Perbandingan Efektivitas Aromaterapi Peppermint dan Lavender Terhadap Penurunan Efek Mual Muntah Post Kemoterapi

Mual Muntah adalah efek samping paling umum terjadi pada kemoterapi. Meskipun dengan berkembangnya terapi farmakologis mual muntah tetaplah menjadi masalah utama kemoterapi. Dengan bertambahanya terapi non farmakologi untuk antimual salah satunya aromaterapi diharapkan mampu membantu mengurangi efek mual muntah akibat kemoterapi. Penelitian ini bertujuan untuk membandingkan efektifitas aromaterapi peppermint dan lavender dalam menurunkan mual muntah post kemoterapi. Penelitian kuantitatif ini menggunakan pendekatan cross sectional dengan metode penelitian Pra- Eksperimental Design, untuk desain penelitian menggunakan One group pretest-posttest design. Sampel berjumlah 38 responden yang dibagi 2 kelompok berdasarkan dengan jenis kanker, regimen dan siklus kemoterapi yang sama kemudian diberikan aromaterapi berbeda. Penelitian ini menguji pengaruh setiap aromaterapi dengan uji Wilcoxon kemudian membandingkan efektivitasnya menggunakan uji statistik SPSS for Windows Mann-Whitney dikarenakan distribusi data tidak normal setelah diuji dengan shapiro wilk dari uji pengaruh ditemukan hasil p-Value <,001 artinya baik aromaterapi Peppermint dan lavender memiliki pengaruh terhadap penurunan mual muntah post kemoterapi. Berdasarkan hasil rank statistic didapatkan aromaterapi Lavender mendapatkan Rank tertinggi dalam menurunkan mual muntah. Namun, uji beda Mann-Whitney menunjukkan nilai Signifikansi sebesar 0,546 lebih besar dari 0,05 sehingga diartikan tidak terdapat perbedaan yang signifikan dari kedua kategori aromaterapi peppermint dan lavender terhadap penurunan mual muntah post kemoterapi. Aromaterapi peppermint dan lavender dapat digunakan sebagai antimual dalam penatalaksananaan mual muntah post kemoterapi karena Kandungan menthol didalam aromaterapi peppermint sebagai antimual dan linalool pada lavender yang bersifat anticemas mampu menurunkan mual muntah 1-2 skala mual mulai dari mual-muntah berat ke ringan

Functional outcome in operated patients of multilevel lumbar canal stenosis and use of HRQoL role in depicting the anxiety and its correlation with the pain

Background Lumbar canal stenosis (LCS) is a degenerative spinal disease of elderly people, and it not only impairs the mechanical activity but also alters the economic and mental status of the patients indirectly. This is single-center observational prospective study conducted for 2 years and included 30 consecutive operated patients of multilevel LCS patients and excluded the patients with single-level LCS, with primary LCS or with grade II subluxation. We analyzed the various measurement indices used for the surgical outcome assessment as ED-5D 5L and OLBPDI (Oswestry low back pain disability index). Statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 21.0 statistical Analysis Software. The independent t test, post hoc analysis, Wilcoxon signed rank statistic test and RM-ANOVA test were also applied. Result Most patients have improvement in pain and all the components of HRQoL (health-related quality of life) after surgery, which was further improved in mean follow-up of 1 year. Our study also suggested that the patients with higher anxiety/depression have higher pain intensity and low HRQoL, which was persistent in postoperative period (p < .001). Conclusion ED-5D 5L and OLBPD are good indices to assess all the components of quality of life and give valuable information overall. Anxiety has shown important correlation with the pain component in both preoperative and postoperative phase.

Adaptive group sequential survival comparisons based on log-rank and pointwise test statistics

Whereas the theory of confirmatory adaptive designs is well understood for uncensored data, implementation of adaptive designs in the context of survival trials remains challenging. Commonly used adaptive survival tests are based on the independent increments structure of the log-rank statistic. This implies some relevant limitations: On the one hand, essentially only the interim log-rank statistic may be used for design modifications (such as data-dependent sample size recalculation). Furthermore, the treatment arm allocation ratio in these classical methods is assumed to be constant throughout the trial period. Here, we propose an extension of the independent increments approach to adaptive survival tests that addresses some of these limitations. We present a confirmatory adaptive two-sample log-rank test that allows rejection regions and sample size recalculation rules to be based not only on the interim log-rank statistic, but also on point-wise survival rate estimates, simultaneously. In addition, the possibility is opened to adapt the treatment arm allocation ratio after each interim analysis in a data-dependent way. The ability to include point-wise survival rate estimators in the rejection region of a test for comparing survival curves might be attractive, e.g., for seamless phase II/III designs. Data-dependent adaptation of the allocation ratio could be helpful in multi-arm trials in order to successively steer recruitment into the study arms with the greatest chances of success. The methodology is motivated by the LOGGIC Europe Trial from pediatric oncology. Distributional properties are derived using martingale techniques in the large sample limit. Small sample properties are studied by simulation.

KECEMASAN ANAK DITINJAU DARI KECEMASAN ORANG TUA DI RSU. BHAKTI HUSADA KRIKILAN

Introduction: Illness and hospitalization cause a crisis in children's lives. In the hospital, the child must face an unfamiliar environment. Often they have to undergo procedures that cause pain, loss of independence and various unknowns. Anxiety that occurs in hospitalized children can be caused by separation which is indicated by refusing to eat, crying and being uncooperative with health workers. Loss of control causes children to become irritable and aggressive, loss of self-concept and body image. Objective: The purpose of this study was to determine the anxiety of children in terms of the anxiety of parents in the RSU. Bhakti Husada Krikilan. Methods: This study uses a correlational design with the type of research used is descriptive analytic. The population in this study was the average of pediatric patients and their parents during the last 3 months in the Inpatient Room at the RSU. Bhakti Husada Krikilan as many as 60 people. Sampling technique using simple random. The tool for the data collection process is a questionnaire sheet, which is then analyzed by the Spearman Rank statistic test. The decision was taken by comparing the p value < 0.05. Results: Based on the results of the study showed that from 49 respondents showed that most of the respondents had parental anxiety in the moderate category as many as 33 people (67.3%). While most of the respondents had child anxiety in the severe category as many as 28 people (57.1%). Based on the results of the Spearman Rank test, it is known that there is a relationship between children's anxiety in terms of parental anxiety at the RSU. Bhakti Husada Krikilan Banyuwangi in 2020 because the p value < 0.05, which is 0.25. Conclusion: Parents with excessive anxiety tend to be more afraid of things that are uncertain. This keeps them from paying close attention to what is really going on and what is in front of them. So, this will make parenting not work as it should. This condition also triggers anxiety in children. For this reason, it is necessary to increase assistance to children to provide a sense of security and comfort so that children's anxiety will decrease

DETERMINING PROBABILITY OF CANCER CELL TRANSFOMATION AT HUMAN PAPILLOMAVIRUS INFECTION

Aim. The purpose of the work was to assess the probability of cancerous transformation of cells for viruses of high and low oncogenic risk. Aim. The purpose of the work was to assess the probability of cancerous transformation of cells for viruses of high and low oncogenic risk. Results. Using normalized squared error (NSE) for viruses of high (20 strains) and low (153 strains) oncogenic risk, rank statistic of 2-exponential type was build. For productive papillomavirus infection, NSE function was determined as the growing accurate 2-exponent of a cell layer basal to the epithelial surface. Logarithm of NSE numerical values is proportional to the cell entropy that is connected with the availability of virus DNA. To calculate entropy, generalized Hartley formula was used with the informational cell of dimension d: H = NdLOG(NSE), where N is the generalized cell coordinate. Conclusions. Using a statistical ensemble of E6 proteins separately for viruses of high and low oncogenic risk made it possible to assess the probability of cancerous transformation of cells, which was proportional to the ratio of the area of entropy of cancer transformation to the area of the productive entropy region papillomavirus infection.

Effect of the "Common House" program on the ecological awareness of regular basic education students in Lima

This research shows the benefits of applying the innovative program "Common House" that allows students to develop knowledge, attitudes and behaviors that demonstrate and consolidate a fraternal relationship with Sister Nature. Fourteen sessions were held in the experimental group and there was a control group that served to compare the impact of the program. The sample consisted of 50 high school students from an Educational Institution in Lima. To measure the level of ecological awareness, a Likert scale was created that was validated by expert judgment and reached a reliability of Cronbach's Alpha = .910. The results of the program were estimated by the non-parametric rank statistic of U Mann Whitney (p < α = 0.05). It is concluded that the “Common House” program is effective in developing levels of ecological awareness in secondary school students.

Reproducibility of mass spectrometry based metabolomics data

Background Assessing the reproducibility of measurements is an important first step for improving the reliability of downstream analyses of high-throughput metabolomics experiments. We define a metabolite to be reproducible when it demonstrates consistency across replicate experiments. Similarly, metabolites which are not consistent across replicates can be labeled as irreproducible. In this work, we introduce and evaluate the use (Ma)ximum (R)ank (R)eproducibility (MaRR) to examine reproducibility in mass spectrometry-based metabolomics experiments. We examine reproducibility across technical or biological samples in three different mass spectrometry metabolomics (MS-Metabolomics) data sets. Results We apply MaRR, a nonparametric approach that detects the change from reproducible to irreproducible signals using a maximal rank statistic. The advantage of using MaRR over model-based methods that it does not make parametric assumptions on the underlying distributions or dependence structures of reproducible metabolites. Using three MS Metabolomics data sets generated in the multi-center Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPD) study, we applied the MaRR procedure after data processing to explore reproducibility across technical or biological samples. Under realistic settings of MS-Metabolomics data, the MaRR procedure effectively controls the False Discovery Rate (FDR) when there was a gradual reduction in correlation between replicate pairs for less highly ranked signals. Simulation studies also show that the MaRR procedure tends to have high power for detecting reproducible metabolites in most situations except for smaller values of proportion of reproducible metabolites. Bias (i.e., the difference between the estimated and the true value of reproducible signal proportions) values for simulations are also close to zero. The results reported from the real data show a higher level of reproducibility for technical replicates compared to biological replicates across all the three different datasets. In summary, we demonstrate that the MaRR procedure application can be adapted to various experimental designs, and that the nonparametric approach performs consistently well. Conclusions This research was motivated by reproducibility, which has proven to be a major obstacle in the use of genomic findings to advance clinical practice. In this paper, we developed a data-driven approach to assess the reproducibility of MS-Metabolomics data sets. The methods described in this paper are implemented in the open-source R package marr, which is freely available from Bioconductor at http://bioconductor.org/packages/marr.

Systemic effect of radiotherapy before or after nivolumab in lung cancer: an observational, retrospective, multicenter study

Background: The combination of radiotherapy (RT) and programmed death 1 inhibitors seems to increase antitumor immune responses. Objective: To assess the outcome and the role of the best combination sequence, i.e. immunotherapy given before, during, and/or after RT, in patients with non-small cell lung cancer (NSCLC). Methods: We conducted an observational, retrospective analysis of 95 consecutive patients with advanced NSCLC who received any radiotherapy treatment and nivolumab, as clinically indicated. Median overall survival (OS) and the 95% confidence interval (CI) were estimated with the Kaplan-Meier method. Cox model was used to obtain hazard ratio (HR) and associated 95% CI with statistical inference by log-rank statistic. Results: Median OS was 11.9 months (95% CI, 6.6–17.2). Patients who received radiotherapy during an immune checkpoint inhibitor treatment started more than 60 days before showed a better outcome than patients who started immunotherapy over 60 days after RT ending (HR, 2.90 [1.37–6.12], p = 0.005; median OS, 22.4 months vs 8.6 months, p = 0.005). Median progression-free survival was 6.3 months (95% CI, 4.6–8.0). Conclusions: This study shows that combining irradiation with nivolumab for the treatment of advanced NSCLC leads to improved OS. The optimal time window for the combination of RT and immunotherapy seems to play a critical role for therapeutic antitumor response derived by abscopal effect.

Determinants of Mortality Among Severely Malnourished Children in Northern Nigeria

Objectives Severe Acute Malnutrition is a significant cause of mortality in children under the age of 5 years in low-resource settings, including Northern Nigeria. The study aimed to determine the associations between selected risk factors and mortality outcomes in children admitted with SAM in a facility in Katsina State, Northern Nigeria. Methods A prospective observational cohort of 201 children aged 6 to 59 months who were admitted with severe acute malnutrition (SAM) in stabilization centers in Katsina State, Northern Nigeria between May 18, 2021, and July 20, 2021, (63 days) were assessed followed up. Outcomes were analyzed using Kaplan-Meir analysis to estimate time to death, and Cox proportional-hazard regression model was used to determine predictors of mortality. Results The log-rank test showed significant differences in the probability of death between categories of diarrheal status (log-rank statistic = 9.760, P = .021) and presence of existing disease (comorbidity) (log-rank statistic = 5.338, P = .021). The study identified that severely malnourished children admitted with comorbidities showed significant association with time to event (death) (AHR: 4.109, 95% CI: 1.51, 32.60). The estimated mean time until death was 57.9 days (±3.0) for children without comorbidities and 20.1 (±3.0) days for children with comorbidities. The median survival time was 18 days for children with comorbidities. Conclusion The presence of comorbidities was significantly associated with mortality. Severely malnourished children with comorbidities had 4 times higher mortality risk than severely malnourished children admitted without comorbidities. Clinicians and health workers should give due emphasis to the early detection and effective management of comorbidities in children with severe acute malnutrition.

Discovery of biomarker candidates associated with the risk of short-term and mid/long-term relapse after infliximab withdrawal in Crohn’s patients: a proteomics-based study

ObjectiveA subset of Crohn’s disease (CD) patients experiences mid/long-term remission after infliximab withdrawal. Biomarkers are needed to identify those patients.DesignNew biomarkers of relapse were searched in the baseline serum of CD patients stopping infliximab when they were under combined therapy (antimetabolite and infliximab) and stable clinical remission (diSconTinuation in CrOhn’s disease patients in stable Remission on combined therapy with Immunosuppressors cohort, n=102). From shotgun proteomics experiment (discovery step), biomarker candidates were identified and further targeted by selected reaction monitoring (verification step). The dataset was stratified to search for markers of short-term (<6 months) or mid/long-term relapse (>6 months). The risk of relapse and the predicting capacity associated with biomarker candidates were evaluated using univariate Cox model and log-rank statistic, respectively. To test their complementary predicting capacity, biomarker candidates were systematically combined in pairs.ResultsDistinct biomarker candidates were associated with the risk (HR) of short-term (15 proteins, 2.9<HR<16.1, p<0.05) and mid/long-term (17 proteins, 2.1<HR<4.7, p<0.05) relapse, they reflect different pathophysiological processes. In stratified and non-stratified datasets, novel marker combinations exhibited a high predicting capacity as shown by their higher Z-scores (false discovery rate <0.001) than C reactive protein and faecal calprotectin (current references in predicting relapse).ConclusionWe identified for the first time circulating biomarker candidates associated with the risk of mid/long-term relapse in CD patients stopping infliximab. We also highlight a sequence of pathophysiological processes leading to relapse, this could help to better understand the disease progression. Our findings may pave the way for a better non-invasive evaluation of the risk of relapse when contemplating antitumour necrosis factor α withdrawal in CD patients.