed in 21 subjects with mild to moderate HOA under three bracing conditions: unbraced, immediately after brace application and after 1 week of brace usage. Additionally, pain, hip proprioception and functional capacity were assessed. A matched group of 21 healthy subjects was included as reference. Kinematic and kinetic data were collected using a 16-camera infrared motion capturing system and two force plates. Visual analogue scales, an angle reproduction test and a 6-min walking test were applied to measure pain, hip proprioception and functional capacity, respectively. Subjects with HOA walked slower, with reduced step length, sagittal hip range of motion and peak extension angle and had a reduced functional capacity. After 1 week of brace application step length, walking speed and functional capacity were significantly increased. Additionally, pain perception was significantly lower in the intervention period. These results encourage the application of functional hip braces in the management of mild to moderate HOA. However, as key parameters of HOA gait such as a reduced peak extension angle remained unchanged, the underlying mechanisms remain partly unclear and have to be considered in the future.
Ultrasound-Triggered on Demand Lidocaine Release Relieves Postoperative Pain
Authors: Chen Xiaohong , Zhang Jianfeng , Yu Yan , Wang Haoran , Ma Genshan , Wang Di , Cao Hanzhong , Yang Jianping 
Published: July 2022

Safe and non-invasive on-demand relief is a crucial and effective treatment for postoperative pain because it considers variable timing and intensity of anesthetics. Ultrasound modulation is a promising technique for this treatment because it allows convenient timed and non-invasive controlled drug release. Here, we created an ultrasound-triggered lidocaine (Lido) release platform using an amino acid hydrogel functioning as three-dimensional (3D) scaffold material (Lido-PPIX@ER hydrogel). It allows control of the timing, intensity and duration of lidocaine (Lido) to relieve postoperative pain. The hydrogel releases Lido due to the elevated reactive oxygen species (ROS) levels generated by PPIX under ultrasound triggering. The Lido-PPIX@ER hydrogel under individualized ultrasound triggering released lidocaine and provided effective analgesia for more than 72 h. The withdrawal threshold was higher than that in the control group at all time points measured. The hydrogel showed repeatable and adjustable ultrasound-triggered nerve blocks in vivo, the duration of which depended on the extent and intensity of insonation. On histopathology, no systemic effect or tissue reaction was observed in the ultrasound-triggered Lido-PPIX@ER hydrogel-treated group. The Lido-PPIX@ER hydrogel with individualized (highly variable) ultrasound triggering is a convenient and effective method that offers timed and spatiotemporally controlled Lido release to manage postoperative pain. This article presents the delivery system for a new effective strategy to reduce pain, remotely control pain, and offer timed and spatiotemporally controlled release of Lido to manage postoperative pain.
Sinapic Acid Attenuated Cardiac Remodeling After Myocardial Infarction by Promoting Macrophage M2 Polarization Through the PPARγ Pathway
Authors: Yang Mei , Xiong Jun , Zou Qiang , Wang Xi , Hu Ke , Zhao Qingyan 
Published: July 2022

BackgroundMacrophage polarization is an important regulatory mechanism of ventricular remodeling. Studies have shown that sinapic acid (SA) exerts an anti-inflammatory effect. However, the effect of SA on macrophages is still unclear.ObjectivesThe purpose of the study was to investigate the role of SA in macrophage polarization and ventricular remodeling after myocardial infarction (MI).MethodsAn MI model was established by ligating the left coronary artery. The rats with MI were treated with SA for 1 or 4 weeks after MI. The effect of SA on bone marrow-derived macrophages (BMDMs) was also observed in vitro.ResultsCardiac systolic dysfunction was significantly improved after SA treatment. SA reduced MCP-1 and CCR2 expression and macrophage infiltration. SA decreased the levels of the inflammatory factors TNF-α, IL-1α, IL-1β, and iNOS and increased the levels of the M2 macrophage markers CD206, Arg-1, IL-10, Ym-1, Fizz-1, and TGF-β at 1 week after MI. SA significantly increased CD68+/CD206+ macrophage infiltration. Myocardial interstitial fibrosis and MMP-2 and MMP-9 levels were decreased, and the sympathetic nerve marker TH and nerve sprouting marker GAP43 were suppressed after SA treatment at 4 weeks after MI. The PPARγ level was notably upregulated after SA treatment. In vitro, SA also increased the expression of PPARγ mRNA in BMDMs and IL-4-treated BMDMs in a concentration-dependent manner. SA enhanced Arg1 and IL-10 expression in BMDMs, and the PPARγ antagonist GW9662 attenuated M2 macrophage marker expression.ConclusionsOur results demonstrated that SA attenuated structural and neural remodeling by promoting macrophage M2 polarization via PPARγ activation after MI.
LACE Index to Predict the High Risk of 30-Day Readmission in Patients With Acute Myocardial Infarction at a University Affiliated Hospital
Authors: Rajaguru Vasuki , Kim Tae Hyun , Han Whiejong , Shin Jaeyong , Lee Sang Gyu 
Published: July 2022

BackgroundThe LACE index (length of stay, acuity of admission, comorbidity index, and emergency room visit in the past 6 months) has been used to predict the risk of 30-day readmission after hospital discharge in both medical and surgical patients. This study aimed to utilize the LACE index to predict the risk of 30-day readmission in hospitalized patients with acute myocardial infraction (AMI).MethodsThis was a retrospective study. Data were extracted from the hospital's electronic medical records of patients admitted with AMI between 2015 and 2019. LACE index was built on admission patient demographic data, and clinical and laboratory findings during the index of admission. The multivariate logistic regression was performed to determine the association and the risk prediction ability of the LACE index, and 30-day readmission were analyzed by receiver operator characteristic curves with C-statistic.ResultsOf the 3,607 patients included in the study, 5.7% (205) were readmitted within 30 days of discharge from the hospital. The adjusted odds ratio based on logistic regression of all baseline variables showed a statistically significant association with the LACE score and revealed an increased risk of readmission within 30 days of hospital discharge. However, patients with high LACE scores (≥10) had a significantly higher rate of emergency revisits within 30 days from the index discharge than those with low LACE scores. Despite this, analysis of the receiver operating characteristic curve indicated that the LACE index had favorable discrimination ability C-statistic 0.78 (95%CI; 0.75–0.81). The Hosmer–Lemeshow goodness- of-fit test P value was p = 0.920, indicating that the model was well-calibrated to predict risk of the 30-day readmission.ConclusionThe LACE index demonstrated the good discrimination power to predict the risk of 30-day readmissions for hospitalized patients with AMI. These results can help clinicians to predict the risk of 30-day readmission at the early stage of hospitalization and pay attention during the care of high-risk patients. Future work is to be focused on additional factors to predict the risk of 30-day readmissions; they should be considered to improve the model performance of the LACE index with other acute conditions by using administrative data.
Resting Energy Expenditure and Body Composition in Children and Adolescents With Genetic, Hypothalamic, Medication-Induced or Multifactorial Severe Obesity
Authors: Abawi Ozair , Koster Emma C. , Welling Mila S. , Boeters Sanne C.M. , van Rossum Elisabeth F. C. , van Haelst Mieke M. , van der Voorn Bibian , de Groot Cornelis J. , van den Akker Erica L. T. 
Published: July 2022

BackgroundPediatric obesity is a multifactorial disease which can be caused by underlying medical disorders arising from disruptions in the hypothalamic leptin-melanocortin pathway, which regulates satiety and energy expenditure.AimTo investigate and compare resting energy expenditure (REE) and body composition characteristics of children and adolescents with severe obesity with or without underlying medical causes.MethodsThis prospective observational study included pediatric patients who underwent an extensive diagnostic workup in our academic centre that evaluated endocrine, non-syndromic and syndromic genetic, hypothalamic, and medication-induced causes of obesity. REE was assessed by indirect calorimetry; body composition by air displacement plethysmography. The ratio between measured REE (mREE) and predicted REE (Schofield equations), REE%, was calculated, with decreased mREE defined as REE% ≤90% and elevated mREE ≥110%. Additionally, the influence of fat-free-mass (FFM) on mREE was evaluated using multiple linear regression.ResultsWe included 292 patients (146 [50%] with body composition measurements), of which 218 (75%) patients had multifactorial obesity and 74 (25%) an underlying medical cause: non-syndromic and syndromic genetic (n= 29 and 28, respectively), hypothalamic (n= 10), and medication-induced (n= 7) obesity. Mean age was 10.8 ± 4.3 years, 59% were female, mean BMI SDS was 3.8 ± 1.1, indicating severe obesity. Mean REE% was higher in children with non-syndromic genetic obesity (107.4% ± 12.7) and lower in children with hypothalamic obesity (87.6% ± 14.2) compared to multifactorial obesity (100.5% ± 12.6, both p&lt;0.01). In 9 children with pseudohypoparathyroidism type 1a, mean REE% was similar (100.4 ± 5.1). Across all patients, mREE was decreased in 60 (21%) patients and elevated in 69 (24%) patients. After adjustment for FFM, mREE did not differ between patients within each of the subgroups of underlying medical causes compared to multifactorial obesity (all p&gt;0.05).ConclusionsIn this cohort of children with severe obesity due to various etiologies, large inter-individual differences in mREE were found. Consistent with previous studies, almost half of patients had decreased or elevated mREE. This knowledge is important for patient-tailored treatment, e.g. personalized dietary and physical activity interventions and consideration of pharmacotherapy affecting central energy expenditure regulation in children with decreased mREE.
Diabetic Foot Risk Classification at the Time of Type 2 Diabetes Diagnosis and Subsequent Risk of Mortality: A Population-Based Cohort Study
Authors: Wang Zhaonan , Hazlehurst Jonathan , Subramanian Anuradhaa , Tahrani Abd A. , Hanif Wasim , Thomas Neil , Singh Pushpa , Wang Jingya , Sainsbury Christopher , Nirantharakumar Krishnarajah , Crowe Francesca L. 
Published: July 2022

AimWe aimed to compare the mortality of individuals at low, moderate, and high risk of diabetic foot disease (DFD) in the context of newly diagnosed type 2 diabetes, before developing active diabetic foot problem.MethodsThis was a population-based cohort study of adults with newly diagnosed type 2 diabetes utilizing IQVIA Medical Research Data. The outcome was all-cause mortality among individuals with low, moderate, and high risk of DFD, and also in those with no record of foot assessment and those who declined foot examination.ResultsOf 225,787 individuals with newly diagnosed type 2 diabetes, 34,061 (15.1%) died during the study period from January 1, 2000 to December 31, 2019. Moderate risk and high risk of DFD were associated with increased mortality risk compared to low risk of DFD (adjusted hazard ratio [aHR] 1.50, 95% CI 1.42, 1.58; aHR 2.01, 95% CI 1.84, 2.20, respectively). Individuals who declined foot examination or who had no record also had increased mortality risk of 75% and 25% vs. those at low risk of DFD, respectively (aHR 1.75, 95% CI 1.51, 2.04; aHR 1.25, 95% CI 1.20, 1.30).ConclusionIndividuals with new-onset type 2 diabetes who had moderate to high risk of DFD were more likely to die compared to those at low risk of DFD. The associations between declined foot examination and absence of foot examinations, and increased risk of mortality further highlight the importance of assessing foot risk as it identifies not only patients at risk of diabetic foot ulceration but also mortality.