Mediating Effect of Motivation on the Relationship Between Lecturer Experience and Learning Environment With Caring Character Among Undergraduate Nursing Student in Indonesia.

Introduction: Caring is learned through faculty role-modeling and clinical interactions, enhancing nursing students' caring character. Relationship between caring, motivation, teacher experience, and learning environment remains uncertain. Objective: The present study aimed to explore the relationship between their caring characters, motivation, lecturer experience, and learning environment among undergraduate nursing students in Indonesia. Methods: A cross-sectional study was conducted between December 2022 and February 2023, recruiting 550 undergraduate nursing students from 10 universities in West Java province, Indonesia. The study included instruments such as students' perceptions of learning, academic motivation scale, service quality assessment of instructional laboratories, and caring character learning instrument. The Bootstrap analysis was used to analyze the mediating effect of study variable. Results: The study involved participants aged 20-25 years. The mean scores for caring characters, lecturer experience, motivation, and learning environment were 2.18 ± 0.97, 3.46 ± 1.20, 4.32 ± 1.53, and 5.96 ± 2.08, respectively. The results showed significant direct effects of lecturer experience on caring character, mediating effects of learning environment, motivation, and chain mediating effects of learning environment and motivation. The direct effect accounted for 44.34% of the total effect, while the indirect effect was 35.21%. Conclusions: The study found that learning environment and motivation mediate the relationship between lecturer experience and caring characters among undergraduate nursing students in West Java, Indonesia. Emphasizing best practices and creating a student-friendly environment is crucial for fostering guidance and support.

Pressure-dependent physical properties of cesium-niobium oxide: a comprehensive study.

Perovskites, an important class of materials, are mostly utilized in memory and spintronic devices. The thermoelectric response calculations for some perovskite oxides have been reported, but their attributes under pressure have rarely been explored. In this current study, the effects of high pressure on various properties of CsNbO3 perovskite oxides in the cubic phase were investigated using the pseudopotential approach and Boltzmann transport theory. Specifically, the structural electronic dispersion relations, density of states, phonon properties, elasto-mechanical properties, optical constants, and thermoelectric performance of the material were analyzed. CsNbO3 was reported to be dynamically stable through the optimization of energy against volume under ambient pressure conditions. The phonon dispersion curves of CsNbO3 were computed at pressures ranging from 60 to 100 GPa to demonstrate its stability under these pressures. At ambient pressure, CsNbO3 is a semiconductor with a wide direct band gap of 1.95 eV. With the increase in pressure, the band gap starts decreasing. An analysis of the imaginary part of the dielectric constant suggests that this material may be useful for sensors and optoelectronic devices. Various thermoelectric response parameters were tested for CsNbO3 at temperatures from 50 K to 800 K, with a step size of 50 K, and pressures of 60-100 GPa. Based on the calculated power factor values and optical parameters, CsNbO3 proved to be a potential candidate for energy harvesting applications.

Identification and characterization of codon usage pattern and influencing factors in HFRS-causing hantaviruses.

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral zoonosis carried and transmitted by infected rodents through urine, droppings, or saliva. The etiology of HFRS is complex due to the involvement of viral factors and host immune and genetic factors which hinder the development of potential therapeutic solutions for HFRS. Hantaan virus (HTNV), Dobrava-Belgrade virus (DOBV), Seoul virus (SEOV), and Puumala virus (PUUV) are predominantly found in hantaviral species that cause HFRS in patients. Despite ongoing prevention and control efforts, HFRS remains a serious economic burden worldwide. Furthermore, recent studies reported that the hantavirus nucleocapsid protein is a multi-functional protein and plays a major role in the replication cycle of the hantavirus. However, the precise mechanism of the nucleoproteins in viral pathogenesis is not completely understood. In the framework of the current study, various in silico approaches were employed to identify the factors influencing the codon usage pattern of hantaviral nucleoproteins. Based on the relative synonymous codon usage (RSCU) values, a comparative analysis was performed between HFRS-causing hantavirus and their hosts, suggesting that HTNV, DOBV, SEOV, and PUUV, were inclined to evolve their codon usage patterns that were comparable to those of their hosts. The results indicated that most of the overrepresented codons had AU-endings, which revealed that mutational pressure is the major force shaping codon usage patterns. However, the influence of natural selection and geographical factors cannot be ignored on viral codon usage bias. Further analysis also demonstrated that HFRS causing hantaviruses adapted host-specific codon usage patterns to sustain successful replication and transmission chains within hosts. To our knowledge, no study to date reported the factors influencing the codon usage pattern within hantaviral nucleoproteins. Thus, the proposed computational scheme can help in understanding the underlying mechanism of codon usage patterns in HFRS-causing hantaviruses which lend a helping hand in designing effective anti-HFRS treatments in future. This study, although comprehensive, relies on in silico methods and thus necessitates experimental validation for more solid outcomes. Beyond the identified factors influencing viral behavior, there could be other yet undiscovered influences. These potential factors should be targets for further research to improve HFRS therapeutic strategies.

Evolution of NLR genes in genus Arachis reveals asymmetric expansion of NLRome in wild and domesticated tetraploid species.

Arachis hypogaea is an allotetraploid crop widely grown in the world. Wild relatives of genus Arachis are the rich source of genetic diversity and high levels of resistance to combat pathogens and climate change. The accurate identification and characterization of plant resistance gene, nucleotide binding site leucine rich repeat receptor (NLRs) substantially contribute to the repertoire of resistances and improve production. In the current study, we have studied the evolution of NLR genes in genus Arachis and performed their comparative genomics among four diploids (A. duranensis, A. ipaensis, A. cardenasii, A. stenosperma) and two tetraploid (wild: A. monticola and domesticated: A. hypogaea) species. In total 521, 354, 284, 794, 654, 290 NLR genes were identified from A. cardenasii, A. stenosperma and A. duranensis, A. hypogaea, A. monticola and A. ipaensis respectively. Phylogenetic analysis and classification of NLRs revealed that they belong to 7 subgroups and specific subgroups have expanded in each genome leading towards divergent evolution. Gene gain and loss, duplication assay reveals that wild and domesticated tetraploids species have shown asymmetric expansion of NLRome in both sub-genome (AA and BB). A-subgenome of A. monticola exhibited significant contraction of NLRome while B-subgenome shows expansion and vice versa in case of A. hypogaea probably due to distinct natural and artificial selection pressure. In addition, diploid species A. cardenasii revealed the largest repertoire of NLR genes due to higher frequency of gene duplication and selection pressure. A. cardenasii and A. monticola can be regarded as putative resistance resources for peanut breeding program for introgression of novel resistance genes. Findings of this study also emphasize the application neo-diploids and polyploids due to higher quantitative expression of NLR genes. To the best of our knowledge, this is the first study that studied the effect of domestication and polyploidy on the evolution of NLR genes in genus Arachis to identify genomic resources for improving resistance of polyploid crop with global importance on economy and food security.

Discovering common pathogenic processes between COVID-19 and HFRS by integrating RNA-seq differential expression analysis with machine learning.

Zoonotic virus spillover in human hosts including outbreaks of Hantavirus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) imposes a serious impact on the quality of life of patients. Recent studies provide a shred of evidence that patients with Hantavirus-caused hemorrhagic fever with renal syndrome (HFRS) are at risk of contracting SARS-CoV-2. Both RNA viruses shared a higher degree of clinical features similarity including dry cough, high fever, shortness of breath, and certain reported cases with multiple organ failure. However, there is currently no validated treatment option to tackle this global concern. This study is attributed to the identification of common genes and perturbed pathways by combining differential expression analysis with bioinformatics and machine learning approaches. Initially, the transcriptomic data of hantavirus-infected peripheral blood mononuclear cells (PBMCs) and SARS-CoV-2 infected PBMCs were analyzed through differential gene expression analysis for identification of common differentially expressed genes (DEGs). The functional annotation by enrichment analysis of common genes demonstrated immune and inflammatory response biological processes enriched by DEGs. The protein-protein interaction (PPI) network of DEGs was then constructed and six genes named RAD51, ALDH1A1, UBA52, CUL3, GADD45B, and CDKN1A were identified as the commonly dysregulated hub genes among HFRS and COVID-19. Later, the classification performance of these hub genes were evaluated using Random Forest (RF), Poisson Linear Discriminant Analysis (PLDA), Voom-based Nearest Shrunken Centroids (voomNSC), and Support Vector Machine (SVM) classifiers which demonstrated accuracy >70%, suggesting the biomarker potential of the hub genes. To our knowledge, this is the first study that unveiled biological processes and pathways commonly dysregulated in HFRS and COVID-19, which could be in the next future used for the design of personalized treatment to prevent the linked attacks of COVID-19 and HFRS.

Understanding health service quality in emergency department through the length of stay and its determinants.

Objectives: To identify and analyse the determinants of emergency department length of stay. METHODS: The cross-sectional study was conducted from December 20 to 31, 2017, at the Centre of Referral Hospital after approval from the ethics review committee of Dr Soetomo General Hospital, Surabaya, Indonesia, and comprised patients of either gender aged 18 years or above who visited the emergency department who required follow-up after triage, such as diagnostics or hospitalisation. Emergency department length of stay, assessment time, review and consultation, and disposition or decision were the variables noted. Data was analysed using SPSS 18. RESULTS: Of the 172 patients, 95(57%) were men and 74(43%) were women. The largest age group was of those aged 45-59 years 61(34.4%). There were 48(27%) cases of surgery and 124(73%) of medicine. Mean emergency department length of stay was 575.94±306.402 minutes (range: 100-2215 minutes), and it was significantly associated with assessment time (p=0.001), review and consultation time (p=0.001) and disposition or decision time (p=0.002). CONCLUSIONS: The emergency department length of stay was found to be rather prolonged and needed to be improved.

Increasing self-care of patients with type-2 diabetes through implementation of nursing agency based on the health promotion model.

Objectives: To analyse the effect of nursing agency model on fasting and 2-hour postprandial glucose levels in type 2 diabetics. Method: The quasi-experimental study was conducted from October to December 2021 in Lamongan, East Java, Indonesia, after approval from the ethics review committee of the University of Muhammadiyah, Lamongan, Indonesia. The sample comprised of type 2 diabetics of either gender aged 19-65 years who were able to move independently. The sample was divided into experimental group A, which was given nursing agency model training for six weeks, and control group B, which was only given diabetes treatment without any training. Patient self-care level was assessed using the Summary of Diabetes Self-Care Activities tool, while other variables were measured through fasting and 2-hour postprandial glucose levels. Data were analysed using a one-way covariance analysis test. RESULTS: Of the 256 individuals assessed, 42(16.4%) met the inclusion criteria, and, of them, 30(71.4%) comprised the final sample; 10(33.3%) males and 20(66.6%) females. Overall, 19(63.3%) patients were aged >50 years, and duration of diabetes was 5-10 years in 23(76.7%) cases. There were 15(50%) patients in each of the two groups. There was significant difference in the mean scores of all dimensions of self-care behaviour between the groups, and it increased significantly in group A post-intervention (p=0.05). There was a significant decrease in fasting and 2-hour postprandial glucose levels in group A compared to group B post-intervention (p=0.001). CONCLUSIONS: The application of the nursing agency model was found to be effective in increasing self-care ability and in reducing fasting and 2-hour postprandial blood glucose levels.

Dynamic Evolution of NLR Genes in Dalbergioids.

Dalbergioid is a large group within the family Fabaceae that consists of diverse plant species distributed in distinct biogeographic realms. Here, we have performed a comprehensive study to understand the evolution of the nucleotide-binding leucine-rich repeats (NLRs) gene family in Dalbergioids. The evolution of gene families in this group is affected by a common whole genome duplication that occurred approximately 58 million years ago, followed by diploidization that often leads to contraction. Our study suggests that since diploidization, the NLRome of all groups of Dalbergioids is expanding in a clade-specific manner with fewer exceptions. Phylogenetic analysis and classification of NLRs revealed that they belong to seven subgroups. Specific subgroups have expanded in a species-specific manner, leading to divergent evolution. Among the Dalbergia clade, the expansion of NLRome in six species of the genus Dalbergia was observed, with the exception of Dalbergia odorifera, where a recent contraction of NLRome occurred. Similarly, members of the Pterocarpus clade genus Arachis revealed a large-scale expansion in the diploid species. In addition, the asymmetric expansion of NLRome was observed in wild and domesticated tetraploids after recent duplications in the genus Arachis. Our analysis strongly suggests that whole genome duplication followed by tandem duplication after divergence from a common ancestor of Dalbergioids is the major cause of NLRome expansion. To the best of our knowledge, this is the first ever study to provide insight toward the evolution of NLR genes in this important tribe. In addition, accurate identification and characterization of NLR genes is a substantial contribution to the repertoire of resistances among members of the Dalbergioids species.

A Novel Homozygous Nonsense Variant in the DYM Underlies Dyggve-Melchior-Clausen Syndrome in Large Consanguineous Family.

(1) Background: Dyggve-Melchior-Clausen Syndrome is a skeletal dysplasia caused by a defect in the DYM gene (OMIM number 607461). Pathogenic variants in the gene have been reported to cause Dyggve-Melchior-Clausen (DMC; OMIM 223800) dysplasia and Smith-McCort (SMC; OMIM 607326) dysplasia. (2) Methods: In the present study, large consanguineous families with five affected individuals with osteochondrodysplasia phenotypes were recruited. The family members were analyzed by polymerase chain reaction for homozygosity mapping using highly polymorphic microsatellite markers. Subsequent to linkage analysis, the coding exons and exon intron border of the DYM gene were amplified. The amplified products were then sent for Sanger sequencing. The structural effect of the pathogenic variant was analyzed by different bioinformatics tools. (3) Results: Homozygosity mapping revealed a 9 Mb homozygous region on chromosome 18q21.1 harboring DYM shared by all available affected individuals. Sanger sequencing of the coding exons and exon intron borders of the DYM gene revealed a novel homozygous nonsense variant [DYM (NM_017653.6):c.1205T>A, p.(Leu402Ter)] in affected individuals. All the available unaffected individuals were either heterozygous or wild type for the identified variant. The identified mutation results in loss of protein stability and weekend interactions with other proteins making them pathogenic (4) Conclusions: This is the second nonsense mutation reported in a Pakistani population causing DMC. The study presented would be helpful in prenatal screening, genetic counseling, and carrier testing of other members in the Pakistani community.

First-Principles Investigations of Thermoelectric Behavior of RuCrX (X = Si, Ge, Sn).

The half-Heusler alloys have not only been recognized for spintronic and memory devices but also for thermoelectric applications. In this research work, the detailed study for thermoelectric parameters of RuCrX (X = Si, Ge, Sn) half-Heusler alloys has been carried out by using the pseudopotential approach alongside the Boltzmann transport theory. The RuCrX (X= Si, Ge, Sn) was reported stable in C1 b -type structure by means of energy-volume optimization, elastic stability criteria, positive phonon frequencies in phonon dispersion curves, and formation energies. The all important thermoelectric properties of these alloys have not yet been explored. The thermoelectric properties such as Seebeck coefficient, electronic part of thermal conductivity, electrical conductivity, and power factor have been discussed within a specific temperature range (300-1200 K). The calculated value of the power factor was found to be 5.11 × 1011 W/(m K2 s) for RuCrSi, 3.42 × 1011 W/(m K2 s) for RuCrGe, and 1.85 × 1011 W/(m K2 s) for RuCrSn at 1200 K.

A novel homozygous variant in the GLI1 underlies postaxial polydactyly in a large consanguineous family with intra familial variable phenotypes.

Polydactyly is a human inherited disorder caused by to anomalies in the genes involved in autopod development. The disorder segregates in both autosomal recessive and autosomal dominant form. Up till now, eleven genes causing non-syndromic polydactyly, have been identified. This includes ZNF141, GLI3, ZRS in LMBR1, MIPOL1, PITX1, IQCE, GLI1, FMA92A1, KIAA0825, STKLD1, and DACH1. In the present study, we have investigated a large consanguineous family of Pakistani origin segregating polydactyly in autosomal recessive pattern. Clinical examination of affected individuals revealed a non-syndromic form of the disorder. Genetic study based on homozygosity mapping and Sanger sequencing using DNA of the normal and affected individuals found a novel homozygous missense sequence variant [NM_005269.3: c.1133C > T, p.(Ser378Leu)] in the GLI1 located on human chromosome 12q13.3. In silico analysis of the identified variant showed a significant change in the secondary structure of the mutant protein that affects its function. Findings of the present study expand the mutation spectrum of the GLI1. In addition, the study will help in prevention of the disorder through carrier testing and bringing awareness among families affected with polydactyly.

The Best Online Tools Based on Media Preference Reflected by Health Information Received on Social Media amongst Diabetic Patients in Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia.

BACKGROUND: Diabetes mellitus has become a major public health problem globally. Social media could be useful in assisting clinical practice and sharing health-related information to improve self-management and to promote a positive behavioural change. This study aims to develop a guide on the best online tools by determining the media preference reflected by health-related information received from social media amongst diabetic patients in Hospital Canselor Tuanku Muhriz (HCTM), Universiti Kebangsaan Malaysia, Kuala Lumpur. METHODS: This study was conducted cross-sectional on 174 respondents, who were selected by using a simple random sampling method. Socio-demographic data and the use of the internet and media for health-related information were obtained via questionnaires. RESULTS: The most preferred social media used for searching and sharing health-related information was WhatsApp (73.6%), followed by Facebook (67.8%), Instagram (18.4%) and Twitter (17.2%). The social media preference related to socio-demographic data of age was statistically significant (P < 0.002), which had a medium effect. Furthermore, the media preference was not significantly related to health-related information searched or shared on social media and the frequency of usage. CONCLUSION: Indeed, the social media have been an essential media platform to enhance public awareness concerning public health. This calls for evolution to further enhance the use of social media amongst healthcare practitioners to emphasise health promotion and empower the patients to play an active role in their healthcare. This study provides a guideline for the medical researchers, practitioners or healthcare providers in choosing WhatsApp as an online medium to communicate with diabetic patients in the future, specifically in Malaysia.

Implementation of a telemedicine service during COVID-19 pandemic in Pakistan.

AIM: In this feasibility study, we aimed to implement a pilot telemedicine service at our healthcare facility in Faisalabad, Pakistan, and describe our experience. METHODS: Telemedicine service was established by Faisalabad Medical University at two of its affiliated locations: (i) a 24-hour COVID-19 Telephone Helpline was established at the Director Emergency Office, Allied Hospital, and District Headquarter (DHQ) Hospital. (ii) A Telemedicine Clinic comprising consultants and postgraduate residents from different specialties was established at Chief Office, Allied Hospital. The data related to the number and categories of calls and advice provided were collected from 27th March 2020 to 31st July 2020. RESULTS: A total of 4582 calls were received, at both locations, during the study period, out of which 2325 callers (51%) were male, and 2257 (49%) were females. At Allied Hospital, 172 patients were advised accordingly for their complaints, whereas, at DHQ Hospital, 320 patients were advised accordingly for their complaints. At the Telemedicine Clinic only, a total of 2436 calls were received during the study period, 1474 (60%) callers were male, and 962 (40%) were female. The majority of the calls were received by medicine (43%), dermatology (21%), and paediatrics (11%) specialties, respectively. CONCLUSION: Despite some limitations, the benefits of telemedicine in this COVID-19 era are enormous and it is feasible to implement telemedicine services in developing countries. The developing countries must invest in the internet and technology access to facilitate telemedicine and other e-health services for not only curbing this pandemic but also to promote a more efficient healthcare system after the pandemic.

The Oral Health Inequities between Special Needs Children and Normal Children in Asia: A Systematic Review and Meta-Analysis.

This meta-analysis aimed to analyze the oral health inequalities among special needs children during 2004-2019 in Asia to reveal the importance and the needs of establishing integrated and equitable special needs dentistry care system in Indonesia. PubMed, Scopus, Cochrane Library, Web of Science, and Wiley Online Library were systematically searched for full-text observational studies published from 1 January 2004 to 15 January 2020, in English in Asia. Studies that included children under 18 years of age with special needs and compared them to healthy controls were selected. Study quality was assessed using the Joanna Briggs Institute 2017 Critical Appraisal Checklist. Risk of bias was assessed using the ROBINS-E tool. The decayed, missing, and filled permanent teeth (DMFT) index indicated that special needs children who suffer from intellectual disability or autism spectrum disorder had significantly more caries than normal children (p < 0.001). The special needs children who had more caries than normal children lived in countries that had a high average DMFT value among 12 years old children (p < 0.001), and these two variables showed a positive correlation in meta-regression analysis (p < 0.001). Having an integrated and equitable care system and elevating children's oral health are important to maintain special needs children's oral health.

Dataset on the perceptions of ordinary people on the persistence of bribery practices in Nigeria.

This dataset provides the perceptions of ordinary people on the relationship between societal acceptance of bribery, anti-bribery measures, socio-economic impacts of bribery, demographic factors and persistence of bribery practices. A multi-stage sampling technique was used to target the respondents. A total of 887 grassroots respondents participated, out of which 836 responses were used for quantitative data analyses. Statistical Packages for Social Sciences (SPSS) version 23 and SmartPLS3.0 were used to determine the reliability and validity of the data. The data is useful to the authorities in formulating strategies to deal decisively with the issues of bribery practices in Nigeria.

Structural equation modelling of the complex relationship between toothache and its associated factors among Indonesian children.

The Indonesian family life survey (IFLS) is used for formulating various government policies. Our preliminary study using data from the IFLS showed increase in the prevalence of toothache from 2007 to 2014. Hence, a need to analyse the factors associated with toothache using structural equation modelling (SEM) for identifying the direct and indirect association of factors with toothache was evident. The objective of this study is to analyse the complex relationships between toothache and its associated risk factors. This cross-sectional study was conducted on the data obtained from the IFLS in 2014. The IFLS data pertaining to toothache and its prevalence were analysed using the STATA software, and the multifaceted relationship was analysed using SEM. The prevalence of toothache among Indonesian children was 15.55% (1,959 of 12,595). SEM showed the direct association between toothache and age (p < 0.001) and parent awareness of children's health conditions (p < 0.005) and food consumption frequency (p < 0.001). Parents' education level and residential area showed an indirect association with toothache, mediated by socio-economic status and parent awareness of children's health conditions (p < 0.001). We identified the multifaceted relationship between toothache and the social covariates. Parents' awareness of their children's health conditions mediated several indirect associations, highlighting its importance.

Factors the incidence of hypoglycemia in diabetes mellitus patients: A pilot study in the emergency room

OBJECTIVE: Hypoglycemia can cause brain disorders and also the death of patients. Diabetes Mellitus patients who came to the emergency room were around 66.7% with hypoglycemia. This situation requires early prevention so as not to increase the number of patients with hypoglycemia. Good prevention requires factors that are sure to cause hypoglycemia. The purpose of this research was to analyse of factors (occupation, education, knowledge, gender, and age) on the incidence of hypoglycemia in diabetes mellitus (DM) patients in the Emergency room (ER). METHODS: The research design used was descriptive analytic with a cross-sectional design. The population in this study were patients with diabetes mellitus who visit the emergency room. A sample of 37 patients was recruited by consecutive sampling technique. Data analysis was performed by Partial Least Squares-Structural Equation Modeling (PLS-SEM) test. RESULTS: The result shows significant effect on the incidence of hypoglycemia with a value of T=3.844. Characteristic factors of the occurrence of hypoglycemia are gender, occupation, knowledge, education, and age. CONCLUSION: It can be concluded that the characteristics of DM subjects have a significant relationship with the incidence of hypoglycemia in patients in the ER

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A special needs dentistry study of institutionalized individuals with intellectual disability in West Sumatra Indonesia.

People with intellectual disability have a higher risk of oral health problems. This study assessed the clinical oral health status and behaviors and treatment needs of people living in an institution in Padang, West Sumatra, Indonesia. We quantified oral health status of 65 individuals with intellectual disability using Oral Hygiene Index Simplified (OHIs), Angle's classification of malocclusion, Community Periodontal Index and Treatment Need (CPITN), and decay index and also recorded their brushing behavior. We found that males had significantly lower OHIs (p < 0.001), more malocclusion (p < 0.001), greater caries number (p < 0.001), greater CPITN (p = 0.001) and higher need of dental treatment (p < 0.01) than females. Additionally, we found that high caries number was associated with poor OHIS, malocclusion, periodontal disease, and dependent brushing behavior (p < 0.001). The findings of this study imply that there is a gap in appropriate oral health care in individuals with intellectual disability. There should be a greater focus on providing appropriate oral health education to people with intellectual disability, improving the health literacy and quality of care of caregivers, and providing more dentists with specialized training in special needs dentistry.

Beneficial Biological Activities of Cinnamomum osmophloeum and its Potential Use in the Alleviation of Oral Mucositis: A Systematic Review.

The aim of this review was to provide an updated overview of studies on the medical-biological activities of Cinnamomum osmophloeum (C. osmophloeum) in vitro and in vivo and the potential therapeutic use of natural agents prepared from this plant for the alleviation of oral mucositis (OM). Reported articles were collected using web search engine tools. The systematic review was organized according to the preferred reporting items for reviews and meta-analyses (PRISMA) statement. Additional sources were identified through cross-referencing to identify the potential use of C. osmophloeum in the alleviation of OM. The results disclosed that C. osmophloeum is comprised of bioactive ingredients that could act diversely as a reagent in anti-inflammation, antibacterial, antioxidant, anti-hyperglycemic, antidyslipidemia, anti-cancer, renal disease therapy and anti-hyperuricemia capacities. Recent studies revealed that the overall effects on anti-inflammation, wound repair, and the antibacterial and antioxidant activities of its constituents would act as a potential remedy for oral mucositis. Up-to-date in vitro and in vivo studies on the medical-biological activities of C. osmophloeum suggested that C. osmophloeum and its constituents could be promising remedies as adjuvants in OM therapy and warrant further investigation.

Meta-Analysis Comparing Outcomes and Need for Renal Replacement Therapy of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement.

Acute kidney injury (AKI) is commonly associated with aortic valve replacement. Surgical aortic valve replacement (SAVR) is a known risk factor for AKI but little is known about the short- and long-term effects of transcatheter aortic valve implantation (TAVI). The purpose of our analysis is to identify the short- and long-term effect of TAVI on renal outcomes. We searched Medline and PUBMED from January 1, 2000 to November 6, 2017 for randomized control trials (RCTs) comparing TAVI to SAVR in patients with severe aortic stenosis. Three hundred sixty-nine trials were identified, 6 RCTs were included in our analysis. RevMan version 5.3 was used for statistical analysis. Heterogeneity is calculated using I2 statistics. Primary outcomes were AKI within 30 days and 1 year of TAVI, and requirement for renal replacement therapy. We included 5,536 patients (2,796 in TAVI and 2,740 in SAVR arm) from 6 RCTs. Baseline characteristics were similar. There was reduced incidence of AKI at 30 days of TAVI compared with SAVR, 57 versus 133 (odds ratio [OR] 0.40, confidence interval [CI] 0.28 to 0.56, p <0.00001, I2 = 7%) with no difference at 1 year (OR 0.65, CI 0.32 to 1.32, p = 0.23, I2 = 76%) and need for renal replacement therapy OR 0.95, CI 0.50 to 1.80, p = 0.87, I2 = 0%). Permanent pacemaker was more frequent in the TAVI arm compared with SAVR arm, 379 versus 110, (OR 3.75, CI 1.67 to 8.42, p = 0.001, I2 = 89%). In conclusion, TAVI is associated with a reduction in AKIs at 30 days despite the exposure to contrast and higher incidence of new permanent pacemaker placement.