bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality Improvement Project of a Closed Catheter System to Reduce Catheter-Associated Urinary Tract Infections during Acute Inpatient Rehabilitation using Stepped-Wedge Design
Authors: Stampas Argyrios , Hua Jason , Naumann Heather , Martinez Claudia I. , Roberts DeAnn , Pedroza Claudia 
Published: June 2022

Objective:
To investigate if an indwelling catheter with a one-way valve (BioFlo® [BF]) reduces the incidence of catheter-associated urinary tract infections (CAUTIs).

Methods:
Prospective quality improvement project.

Design:
Stepped-wedge nursing unit enrollment in acute inpatient rehabilitation facility (IRF) was conducted over 9 months. All patients admitted to IRF that used an indwelling catheter at any time during admission were included, with all days and types of voiding methods collected when in the study period. Comparisons were between BF versus usual care (Foley catheter), with incidence of CAUTI as the primary outcome measure.

Results:
There were 227 patients: 21 using BF only, 146 using Foley only, and 60 using both. This resulted in 206 Foley users and 81 BF users. The BF group had a greater percentage of patients with CAUTI compared to the Foley group (30% vs. 17%, P = 0.021). Using generalized linear modeling and adjusting for confounders revealed an 89% increased risk of CAUTI in the BF group compared to the Foley group (odds ratio: 1.89, P = 0.033). Bayesian analysis determined that the probability of BF increasing the rate of CAUTI was 96% (95% credible interval: 0.95–2.7).

Conclusions:
Maintaining a closed catheter system with BF does not reduce the rates of CAUTIs during acute inpatient rehabilitation.
Graphical education and appropriate time before elective colonoscopy make better bowel preparation
Authors: Sun Jiachen , Chen Yongpeng , Gu Yuqin , Chen Junrong , Li Chujun , Zhou Qiulun , Hu Jiancong , Jiang Guozhi 
Published: June 2022

Background:
Inadequate bowel preparation leads to lower polyp detection rates, longer procedure times and lower cecal intubation rates. However, there is no consensus about high-quality bowel preparation, so our study evaluated graphical education and appropriate time before elective colonoscopy.

Patients and Methods:
We performed a secondary analysis of a national colorectal cancer screening programme of 738 patients. The patients were divided into a group given a graphical information manual (n = 242) or a word-only one (n = 496). They were also divided into groups according to the interval between bowel preparation and colonoscopy: 6–8 h (Group 1, n = 106), 9–12 h (Group 2, n = 228) and 13–17 h (Group 3, n = 402). All patients were scored according to the Boston Bowel Preparation Scale (BBPS) during the examination.

Results:
The bowel preparation of the graphical group was significantly better than the text group (P < 0.001). After adjustment, the bowel preparation score of Group 1 and Group 2 were both significantly higher than that of Group 3 (P = 0.012 and P = 0.032). Maximum BBPS was 6.31 when the interval time was 6.52 h (95% confidence interval: 5.95–6.66), and when the interval was <10 h, the BBPS was ≥6.

Conclusion:
High-quality bowel preparation was linked to graphical education and appropriate time before colonoscopy. We suggest that the interval between taking the first laxative and colonoscopy should be <10 h, preferably 6.5 h. Prospective multicentre research is needed to give more evidence of high-quality bowel preparation methods.
Surgical management of cystic duct stump calculi causing post-cholecystectomy syndrome: A prospective study
Authors: Kumar Saket , Kurian Nishant , Singh Rakesh Kumar , Chidipotu Venkat Rao , Kumar Sanjay , Raj Amarjit Kumar , Mandal Manish 
Published: June 2022

Aim:
Remnant cystic duct stump calculi are an uncommon but important cause of ‘post-cholecystectomy syndrome’. High index of suspicion is needed to diagnose this condition in a symptomatic post-cholecystectomy patient. We present our experience with the surgical management of this condition.

Patients and Methods:
This prospective study included 19 patients with residual gallstone disease who underwent completion cholecystectomy between August 2016 and October 2021. Investigations included abdominal ultrasound and magnetic resonance cholangiopancreatography. The demographic, clinical, surgical and early post-operative variables of these patients were prospectively maintained and analysed.

Results:
The study included 14 women and 5 men. The mean age was 42.1 years (range, 14–80 years). The median duration between index surgery and completion cholecystectomy was 36 months (range, 2–178 months) (interquartile range, 105 months). The follow-up duration was 2 months. The initial surgery was open cholecystectomy in 17 and laparoscopic cholecystectomy in 2 patients. All patients with residual stump stone presented with pain, while 10 out of 19 patients complained of dyspepsia. Completion cholecystectomy could be performed laparoscopically in 16 cases, whereas 3 patients underwent open surgery. The mean operative time was 80 min (range, 55–140 min), and the mean blood loss was 100 ml (range, 50–160 ml). The mean hospital stay was 3 days (range, 2–10 days). No post-operative mortality or major morbidity was recorded in any of our patients.

Conclusion:
Laparoscopic excision of the cystic duct stump is feasible and safe even after previous open cholecystectomy. It is increasingly becoming the treatment of choice where expertise is available.
Clinical outcomes of patients with COVID-19 and inflammatory rheumatic diseases receiving biological/targeted therapy
Authors: Pehlivan Özlem , Aydin Tutku 
Published: June 2022

BACKGROUND:
Anti-cytokine treatments are used in the treatment of severe COVID-19. Other studies have shown statistical significance with TNF inhibitors but not with other biological/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARD).

OBJECTIVES:
Compare the rate of severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) infection and the course and incidence of COVID-19 infection in patients who received b/tsDMARD with control patients.

DESIGN:
Analytical cross-sectional

SETTINGS:
Tertiary care hospital

PATIENTS AND METHODS:
All patients who applied to the rheumatology outpatient clinic between June 2020-March 2021 and received b/tsDMARD were included in the study. All patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis who applied to the rheumatology outpatient clinic in the three months before March 2021 and did not receive b/tsDMARD were included as the control group. History of COVID-19 infection and treatments were recorded. Multivariate analysis was performed to assess factors associated with use of tumor necrosis factor (TNF) inhibitors and differences between specific biologic drugs.

MAIN OUTCOME MEASURES:
Rate of COVID-19 disease among patients using biological/targeted synthetic therapy and non-biological/targeted synthetic therapy. COVID-19 clinical outcomes (hospitalization, intensive care admission, mechanical ventilation and death).

SAMPLE SIZE:
553 in total; 341 received b/tsDMARD, 212 in the control group that did not receive b/tsDMARD.

RESULTS:

One hundred patients (18%) had been infected with SARS-COV-2. The difference in SARS-COV-2 infection between b/tsDMARD and the control was statistically significant (13, 2% vs. 25, 9%, respectively) (
P
<.001). The hospital stays were longer in the controls (
P
<.001). Multinomial regression analysis revealed that COVID-19 negative patients were more likely to use tumor necrosis factor (TNF) inhibitors (OR: 2, 911; 95% CI: 1.727-4.908;
P
<.001) compared to COVID-19 positive participants. Multinomial logistic regression analysis indicated that non-hospitalized patients were more likely to use TNF inhibitors (OR: 11, 006; 95% CI: 3.447-35.138;
P
<.001) and there was no significant difference between b/tsDMARDs other than TNF inhibitors in frequency of hospitalization.

CONCLUSIONS:
Patients who were medicated with b/tsDMARD were less likely to be infected with COVID-19 and be hospitalized due to the infection. We have found that this effect was particularly dependent on the use of TNF inhibitors.

LIMITATIONS:
Conducted in a single center and unable to provide a homogeneous study population.

CONFLICT OF INTEREST:
None.
Characteristics of mechanically ventilated COVID-19 patients in the Al-Ahsa Region of Saudi Arabia: a retrospective study with survival analysis
Authors: Alamer Amnah , Asdaq Syed Mohammed Basheeruddin , AlYamani Mohammad , AlGhadeer Hussain , Alnasser Zahra H. , Aljassim Zainab , Albattat Maryam , Alhajji Ahmed , Alrashed Ahmed , Mohzari Yahya , Aledrees Abrar , Almuhainy Badr , Abraham Ivo , Alamer Ahmad 
Published: June 2022

BACKGROUND:
About 5-10% of coronavirus disease 2019 (COVID-19) infected patients require critical care hospitalization and a variety of respiratory support, including invasive mechanical ventilation. Several nationwide studies from Saudi Arabia have identified common comorbidities but none were focused on mechanically ventilated patients in the Al-Ahsa region of Saudi Arabia.

OBJECTIVES:
Identify characteristics and risk factors for mortality in mechanically ventilated COVID-19 patients.

DESIGN:
Retrospective chart review

SETTING:
Two general hospitals in the Al-Ahsa region of Saudi Arabia

PATIENTS AND METHODS:
We included mechanically ventilated COVID-19 patients (>18 years old) admitted between 1 May and 30 November 2020, in two major general hospitals in the Al-Ahsa region, Saudi Arabia. Descriptive statistics were used to characterize patients. A multivariable Cox proportional hazards (CPH) model was used exploratively to identify hazard ratios (HR) of predictors of mortality.

MAIN OUTCOME MEASURES:
Patient characteristics, mortality rate, extubation rate, the need for re-intubation and clinical complications during hospitalization.

SAMPLE SIZE AND CHARACTERISTICS:
154 mechanically ventilated COVID-19 patients with median (interquartile range) age of 60 (22) years; 65.6% male.

RESULTS:

Common comorbidities were diabetes (72.2%), hypertension (67%), cardiovascular disease (14.9%) and chronic kidney disease (CKD) (14.3%). In the multivariable CPH model, age >60 years old (HR=1.83, 95% CI 1.2-2.7,
P
=.002), CKD (1.61, 95% CI 0.9-2.6,
P
=.062), insulin use (HR=0.65, 95% CI 0.35-.08,
P
<.001), and use of loop diuretics (HR=0.51, 95% CI 0.4,
P
=.037) were major predictors of mortality.

CONCLUSION:
Common diseases in mechanically ventilated COVID-19 patients from the Al-Ahsa region were diabetes, hypertension, other cardiovascular diseases, and CKD in this exploratory analysis.

LIMITATIONS:
Retrospective, weak CPH model performance.

CONFLICTS OF INTEREST:
None.
Prognosis of gastric adenocarcinoma associated with girdin, Akt, and cortactin
Authors: Zhang Yue , Liu Cheyan , Zhou Lei 
Published: June 2022

BACKGROUND:
The actin-binding protein girdin regulates tumor cell migration and invasion by maintaining actin structure. PI3K/Akt signaling is an important actin-remodeling pathway. The protein cortactin acts directly on microfilaments and promotes tumor invasion and metastasis by rearranging the cytoskeleton. However, there are few reports on the co-expression of girdin, Akt, and cortactin in gastric adenocarcinoma (GAC).

OBJECTIVES:
Evaluate girdin, Akt, and cortactin expression in GAC tissues and assess their relationship to the prognosis of GAC patients.

DESIGN:
Survival analysis

SETTING:
Medical college in China

PATIENTS AND METHODS:
We compared survival in 110 paraffin-preserved GAC with corresponding normal gastric mucosa tissues in relationship to girdin, Akt, and cortactin expression levels.

MAIN OUTCOME MEASURE:
Expression levels of the proteins.

SAMPLE SIZE:
110

RESULTS:

The expression of girdin, Akt, and cortactin were all upregulated in GAC tissues compared with corresponding normal tissues (66.4% vs 36.3%, 57.3% vs 28.2% and 69.1% vs 22.7%, respectively;
P
<.05) and expression was mutually positive (all
P
<.05). Overall survival in the girdin, Akt, and cortactin high expression groups was reduced. Multivariate analysis showed that girdin, Akt, cortactin, lymph node metastasis (LNM) and TNM stages were independent factors affecting GAC patients prognosis (
P
<.05).

CONCLUSIONS:
Girdin and cortactin may promote GAC invasion and metastasis via the PI3-K/Akt signaling pathway. Girdin, Akt, and cortactin co-expression might serve as a novel molecular target for GAC therapy and improve the prognosis of patients with this disease.

LIMITATIONS:
A small sample size and lack of related research on molecular mechanisms.

CONFLICT OF INTEREST:
None.
Histopathological pattern of endometrial biopsies in patients with abnormal uterine bleeding in a tertiary referral hospital in Jordan
Authors: Alshdaifat Eman Husssein , El-Deen Al-Horani Sami Saif , Al-Sous Majd Mahmoud , Al-Horani Sharaf , Sahawneh Fernas Emile , Sindiani Amer Mahmoud 
Published: June 2022

BACKGROUND:Abnormal uterine bleeding (AUB) is a symptom that deviates from the normal menstrual cycle. AUB is characterized by changes in the frequency, volume, and duration of the menstrual flow. The etiology of AUB, which varies with age, may be attributed to both structural and non-structural causes.OBJECTIVES:Determine the histopathological pattern of endometrial biopsies in patients with AUB across different age and parity groups who have undergone dilation and curettage (D&C), along with the discrepancy between D&C and histopathological findings after hysterectomy.DESIGN:Retrospective chart reviewSETTING:Tertiary referral hospitalPATIENTS AND METHODS:We collected data on all patients diagnosed with AUB between January 2015 and December 2020. Histopathological findings of all D&C endometrial biopsy samples were examined after being categorized by age and parity groups. Sensitivity, specificity, positive predictive value, and NPV were calculated to evaluate the diagnostic accuracy of D&C.MAIN OUTCOME MEASURES:Histopathological pattern of D&C endometrial biopsies by age and parity groups.SAMPLE SIZE:3233 patients.RESULTS:Most patients were in the 18-39 year age group, with normal cyclical findings being the most common histopathological finding. Malignant lesions were observed in 42 patients with a majority being older than 50 years. In 13.3% (42/316) of patients, D&C failed to detect intrauterine disorder that was found on hysterectomy. The overall accuracy of D&C in determining the existence of normal versus pathological findings was 75.60%, the sensitivity was 72.90%, the specificity was 77.90%, the positive predictive value was 73.86% and the NPV was 77.05% in our patients.CONCLUSION:Normal cyclic changes account for the highest proportion of histopathological findings. However, hyperplasia and malignancies are important causes of perimenopausal and postmenopausal bleeding. While the use of D&C as a sampling tool for AUB cases remains questionable, the use of D&C in diagnosing premalignant and malignant cases is highly effective.LIMITATIONS:Single-center, retrospective design, incomplete medical records, and inter-rater reliability could not be determined.CONFLICT OF INTEREST:None.
PENINGKATAN HASIL DAN AKTIVITAS BELAJAR PADA MATERI JARINGAN MAKHLUK HIDUP MELALUI MODEL PEMBELAJARAN GUIDED INQUIRY LEARNING
Authors: Nurhayati Evi 
Published: June 2022

Penelitian tindakan kelas ini bertujuan untuk menelaah pengaruh pembelajaran guided inquiry learning terhadap peningkatan hasil belajar dan aktivitas belajar siswa kelas XI MIPA 1 SMA Negeri 6 Semarang. Dalam penelitian ini, subjek penelitian adalah siswa kelas XI MIPA 1 SMA Negeri 6 Semarang. Teknik pengumpulan data dalam penelitian ini meliputi observasi kelas, wawancara, penyebaran angket, evaluasi formatif, dan diskusi dengan guru mitra (kolaborator). Sedangkan analisis data yang digunakan dalam penelitian ini adalah teknik analisis data secara kuantitatif dan kualitatif. penerapan model pembelajaran guided inquiry learning dapat meningkatkan kemampuan literasi sains dengan indikator keberhasilan yaitu hasil literasi sains siswa di kelas pada Siklus I mampu mencapai rata-rata skor setiap aspek yaitu ≥ 75 % atau pada kriteria baik dan pada Siklus II meningkat menjadi rata-rata skor setiap aspek yaitu ≥ 85% atau pada kriteria sangat baik. Hasil penelitian menunjukkan bahwa rata-rata nilai secara klasikal naik dari 68 pada Siklus I yang menjadi 80 pada Siklus II dan persentase siswa yang mampu memenuhi kriteria ketuntasan minimal pada Siklus II telah mencapai sebesar 89%. Aktivitas belajar siswa juga mengalami peningkatan dilihat dari aktivitas bertanya yang meningkat dari skor 14 pada Siklus I menjadi skor 29 pada Siklus II atau meningkat sebesar 41,67%. Aktivitas menjawab pertanyaan meningkat dari skor 18 pada Siklus I menjadi skor 27 pada Siklus II atau meningkat sebesar 25%. Sedangkan, aktivitas mengerjakan tugas meningkat dari skor 23 pada Siklus I menjadi skor 32 pada Siklus II atau meningkat sebesar 25. Semua hasil tindakan telah mencapai kriteria yang diharapkan. Berdasarkan hasil penelitian tindakan kelas yang sudah dilakukan diperoleh simpulan bahwa pembelajaran guided inquiry learning berbantu media Liveworksheet yang mampu meningkatkan kemampuan literasi sains siswa kelas XI MIPA 1 SMA Negeri 6 Semarang.
ANALISIS NILAI KARAKTER YANG TERDAPAT DALAM FILM UPIN DAN IPIN PADA KEHIDUPAN SEHARI-HARI SISWA
Authors: Pratama Gilang Aditya , Soegeng Soegeng , Sukamto Sukamto 
Published: June 2022

Banyak pengaruh yang ditimbulkan dari menonton film Upin dan Ipin, mulai dari pesan moral yang mendidik hingga meniru bahasa yang terdapat pada film tersebut yaitu bahasa Melayu. Tujuan dari penelitian ini yaitu untuk menganalisis nilai-nilai karakter pada film Upin dan Ipin episode Taman Riang. Jenis penelitian yang digunakan adalah kualitatif dengan metode deskriptif. Metode pengumpulan data dilakukan dengan wawancara, simak, catat, angket, dan dokumentasi. Berdasarkan hasil analisis data penelitian, maka ditemukan nilai karakter pada setiap adegan film Upin dan Ipin. Nilai karakter yang ditemukan dalam film Upin dan Ipin episode Taman Riang yaitu religius, kerja sama, kerja keras, jujur, peduli sosial, rasa ingin tahu, toleransi, menghargai prestasi, komunikatif/bersahabat dan iri hati. Simpulan hasil dari analisis film Upin dan Ipin episode Taman Riang yaitu terdapatsepuluh nilai karakter yang terkandung dalam film Upin dan Ipin yang dapat digunakan guru untuk media alat bantu dalam proses penyampaik
PENINGKATAN SERVICE BAWAH MELALUI PERMAINAN MODEL LETABOL (LEMPAR TANGKAP BOLA) PADA HASIL BELAJAR BOLA VOLI
Authors: Muhdhor Muhdhor 
Published: June 2022

Penelitian ini bertujuan untuk mengetahui seberapa besar peningkatan kemampuan servis bawah melalui model letabol (lempar tangkap bola) terhadap hasil belajar Peserta Didik Kelas V SD Negeri Tlogosari Wetan 02 Kecamatan Pedurungan tahun pelajaran 2018/2019. Penelitian ini menggunakan metode penelitian tindakan Kelas (PTK) dengan rancangan penelitian siklus I dan siklus II peningkatan kemampuan servis bawah melalui model letabol (lempar tangkap bola) terhadap hasil belajar Peserta Didik Kelas V semester II SD Negeri Tlogosari Wetan 02 Kecamatan Pedurungan. Hasil penelitian menunjukkan hasil pada siklus I dengan kegiatan servis bawah melalui permainan tradisional17.85% dengan keberhasilan hasil belajar peserta didik dalam mencapai nilai kriteria ketuntasan minimal peserta didik 4 siswa dan 1 siswa putri setelah melalui perbaikan pada siklus II pada teknik dasar servis bawah bolavoli melalui permainan tradisional. Prosentase keberhasilan rata-rata meningkat menjadi 89.28% 33 siswa yang mendapat nilai diatas kriteria ketuntasan minimal (KKM) dari jumlah 39 peserta didik dengan hasil perubahan yang signifikan.Simpulan : 1) ada peningkatan servis bawah melalui permainan kucing dan tikus terhadap hasil belajar sebanyak 39 siswa yang mendapat diatas kriteria ketuntasan minimal 75 yang sudah ditetapkan . 2) permainan tradisional sangat efektif untuk memberikan stimulus pada peserta didik untuk peningkatan hasil belajar peserta didik. Kurikulum Tahun 2013 yang mengedepankan penilaian proses dan hasil nyata maka permainan tradisional sangat membantu dalam peningkatan kemampuan servis bawah bola voli.
UPAYA MENINGKATKAN HASIL BELAJAR MATEMATIKA MATERI LINGKARAN DENGAN MENERAPKAN DISCOVERY LEARNING
Authors: Rubiyati Rubiyati 
Published: June 2022

Berdasarkan latar belakang masalah yang telah diuraikan di atas, maka dapat diidentifikasikan beberapa masalah sebagai berikut : siswa kurang mampu menguasai pembelajaran Matematika kelas VI semester genap SD Negeri Tlogosari Kulon 03. Dari 40 anak hanya 16 anak (40,00%) yang mencapai KKM. Upaya guru untuk meningkatkan kemampuan hasil belajar Matematika materi “Lingkaran” dengan menggunakan Discovery Learning pada siswa kelas VI semester genap SD Negeri Tlogosari Kulon 03 Semarang. Penelitian ini menggunakan jenis PTK (penelitian tindakan kelas), dilaksanakan di SD Negeri Tlogosari Kulon 03 Kecamatan Pedurungan, Kota Semarang pada bulan Oktober – November 2019. Subjek penelitian tindakan kelas ini adalah: siswa Kelas VI yang berjumlah 40 siswa. Hasil penelitian menunjukkan: (1) Pembelajaran dengan menggunakana Discovery Learning dapat meningkatkan hasil belajar siswa pada Materi “Lingkaran” pelajaran Matematika Kelas VI di SD Negeri Tlogosari Kulon 03 Kec. Pedurungan Kota Semarang yang ditandai dengan peningkatan hasil belajar siswa dalam setiap siklus, yaitu prasiklus 63,50; siklus I rata-rata 72,70 dan siklus II rata-rata 82,10; (2) Pembelajaran dengan menggunakan Discovery Learning dapat meningkatkan ketuntasan hasil belajar siswa pada Materi “Lingkaran” pelajaran Matematika Kelas VI di SD Negeri Tlogosari Kulon 03 Kec. Pedurungan Kota Semarang yang ditandai dengan peningkatan hasil belajar siswa dalam setiap siklus, yaitu prasiklus 40,00%; pada sikus I meningkat menjadi 62,50% dan siklus II mencapai 87,50%. Kesimpulan penelitian ini yaitu hasil belajar dan ketuntasan belajar siswa dalam pelajaran Matematika pada materi “Lingkaran” dapat meningkat menerapkan Discovery Learning siswa kelas VI Semester 1 SD Negeri Tlogosari Kulon 03 Kecamatan Pedurungan Kota Semarang Tahun Pelajaran 2019/2020.