Impact of Muscle Mass on Survival in Patients with Sepsis: A Systematic Review and Meta-Analysis

<b><i>Introduction:</i></b> The aim of this study is to investigate the association between loss of muscle mass and prognosis of sepsis. <b><i>Methods:</i></b> Six databases, including PubMed, Embase, Cochrane Library, Web of Science, Scopus, and Ovid, were searched by the deadline of August 18, 2020. A meta-analysis was conducted on the collected data by means of a random-effects model. The quality of each included article was assessed according to the Newcastle-Ottawa Scale. <b><i>Results:</i></b> Out of 1,819 references, 6 articles and 1 conference abstract were included. Sepsis patients with a loss of muscle mass or sarcopenia had higher mortality (risk ratio [RR]: 1.94, 95% confidence intervals [CI]: 1.59–2.37; I-squared = 18.7%, <i>p</i> &#x3c; 0.001). The RR of mortality within 30 days (RR: 2.31, 95% CI: 1.78–2.99, <i>p</i> &#x3c; 0.001) was higher than that of mortality over 30 days. Loss of psoas muscle mass, as evaluated by CT, showed the highest RR of sepsis mortality. In addition, based on data on overall survival retrieved from 4 trials, the pooled hazard ratio (HR) for patients with a loss of muscle mass or sarcopenia was 3.04. Subgroup analysis showed that survival time was the main source of heterogeneity for the overall HR. Furthermore, the scanning areas of muscle mass in survival patients were 0.33 cm²/m² higher than those measured in deceased patients. <b><i>Conclusion:</i></b> A loss of muscle mass, as evaluated by CT scan, was associated with a poor outcome in sepsis.

Communication of Diagnosis of Infertility: A Systematic Review

Background: When infertility is diagnosed, physicians have the difficult task to break bad news. Their communication skills play a central role in improving patients' coping abilities and adherence to infertility treatments. However, specific guidelines and training courses on this topic are still lacking. The aim of the present study is to provide some practical advice for improving breaking bad news in infertility diagnosis through a systematic literature review of qualitative and quantitative studies.Methods: Electronic searches were performed in the MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Psychology and Behavioral Sciences Collection databases. All articles focusing on the communication of the diagnosis of infertility were included. The main findings of each included article were then summarized.Results: Literature search identified 11,838 references that were screened for eligibility. Full texts of 81 articles were retrieved, and their analysis led to the inclusion of 4 articles, which treated the theme of communication of infertility only partially. The main addressed aspects concerning the communication of the infertility diagnosis were the following: (i) the value that patients give to healthcare professionals' communication skills; (ii) the importance of giving clear information on diagnostic procedures and treatments in order to decrease patients' anxiety; and (iii) the importance of involving both partners.Conclusions: This review pointed out that the communication of the infertility diagnosis is still underinvestigated. Specific guidelines are currently not available, but other protocols could be used. Taking into account the principal aspects of communication highlighted with this review, in this study, we suggested an adaptation of the original SPIKES protocol that could be used by healthcare professionals for the communication of the infertility status.

COMPARISON OF KETOROLAC VERSUS DICLOFENAC AS TREATMENT FOR ACUTE RENAL COLIC: A SYSTEMATIC REVIEW AND A NETWORK META-ANALYSIS (DIRECT AND INDIRECT COMPARISON)

Objective: The purpose of this study is to compare which analgesic is better between ketorolac and diclofenac. Material & Methods: A systematic search was conducted in Pubmed, Science Direct, Cochrane, EBSCO, Proquest database, and PICO analysis was used in determining the study question. The included article in the analysis was randomized controlled trials. Results: A total of 6 articles were included in the analysis, with no significant differences between ketorolac and diclofenac both in a direct comparison and indirect comparison (OR 2.74 [95%CI 0.72 – 10.43]; p= 0.14 and OR 0.51 [95%CI 0.29 – 0.91]; p= 0.49). Conclusion: Both ketorolac and diclofenac have the same efficacy in treating renal colic.

Library technicians collaborating with librarians on knowledge syntheses: a survey of current perspectives

Introduction: Though it is well recognized that librarians bring value to knowledge synthesis teams, library technicians have largely been excluded from this process. This study was designed to determine the extent to which library technicians are currently participating in knowledge syntheses, to investigate where these two professional groups, librarians and library technicians, see opportunities for future collaboration, and to identify the challenges and successes perceived by both groups. Methods: An electronic survey, consisting of multiple choice and short answer queries, was distributed to targeted listservs. The target audience for survey participants was librarians, or library technicians, who worked in a library with any scale of knowledge synthesis service. Responses were collated, coded, and organized by themes. Results: 170 responses were received and evenly represented librarians (n=84) and library technicians (n=79), including 7 incomplete responses. 31% (n=50) of respondents stated that they currently collaborate or have collaborated in the past on knowledge synthesis projects with the other professional group. Tasks completed by the library technician included article retrieval, citation management, retrieving reference lists, and database searching. The major challenge reported with collaboration on knowledge synthesis projects was the library technician qualifications. Major successes included time efficiency for librarians, and the opportunity for technicians to develop new skills.

Analisis Penerapan Kode Etik Jurnalistik Pada Pemberitaan Pemindahan Ibu Kota Indonesia di Liputan6.com

Freedom of the Press is the right to express, disseminate ideas, organize, and so forth. Freedom of the Press is based on the provisions made by the Press Council called the Journalistic Code of Ethics. The Journalistic Code of Ethics is the professional ethics of journalists. As the party that disseminates information to the public, journalists need to practice the provisions of the Journalistic Code of Ethics which consists of 11 articles, because various news reports that journalists report should have an impact on society. Then, one of the news that received more attention from the public, namely regarding the relocation of the Indonesian capital. At that time, the news received various responses from various parties. Therefore, various media are aggressively producing news related to this, such as Liputan6.com. In this study, the Journalistic Code of Ethics analyzed with the news included article 1, 2, and 3. The purpose of this study was to determine the application of the Journalistic Code of Ethics in reporting the removal of the Indonesian Capital City on Liputan6.com. Theories used include news reporting and the Journalistic Code of Ethics. Then, for the research method used, namely quantitative content analysis using coding sheets to process, and analyze the data. The results of this study indicate Liputan6.com has implemented a Journalistic Code of Ethics, although of the 55 news samples there are still 19 news that do not meet the element of balance.Kebebasan pers merupakan hak untuk berekspresi, menyebarluaskan gagasan, dan berorganisasi. Kebebasan pers dilandasi oleh ketentuan yang dibuat Dewan Pers yang disebut Kode Etik Jurnalistik. Kode Etik Jurnalistik adalah etika profesi wartawan. Sebagai pihak yang menyebarkan informasi kepada khalayak, jurnalis perlu mempraktikan ketentuan Kode Etik Jurnalistik yang terdiri dari 11 pasal. Hal ini karena berbagai berita yang jurnalis laporkan akan memberi dampak pada masyarakat. Salah satu pemberitaan yang mendapatkan perhatian lebih dari masyarakat, yaitu mengenai pemindahan ibu kota Indonesia. Pada saat itu, kabar tersebut mendapatkan berbagai respon dari berbagai pihak. Oleh karena itu, berbagai media gencar dalam memproduksi berita terkait hal tersebut, salahsatunya Liputan6.com. Pada penelitian ini, Kode Etik Jurnalistik yang dianalisis dengan pemberitaan tersebut, antara lain pasal 1, 2, dan 3. Tujuan dari penelitian ini ialah untuk mengetahui penerapan Kode Etik Jurnalistik pada pemberitaan pemindahan Ibu Kota Indonesia di Liputan6.com. Teori yang digunakan diantaranya pemberitaan, dan Kode Etik Jurnalistik. Metode penelitian yang dipakai yakni analisis isi kuantitatif dengan memakai lembar codinguntuk mengolah, dan menganalisis datanya. Hasil dari penelitian ini menunjukan Liputan6.com sudah menerapkan Kode Etik Jurnalistik, meskipun dari 55 sampel berita masih terdapat 19 berita yang tidak memenuhi unsur keberimbangan.

INVESTIGATIVE TECHNIQUES IN THE DIGITAL AGE: CYBERCRIME AND CRIMINAL PROFILING

<p>The advent of the Internet and social networks has reduced human and empathic relationships, consequently increasing virtual ones. Cyberspace offers the possibility of carrying out illegal acts with the perception of remaining unpunished. In this article we discussed the differences between crime and cybercrime which takes different forms within cyberspace such as cyberstalking, cyberbullying, online sexual offences and property crimes such as white-collar crimes. Furthermore, the evolution of criminal profiling in the digital age has been described and the profile of the cyber-criminal has been defined as outlined by the Italian State Police. The multiplication of criminal activities perpetrated through the web has led the Legislator to wonder about the most effective repressive methods to repress and try to ward off the numerous dangers that are wandering within cyberspace. The Italian legislator, through various legislative interventions, has introduced changes to the Penal Code as in article 612-bis, introducing in paragraph 2 an increase in punishment for the case in which the crime is committed through IT tools such as e-mail, SMS, chat malware and, above all, social networks. Also, the legislator included article 612-ter in the Penal Code to prosecute the illegal dissemination of sexually explicit images and videos. Finally, criminological research must consider that cybercrime has different variables than traditional crime and the evaluation of criminal behaviour should take into account the influence of the virtual dimension on the cognitive processes of the subjects.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0548/a.php" alt="Hit counter" /></p><a href="https://doi.org/10.5281/zenodo.3877668"><img src="https://zenodo.org/badge/DOI/10.5281/zenodo.3877668.svg" alt="DOI" /></a>

Prevalence of Neonatal Sepsis in Ethiopia: A Systematic Review and Meta-Analysis

Introduction. Neonatal sepsis is a systemic infection occurring in infants during the first 4 weeks of life and is a major cause of mortality and morbidities of newborns due to their age-related weak and immature immune systems. In Ethiopia, despite many studies being conducted on neonatal sepsis, the reported findings are inconsistent. The aim of this study is to determine the prevalence of neonatal sepsis to enhance the utility and interpretation of the evidence. Methods. An extensive systematic review and meta-analysis were performed to extract studies on the prevalence of neonatal sepsis in Ethiopia. The PubMed, Cochrane Library, ScienceDirect, Web of Science, and Google Scholar were systematically searched. Two independent authors selected and extracted the data from each included article. The heterogeneity of included studies was assessed using the Higgins I2 test, and a random-effects model was performed in Stata/se Version 14. Results. Eighteen studies with a sample size of 10,495 study subjects were included with a reported range of neonatal sepsis from 17% to 78%. The pooled prevalence of neonatal sepsis was 45% (95% CI: 35, 55; I2=99.3%, p<0.01). Early onset neonatal sepsis was found to have a prevalence of 75.4% (95% CI: 68.3, 82.6). Subgroup analysis in the study area (i.e., by region) was calculated revealing the highest neonatal sepsis in Amhara region at 64.4% (95% CI: 44.9, 84.0) and the lowest in Southern Nations, Nationality, and People at 28% (95% CI: 16, 40). Conclusion. In this review, the prevalence of neonatal sepsis in Ethiopia was found to be high, especially in terms of early onset neonatal sepsis. As a result of the findings, it is important to consider the early and optimal points for interventions to better manage the prevalence and outcomes of neonatal sepsis. Further research is needed to investigate the neonatal sepsis status at different regions and associated factors for neonatal sepsis not yet studied.

The state of mHealth development and use by palliative care services in sub-Saharan Africa: a systematic review of the literature

BackgroundCurrent coverage of palliative care services in sub-Saharan Africa (SSA) remains woefully inadequate, but harnessing mHealth could be one approach to facilitate greater service coverage and engagement with patients with life-limiting progressive disease.AimsA systematic literature review to identify the development and use of mHealth in palliative care services in SSA.Methods13 electronic databases from 1990 to 2015 were searched alongside the manual searching of journals and citation searching of included article reference lists. Articles were assessed against inclusion and exclusion criteria and study details extracted and tabulated by two researchers. Studies were plotted against a modified WHO mHealth and ICT framework to classify how they are targeting health system strengthening.ResultsOf the 1110 articles identified, 5 met the inclusion criteria, describing mHealth use in Nigeria, Uganda, Kenya and Malawi. Descriptive analysis has shown that existing mHealth interventions for palliative care services in SSA are limited in number and are being developed for use at the palliative treatment, guidance and coordination stage of care provision. Levels of detail about the development and structure of interventions are low.ConclusionsmHealth interventions for palliative care in SSA are limited. This is an opportune time to explore how evidence-based mHealth interventions could form part of the evolving palliative care services in the region.

Active Compounds of Rhubarb Root and Rhizome in Animal Model Experiments of Focal Cerebral Ischemia

Rhubarb root and rhizome (RRR) has been clinically used for stroke at least 2000 years and is still used in modern times in both China and elsewhere worldwide. The objective of present study was to evaluate the efficacy of active compounds of RRR (ACRRR) for experimental ischemic stroke. Studies of ACRRR in animal models of ischemic stroke were identified from 5 databases until April 2014. Study quality for each included article was evaluated according to the CAMARADES 10-item checklist. Outcome measures were neurological deficit score and infarct size. All the data were analyzed using RevMan 5.1 software. As a result, 20 studies were identified describing procedures involving 577 animals. The quality score of studies ranges from 2 to 6, and the median was 3.4. Six studies showed significant effects of ACRRR for improving infarct size compared with model group (P<0.01). Six studies indicated significant effects of ACRRR for improving the neurological deficit scores according to Zea longa criterion or eight-point criterion (P<0.01). In conclusion, these findings demonstrated a possible efficacy of ACRRR that have potential neuroprotective effect for experimental ischemic stroke. However, these apparently positive findings should be interpreted with caution because of the methodological flaws.

Rethinking Indirect Responsibility

In its Draft Articles on the Responsibility of International Organizations, the International Law Commission included Article 17 in order to regulate instances in which binding decisions and authorizations were made by international organizations that bound or applied in respect of their member States. Given that courts have struggled in vain to come up with a uniform approach applicable in such situations, one would expect that Article 17 would have been a cause for celebration. Commentators, however, lamented the inclusion of the provision, arguing that it cannot function effectively because it forms part of the problematic Chapter IV that regulates scenarios of indirect responsibility. The article rejects this approach. For the first time, it offers an integrated normative analysis of all Chapter IV provisions, and calls on the reader to rethink indirect responsibility in a way that advances and promotes coherence in the law of international responsibility. The paper adopts a contextual approach, and suggests that this understanding of Article 17 offers courts a twofold opportunity: first, the ability to effectively tackle cases that have troubled them to date; and second, to initiate a change in the way in which States and international organizations interact in the international arena.