bluuebunny/crossref_metadata_2025 huggingface dataset:
Rice straw mulch and organic fertilizer effect on growth and production of lettuce (Lactuca sativa L.)
Authors: Ikhsan I , Zaitun Z , Mayani N , Erika C , Pratama R R
Published: June 2023

Lettuce is one of the most popular horticultural crops. It is necessary to make an effort to increase lettuce production to meet market demand. One of the efforts is engineering cultivation systems through rice straw mulch and organic fertilizers application. The aims of studied to determine the effect of rice straw mulch and organic fertilizer on growth and production of lettuce. The research was conducted at Nudira Fresh Green House, PT. Nudira Sumber Daya Indonesia, Warnasari Village, Pangalengan Subdistrict, Bandung District, West Java. This study used factorial randomized block design with 3 replications. There were 2 factors with 8 treatment combinations. Factor I was mulch dose: control, 4 t ha−1 rice straw mulch, 6 t ha−1 rice straw mulch, 8 t ha−1 rice straw mulch. Factor II was organic fertilizer types: 20 t ha−1 cow manure, and 20 t ha−1 compost. The results showed that the rice straw mulch dose and organic fertilizer type did not significantly effect on plant height, leaves number, production per plant sample, and production per plant plot. Application of 8 t ha−1 rice straw mulch was able to increase plant height, production per plant sample, and production per plant plot. The cow manure application was able to increase plant height, leaves number, production per plant plot, and production per plant sample compared to using compost.
The effectiveness of weed extract with different temperature aquades solvent for controlling antraknosa disease of red chili (Capsicum annum L.)
Authors: Budi G P , Pribadi T , Fitri S N , Biky M A
Published: June 2023

Red chili is an agricultural commodity with high economic value. National red chili production is still low and often does not meet the needs of the Indonesian people. One of the causes is anthracnose disorder. Red chili anthracnose caused by the fungus Colletotrichum capsici is characterized by symptoms of small black spots that can widen, dry out and shrink and the fruit can fall off. The aim of the study was to determine the effectiveness of extracts of several types of weeds with distilled water at different temperatures against anthracnose disease, growth, and yield of red chili plants. The study was a field experiment using a two-factor Completely Randomized Design (CRD). Factor 1 Types of weeds consist of: bandotan, kirinyuh, teki. Factor 2 Aquades Solvents with Different Temperatures consist of: room temperature, 50°C, 90°C. The variables observed were the intensity of anthracnose disease, plant height, number of healthy fruit, healthy fruit weight, number of sick fruit, phytotoxicity test and phytochemical screening test. The process of spraying botanical extracts is carried out once a week. The results showed that the type of weed extract treatment had a significant effect on the intensity of anthracnose disease and the number of sick fruits and had no significant effect on the number of healthy fruit, healthy fruit weight, and plant height. The treatment of distilled water with different temperatures did not significantly affect all observed variables. The interaction between the type of extract and the temperature of the solvent had a significant effect on the number of sick fruits. Bandotan extract treated with distilled water at room temperature produced the least number of sick fruits, namely 3.4 fruit/plant. The solvent temperature of 50°C produced more phytochemical compounds than the 3 types of weeds extracted. Red chili plants do not show any phytotoxic symptoms.
Implementation of agricultural insurance for sustainable food crop in Mutiara Timur and Suka Makmur Sub Districts
Authors: Indra I , Ula N , Nugroho A
Published: June 2023

The extreme climate has caused anomaly in rainfall, so there is the potential for floods and droughts to have a direct impact on the agricultural sector, particularly the decline in rice production. To overcome this, the government issued a policy in the form of an agricultural insurance program known as agricultural insurance to protect rice plants from the threat of crop failure. Aceh Province, which is one of the central provinces of lowland rice production in Indonesia, has implemented the agricultural insurance program since 2016, but it did not run smoothly due to several weaknesses of the program. Currently, agricultural insurance programs have developed rapidly, one of which is climate index-based agricultural insurance that can overcome the weaknesses of indemnity-based agricultural insurance. Based on the above background, researchers are interested in studying the Willingness To Join (WTJ) and Willingness To Pay (WTP) of farmers on climate index-based agricultural insurance. The analytical methods used are binary logistic regression analysis, Contingent Valuation Method (CVM), and Heckman Selection Models. The results showed that socio-economic factors namely farmer’s age, experience in rice farming, land area, and income from rice farming had a significant effect on WTJ and WTP agricultural insurance premiums with an average premium was Rp168,667 ha−1 per planting season. There are 2 things that the government needs to do to make the agricultural insurance program more successful. First, the application of cheaper insurance premiums and second, increasing farmers’ knowledge about the insurance scheme through more intensive socialization.
Screening of indigenous Rhizobacteria isolates from Patchouli Rhizosphere producing HCN, Siderophores and Chitinolytic Enzymes
Authors: Halimursyadah H , Syafruddin S , Syamsuddin S , Sriwati R
Published: June 2023

The consortium of bacteria that inhabit the rhizosphere, acting as plant growth promoting rhizobacteria is known as indigenous rhizobacteria. Rhizobacteria can produce chemical compounds that can protect plants from pathogens and various plant-disturbing organisms. Optimization of the growth and yield of patchouli can be done by utilizing the potential of rhizobacteria derived from patchouli rhizosphere. This study aims to obtain rhizobacteria capable of producing secondary metabolites of HCN compounds, siderophores and chitinolytic enzymes which are thought of as biocontrol agents in plant protection. The soil samples used were taken from patchouli rhizosphere areas in three locations, namely Alue Abed, Aceh Jaya and Krueng Itam and Purwosari, Nagan Raya. The exploration results obtained 4 isolates of rhizobacteria from Alue Abed, Calang, 8 isolates from Krueng Itam, Nagan Raya and 37 isolates from Purwosari, Nagan Raya. Based on the test results of qualitative and quantitative physiological properties, 34 isolates were able to produce HCN, 49 isolates produced siderophores and 42 isolates were able to carry out chitinolytic enzyme activity. Rhizobacteria isolate producing HCN, siderophores and chitinolytic enzymes are potential indigenous rhizobacteria candidates and potential for future testing as bio-protections of plants from pathogen attack.
Andaliman development as a regional superior product in Toba district North Sumatra Province based on regional innovation system
Authors: Husni N
Published: June 2023

Andaliman as a spice that is closely related to people’s lives in Toba Regency can provide added value through a regional innovation system (RIS). This study aims to analyze the development of andaliman as a superior product in the Lake Toba area based on RIS. The research was conducted in October 2021, located in Toba Regency, North Sumatra Province. Key informants in the research are: Regional Development Planning Agency; Department of Agriculture and Fisheries; Department of Trade, Industry and Small and Medium Enterprise Cooperatives; andaliman farmers; as well as, entrepreneurs of andaliman processed products. This study uses a qualitative method with an observation approach. Data were collected through: documentation studies, surveys, interviews and Focus Group Discussion. The development of andaliman as a regional superior product based on the regional innovation system in Toba Regency has the potential to be realized with the support of innovation actors consisting of academic, business, community, and government components.
Measuring the level of technology at small-scale citronella oil agroindustry in Aceh
Authors: Romano  , Ramayana  , Tambarta E , Zikri I
Published: June 2023

The development of the citronella oil agroindustry is facing challenges in terms of quality and limited production capacity, especially in the innovation and value-added sectors. This article aims to measure the level of application of innovation in the citronella oil agroindustry chain, starting from the aspects of cultivation, product handling, refining processes, and marketing institutions, including their effect on production value. This study takes location settings in five sub-districts of citronella oil production centers in Kabupaten Gayo Lues. A survey has been conducted on 40 respondents who were chosen deliberately to understand the general picture of the current production system of the community. To deepen the information, FGD was also conducted with 30 key informants. The results show that the application of innovations and good practices on all production lines from cultivation, post-harvest handling, refining, and marketing is low. So this has direct implications for the low productivity and value of citronella oil products produced. Four main components have the most influence, namely the handling of citronella leaves/leaves as raw materials, the refining process, the sale of citronella oil, and stock handling and marketing partnerships.
Phenotypic performance of F3 progenies from crossbreeding of Sigupai and IRBB27
Authors: Deski P A S , Bakhtiar B , Jaya R , Sari W E , Zuyasna Z , Zakaria S
Published: June 2023

Sigupai is one of Aceh’s indigenous rice varieties originating from the Southwestern region of Aceh. This variety has advantages in the form of fluffier and good rice cooking performance and fragrant aroma, easy maintenance, and minimal fertilizer requirements. This variety has agronomic characteristics that need to be improved such as a harvesting age of up to six months with high plant stature that makes it easy to fall. A series of breeding processes and analyses have been conducted to improve the performance of this variety by crossing it with IRBB27. The phenotypic characters of the F3 progenies (genotypes T11, T22, and T25) were carried out. The purpose of this study was to identify the phenotypic character of the F3 progenies belonging to (genotypes T11, T22, and T25 ). These genotypes originated from the selected plant in F2 progenies by crossbreed between Sigupai and IRBB27. This research was carried out at the Experimental Farm and Genetics and Plant Breeding Laboratory, Faculty of Agriculture, Syiah Kuala University, Darussalam Banda Aceh, from December 2021 to June 2022. The planting medium used was a mixture of soil and manure with a ratio of 2:1. The seeds planted consisted of F3 progenies (genotype T11, T22, T25, as well as their parents Sigupai, and IRBB27. The results showed that there were 3 plants in the F3 Sg/IRBB27 prospective to be developed. These plants originated from genotype T11 (plant no. 6), genotype T22 (plant no. 6), and genotype T25 (plant no. 2). These prospective progenies have medium harvesting ages ranging from 122-132 DAS, and shorter plant heights compared to their mother parent ‘Sigupai’ (121-127 cm), with their products ranging from 5.13-7.40 tons ha−1.
Maximum entropy application in predicting the vulnerability of land and forest fires in South Sumatra Province, Indonesia
Authors: Usmadi D
Published: June 2023

Land and forest fire disasters impact humans, biodiversity, and the environment. Identification and distribution of land and forest fire vulnerabilities are essential so that disaster mitigation and management can be fast, precise, and prioritized. The research objectives are to identify land and forest fires that occurred in South Sumatra Province in the 2017–2021 period, to identify environmental and anthropogenic variables that influence the occurrence of land and forest fires, and to map the distribution of land and forest fire vulnerability in South Sumatra Province. Land and forest fires use MODIS Hotspots data for 2017–2021. Prediction land and forest fire vulnerability using maximum entropy (Maxent) with predictive variables are climates, topography, soil, vegetation, and anthropogenic. The accuracy of the maxent model uses the AUC value. The number of hotspots with a confidence level of 70% in South Sumatra Province from the 2017–2021 period was 6,778 hotspots, with the highest number of hotspots occurring in 2019 being 5,826 hotspots. Maximum entropy (Maxent) can predict land and forest fires well in South Sumatra with AUC values of 0.807 (training data) and 0.801 (test data). Soil organic carbon, mean temperature of driest quarter, slope, and distance from rivers are essential variables influencing land and forest fires. The areas of land and forest fires vulnerability in South Sumatra Province are not vulnerable at 35,104 km2 (41.28%), low vulnerability at 26,394 km2 (31.04%), medium vulnerability at 15,413 km2 (18.13%), and high vulnerability at 8,119 km2 (9.55%). The districts/cities in South Sumatra Province with the most expansive areas of medium and high vulnerability are Ogan Komering Ilir, Musi Banyuasin, and Banyuasin districts. Data on land and forest fire vulnerability distribution in South Sumatra can be a reference for all parties in land and forest fire mitigation and prevention activities.
Herbicidal effects of n-hexane, ethyl acetate and methanol extracts of cogon grass (Imperata cylindica l.) and their phytotoxicity on spiny amaranth (Amaranthus spinosus l.) growth
Authors: Erida G , Ichsan C N , Hafsah S , Husna R , Marliah A , Nurahmi E , Hayati E
Published: June 2023

This research has the purpose of examining the activities of herbicidal effect of n-hexane, ethyl acetate and methanol extracts of cogon grass (Imperata cylindica L.) on spiny amaranth (Amaranthus spinosus L.) The rhizomes of I. cylindrica were extracted with n-hexane, ethyl acetate, and methanol, in that order. The extracts were tested on A. spinosus at concentrations of 5%, 10%, 15%, and 20%. We applied a synthetic herbicide at a concentration of 0.686 kg (2,4-D at 0.686 kg a.i. ha−1) for positive control, and for negative control, we used water without any chemicals (distilled water). The I. cylindrica extracts affects weed control, leaf area, root length, and shoot and root dry weight of A. spinosus. The application of 20 percent of n-hexane extract was the best treatment in terms of controlling A. spinosus (40.83%), but it was not different from other organic solvent treatments at various concentrations, in contrast to aquades (0.00%) and synthetic herbicides (100%). The n-hexane extract of I. cylindrica showed the strongest herbicide effect on A. spinosus after 28 DAA, while ethyl acetate and methanol showed only minimal herbicide effect. Gas Chromatography-mass spethroscopy (GC-MS) analysis showed that rhizome extracts of I. cylindrica contained 3 key compounds each as under : n-hexane extracts : [phthalic acid (43.30%), dibuthyl phthalate (29.75%), linoelaidic acid (5,93%)]; ethyl acetate extracts : [propanetriol acetate (31.73%), phthalic acid (5.69%), n-hexadecanoic acid (5.39%)]; methanol extracts : [acetic acid (52.95%), acetamide (21.86%), octaethylene glycol monododecyl (11.34%). The n-hexane extract proved promising to control A. spinosus
Embedded fuzzy logic for controlling pH and nutrition in hydroponic cultivation
Authors: Nasution I S , Satriyo P , Dhafir M , Devianti  , Iswanda A , Rani S , Fitria S R , Munawar A A
Published: June 2023

The uptake of plant nutrients causes nutritional imbalances in hydroponic recirculating systems. Generally, the biological parameters of nutrition solution systems are regulated by pH and nutrients that affect plant health; thus, they must be monitored and managed. In order to solve this issue, a fuzzy logic-based automated control system for intelligent hydroponics was developed. This paper describes the implementation of fuzzy logic controllers into a hydroponic monitoring system. This method produces a controlled hydroponic system in hydroponics by first gathering hydroponic plant data in real time. The system is created using the following steps: system design, prototyping, testing, and assessment. The system’s input consists of TDS and pH sensors, which are used to detect the plant’s nutrient content and pH. The system’s output is a 4-channel relay coupled to 4 small pumps for raising the pH level (pH up), reducing the pH level (pH down), and delivering nutrition AB mix. The fuzzy inference engine employs a combination of the Min-Max and Mamdani techniques. Defuzzification was performed using the centroid technique. The embedded fuzzy logic library (eFLL) is an auxiliary library used by the Arduino IDE. The developed mechanism makes appropriate selections about the nutrition solution management system and pH level.
The effectiveness of young coconut waste biochar application and goat manures to entisol soil on tomatoes (Solanum lycopersicum L.) vegetative growth
Authors: Warzukni W , Jauharlina J
Published: June 2023

This study aims to determine the effectiveness of applying young coconut biochar waste and goat manures to entisol soil on the vegetative growth of tomatoes. The research was conducted at the Biochar Research Center, Agriculture Faculty, Syiah Kuala University, which took place on August to December 2021. This study used a factorial randomized block design consisting of 2 factors. The first factor is treatment of Young Coconut Waste Biochar (B1: control, B2: 18.52 g polybag-1, B3: 37.04 g polybag-1) and the second factor is treatment dose of goat Manure (W), (W1: control, W2: 18.52 g polybag-1, W3: 37.04 g polybag-1 and W4: 55.55 polybag-1). Variables observed in this study were plant height (2, 4, 6, 8 weeks after planting), number of aged branches (2, 4, 6, 8 weeks after planting), net assimilation rate, plant growth rate and relative growth rate. The results showed that the application of young coconut biochar wastes and goat manures had no significant effect on the vegetative growth of tomatoes such as plant height at 4, 6, 8 weeks after planting, number of branches at 4, 6, 8 weeks after planting and net assimilation rate. There was an interaction on plant height at 2 weeks after planting but the application of biochar from young coconut waste and goat manure was not able to increase plant height, while in plant growth rate and relative growth rate the best dose was found in the application of 55.55 g polybag-1 goat manure.
Multi-dimensionally modulated optical vortex array
Authors: Tai Yuping , Fan Haihao , Ma Xin , Shen Yijie , Li Xinzhong
Published: June 2023

We report on a multi-dimensionally modulated optical vortex array (MMOVA). First, we propose a modified transform technique of the lattice coordinates, which possesses more modulated parameters. Then, the MMOVA is experimentally generated and the optical vortex (OV) is verified and determined by the interference method. Besides the whole structural transformation of MMOVA, the modulation of local part and even the individual OV are executed, which demonstrate the distinct capacity of MMOVA over that of the existing optical vortex array (OVA). The proposed MMOVA provides a novel scheme to generate OVAs with higher modulated dimensions, which will open up potential applications for multiple micro-particles manipulation.
Impact of Phenamacril on the Growth and Development of Fusarium pseudograminearum and Control of Crown Rot of Wheat
Authors: Hou Ying , Guo Yuwei , Wang Lili , He Shan , Zheng Wei , Liu Shengming , Xu Jianqiang
Published: June 2023

Fusarium pseudograminearum is the dominant pathogen causing Fusarium crown rot (FCR) of wheat. Phenamacril is a 2-cyanoacrylate fungicide, having a control effect on diseases caused by Fusarium spp. The objective of this study was to investigate the inhibitory effect of phenamacril on F. pseudograminearum and its control efficacy against FCR. The results showed that phenamacril had a strong inhibitory effect on the mycelial growth of F. pseudograminearum, EC50 values of phenamacril to 63 tested strains were in the range of 0.0998 to 0.5672 μg/ml, and the average EC50 value was 0.3403 ± 0.0872 μg/ml and could be used as the baseline sensitivity of F. pseudograminearum to phenamacril. Phenamacril reduced the germination rate of conidia of F. pseudograminearum, and the EC50 value was 5.0273 to 26.4814 μg/ml. In addition, we found that phenamacril had a teratogenic effect on conidia and blastotubules, which increased the ratio of conidial germination from the middle cells and showed high efficacy on the sporulation quantity of F. pseudograminearum with an EC50 value in the range of 0.0770 to 0.1064 μg/ml. There was no significant correlation between the sensitivity of F. pseudograminearum to phenamacril and its sensitivity to fludioxonil, carbendazim, tebuconazole, and kresoxim-methyl. In vitro and greenhouse assays showed that the treatment with 0.125 μl of active ingredient per gram recorded the best control effect on wheat crown rot, reaching 87.8 and 77.3%, respectively. In two experimental sites in Luoyang, phenamacril also had great control effect against FCR, reaching 83.9%. It was proven that phenamacril has a superior control effect against FCR. This study has laid a foundation for the study of the mechanism of action of phenamacril against F. pseudograminearum and provided a theoretical basis for the application of phenamacril to control FCR.
Impact of Cucurbita moschata Resistant Rootstocks on Cucumis sativus Fruit and Meloidogyne incognita Development
Authors: Li Xuzhen , Sun Yinhui , Yuan Xin , Ma Zhaoyang , Hong Yuanyuan , Chen Shuxia
Published: June 2023

Plant grafting can provide resistance to nematodes. There is a distinct need to determine the role of Meloidogyne incognita-resistant rootstocks on the growth and quality of grafted cucumber plants. Cucumber (Cucumis sativus L.) cultivar Jinchun No. 4 (J) was hole grafted onto the pumpkin (Cucurbita moschata) cultivars Xiuli (X), Banzhen No. 3 (B), and its root to generate JX, JB, and JJ plants. The histopathology and M. incognita development associated with JX, JB, and JJ were analyzed under incubator and high plastic tunnel conditions. Under incubator conditions, M. incognita root galls and egg mass indices associated with the JX and JB resistant rootstocks were significantly (P < 0.05) lower than those associated with JJ susceptible rootstocks. In addition, the number of eggs were 73.3 ± 8.8% and 85.3 ± 7.7% less, respectively. The number of second-stage juveniles (J2s) in JX roots decreased by 57.1 ± 9.2% compared with that in JJ, and the giant cell and J2 development were poor in JX and JB roots. In pot experiments under a high plastic tunnel, plant height, stem diameter, leaf area, and yield of M. incognita-infected JX plants were not significantly different from those of noninoculated control. There was no significant difference in fruit weight, length, firmness, soluble solids, and color among the three grafted plants. The yield per JB plant was increased compared with that of JJ, irrespective of nematode presence. In the M. incognita-infested soil experiment in a high plastic tunnel, the yield per JX and JB plant were significantly higher than JJ (P < 0.05). Thus, the pumpkin rootstock Xiuli and Banzhen No. 3 are promising rootstocks for managing M. incognita without affecting cucumber fruit quality. Grafting provides a good basis for studying the defense mechanism of rootstocks against M. incognita.
Sensitivity of Mucor piriformis to Natamycin and Efficacy of Natamycin Alone and with Salt and Heat Treatments Against Mucor Rot of Stored Mandarin Fruit
Authors: Saito S. , Wang F. , Xiao C. L.
Published: June 2023

Mucor rot caused by Mucor piriformis is an emerging postharvest disease of mandarin fruit in California. Natamycin is a newly registered biofungicide for postharvest use on citrus and some other fruits. In the study, baseline sensitivity to natamycin in 50 isolates of M. piriformis was determined in vitro. The mean EC50 (effective concentration to inhibit sporangiospore germination by 50%) and MIC (minimum inhibitory concentration to inhibit mycelial growth by 100%) values were 0.59 μg/ml and less than 1.0 μg/ml, respectively. Natamycin at the label rate of 920 μg/ml alone or in combination with 3% potassium sorbate (PS) or 3% sodium carbonate (SC) applied at 20 or 50°C was evaluated for control of Mucor rot on inoculated ‘Tango’ mandarin fruit. Natamycin alone reduced Mucor rot incidence on stored mandarin fruit from 100% among nontreated control fruit to approximately 30%, a reduction of more than 70% compared to the nontreated control, while 3% PS and 3% SC had no to little control. When applied at 50°C, natamycin and 3% PS reduced Mucor rot incidence by 65.0 and 31.2%, respectively; while natamycin in combination with 3% PS reduced disease incidence by 92.5% compared to the nontreated control after 2 weeks of storage at 5°C. This combined treatment remained effective even when the application of the treatment was delayed for 6 and 12 h after inoculation. However, the effectiveness of the treatments declined when storage was extended to 3 or 4 weeks. Natamycin can be an effective tool to control Mucor rot on mandarin fruit, and minimizing the period of extended storage could help maintain the control efficacy of natamycin.
Association of State Drug Laws with Nonmedical Use of Prescription Medications in Adolescents
Authors: Shanmugam Hariharan , Baum Christopher F. , Hawkins Summer Sherburne
Published: June 2023

Objective

The aim of the study is to examine the associations between mandatory access prescription drug monitoring programs (PDMPs), pain management clinic (PMC) laws, and doctor shopping (DS) laws with adolescent nonmedical use of prescription medications (NUPM).

Methods

We linked 2011–2015 Youth Risk Behavior Survey data on 364,103 adolescents across 40 states with PDMP, PMC laws, and DS laws. We conducted a 2-way fixed effects logistic regression model to examine the associations between state drug laws and adolescent self-reported NUPM.

Results

We found some evidence that implementation of a mandatory access PDMP was associated with a decrease in nonmedical use of prescription drugs at the P = 0.079 level (average marginal effect: −0.017, 95% confidence interval = −0.036 to 0.002), while there were no associations with the implementation of PMC and DS laws.

Conclusions

Our findings suggest that current state drug laws to combat NUPM are inadequate for adolescents.
A Clinical Score for Quantifying Edema in Mechanically Ventilated Children With Congenital Heart Disease in Intensive Care
Authors: Gelbart Ben , Kapalavai Sudeep Kumar , Marchesini Vanessa , Presneill Jeffrey , Veysey Andrea , Serratore Alyssa , Appleyard Jessica , Bellomo Rinaldo , Butt Warwick , Duke Trevor
Published: June 2023

IMPORTANCE:

Standardized clinical measurements of edema do not exist.

OBJECTIVES:

To describe a 19-point clinical edema score (CES), investigate its interobserver agreement, and compare changes between such CES and body weight.

DESIGN, SETTING, AND PARTICIPANTS:

Prospective observational study in a tertiary PICU of mechanically ventilated children with congenital heart disease.

MAIN OUTCOMES AND MEASURES:

Differences in the median CES between observer groups.

RESULTS:

We studied 61 children, with a median age of 8.0 days (interquartile range, 1.0–14.0 d). A total of 539 CES were performed by three observer groups (medical 1 [reference], medical 2, and bedside nurse) at 0, 24, and 48 hours from enrollment. Overall, there was close agreement between observer groups in mean, median, and upper quartile of CES scores, with least agreement observed in the lower quartile of scores. Across all quartiles of CES, after adjusting for baseline weight, cardiac surgical risk, duration of cardiopulmonary bypass, or peritoneal dialysis during the study, observer groups returned similar mean scores (medical 2: 25th centile +0.1 [95% CI, –0.2 to 0.5], median +0.6 [95% CI, –0.4 to 1.5], 75th centile +0.1 [95% CI, –1.1 to 1.4] and nurse: 25th centile +0.5 [95% CI, 0.0–0.9], median +0.7 [95% CI, 0.0–1.5], 75th centile –0.2 [95% CI, –1.3 to 1.0]) Within a multivariable mixed-effects linear regression model, including adjustment for baseline CES, each 1 point increase in CES was associated with a 12.1 grams (95% CI, 3.2–21 grams) increase in body weight.

CONCLUSIONS AND RELEVANCE:

In mechanically ventilated children with congenital heart disease, three groups of observers tended to agree when assessing overall edema using an ordinal clinical score assessed in six body regions, with agreement least at low edema scores. An increase in CES was associated with an increase in body weight, suggesting some validity for quantifying edema. Further exploration of the CES as a rapid clinical tool is indicated.
A Multi-Hospital Survey of Current Practices for Supporting Recovery From Sepsis
Authors: Hechtman Rachel K. , Cano Jennifer , Whittington Taylor , Hogan Cainnear K. , Seelye Sarah M. , Sussman Jeremy B. , Prescott Hallie C.
Published: June 2023

OBJECTIVES:

Sepsis survivors are at increased risk for morbidity and functional impairment. There are recommended practices to support recovery after sepsis, but it is unclear how often they are implemented. We sought to assess the current use of recovery-based practices across hospitals.

DESIGN:

Electronic survey assessing the use of best practices for recovery from COVID-related and non-COVID-related sepsis. Questions included four-point Likert responses of “never” to “always/nearly always.”

SETTING:

Twenty-six veterans affairs hospitals with the highest (n = 13) and lowest (n = 13) risk-adjusted 90-day sepsis survival.

SUBJECTS:

Inpatient and outpatient clinician leaders.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

For each domain, we calculated the proportion of “always/nearly always” responses and mean Likert scores. We assessed for differences by hospital survival, COVID versus non-COVID sepsis, and sepsis case volume. Across eight domains of care, the proportion “always/nearly always” responses ranged from: 80.7% (social support) and 69.8% (medication management) to 22.5% (physical recovery and adaptation) and 0.0% (emotional support). Higher-survival hospitals more often performed screening for new symptoms/limitations (49.2% vs 35.1% “always/nearly always,” p = 0.02) compared with lower-survival hospitals. There was no difference in “always/nearly always” responses for COVID-related versus non-COVID-related sepsis, but small differences in mean Likert score in four domains: care coordination (3.34 vs 3.48, p = 0.01), medication management (3.59 vs 3.65, p = 0.04), screening for new symptoms/limitations (3.13 vs 3.20, p = 0.02), and anticipatory guidance and education (2.97 vs 2.84, p < 0.001). Lower case volume hospitals more often performed care coordination (72.7% vs 43.8% “always/nearly always,” p = 0.02), screening for new symptoms/limitations (60.6% vs 35.8%, p < 0.001), and social support (100% vs 74.2%, p = 0.01).

CONCLUSIONS:

Our findings show variable adoption of practices for sepsis recovery. Future work is needed to understand why some practice domains are employed more frequently than others, and how to facilitate practice implementation, particularly within rarely adopted domains such as emotional support.
Epidemiology, Resistance Profiles, and Outcomes of Bloodstream Infections in Community-Onset Sepsis in the United States*
Authors: Ohnuma Tetsu , Chihara Shingo , Costin Blair , Treggiari Miriam , Bartz Raquel R. , Raghunathan Karthik , Krishnamoorthy Vijay
Published: June 2023

OBJECTIVES:

To describe frequency of positive blood cultures, patterns of pathogens’ characteristics and their resistance profile in patients with blood cultures drawn due to a presumed diagnosis of community-onset sepsis, and to examine the association between blood culture-positive pathogens and hospital mortality.

DESIGN:

Retrospective cohort study.

SETTING:

Two hundred one U.S. hospitals from 2016 to 2020 using the Premier Healthcare Database.

SUBJECTS:

Adult patients presenting with community-onset sepsis who had blood cultures collected within 2 days of hospital admission. We defined sepsis using the U.S. Centers for Disease Control Adult Sepsis Event Surveillance criteria.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We identified 147,061 patients with community-onset sepsis. The number of blood culture-positive sepsis episodes was 21,167 (14%) and the number of nonblood culture-positive sepsis episodes was 20,326 (14%). Among patients with blood culture-positive sepsis, Gram-negative rods were isolated in 55% of patients, Gram-positive cocci were isolated in 47%. Of those, methicillin-resistant Staphylococcus aureus (MRSA) was 11%, ceftriaxone-resistant Enterobacterales/extended-spectrum β-lactamase was 7%, and carbapenem-resistant Enterobacterales was 1.3%. The crude in-hospital mortality was 17% for culture-negative sepsis, 13% for nonblood culture-positive sepsis, and 17% for blood culture-positive sepsis. In multilevel logistic regression models, compared with culture-negative sepsis, blood culture-positive sepsis (adjusted odds ratio [aOR], 0.89; 95% CI, 0.85–0.94) and nonblood culture-positive sepsis (aOR, 0.82; 95% CI, 0.78–0.87) were associated with lower odds of in-hospital mortality. Acinetobacter species, Pseudomonas aeruginosa, methicillin-sensitive Staphylococcus aureus, and MRSA were associated with higher in-hospital mortality, whereas Escherichia coli, Klebsiella species, Proteus species, and Streptococcus species were associated with lower in-hospital mortality.

CONCLUSIONS:

In patients hospitalized with community-onset sepsis, the prevalence of blood culture-positive sepsis was 14%. Among positive blood culture sepsis resistant organisms were infrequent. Compared with culture-negative sepsis, blood culture-positive sepsis and nonblood culture-positive sepsis were associated with lower in-hospital mortality.
Effect of Structural Moral Case Deliberation on Burnout Symptoms, Moral Distress, and Team Climate in ICU Professionals: A Parallel Cluster Randomized Trial*
Authors: Kok Niek , Zegers Marieke , Teerenstra Steven , Fuchs Malaika , van der Hoeven Johannes G. , van Gurp Jelle L.P. , Hoedemaekers Cornelia W.E.
Published: June 2023

OBJECTIVES:

Moral case deliberation (MCD) is a team-based and facilitator-led, structured moral dialogue about ethical difficulties encountered in practice. This study assessed whether offering structural MCD in ICUs reduces burnout symptoms and moral distress and strengthens the team climate among ICU professionals.

DESIGN:

This is a parallel cluster randomized trial.

SETTING:

Six ICUs in two hospitals located in Nijmegen, between January 2020 and September 2021.

SUBJECTS:

Four hundred thirty-five ICU professionals.

INTERVENTIONS:

Three of the ICUs organized structural MCD. In three other units, there was no structural MCD or other structural discussions of moral problems.

MEASUREMENTS AND MAIN RESULTS:

The primary outcomes investigated were the three burnout symptoms—emotional exhaustion, depersonalization, and a low sense of personal accomplishment—among ICU professionals measured using the Maslach Burnout Inventory on a 0–6 scale. Secondary outcomes were moral distress (Moral Distress Scale) on a 0–336 scale and team climate (Safety Attitude Questionnaire) on a 0–4 scale. Organizational culture was an explorative outcome (culture of care barometer) and was measured on a 0–4 scale. Outcomes were measured at baseline and in 6-, 12-, and 21-month follow-ups. Intention-to-treat analyses were conducted using linear mixed models for longitudinal nested data. Structural MCD did not affect emotional exhaustion or depersonalization, or the team climate. It reduced professionals’ personal accomplishment (−0.15; p < 0.05) but also reduced moral distress (−5.48; p < 0.01). Perceptions of organizational support (0.15; p < 0.01), leadership (0.19; p < 0.001), and participation opportunities (0.13; p < 0.05) improved.

CONCLUSIONS:

Although structural MCD did not mitigate emotional exhaustion or depersonalization, and reduced personal accomplishment in ICU professionals, it did reduce moral distress. Moreover, it did not improve team climate, but improved the organizational culture.
Exploring the Knowledge Structures of Korean and International Nursing Research on Premature Infants Using Text Network Analysis
Authors: Lee Myeong Seon , Lee Seonah
Published: June 2023

This study aimed to identify the knowledge structures of Korean and international nursing studies on premature infants using text network analysis, which represents a text as a network graph that describes how keywords are linked. This network graph refers to a knowledge structure. International and Korean journal databases were searched to extract nursing studies regarding premature infants published in academic journals from 1998 to 2020. Abstracts from the selected studies were analyzed using the following four steps: word extraction and refinement, keyword extraction, co-occurrence matrix generation, and text network visualization. The results demonstrated that 182 Korean and 2502 international studies were published. The common keywords of Korean and international studies were “kangaroo mother care,” “stress,” and “child.” The keywords of the international studies had more branches linking to other keywords than those of the Korean studies. Thus, the knowledge structure of international studies included diverse concepts. These findings will serve as important guidance for future research worldwide. Furthermore, studies to develop a more comprehensive knowledge structure of international research on premature infants are needed. The knowledge structure of Korean studies mainly included concepts related to mothers. Korean studies regarding hospitalized premature infants and communication with parents need to be conducted.
I am Seen
Authors: Burke Erin
Published: June 2023

Nurses and advanced practice providers are encouraged to embrace resilience skills to deal with compassion fatigue and prevent burnout. As a Christian nurse, I learned the importance of daily staying close to Jesus when a beloved pediatric oncology patient died and I experienced overwhelming grief. Through prayers, Bible reading, and honoring the patient with coworkers, I found hope in Jesus' presence. God sees me as his beloved child and gives me strength to continue my work.
Prolonged Grief Disorder
Authors: Stegmeir Diane
Published: June 2023

Prolonged grief disorder (PGD), sometimes called complicated grief, can impair a person's ability to function in daily life and elevate the risk for physical and mental decompensation. In 2022, PGD was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), increasing the potential for treatment with interpersonal therapy and medication. Nurses with knowledge of the signs and risk factors of PGD can identify people experiencing extended, unresolving grief and can offer care and referrals for therapy and support.
Cultivating Student Success After Repeated Failure
Authors: Mingo Sharon
Published: June 2023

Everyone experiences failure. This reality contrasts with human desire and societal culture to succeed. Students experiencing academic failure can struggle to learn from failure, find hope, build resilience, and create self-efficacy. Insights and strategies of learning and applying Scripture and practicing positive affirmations in a mentoring atmosphere with Christian faculty can lead students to understand and accept God's orchestration of failure for good.
Opening My Eyes Building Nursing Student Awareness of Spirituality and Catholic Social Justice Principles
Authors: Watson Sherylyn M. , Cole Michelle A. , Goncalves Susan A.
Published: June 2023

How can nursing academia impart concepts of spirituality, social justice, and personal and professional growth to nursing students? The authors of this qualitative study explored the narratives of 21 nursing students' reflective journals written while students were participating in a global clinical mission. A guided reflective journal grounded in Catholic social teachings and St. Francis' social justice principles was used daily during the mission to capture participants' thoughts and feelings. Data analysis revealed that students discovered principles of spirituality and social justice and expressed a deeper appreciation for being present for others, providing healthcare to all equally, and promoting the common good. Guided questions enhanced the experiential learning experience, fostering personal and professional growth.
Global Service-Learning Fosters Collaboration, Cultural Humility, and Spiritual Growth among BSN Students
Authors: Digges Jean Marie , Faw Kathy
Published: June 2023

Nursing practice is evolving to include a more global perspective; therefore, nursing education must transcend the confines of the traditional classroom to prepare students to serve vulnerable populations across the globe. Collaboration, cultural humility, and spiritual growth through reflective practice are three themes identified in the literature as takeaways for students participating in global service-learning experiences. The development and implementation of a course on global service-learning is explored in this article. Biblical examples and anecdotal student comments support the themes identified in the literature.
The Interaction of Kidneys and Gut in Development of Salt-Sensitive Hypertension
Authors: Chrysant Steven G.
Published: June 2023

The incidence of salt-sensitive hypertension is quite common and varies between 30-60% in hypertensive patients. Regarding the causal role of high salt intake in the development of salt-sensitive hypertension, recent evidence has demonstrated that the gut through its microbiota plays a significant role in its genesis. Besides the gut, the kidneys also play important role in salt-sensitive hypertension and there is clinical and experimental evidence of an interrelationship between the gut and the kidneys in the development of salt-sensitive hypertension through the so-called “gastro-renal axis.” The gut besides being an absorptive organ, it is also a hormonal secretory organ involving the secretion of gastrin, dopamine, norepinephrine, angiotensin, and aldosterone which through their action with the kidneys are involved in the development of salt-sensitive hypertension. In addition, the kidneys exert a protective role against the development of hypertension through the secretion of prostaglandins and their vasodilatory action. To assess the current evidence on the role of high salt intake and the interplay of the gut and kidneys in its development, a Medline search of the English literature was contacted between 2012 and 2022, and 46 pertinent papers were selected. These papers together with collateral literature will be discussed in this review.
Is My Child Racist? Supporting Caregivers in Conceptualizing Race for Children
Authors: Carrasco Veronica Ilene , Solgi Mohadeseh , Davis Aaron , Chavis Antwon , Zuckerman Katharine , Augustyn Marilyn
Published: June 2023

CASE:

M is a 4-year-old White girl whose parents contact their primary care pediatric clinician with a behavioral concern: over the course of several months, M has insisted that she is pregnant with quintuplets. Although some of the quintuplets have light skin tones, others have darker skin tones. When elaborating about the fantasy, M often explains that the babies fight in her tummy, and the Brown babies are “acting badly” by spitting, scratching, and hitting the others. Although M can sometimes provide an explanation for why the Brown babies misbehaved (i.e., they ate chocolate), often she is not able to produce an answer. The child frequently reiterates the same story to her parents, which has left M's parents uncertain how to react.

In terms of her life course thus far, M has had typical development and behavior. She has attended all her well-child visits and met the usual developmental milestones. Beyond general development, her exposure to diverse people has been ample because she is from a multiethnic household in which 2 languages are regularly spoken. Outside of her home, she has close Brown and Black friends in her preschool, and the school has discussed race and skin color in an affirming way with the children. At home, she has books that feature children of different skin tones.

What advice can M's pediatric clinician offer? How can parents and pediatric clinicians support children who present with race-based thoughts or actions that seem discriminatory?
Prenatal organophosphate ester exposure and executive function in Norwegian preschoolers
Authors: Hall Amber M. , Keil Alexander P. , Choi Giehae , Ramos Amanda M. , Richardson David B. , Olshan Andrew F. , Martin Chantel L. , Villanger Gro D. , Reichborn-Kjennerud Ted , Zeiner Pål , Øvergaard Kristin R. , Sakhi Amrit K. , Thomsen Cathrine , Aase Heidi , Engel Stephanie M.
Published: June 2023

Background:

Organophosphate esters (OPEs) are ubiquitous chemicals, used as flame retardants and plasticizers. OPE usage has increased over time as a substitute for other controlled compounds. This study investigates the impact of prenatal OPE exposure on executive function (EF) in preschoolers.

Methods:

We selected 340 preschoolers from the Norwegian Mother, Father, and Child Cohort Study. Diphenyl-phosphate (DPhP), di-n-butyl-phosphate (DnBP), bis(2-butoxyethyl) phosphate (BBOEP), and bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) were measured in maternal urine. EF was measured using the Behavior Rating Inventory of Executive Functioning-Preschool (BRIEF-P) and the Stanford-Binet fifth edition (SB-5). EF scores were scaled so a higher score indicated worse performance. We estimated exposure-outcome associations and evaluated modification by child sex using linear regression.

Results:

Higher DnBP was associated with lower EF scores across multiple rater-based domains. Higher DPhP and BDCIPP were associated with lower SB-5 verbal working memory (β = 0.49, 95% CI = 0.12, 0.87; β = 0.53, 95% CI = 0.08, 1.02), and higher BBOEP was associated with lower teacher-rated inhibition (β = 0.34, 95% CI = 0.01, 0.63). DPhP was associated with lower parent-reported BRIEF-P measures in boys but not girls [inhibition: boys: 0.37 (95% CI = 0.03, 0.93); girls: –0.48 (95% CI = –1.27, 0.19); emotional control: boys: 0.44 (95% CI = –0.13, 1.26); girls: –0.83 (95% CI = –1.73, –0.00); working memory: boys: 0.49 (95% CI = 0.03, 1.08); girls: –0.40 (95% CI = –1.11, 0.36)]. Fewer sex interactions were observed for DnBP, BBOEP, and BDCIPP, with irregular patterns observed across EF domains.

Conclusions:

We found some evidence prenatal OPE exposure may impact EF in preschoolers and variation in associations by sex.