Checklist Of Signs Research Articles

Enhancing hemodynamic stability: the role of liaison nurses in patient transfers to angiography

IntroductionAngiography is associated with anxiety, stress, and changes in patients’ vital signs. The role of the liaison nurse is to bridge gaps and solve problems between departments, thereby preventing the occurrence of undesired complications during patient transfers. Proper preparation of patients by the liaison nurse may lead to an improvement in the hemodynamic status of patients. The present study was conducted to investigate the effect of liaison nurse on hemodynamic status during transfer process to angiography.MethodThis randomized controlled trial was conducted from December 2019 to March 2020 on 62 patients who were candidates for elective angiography at Imam Reza Hospital in Mashhad. Participants were selected using a convenience sampling method and then randomly assigned to either the control or intervention group using a lottery system. In the intervention group, patients benefited from the presence of a liaison nurse from the moment the transfer order was issued by the doctor. Tools used included a demographic information questionnaire and a hemodynamic signs checklist. Data were analyzed using SPSS 25 with independent T-tests, paired T-tests, Wilcoxon, Mann-Whitney test, chi-squared, and Fisher’s exact test.ResultFollowing the intervention, the mean systolic blood pressure, heart rate, and respiratory rate in the intervention group were found to be significantly lower than those in the control group (p < 0.05). In contrast, the mean body temperature, diastolic blood pressure and the percentage of arterial blood oxygen saturation did not exhibit a statistically significant difference between the two groups (p > 0.05).ConclusionThe liaison nurse role emerges as a valuable strategy for enhancing patients’ hemodynamic stability, and its implementation can have a positive impact on patient outcomes in hospital settings.

Comparative clinical study of Mist Amen Fevermix and Edhec Malacure: two polyherbal products used for the treatment of uncomplicated malaria in Ghana against Artemether/Lumefantrine

The use of herbal products for the treatment of malaria, has increased globally. However, inadequate scientific studies about the safety and effectiveness of such herbal products have been raised. Also, the reduced sensitivity of the malaria parasites to artemisinin-based combination therapies is of concern. There is therefore the need for new antimalarial medications including those from alternative sources such as herbal medicinal products. In this study, a prospective, comparative parallel group randomized, clinical study was done to assess the safety and effectiveness of Mist Amen Fevermix and Mist Edhec Malacure with Artemether/Lumefantrine as control at the Tafo Government Hospital, Kumasi between July and November 2019, after Committee on Human Research, Publication and Ethics approval (CHRPE/AP/424/19). The study was conducted in accordance with Good Clinical and Laboratory Practice (GCLP) and registered with the Pan African Clinical Trials Registry with trial number PACTR202109664146698. Participant completed an informed consent form. Randomization was based on a single sequence to allocate participants to a group. SPSS version 19. One-way ANOVA test and exploratory statistics was used for data analysis. Total sample size was 150 participants with 50 on each arm of the group. Male and female patients aged 15–45 years and meet inclusion criteria with clinically established malaria were treated with Mist Amen Fevermix and Mist Edhec Malacure, at the specified doses of 45 mls (0.1063 g) and 30 mls (0.0521 g) three times daily after meals for three days. Artemether/Lumefantrine was administered at a dose of 80/480 mg/kg twice daily after meals for three days. Baseline data was taken on day 0. Patients were then followed up on Day 3, 7 and 28 to establish treatment outcomes and any side effect using a checklist for signs and symptoms and Karnofsky’s scale to assess the quality of life. Mist Amen Fevermix was effective with a cure rate of 95.89%. Mist Edhec Malacure was also effective with a cure rate of 91.87%. The cure rate of Artemether/Lumefantrine was 97.25%. Kidney and liver panels were within normal reference range at the end of the 28-day study. This study supports the use of Mist Amen Fevermix and Mist Edhec Malacure, two multi-component products as safe and effective for the treatment of uncomplicated malaria. Both products achieved a comparable clinical treatment outcome with Artemether/Lumefantrine.

Checks and balances: a meta-analysis on the known-groups validity of functional postural control tests in children.

Pediatric physical therapists commonly treat children with postural control deficits. Ideally, pediatric functional postural control tests should therefore be able to identify postural control deficits in children with various disorders. Despite a plethora of available tests, evidence for their validity - especially known-groups - remains scarce. This review aims to determine the known-group validity of available functional postural control tests to differentiate various pediatric pathological groups of different ages from their typically developing (TD) peers. PubMed, Web of Science and Scopus were systematically searched (last update: February 2023; PROSPERO: CRD42023408982). Forty case-control studies with a pathological pediatric sample (N.=1331) and TD peers (N.=1889) were included and selected for data-extraction and -analysis. Risk of bias was assessed using the SIGN checklist and level of evidence was scored using GRADE. Random-effect meta-analyses were performed to estimate pooled standardized mean differences (SMD) for the various test types and subclassified based on pathology and/or age. When compared with TD peers, children with underlying pathologies performed significantly worse on pediatric functional postural control test batteries (SMD=-2.21), the Timed Up and Go Test and variants (SMD=2.30), the One Leg Stance test and variants (SMD=-2.14), while the Reach tests showed a smaller difference (SMD=-1.19). Subclassification within the meta-analyses showed that pathology was an influencing factor for the test batteries and the one leg stance test and variants. Age was an influencing factor for the reach tests. None of the included functional postural control tests exceeded a low level of evidence. Pediatric functional postural control tests that assess multiple aspects of postural control (such as test batteries) seem to offer higher known-groups validity than single-task tests (e.g. reach tests). The underlying pathology has a larger impact on the validity of these tests than age. There remains an overall low level of evidence for the known-groups validity of pediatric functional postural control tests indicating the need for research with more homogenous groups and norm reference data.

Penggunaan buku saku SD (Stop Dehidrasi) dalam mencegah dehidrasi pada remaja

Dehydration in adolescents is one of the things that can affect the concentration of adolescents during education and other activities. This condition can cause the body not to function normally. Dehydration itself is often thought of as simple thirst. In fact, if not appropriately treated, dehydration can develop into more serious, such as hypovolemia. Based on this, activities are needed that can overcome the level of knowledge of adolescents in overcoming and preventing dehydration. The SD Pocket Book (Stop Dehydration) is a media that contains information on how to calculate fluid needs, how to drink well, and signs of dehydration experienced by adolescents, as well as a checklist of signs of dehydration as an illustration so that adolescents can understand the actions that need to be taken before being taken to the hospital or that can be done alone at home. SMP 2 N Lubuklinggau is one of the junior high schools located in the working area of the Citra Medika Health Center at a distance of 5 KM from the Puskemas. The implementation and evaluation have been carried out from June to September 2023. The results of the evaluation carried out increased knowledge and decreased the number of visits to the School Health Unit (UKS).

Study on primary screening technique for children with autism spectrum disorder

To explore screening tools for children with autism spectrum disorder (ASD), which are convenient for primary hospitals, it can provide basic data for formulating ASD prevention policies. This was a cross-sectional study by cluster sampling. Huyi District and Xincheng District were extracted for investigation in Xi'an City. From July 2021 to September 2022, all children aged from 3 months to 36 months who live in the two districts were subjected to primary screening. The child care physician used the routine screening tool "warning signs checklist for screening psychological, behavioral and developmental problems of children" and cartoon pictures of "early high-risk warning signs of autism", the children who were positive in the initial screening were referred to the district level maternal and child health hospital for re-screening, and those who were positive in the re-screening were referred to Xi 'an Children's Hospital for diagnosis. The results showed that a total of 17 905 children aged from 3 months to 36 months were initially screened in the two districts, including 10 588 children aged from 18 months to 36 months, 50 children who were positive in the initial screening and 50 children who were re-screened. 23 children (18 boys and 5 girls) were diagnosed with ASD. The prevalence rate of ASD in children was 2.17‰ (95% confidence interval:1.29‰-3.06‰). 42 children were positive for "warning signs checklist" at the preliminary screening, and 19 were confirmed as ASD. 27 children were positive for "cartoon pictures" in the preliminary screening, and 23 were confirmed with ASD. The "cartoon pictures" in the preliminary screening and diagnosis of consistent rate was higher than the "warning signs checklist", two kinds of screening methods comparison were statistically significant difference in the odds of consistent (χ2=11.01, P=0.001). In conclusion, relying on the three-level network of maternal and child health care, it is conducive to the whole process management of screening and diagnosis of children with ASD, and to guide the formulation of prevention policies. The cartoon pictures of "early high-risk warning signs of autism" can assist the identification of children with ASD based on the "warning signs checklist", which is simple, effective and suitable for promotion in the community health care.

Sign Language Studies with Chimpanzees in Sanctuary.

Adult chimpanzees Tatu and Loulis lived at the Fauna Foundation sanctuary. They had acquired signs of American Sign Language (ASL) while young and continued to use them as adults. Caregivers with proficiency in ASL maintained daily sign language records during interactions and passive observation. Sign checklists were records of daily vocabulary use. Sign logs were records of signed interactions with caregivers and other chimpanzees. This study reports sign use from eight years of these records. Tatu and Loulis used a majority of their base vocabularies consistently over the study period. They used signs that they had acquired decades earlier and new signs. Their utterances served a variety of communicative functions, including responses, conversational devices, requests, and descriptions. They signed to caregivers, other chimpanzees, including those who did not use signs, and to themselves privately. This indicates the importance of a stimulating and interactive environment to understand the scope of ape communication and, in particular, their use of sign language.

Acute and subacute clinical markers after sport-related concussion in rugby union players.

The purpose of this study was to investigate the relationship between on-field post-concussion symptoms reported by athletes, on-field neurological signs reported by a trainer or physician, and/or post-concussion symptoms 72 h after brain injury in male rugby players. Cross-sectional study in a Sports Concussion Clinic setting. We enrolled 92 adult rugby union players, within the first 72 h after sport concussion. Four scales were measured. Immediate Concussion Sign Checklist (sideline); Immediate Concussion Symptom Checklist (24 h after concussion); Post-Concussion Symptoms Scale and Beck Depression Inventory (in-office 72 h after concussion). Odds ratios revealed that overtly symptomatic athletes were over 2.6 times more likely (p = 0.047) to exhibit post-traumatic amnesia than asymptomatic athletes. There were no differences in terms of on-field loss of consciousness or confusion. Immediate symptoms reported by athletes retrospectively were associated with symptoms reported on the Beck Depression Inventory (odds ratio 2.8; 95 % confidence interval 1.14-6.88), headache (odds ratio 4.9; 95 % confidence interval 1.92-12.79), memory concerns (odds ratio 3.15; 95 % confidence interval 1.06-9.34), pressure in the head (odds ratio 2.8; 95 % confidence interval 1.03-8.08), and visual disturbances (odds ratio 3.9; 95 % confidence interval 1.05-14.50) reported 72 h after sports concussion. Athletes who were overtly symptomatic after sports concussion were significantly more likely to experience post-traumatic amnesia and two or more on-field concussion signs relative to those athletes who were asymptomatic. Also, players with immediate symptoms reported higher depressive symptoms, somatic symptoms (headache and visual disturbances), and cognitive symptoms.

Establishing Core Symptoms of Acute Serotonin Reuptake Inhibitor Withdrawal: Results from an International Survey of Online Peer-Support Communities.

Serotonin reuptake inhibitor (SRI) antidepressants are commonly associated with withdrawal reactions. The Discontinuation Emergent Signs and Symptoms (DESS) checklist has been considered the gold standard research and screening tool for SRI withdrawal but has several limitations, including its length, lack of specificity, and omission of baseline symptom and symptom severity scores, making it impractical for use in clinical or research settings. We investigated the prevalence and severity of common SRI withdrawal symptoms to determine whether a very small subset of symptoms can capture most occurrences of SRI withdrawal. We surveyed 344 members of online peer-support communities aged 18-65, reporting withdrawal symptoms after chronic SRI treatment. The severity of nine common withdrawal symptoms was evaluated at baseline and during the withdrawal period. Dizziness, brain zaps, irritability/agitation, and anxiety/nervousness demonstrated the largest increase in severity during withdrawal relative to baseline. Nearly all (97.7%) of the 344 subjects and all (100%) 153 subjects with relatively low baseline symptom scores (total<5) reported a worsening of one of these four symptoms. The presence of a baseline anxiety disorder did not affect rates of withdrawal-emergent anxiety/nervousness. Nearly all surveyed subjects reported worsening either of dizziness, brain zaps, irritability/agitation, or anxiety/nervousness in acute withdrawal. A screening test incorporating these four core symptoms may be sufficiently sensitive to rule out SRI withdrawal and may be valuable in clinical and research settings. Incorporating withdrawal symptom severity may further enhance specificity.

Relationship Among CD4 Count, Symptoms Experience and Depression in People Living With HIV/AIDS (PLHIV)

Background: Depression is common in people living with HIV/AIDS and there is some evidence that depressive symptoms may have adverse effects on immune functioning. The aim of the study was to assess the CD4 count; Symptoms experience and Depression among HIV/AIDS patients attending the ART centre district government Hospital, Navanagar, Bagalkot. Methodology: This was a cross sectional study with a convenient sample of 230 PLHIV attending the ART Centre, District Government Hospital, Bagalkot Symptoms Experience was assessed using Revised Sign and Symptom Checklist for HIV (SSC-HIV rev) and depression was assessed using Centre for Epidemiological Studies Depression Scale (CES-D), CD4 count was taken from medical records of PLHIV.Data were analyzed using descriptive and inferential statistics. Findings: Results indicate, majority (51.3%) PLHIV hadCD4 less than 500 cells/ mm3with mean of CD4count score 553.76 ±262.44. Majority (88.7%) of PLHIV had moderate symptoms experience and most (95.2%) of them had significant clinical depression. There was a significant positive correlation between depression and symptoms experience( r = 0.588, P&lt;0.01), but no significant correlation found between CD4 count and symptoms experiences and CD4 count and depression. Conclusion: The finding of the study concludes depression will have negative impact on patients’ clinical symptoms and CD4 count. Hence along with the medical management of PLHIV underlying depression should be treated meticulously. Keywords: CD4 count, Symptoms experience, Depression, People living with HIV/AIDS.

The effect of kangaroo mother care on stabilization of vital signs heart rate, respiratory rate and arterial saturation in low-birth-weight preterm babies

Background: Kangaroo mother care (KMC) have positive effects on the preterm infant's health status in the form of stabilization of vital parameters. Therefore, this study was conducted to evaluate the effect of KMC on stabilization of vital signs in low-birth-weight premature babies. Methods: This is a quasi-experimental study. One hundred and seventy newborns who were admitted to in neonatal intensive care unit of Karnataka institute of medical sciences Hubli, India were selected by convenience sampling. They were randomly divided into experimental group, n=85 and control group, n=85. In the experimental group, newborns were taken daily KMC for four hours during 7 days. In the control group, routine care was performed. The data gathering tool was questionnaire of infants and mother characteristics, checklists of vital signs using SPSS 22 version software. Chi-square test was used as test of significance for qualitative data. Continuous data was represented as mean and SD. P&lt;0.05 was considered as statistically significant. Results: Before intervention, there was no significant difference between the vital signs of the infants in experimental and control groups. However, after intervention, there was a significant difference between the two groups in terms of vital parameters (p&lt;0.001). Conclusions: The findings of this study indicate the effect of KMC on stabilization of vital signs, it is recommended that KMC is taken as one of the routine cares of premature low birth weight babies.

Effect of Aromatherapy With Rosemary Essential Oil on Preoperative Anxiety, Stress, Depression and Physiological Parameters in Candidates For General Surgery: A Clinical Trial

Objective: Anxiety and stress are among the most common mental problems in patients before surgery. This study aims to determine the effect of aromatherapy with rosemary essential oil on preoperative anxiety, stress, depression and physiological parameters in candidates for general surgery. Methods: In this clinical trial, 60 candidates for general surgery at Ayatollah Kashani Hospital in Shahrekord, Iran in 2019 were randomly divided into two groups of aromatherapy (n=30) and control (n=30). In the aromatherapy group, on the day of surgery, one hour before going to the operating room, three drops of 10% rose essential oil were poured on a tissue and pinned to the patients’ pillows, and they were asked to smell it for 20 minutes. There was no intervention in the control group. Data collection tools were a demographic form, the 21-item depression anxiety stress scale, and vital signs checklist. Data were analyzed in SPSS software, version 21 using chi-square test and paired t-test. Results: Before the intervention, the mean scores of anxiety, stress, and depression in the aromatherapy group were 16.80, 17.77, and 16.27, respectively, where the difference in these three variables was not significant (P&gt;0.05). After the intervention, their mean scores were 15.03, 15.57, and 15.83, respectively, where the difference in these variables was significant (P&lt;0.05). There was a significant difference in these variables between the two groups (P&lt;0.05). Conclusion: Aromatherapy with rosemary essential oil can reduce anxiety, stress, depression and improve some physiological indicators of patients before general surgery. Therefore, it is recommended to use it along with modern medicine.

Smokeless tobacco use and reproductive outcomes among women: a systematic review

Background: Both smoked and smokeless tobacco use have deleterious effects on most major organ systems including the reproductive system. We conducted a systematic review on smokeless tobacco (SLT) use and reproductive outcomes among women. Methods: We searched Pubmed, ProQuest, Cochrane, Wiley and Emerald databases for studies involving smokeless tobacco use in women with any or a combination of three conditions: infertility, menstrual disorders and pelvic inflammatory disease (PID). Eligibility criteria included English language publications from 1st January 1990 - 31st October 2020. CADIMA software used for filtering the studies and modified SIGN checklist for the quality assessment. The findings are reported as per the PRISMA guidelines. The AXIS and ROBIN E tool were used for assessment of risk of bias. Results: In total, three studies addressed our research question. Two studies addressed infertility (prospective cohort: n=501, cross sectional: n=192) of which, the cross-sectional study compared the mean cotinine levels between those with infertility, menstrual disorders and PID. This study also explored the association between SLT and PID. PID was the most common gynecological complaint. Women with PID had significantly higher urinary cotinine levels = 24.95±12.259) ng/ ml (p=0.0144). Mean urinary cotinine in women with menstrual complaints was 19.32±10.29 ng/ml. The other study used population-based sampling of 501 couples who attempted pregnancy (enrolled in the LIFE Study). Results showed that 9% and 2% (n=28) of men used snuff and chewed tobacco respectively. and few of the women used smokeless tobacco. Time to pregnancy was shorter among smokeless tobacco users relative to smokers. Conclusions: Available studies exploring associations between SLT and reproductive outcomes are inconclusive due to limitations in the study methodologies. More studies with robust study designs are required from low- and middle-income countries with high prevalence of SLT use.

A reassessment of Jackson\u2019s checklist and identification of two Down syndrome sub-phenotypes

Down syndrome (DS) is characterised by several clinical features including intellectual disability (ID) and craniofacial dysmorphisms. In 1976, Jackson and coll. identified a checklist of signs for clinical diagnosis of DS; the utility of these checklists in improving the accuracy of clinical diagnosis has been recently reaffirmed, but they have rarely been revised. The purpose of this work is to reassess the characteristic phenotypic signs and their frequencies in 233 DS subjects, following Jackson's checklist. 63.77% of the subjects showed more than 12 signs while none showed less than 5, confirming the effectiveness of Jackson's checklist for the clinical diagnosis of DS. An association between three phenotypic signs emerged, allowing us to distinguish two sub-phenotypes: Brachycephaly, short and broad Hands, short Neck (BHN), which is more frequent, and "non-BHN". The strong association of these signs might be interpreted in the context of the growth defects observed in DS children suggesting decreased cell proliferation. Lastly, cognitive assessments were investigated for 114 subjects. The lack of association between the presence of a physical sign or the number of signs present in a subject and cognitive skills disproves the stereotype that physical characteristics are predictive of degree of ID.

Cardiorespiratory effect of Swedish back massage in hypertensive patients: a randomized clinical trial

Background: Chronic stress is one of the main risk factors for incident hypertension. Behavioral methodologies, such as unwinding and rub, have a dramatic effect on controlling the individuals’ reaction to stress, diminishing hypertension and heart rate, as well as changing temperature and respiration rate. Material and methods: 90 patients with primary hypertension were enrolled to this open-label study. The patients have been haphazardly classified into an affect and an intervention cluster. In the two groups, systolic and diastolic blood pressure, heart rate, body temperature and respiratory rate) were measured and recorded two times a week before and after a ten-min Swedish back massage and relaxation for six weeks. The records have been accrued using a questionnaire which includes demographic records, a checklist of vital signs (systolic and diastolic blood pressure, heart rate, temperature, and respiratory) record, a fixed manometer and thermometer. Results: Within the experimental group, systolic and diastolic blood pressure, heart rate, and respiratory levels reduced to 6.44 and 4.77 mm Hg, 2.9 bpm, 0.94 breaths per minute, respectively (p &lt; 0.001) and temperature increased to 0.08°C after the back massage (p = 0.004). Conclusion: The obtained results show the effectiveness of back massage in reducing blood pressure, heart rate, and respiratory as well as increased temperature in the study participants.

Autonomic dysfunction in adults following mild traumatic brain injury: A systematic review.

Increasing evidence suggests autonomic nervous system (ANS) dysfunction may occur following mild traumatic brain injury (mTBI). Measures of heart rate, heart rate variability, blood pressure and baroreceptor sensitivity can be used to evaluate ANS dysfunction following mTBI. Summarize the evidence for ANS dysfunction in adults following mTBI. A search of Embase, MEDLINE, Cochrane Central Register, PsycINFO, CINAHL and SPORTDiscus databases was conducted. Search topics included: mTBI and ANS. Identified abstracts were independently reviewed by 2 reviewers followed by full text screening. Risk of bias was assessed using a modified SIGN checklist. A structured synthesis was performed. Thirty-nine studies (combined 1,467 participants diagnosed with mTBI) evaluating ANS function were included. ANS function was evaluated under various conditions including: rest, during exertion, cold pressor test, Valsalva maneuver, using face cooling and eyeball pressure paradigms. Short-term or ultra-short-term recordings were most common. The majority of studies (28/39) were rated as "unacceptable" for quality of evidence. Altered parameters of ANS function have been reported in multiple conditions following mTBI, both acutely and in the post-acute/chronic stages of recovery. However, due to methodological limitations, conclusions regarding the severity and timing of ANS dysfunction following mTBI cannot be drawn.

The mouth-opening muscular performance in adults with and without temporomandibular disorders: A systematic review.

BackgroundThe mouth‐opening muscular performance in patients with temporomandibular disorders (TMDs) is unclear. Understanding the impairments of this muscle group within specific TMDs is important to develop proper management strategies.ObjectiveTo characterise the mouth‐opening muscular performance in adults with and without TMDs.MethodsPubMed, EMBASE, CINAHL, Scopus, Web of Science and Cochrane databases were searched from inception to 12 November 2020. Bibliographies were searched for additional articles, including grey literature. Case‐control, cross‐sectional and interventional studies reporting mouth‐opening muscular strength and/or endurance were included. Risk of bias was assessed by the SIGN checklist for case‐control studies and by the NIH quality assessment tool for cross‐sectional studies. Results were pooled with a random‐effects model. Confidence in cumulative evidence was determined by means of the GRADE guidelines.ResultsFourteen studies were included; most were rated as having a moderate risk of bias. Only three studies assessed patients with TMDs and the other 11 assessed healthy adults. Significant sex differences in muscular performance were found for healthy adults in the review (strength deficit for females versus males). There was a significant reduction in maximal mouth opening performance (strength and endurance) in the three studies that assessed patients with temporomandibular disorders.ConclusionSex plays a significant role in maximal mouth opening strength. There is a lack of reliable data on the normal mouth‐opening strength and endurance of healthy adults as well as for patients with TMDs.ImplicationsLack of reliable TMDs patient data and comparable healthy adult data highlight future direction for research.

What should urologists know about Pseudojournals and open access publishing? A narrative review of the literature.

ABSTRACTIntroduction:The majority of the open access publishing allows the researchers to publish their articles for a fee and at the same time enables the readers to access the research without paying the expensive journal subscription charges. Under the garb of open access publishing, predatory journals run a scam to dupe the researchers of money. This study was conducted to highlight the characteristics of pseudojournals and increase the awareness about their modus operandi.Methods:The email inboxes of 3 academic urologists (APS, AS, and KP) were searched for emails soliciting articles for open access journals. A list of all such journals was compiled. These journals were checked for metrics from the Journal Citation Reports and the Scimago Journal Rankings. All these journals were then cross-checked with the available whitelists and blacklists. Features pointing toward a pseudo journal were identified as red flag signs for these journals and were noted. A literature search was performed on open access publishing and predatory journals, and the salient points were noted. A checklist of red flag signs was compiled.Results:A total of 71 emails soliciting article submissions from 68 journals were received by the three urologists (APS, AS, KP). Of these, 54 were highly suggestive of being a pseudojournal, 5 journals were operating in the gray zone between genuine open access journals and outright predatory journals, and 9 were genuine open access journals. A total of 33 articles on predatory journals were reviewed after the literature search as per the PRISMA guidelines. The red flag signs identified along with the literature review were used to create the SAFEiMAP checklist, which can be used to identify predatory journals.Conclusion:Predatory journals have infiltrated the whitelists, and the indexing databases like PubMed and no blacklist is all-inclusive. Understanding the concept and the types of open access publishing gives the researchers a better idea on how to differentiate fake journals from the genuine ones. Using a checklist will help to identify the red flag signs of such journals and identify those journals that operate in the gray zone.

Clinical Utility of Semistructured Interview and Scales to Assess Withdrawal Syndromes With Dose Reduction or Discontinuation of Selective Serotonin Reuptake Inhibitors or Serotonin Norepinephrine Reuptake Inhibitors.

Withdrawal syndromes can occur after dose reduction or discontinuation of selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). Few measurement instruments are available to assess them: Diagnostic Clinical Interview for Drug Withdrawal 1-New Symptoms of SSRI and SNRI (DID-W1) and Discontinuation Emergent Signs and Symptoms (DESS) checklist. We assessed their interrater reliability, verified the percent agreement between the two, and tested DESS sensitivity and specificity on the basis of the diagnoses formulated via the DID-W1. One-hundred thirty-four subjects who referred for withdrawal at 3 outpatient facilities were enrolled and assessed via the DESS and the DID-W1. Percent agreement and Cohen κ were calculated to measure DID-W1 and DESS interrater reliability, as well as the agreement between DID-W1 and DESS items. Sensitivity and specificity of DESS were derived from the identification of true-positive, false-negative, true-negative, and false-positive on the DID-W1. Both tools showed excellent interrater reliability (DID-W1 Cohen κ = 0.958; DESS Cohen κ = 0.81-1). The degree of agreement between DID-W1 and DESS items was poor or fair (Cohen κ < 0.40) for some items and moderate (Cohen κ = 0.41-0.60) for others. Sensitivity and specificity of DESS were 0.937 (true-positive = 60, false-negative = 4) and 0.285 (true-negative = 20, false-positive = 50), respectively. DID-W1 was a reliable method to identify and diagnose withdrawal syndromes. The DESS checklist showed to be a useful tool for detecting withdrawal SSRI/SNRI symptoms when the aim is to achieve high sensitivity to identify true positives.

Smokeless tobacco use and reproductive outcomes among women: a systematic review

Background: Both smoked and smokeless tobacco use have deleterious effects on most major organ systems including the reproductive system. We conducted a systematic review on smokeless tobacco (SLT) use and reproductive outcomes among women. Methods: We searched Pubmed, ProQuest, Cochrane, Wiley and Emerald databases for studies involving smokeless tobacco use in women with any or a combination of three conditions: infertility, menstrual disorders and pelvic inflammatory disease (PID). Eligibility criteria included English language publications from 1st January 1990 - 31st October 2020. CADIMA software used for filtering the studies and modified SIGN checklist for the quality assessment. The findings are reported as per the PRISMA guidelines. The AXIS and ROBIN E tool were used for assessment of risk of bias. Results: In total, three studies addressed our research question. Two studies addressed infertility (prospective cohort: n=501, cross sectional: n=192) of which, the cross-sectional study compared the mean cotinine levels between those with infertility, menstrual disorders and PID. This study also explored the association between SLT and PID. PID was the most common gynecological complaint. Women with PID had significantly higher urinary cotinine levels = 24.95±12.259) ng/ ml (p=0.0144). Mean urinary cotinine in women with menstrual complaints was 19.32±10.29 ng/ml. The other study used population-based sampling of 501 couples who attempted pregnancy (enrolled in the LIFE Study). Results showed that only 2% (n=28) of men and none of the women used smokeless tobacco. Compared with never users of tobacco, smoking by females was individually associated with longer time-to-pregnancy; smoking among males remained significant when modeling partners together. Conclusions: Available studies exploring associations between SLT and reproductive outcomes are inconclusive due to limitations in the study methodologies. More studies with robust study designs are required from low- and middle-income countries with high prevalence of SLT use.

Evaluation of ANSI Z535 Safety Sign Installation

A safety sign is a sign of equipment to provide protection for workers or visitors in the workplace. American National Standards Institute Z535 (ANSI Z535) is used as a basic guideline for installing safety signs in the workplace because it is more communicative by using global symbols to overcome language barriers. Occupational Safety Division of Manpower and Transmigration Departement, East Java Province (UPT Keselamatan Kerja Surabaya) is a workplace that has a risk of occupational accidents. The preliminary surveys in the area of the 3rd floor of the Division of Occupational Safety (UPT Keselamatan Kerja) Surabaya revealed that there were many sites with insufficient safety signboards. Many of the installed safety signs did not comply with ANZI Z535 standards. This study aimed to evaluate the installation of safety signs compared to the ANZI Z535 standard on the 3rd floor of UPT K2 Surabaya. This was an observational study examining the installation of safety signs. The data were obtained using the ANSI Z535 safety sign checklist. We found 2 out of 5 types of safety signs were in accordance with ANSI safety sign standards with a comparison percentage of more than 66%, such as the notice sign (67.85%) and safety condition sign (75%). Three other types of safety signs were in the unfavorable category with a percentage of less than 66%, such as danger sign (65.63%), warning sign (50%), and caution sign (46.88%). Some sites required additional safety signs, such as warning signs (at distillation site), caution signs (oven, stairs), notice signs (cylinder storage, elevator, chemical warehouse), and safety condition signs (stair, eyewash).