Radical nephroureterectomy (RNU) remains the gold standard for the surgical management of upper tract urothelial carcinoma (UTUC) from the ureterovesical junction to the renal pelvis. However, the removal of the ipsilateral intact kidney causes morbidity due to renal functional deterioration after RNU. Recently, the indications for nephron-sparing surgery (NSS) in UTUC have been expanded to preserve the intact kidney. Minimally invasive surgical approaches, including endourological, laparoscopic, and robotic-assisted techniques for segmental resection of the distal ureter with ureteral reimplantation have shown favorable oncological and clinical outcomes (for both noninvasive and invasive ureteral tumors). The established guidelines for UTUC have limited indications for NSS. Because of low tumor burden, stage Ta/T1 UTUC is considered the best indication for NSS. NSS requires close follow-up and managing the risk of recurrence in the preserved ipsilateral ureter and/or renal pelvis. To overcome these limitations, adjuvant administration of various immuno-chemotherapeutic agents is being explored to overcome the resistance to therapeutic cell death and evasion of immune destruction from current therapies with better prognostic outcomes. The aim is to reduce urothelial cancer recurrence improving the effectiveness of NSS and to achieve comparable outcomes to RNU in UTUC. In this review article, we have comprehensively discussed the different types of NSS in UTUC, the indications for NSS in the international guidelines, and oncological outcomes of each of the NSS techniques.

Purinergic P2Y Receptor Antagonists ; Consensus ; Cardiovascular System ; Cardiology ; Asia

Background: Workplace bullying is defined as frequent, ongoing, and detrimental incidence of unreasonable acts/behaviors directed towards an individual. The consequences of bullying to individuals often lead to absenteeism, resignation, job dissatisfaction, and suicidal ideation making it a major public health concern. This organizational issue, when not addressed, will greatly affect the workflow in any organization. There is a paucity of literature on this problem in the Southeast Asian countries Objective: This study aimed to describe the extent of workplace bullying among employees of a public higher education institution. Methodology: The researchers used a descriptive, cross-sectional study design. Survey questionnaires in Google Form were emailed to all employees with a 35.96% participation rate. The survey instrument asked participants to indicate their awareness about any bullying behavior in their unit and to specify the typical profile of bullies and victims they know of. Responses to quantitative variables were summarized using the mean and standard deviation, while qualitative variables were reported as frequency and percentage distribution. The software used for analysis were Microsoft Excel and EpiInfo 7. Results: At least one-third (36.94%) of survey respondents indicated that they witnessed a form of bullying in the workplace with more awareness seen among faculty members and permanent employees. The most common type of bullying observed in the workplace was criticism in public. Notably, this type of bullying was similar across employee categories. The predominant reactions of victims of bullying include feeling of fear and loss of trust, and confiding to a friend or co-worker. Conclusion The phenomenon of bullying has been witnessed by the employees and reported to have adverse effects on victims. Informational campaigns coupled with anti-bullying policy and programs are necessary to promote employee well-being.
Occupational Stress ; Universities ; Occupational Stress ; Philippines

INTRODUCTION: Since there are limited studies about the return-to-work experiences of Filipino amputees, this study will be able to contribute to studies that delve deeper into the lower extremity amputees’ experiences and put into light the factors that may be present in relation to their return to work. METHODS: This study utilized a qualitative phenomenological design. Participants who were willing to join the study were all gathered for a focus group discussion conducted by a hired interviewer. The researchers adapted Colaizzi’s descriptive phenomenological method for analyzing the data. RESULTS: Factors that allowed amputees to have a successful return to work experience were motivation to continue with life, positive impact of lower extremity prosthesis, and rehabilitation. Factors that hindered the successful return to work of amputees were social barriers, work environment, negative self-image, discrimination from the community, and ft of prosthesis. CONCLUSION Employment was possible after amputation among amputees who were provided with prosthesis at UERMMMCI, since most of the respondents of this study were employed. Positive and negative factors that infuenced their return to work were also identifed. Non-compliance to rehabilitation limited the usage of prosthesis resulting in not being able to return to work.
Bioprosthesis

Coccidiosis in chickens is an intestinal parasitic disease caused by protozoan parasites named Eimeria spp. In some Eimeria infections, intestinal lymphocytes are known to highly express chicken NK-lysin (cNK-lysin), an antimicrobial peptide with anticoccidial activity. Therefore, this study aims to investigate the expression of cNK-lysin in E. necatrix-infected chickens and its role in E. necatrix infection. The expression of cNK-lysin transcript was significantly increased in E. necatrix sporozoites-treated lymphocytes. In E. necatrix infection, cNK-lysin transcript was induced in intestinal lymphocytes but not in the spleen. The recombinant cNK-lysin exhibited anticoccidial activity against E. necatrix sporozoites as well as immunomodulatory activity on macrophages by inducing proinflammatory cytokines. These results indicated that E. necatrix infection induces high local expression of cNK-lysin and the secreted cNK-lysin helps protect coccidiosis.

OBJECTIVE: Smartphone use is pervasive among youth in Japan, as with many other countries, and is associated with spending time online and on social media anywhere at any time. This study aimed to test a Japanese version of the Smartphone Addiction Scale-Short Version (SAS-SV) among Japanese college students. METHODS: The subjects of this study were 602 college students in Japan. The study questionnaire consisted of questions about demographics (age, gender etc.), possession of a smartphone, internet use [length of internet use on weekdays and weekend, favorite social networking service (SNS) etc.], Young’s Internet Addiction Test (IAT), and the Smartphone Addiction Scale-Short Version (SAS-SV) translated into Japanese. RESULTS: There was a total of 573 respondents (180 male, 393 female) who completed the questionnaire (mean 19.3±1.3 years). LINE was the most popular social media platform (52.0%) followed by Twitter (36.3%). The overall Internet Addiction Test (IAT) score was 45.3±13.2, with 4.5% classified as having severe addiction (IAT ≥70). The mean SAS-SV scores were 24.4±10.0 for males and 26.8±9.9 for females. Based on proposed cutoff scores, 22.8% of males and 28.0% of females screened positive for smartphone addiction. The total scores of the SAS-SV and the IAT was correlated significantly. CONCLUSION As the number of smartphone users becomes higher, problems related to smartphone use also become more serious. Our results suggest that the Japanese version of SAS-SV may assist in early detection of problematic use of smartphones.

Background: Understanding and addressing social determinants of health through evidence-based action is a strategy that has been advocated by the World Health Organization as part of its “Health for All” strategy in 1978 and “Health in All Policies“ framework in 2013. It has then been recommended that the research agenda-setting process should be informed by socio-economic development plans with the specific aim of gathering data on social, economic, and cultural conditions that affect health. Objective: This paper reviewed the PDP 2011-2016, PDP 2017-2022, MDGs, and SDGs and identified common directions with the NUHRA 2011-2016 and 2017-2022. Methods: A content analysis of the three identified priorities of the NUHRA vis-a-vis the PDP 2011-2016, the PDP 2017-2022, the MDGs, and the SDGs was done in order to identify harmonization of the priorities of the NUHRAs targets and indicators with those of the other plans and agendas. A gap analysis across all topics was done to identify links and gaps. Results: The results established the common ground between health research priorities and international and national plans. Comparing the number of direct relationships between the NUHRAs, PDPs, MDGs, and SDGs, it was noted that there were more direct links between NUHRA 2017-2022, PDP 2017-2022, and the SDGs compared to NUHRA 2011-2016, PDP 2011-2016, and MDGs. The direct links were mostly found in 1) maternal, newborn and child health, 2) health systems, 3) communicable diseases, 4) water, sanitation, and hygiene, 5) environment, and 6) infrastructure development. Conclusion The NUHRAs may serve as pathways to achieve the goals stipulated in other socio-economic development plans. The relationships of these to health are complex, nonlinear and often the effects manifest after a long period of time, and as such require rigorous research.
Social Determinants of Health

<p style="text-align: justify;">BACKGROUND AND OBJECTIVE: This paper aims to describe long-term visions for health research in the Philippines. Ambisyon Natin 2040, an overarching vision for a dynamic country by the year 2040, is its main inspiration as this enables innovation and sustainable development.p><p style="text-align: justify;">METHODS: The health research profile conceptual framework developed by Tugwell et al., (2006) was utilized to structure the articulation of these visions. Review of related literature, reports, and documents and in-depth interviews with key players in health research were conducted.p><p style="text-align: justify;">RESULTS: In view of economic and technological developments in the country, it is expected that in 2040, health research priorities shall be more trans-disciplinary and more advanced. Research on health regulation and ethics will continue to be of importance. A more enabling environment for health research is also envisioned, since majority of research funding is expected to come from government, in addition to more research-friendly laws. More innovative platforms will be utilized to disseminate research results. The increasing international exposure and impact of academic work in the Philippines is also envisaged.p><p style="text-align: justify;">CONCLUSION AND RECOMMENDATIONS: Health research in the Philippines has been benefitted by a lot of gains and advances in the past years. Thus, to create an enabling health research system in the Philippines by 2040, focusing on innovations in health research, increased number of funding sources, and crafting of better policies on health research should be pursued. Sustaining these gains and advancing health research in our country entail collective effort from different stakeholders, both public and private.p>
Philippines

<p>OBJECTIVES: Stakeholders and stakeholder engagement in agenda setting are not well documented despite its increased recognition. This paper aimed to describe stakeholder engagement in the agenda setting. Specifically, it aimed to (1) describe the process of stakeholder engagement in the development of the NUHRA 2017-2022; (2) describe characteristics of stakeholders involved; and (3) identify lessons learned during the engagement.p><p>METHODS: Documents pertinent to the agenda setting process, which included profile of participants and feedback on the consultation process were reviewed and analyzed. Key informant interviews were also conducted among selected PCHRD officials and members of the Philippine National Health Research System - Research Agenda Committee. Stakeholder mapping was conducted prior to the engagement to identify potential stakeholders. Consultations were conducted in each region involving different stakeholders. Stakeholders in the consultation process were national government agencies, local government units, academe, public and private health facilities, and non-government organizations (NGOs).p><p>RESULTS: The stakeholder with the highest representation was the national government (n=110), while the lowest were public and private health facilities (n=14 each). Interactive discussion of stakeholders with diverse background, is the top item that went well during the consultation and should be retained in the future, and; brainstorming session and presentation were identified item that needs improvement.p><p>CONCLUSION: A diverse and well-represented set of stakeholders is important in an agenda setting to appropriately identify priorities and to improve uptake of the agenda. Stakeholder engagement, however, should not be limited to agenda setting, collaborative work must be sustained in all aspects of the research cycle.p>
Stakeholder Participation ; Philippines

<p>BACKGROUND: As one of the research councils under the Department of Science and Technology (DOST), health research priority setting has been the mandate of the Philippine Council for Health Research and Development (PCHRD) since its establishment in 1982. The development of the National Unified Health Research Agenda (NUHRA) convenes the major stakeholders for health in the country to establish the priorities for health research. The NUHRA aims to address the most urgent health issues in the country for the generation of solutions to the health concerns of the country.p><p>OBJECTIVES AND METHOD: Through document review, this paper describes the approaches and lessons learned in research priority setting since the establishment of the Philippine National Health Research System.p><p>RESULTS: The Philippines has employed a bottoms-up, top-down, and a combination of both approaches to develop its health research agenda.p><p>CONCLUSION: The health research agenda-setting must consider evolving funding sources, its link to production of researches with high probability of knowledge translation to health technology innovation, and policy formulation. Measuring the impact of the NUHRA to the health systems and health situation of the country is a difficult assessment, but the gradual change in healthcare technology utilization and evidence-informed policies towards health equity can be a subjective measurement of the NUHRA's success.p>
Research ; Support Of Research ; Philippines