bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of Surgical Care and Outcomes for Patients with Appendicitis in a Tertiary Public Hospital with Tiered Services
Authors: Caballes Alvin B. 
Published: April 2022

Background. Tiered services, differentiated by the financial capacity of patients and related payment arrangements with hospitals, are the norm in Philippine facilities. This study considered how these, together with selected demographic and clinical factors, were associated with surgical care utilization, provision, and outcomes for patients with appendicitis in a public university hospital.
Methods. This was a retrospective cohort study, utilizing data obtained from an electronic patient registry. Patients who underwent emergent appendectomies from January 2017 to December 2018 were included. Data were analyzed using multivariate and logistic regression, with the following dependent variables: time from symptom onset to emergency department consultation (ED Lag), time from consult to surgery (OR Lag), selection for laparoscopic appendectomy (LA), the occurrence of complicated appendicitis (CA), and length of stay (LOS). Morbidities and mortalities were tallied.
Results. There were 1,501 patients included in the study. Young adult males comprised the majority and mostly had non-private accommodations. Non-CA was the impression in more than 80% of cases. Extremes of age were associated with longer ED and OR Lags, greater likelihood of CA, and longer LOS. Patients initially assessed as having CA had shorter OR Lags, were less likely to undergo LA, and had longer LOS. Private patients were more likely to have undergone LA, lower CA odds, and slightly longer LOS.
Conclusions. Variations in surgical care utilization, provision, and outcomes for patients with appendicitis were independently associated with socioeconomic and clinical status differences.
Bacteriology and Antibiotic Sensitivity Pattern of Isolates in Patients who Underwent Percutaneous Nephrolithotripsy (PCNL) at the Philippine General Hospital: A Retrospective Cohort Study
Authors: Flor Joan Marie S. , Lapitan Marie Carmela M. 
Published: April 2022

Background. Despite being a clean-contaminated procedure, performed only in patients with sterile urine preoperatively, percutaneous nephrolithotripsy (PCNL) is associated with significant infectious perioperative complications. A local antibiogram is of paramount importance in optimizing antibiotic prophylaxis in PCNL because of the substantial variation in bacterial distribution and antibiotic sensitivity worldwide.
Objectives. The incidence of post-PCNL infectious complications, microorganism distribution, and antibiotic sensitivities from patients admitted for PCNL was determined. The risk factors associated with positive cultures and the development of fever and bacteremia were also analyzed.
Methods. A retrospective study of 102 patients who underwent PCNL under a surveillance protocol was done. The susceptibility of isolates from different specimens was evaluated against the most common antibiotics in the hospital. Chi-square and Student’s t-test were used to determine differences in the frequencies and means for other risk factors for those who developed fever and urosepsis and those who did not.
Results. The incidence of fever and urosepsis was 25% and 4%, respectively. The most common organism on urine specimens was Escherichia coli which showed high sensitivity to aminoglycosides. The most common isolate on stones was Pseudomonas aeruginosa, which showed higher sensitivities to the fluoroquinolones. The isolates showed nearly consistent resistance to ceftriaxone. No significant association was found between the clinical variables studied and the occurrence of infectious complications.
Conclusion. There are comparable rates of infectious complications to published literature. A change in antibiotic prophylaxis was warranted, given the high resistance to ceftriaxone and the predominance of Pseudomonas aeruginosa on stone isolates. Further surveillance is required to identify significant risk factors for the development of post-PCNL infectious complications.
Quality of Nutritional Care Assessment among Critically-ill Patients in a Tertiary Government Hospital
Authors: Bruno Racquel G. , Jimeno Cecilia A. , Jasul, Jr. Gabriel V. , Sahagun Jereel Aron R. , Moalong Kevin Michael C. 
Published: April 2022

Background and Objectives. Malnutrition is prevalent both at baseline admission and because of hospitalization. It is aggravated by adverse hospital practices and results in poor outcomes, reduced quality of life, and higher treatment costs. Improving quality of care involves nutritional intervention as a low-risk, cost-effective strategy which guides providers in improving practices systems-wise. This study aims to assess the quality of nutritional care and the nutritional status of critically- ill patients admitted in a low-resource setting.
Materials and Methods. This is a mixed methods study among adults admitted in intensive care units (ICUs) of a tertiary government hospital. Anthropometric and biochemical indicators were obtained through chart review. The degree of malnutrition was assessed using the Subjective Global Assessment. Quality indicators under Donabedian domains were assessed and compared to current standards. The length of ICU stay and mortality rate were recorded. Dietary prescription and provision practices of healthcare providers were supplemented by a focus group discussion (FGD). Factors causing provision interruptions were also identified.
Results and Discussion. Sixty-four ICU admissions were included. Staff-to-patient ratio was not ideal. Under process-related factors, out of 49% with actual anthropometric documentations (rest were estimates), 24% had normal body mass indices (BMI), 17% were underweight, and the rest were either overweight or obese. The baseline ICU malnutrition rate was 69%. Malnutrition screening, and assessment of risk and biochemical indicators were not done routinely. Majority (92%) had baseline dietary prescription but only 69% had specific energy and macronutrient breakdown, all done through predictive weight-based equations. Nutritional supplies arrived within 8 hours in 65% of patients. Feeding was initiated within 24–28 hours in 94% of patients. Commercial formula was the preferred type of enteral nutrition (EN). Total duration on nothing-by-mouth (NPO) (hours) throughout ICU stay was significant. Supportive measures to improve gastro-intestinal (GI) tolerance were not standardized. Common factors in delaying feeding initiation were hemodynamic instability, fasting for procedures and GI bleeding. Throughout the ICU stay, fasting for procedures, hemodynamic instability and mechanical ventilation (MV)-related factors were common. ICU mortality rate was 19% and average length of ICU stay was 5 days.
Conclusion. Malnutrition is still prevalent in our ICUs and is affected by suboptimal healthcare practices. Staff - to-patient ratios, malnutrition risk screening and assessment, dietary referrals, documentation and minimizing interruptions in nutritional care provision needs improvement. A system review and establishment of a nutrition team is imperative.
Quality of Care of Adult Patients with ST-Elevation Myocardial Infarction (STEMI) at the Emergency Room of a Tertiary Hospital in the Philippines
Authors: Ramiro Valerie R. , Tiongson Marc Denver A. , Taquiso Jezreel L. , Abrahan IV Lauro L. , Balabagno Maria Margarita O. , Ramos John Daniel A. , Punzalan Felix Eduardo R. 
Published: April 2022

Introduction. Coronary artery disease (CAD) remains a significant public health problem worldwide and in the Philippines. Adherence to guideline-directed therapy improves the quality of care (QOC).
Objective. We aimed to evaluate the QOC initially received by ST-Elevation Myocardial Infarction (STEMI) patients at our Emergency Room (ER), based on compliance to 2014 PHA CAD guidelines recommendations.
Methods. We reviewed the charts of adult patients with STEMI admitted at the ER who were not previously managed in a different hospital. The primary outcome was QOC assessed through quality indicators (QI) based on class I and IIa recommendations in the PHA CAD guidelines.
Results. Of the 29 patients included, all had ECG done upon admission, but only four were done within 10 minutes (QI: 13.79%). All eligible patients received antiplatelets (QI: 100%). Six eligible patients (QI: 100%) received nitrates, and four eligible patients (QI: 100%) received morphine. Of 16 eligible patients, only six were reperfused within the recommended 12 hours of ischemia (QI: 37.5%), two by thrombolysis and four by the primary percutaneous coronary intervention (PCI).
Conclusion. The timely performance of initial ECG and reperfusion need improvement. Suitable performance measures for the provision of nitrates and morphine to eligible patients were met. Investigating intrinsic and extrinsic factors that lead to the time delays observed are also recommended.
Evaluation of the Patient Medication Counseling Services in the Philippine General Hospital Using the CIPP Model
Authors: Luib Sarah A. , Loquias Monet M. , Capule Francis R. , Garcia Kristine Eves S. , Sendito Maria Jennylyn V. 
Published: April 2022

Objectives. The patient medication counseling (PMC) services at Philippine General Hospital (PGH) started 21 years ago. While several changes have been incorporated into the program, no formal evaluation has been conducted to date. The objective of this evaluation was to assess the relevance, usefulness, responsiveness, acceptability, efficiency, impact, and sustainability of the service using the context, input, process (CIPP) model of Stufflebeam.
Methods. The study utilized a mixed-methods study design. Interviews and surveys were conducted on pharmacist-counselors, a purposive sample of doctors, nurses, and other stakeholders. A review of records from the Department of Pharmacy of UP College of Pharmacy (UPCP) and PGH, such as patient and student satisfaction surveys and monthly reports of counseled patients served from 2015 to 2019, was conducted. The results were analyzed using descriptive statistics for quantitative data and content analysis for qualitative data.
Results. Context evaluation revealed that the establishment of PMC resulted from informal interactions with hospitalized patients due to incorrect use of prescription medicines. Correct information was envisioned to address the irresponsible use of medicines. The input evaluation revealed that only 24% (N=75) of the pharmacists are involved in PMC, which comprise only 10% of their workload. There was also a lack of comprehensive training for counseling and insufficient physical facilities. The process evaluation identified lack of time (94%) as a significant limiting factor for the involvement of pharmacists in PMC. The interns became an additional workforce for the service, but scheduling and the consistent availability of both students and faculty-preceptors were experienced. The product evaluation revealed positive perceptions among the pharmacists, faculty, and student interns. From the patient satisfaction survey records of 5,071 patients counseled, 98 to 100% expressed high service satisfaction, and 100% were likely to recommend PMC to other patients. The pharmacists, interns, and faculty-preceptors suggested that PMC improved their confidence, communication skills, and decision-making.
Conclusion. The PMC service is relevant and valuable to ensure patients' rational and quality use of medicines. As a value-added service to existing hospital pharmacy services, it serves as a venue for enhancing soft skills among pharmacists and students alike. However, physical and human resources and current processes need to be upgraded to improve efficiency, ensure sustainability, and expand service coverage to more patients.
Vascular reconstruction with prosthetic graft in treatment of extremities soft tissue sarcoma: A case report and literature review
Authors: Sam Hoang Minh , Anh Hoang Tuan , Tri Ung Tran , Thuy Nguyen Tran 
Published: April 2022

Background: Limp-sparing procedures are currently considered the standard treatment for extremities soft tissue sarcoma. Surgical excision combine with vascular resection and reconstruction is necessary to provide an adequate margin and preseve limb when tumour invase major vessel.
Methods: A retrospective description of a vascula invasive lower extremity sarcoma. Clinical features, laboratory findings, management and result were discussed with brief review of literature.
Case presentation: A female patient, 55 years old, was diagnosed with right thigh leiomyosarcoma T4N0M0 by open biopsy. Patient was managed with neoadjuvant radiotherapy follow by wide margin resection combine with superficial femoral vessel excision and reconstruction by prosthetic graft. The patient recovered well with no complication and was discharged 15 days after surgery.
Conclusion: Vascular reconstruction with prosthetic graft is fesiable option in limb salvage surgery for vascula invasive soft tissue sarcomas of the extrimities.
Abnornal connection of the left partial pulmonary vein to the innominate vein: A clinical case and literature review
Authors: Bao Luong Tuan , Tien Do Anh , Thuy Nguyen Tran 
Published: April 2022

Background: The left partial abnormal pulmonary venous connection is a very rare and easily missed congenital anomaly. If not handled properly, this defect can cause many serious disorders in the development of the child. Surgery to return the pulmonary vein to the left atrium is the solution to this situation.
Methods: We report a case of a left partial abnormal pulmonary vein draining into the left innominate vein with a perimembranous ventricular septal defect that was diagnosed and operated on at the Pediatric Cardiovascular Surgery Department, Heart center, E hospital. In this case, we discuss methods of diagnosis, treatment, and review the medical literature on this abnormal form of pulmonary veins.
Results: Female, 15 months old, history: second child, normal delivery, full-term, birth weight 3000g, no asphyxia, no cyanosis after birth; detected congenital heart from 30 weeks gestation. After birth, the child can eat, suckle, and have normal mental-motor development. Recently, the child ate poorly, had slow weight gain, went to the provincial hospital for examination, was transferred to E hospital's cardiovascular center. Ultrasound and cardiac catheterization detected perimembranous ventricular septal defect and left partial pulmonary vein abnormality. We performed a total surgical repair including patching the ventricular septal defect and transferring the pulmonary vein to the left atrium through the incision between the sternum. Postoperative echocardiography gave good results. The patient was discharged from the hospital 9 days after surgery.
Conclusion: Surgery to transfer the pulmonary vein to the left atrium for the abnormality of the left partial pulmonary vein connection has good results.
Development of a forecast-oriented kilometre-resolution ocean–atmosphere coupled system for western Europe and sensitivity study for a severe weather situation
Authors: Pianezze Joris , Beuvier Jonathan , Lebeaupin Brossier Cindy , Samson Guillaume , Faure Ghislain , Garric Gilles 
Published: April 2022

Abstract. To improve high-resolution numerical environmental prediction, it is essential to represent ocean–atmosphere interactions properly, which is not the case in current operational regional forecasting systems used in western Europe. The objective of this paper is to present a new forecast-oriented coupled ocean–atmosphere system. This system uses the state-of-the-art numerical models AROME (cy43t2) and NEMO (v3.6) with a horizontal resolution of 2.5 km. The OASIS coupler (OASIS3MCT-4.0), implemented in the SurfEX surface scheme and in NEMO, is used to perform the communications between models. A sensitivity study of this system is carried out using 7 d simulations from 12 to 19 October 2018, characterized by extreme weather events (storms and heavy precipitation) in the area of interest. Comparisons with in situ and L3 satellite observations show that the fully coupled simulation reproduces the spatial and temporal evolution of the sea surface temperature and 10 m wind speed quantitatively well. Sensitivity analysis of ocean–atmosphere coupling shows that the use of an interactive and high-resolution sea surface temperature (SST), in contrast to actual numerical weather prediction (NWP) where SST is constant, modifies the atmospheric circulation and the location of heavy precipitation. Simulated oceanic fields show a large sensitivity to coupling when compared to the operational ocean forecast. The comparison to two distinct forced ocean simulations highlights that this sensitivity is mainly controlled by the change in the atmospheric model used to drive NEMO (AROME vs. IFS operational forecast), and less by the interactive air–sea exchanges. In particular, the oceanic boundary layer depths can vary by more than 40  % locally, between the two ocean-only experiments. This impact is amplified by the interactive coupling and is attributed to positive feedback between sea surface cooling and evaporation.
Brief communication: Preliminary ICESat-2 (Ice, Cloud and land Elevation Satellite-2) measurements of outlet glaciers reveal heterogeneous patterns of seasonal dynamic thickness change
Authors: Taubenberger Christian J. , Felikson Denis , Neumann Thomas 
Published: April 2022

Abstract. Dynamic changes of marine-terminating outlet glaciers are projected to be
responsible for about half of future ice loss from the Greenland Ice Sheet.
However, we lack a unified, process-based understanding that can explain the
observed dynamic changes of all outlet glaciers. Many glaciers undergo
seasonal dynamic thickness changes, and classifying the patterns of seasonal
thickness change can improve our understanding of the processes that drive
glacier behavior. The Ice, Cloud and land Elevation Satellite-2 (ICESat-2)
provides space-based, seasonally repeating altimetry measurements of the ice
sheets, allowing us to quantify near-termini seasonal dynamic thickness
patterns of 37 outlet glaciers around the Greenland Ice Sheet. We classify
the glaciers into seven common patterns of seasonal thickness change over a
2-year period from 2019 to 2020. We find small groupings of neighboring
glaciers with similar patterns of seasonal thickness change, but, within larger
sectors of the ice sheet, patterns of seasonal thickness change are mostly
heterogeneous. Future studies can build upon our results by extending these
time series, comparing seasonal dynamic thickness changes with external
forcings, such as ocean temperature and meltwater runoff, and with other
dynamic variables such as seasonal glacier velocity and terminus position
changes.
OPTIMALISASI BANDWIDTH MENGGUNAKAN METODE HIERARCHICAL TOKEN BUCKET DI SMK PASUNDAN RANCAEKEK
Authors: Diki Muhamad , Rismayadi Ali Akbar 
Published: April 2022

Jaringan komputer kini telah semakin pesat berkembang. Masa pandemi COVID-19 kini telah merubah interaksi komunikasi menjadi jarak jauh bagian penting dalam kehidupan sosial setiap organisasi maupun individu. Terutama dalam dunia Pendidikan akses internet digunakan untuk mencari sumber informasi sebagai bahan belajar mengajar. Pada tahap perancangan, bandwidth dikelola dengan fungsi Queue Tree. Fungsi ini bersifat unidirectional, artinya konfigurasi antrian hanya dapat menunggu dalam satu arah untuk jenis trafik. Tahapan yang akan diterapkan pada penelitian ini akan menggunakan metode Hierarchical Token Bucket (HTB) sebab mempunyai kelebihan mengurangi arus data internet di setiap levelnya serta kelas parentnya yang bisa digunakan kepada tingkat yang lebih besar ataupun dipinjam dari tingkat yang lebih rendah. dimana bandwidth 10 Mbit/s sampai dengan 5 Mbit/s untuk browsing dan 5 Mbit/s untuk konferensi video, di mana setiap tingkat menerima bagian bandwidth yang wajar dan pengguna dapat menggunakan bandwidth yang tidak digunakan. Filterasi pada website yang di blok berjalan dengan baik. dan hasilnya terlihat bahwa kualitas jaringan dengan metode HTB dan manajemen bandwidth lebih optimal dan maksimal dan juga tidak terjadi hal-hal seperti lag dan lain sebagainya kepada client.
RANCANG BANGUN APLIKASI INVENTORY DENGAN QRCODE BERBASIS WEBSITE PADA RSI ASSYIFA SUKABUMI
Authors: Ermawati Erni , Wahyuni Tri , Indriyanti Indriyanti , Ichsan Nurul , Fatah Haerul 
Published: April 2022

Inventory dalam sebuah perusahaan merupakan hal yang penting. Namun RSI. Assyifa Sukabumi saat ini masih melakukan proses pengecekan barang secara manual dari satu ruangan ke ruangan yang lain. Sehingga sering terjadi kendala saat proses inventory dilakukan dan mengurangi produktivitas pekerjaan. Tujuan pembuatan sistem ini adalah untuk memudahkan petugas dalam melakukan proses inventory. Proses inventory yang dilakukan yaitu proses pengecekan oleh petugas terkait jumlah barang yg pindah/hilang/rusak dilakukan setiap 1 bulan sekali. Adanya sistem ini memudahkan petugas untuk melakukan pengecekan tanpa harus membawa kertas & balpoin. Serta dapat langsung mengetahui data yg lama secara otomatis melalui sistem tanpa harus membuka berkas/file lama yg kadang lupa menyimpan, file hilang, atau file corrupt. Pada sistem ini data sudah terintegrasi per ruangan, bahkan pertanggal tertentu. Jenis metode pengembangan menggunakan pendekatan UCD (user centered design). Pada tahap perancangan sistem menggunakan Unified Modeling Language (UML). Bahasa pemrograman yang digunakan dalam pembuatan aplikasi ini adalah PHP, tools menggunakan sublime dan untuk database menggunakan MySQL. Hasil dari penelitian ini menunjukan aplikasi inventory dengan menggunakan Qrcode berbasis website yang dirancang dan dibangun berhasil mampu mendukung proses inventory. Berdasarkan dari hasil pengujian sistem dengan metode blackbox juga menunjukan bahwa semua fungsionalitas dari aplikasi inventarisir yang dirancang dapat berjalan dengan tepat dan sangat baik.
PENERAPAN MODEL ADDIE DALAM PEMBUATAN PERMAINAN EDUKASI BAHASA INGGRIS BERBASIS ANDROID
Authors: Maulana Muhamad Iqbal , Junianto Erfian 
Published: April 2022

Bahasa sebagai salah satu perantara manusia bisa saling berkomunikasi. Bahasa inggris sebagai Bahasa internasional sudah menjadi kurikulum pembelajaran sebagai persiapan menghadapi era 4.0, pengajaran Bahasa inggris sedari dini pada anak dalam masa periode emas lebih tepat. Oleh karena itu pengajaran yang interaktif dan edukatif untuk anak diperlukan. Permainan edukasi Bahasa inggris berbasis android bisa menjadi salah satu cara dalam membantu pembelajaran yang interaktif dan edukatif. Android sebagai sistem operasi yang ada pada ponsel pintar memudahkan dalam pembuatan dan pendistribusian permainan edukasi Bahasa inggris ini, karena presentasi kepemilikan ponsel pintar yang mencapai 89,45% pada tahun 2020. Pembuatan permainan edukasi Bahasa inggris berbasis android ini menggunakan metode ADDIE, metode ini sendiri sangat berguna dalam pembuatan permainan karena mencakup beberapa aspek yang terstruktur sehingga bisa menghasilkan permainan yang sesuai untuk kurikulum pembelajaran. Permainan edukasi Bahasa inggris berbasis android ini memiliki 2 mode yang bisa dimainkan, yaitu multiple choice dan matching quiz. Sebelum permainan dimulai, pada menu awal terdapat 2 pilihan tombol yaitu learn dan play, sehingga user bisa mempelajari dulu apa yang nanti akan dimainkan dalam permainan edukasi Bahasa inggris berbasis android ini. Hasil dari penelitian dengan wawancara melalui kusoiner terhadap beberapa responden, permainan edukasi Bahasa inggris ini menunjukan hasil yang cukup baik.