Hemophagocytic lymphohistiocytosis (HLH) is a non-malignant, fatal syndrome resulting from dysregulation of normal innate and adaptive immune responses. While chemoimmunotherapy reduces the mortality of children, dangerous febrile neutropenia often occurs and leads to a poor prognosis. This study aimed to investigate whether adenosine deaminase (ADA) is a predictive marker for the occurrence of febrile neutropenia (FN) in HLH. The clinical data of 76 hospitalized HLH children were retrospectively retrieved. The relationship between the occurrence of FN and clinical features and laboratory findings such as age, ADA levels, ferritin (FER) levels, alanine transaminase (ALT) levels, aspartate aminotransferase (AST) levels, hemoglobin (Hb) levels, neutrophil counts, platelet counts, globulin levels and albumin levels were analyzed. Univariate analysis showed that the increases of ADA levels and FER levels were related to the occurrence of FN, while age, ALT levels, AST levels, Hb levels, neutrophil counts, platelet counts, globulin levels and albumin levels were not. Multivariate analysis showed that only elevated ADA level was related to the onset of FN. Our work demonstrates that increased ADA level may predict the risk of FN in children with EBV-related hemophagocytosis.

BackgroundThe surgical procedure is understood by the oncological patient as a risky event. The emotional unbalance caused, namely the emotional vulnerability, may affect the postoperative recovery. The preoperative visit consists in a first contact between the Operating Room (OR) nurse and the surgical patient, to assess and identify his needs and plan the intraoperative period. The welcome to the OR should be adequate to the needs and characteristics of the patient and facilitate his adaptation to this reality. Methods These nursing interventions allow the care humanization through the psychologic/emotional support and in the transmission of information of the surgical procedure. The lack of these acts in the OR have raised the need to undertake a project named “Welcome of the oncological patient in the operating room: nursing cares”. The goal of this project is to improve the quality of the nursing care during the welcome of the oncological patient in the OR. The question behind this project is: “What is the effect of existing (or proposed) nursing care protocols for receiving patients to the Operating Room?\" Results This project was developed in three different places to acquire and develop competences. The methodology was supported bibliographic search, literature review scoping, observation and providing of nursing care, critical reflections on events and support documents to the nursing care. Conclusions The project allows the improvement of quality of the nursing care to the oncological patient during the OR welcome.

The working system consists of a sub-system. Before implementation of any system, it must be verified through the formal verification system so it can detect that whether the system will work smoothly without any fault before its actual implementation. The web service protocols are considered as systems therefore they can be verified through formal methods. This research is concern about the formal verification of web service protocols. The system specification shows the behavior of the system defined in the form of a state transition diagram, table, data flow diagram, and plain English. The main contribution of this research is to verify the Web Service Business Activity (WSBA) protocol of Microsoft and IBM company through the UPPAAL and TLC+ tools. The research has been verified two important properties Mutual / consist outcome and Deadlock along with performance comparison of the tools. The experiment on web service business protocol is applied to up to four participants. The experimental results show that how many states visits and how much time is taken to serve the service(s) to the participant(s).

The role of the industrial workers is a significant element of any society and a key stakeholder of an industrial setup. Their roles and existence in an organization not only affect the organizational culture but also the working environment. In the same way, modern organizational culture and its environment also affects the employee’s psychology, their behavior and bring new challenges each new day. This paper aims to review, confer, and analyze the organizational, social, and cultural challenges faced by industrial workers and how these factors affect psychology, personal, and professional life. In the first phase, a dedicated 25-item questionnaire on a Likert scale was used for investigating four socio-cultural factors (the individual, the relationship with their family, social and organizational factors) in fifty industrial workers. Sequentially, in the second phase, the study statistically analyzes, how these factors influence their behavior and psychology. Data showed that the four factors (family, social, individual, and organizational) were correlated demonstrating a Cronbach’s alpha of 0.916. Social and organizational factors are the most influential. These results suggest how to cope up with these challenges, each industrial organization ought to address these factors systematically and need to properly plan work-related issues that affect the industrial worker.

Organization’s performance depends upon the knowledge and intellectual resources including people, their work experiences, ideas etc. Knowledge management play an important role for an organization’s survival and competitive strength. There are different factors which reduce organizational performance by obstructing effective implementation of knowledge management in organizations i.e., organizational barriers, cultural barriers, technical barriers, personal barriers and environmental barriers. Purpose of this study is to find out the leading barrier(s) towards effective knowledge management implementation in Pakistan. Percentage values of these barriers are 94.8, 94.4, 96.4, 96 and 94.4 respectively. Results show that knowledge management implementation is greatly affected by technological barriers and personal barriers and is suppressed by employ’s performance.

Objectives: To investigate the effectiveness of comprehensive nursing care (CNC) on delirium after endoscopic mucosal dissection of gastric submucosal tumor (GSMT). \nMaterials and methods: Patients undergone endoscopic resection of GSMT at Affiliated Hospital of Southwest Medical University between July 2017 and October 2019 were enrolled in the study. The patients were subjected to regular nursing care and CNC before and after surgery, and examined for the occurrence of delirium and other therapeutic outcomes. A number of nursing practices were incorporated into CNC, including psychological rehabilitation, pain management, oxygen therapy, vision and hearing monitoring and sleep management.\nResults: A total of 341 patients were included in the study with an average age of 72.7 years. Compared with regular nursing, patients in CNC group had significantly shorter operation time, earlier postoperative feeding time and shorter hospital stay; they also had significant less delirium (9.86% vs 17.91%, P < 0.05) and better patient satisfaction (91.55% vs 49.25%, P < 0.05).\nConclusions: CNC is effective in reducing the occurrence of delirium and can improve the therapeutic outcomes following endoscopic resection of GSMT in elderly patients.