bluuebunny/crossref_metadata_2025 huggingface dataset:
Safeguarding the Patient and the Profession: The Value of Critical Care Nurse Certification
Authors:   American Association of Critical-Care Nurses,   AACN Certification Corporation
Published: November 2019

Today’s critically ill patients require heightened vigilance and extraordinarily intricate care. As skilled and responsible health professionals, the 403 000 critical care nurses in the United States must acquire the specialized knowledge and skills needed to provide this care and demonstrate their competence to the public, their employers, and their profession. Recognizing that nurses can validate specialty competence through certification, this white paper from the American Association of Critical-Care Nurses and the AACN Certification Corporation puts forth a call to action for all who can influence and will benefit from certified nurses’ contribution to patient care.
Visiting Preferences of Patients in the Intensive Care Unit and in a Complex Care Medical Unit
Authors: Gonzalez Colleen E. , Carroll Diane L. , Elliott Jeanne S. , Fitzgerald Patricia A. , Vallent Heather J.
Published: November 2019

• Background Within the challenging healthcare environment are nurses, patients, and patients’ families. Families want proximity to their loved ones, but the benefits of such proximity depend on patients’ conditions and family-patient dynamics.

• Objectives To describe patients’ preferences for family visiting in an intensive care unit and a complex care medical unit.

• Methods Sixty-two patients participated in a structured interview that assessed patients’ preferences for visiting, stressors and benefits of visiting, and patients’ perceived satisfaction with hospital guidelines for visiting.

• Results Patients in both units rated visiting as a nonstressful experience because visitors offered moderate levels of reassurance, comfort, and calming. Patients in the intensive care unit worried more about their families than did patients in the complex care medical unit but valued the fact that visitors could interpret information for the patients while providing information to assist the nurse in understanding the patients. Patients in the intensive care unit were more satisfied with visiting practices than were patients in the complex care medical unit, although both groups preferred visits of 35 to 55 minutes, 3 to 4 times a day, and with usually no more than 3 visitors.

• Conclusions These data provide the input of patients in the ongoing discussion of visiting practices in both intensive care units and complex care medical units. Patients were very satisfied with a visiting guideline that is flexible enough to meet their needs and those of their family members.
Critical Care Research: Weaving a Body-Mind-Spirit Tapestry
Authors: Guzzetta Cathie E.
Published: November 2019

Master weavers historically characterize the weaving of a tapestry as a calling, a transformation, a healing or sacred work. Tapestries are created by the collective efforts of many and are configured by the weavers’ consciousness and spirit. A holistic framework used to weave a body-mind-spirit tapestry for guiding holistic clinical practice and research is described. Various research studies that document the effects of holistic interventions on patients’ outcomes are examined. Implications for clinical practice are explored.
Short-Term Complications and Resource Utilization in Matched Subjects After On-Pump or Off-Pump Primary Isolated Coronary Artery Bypass
Authors: Hravnak Marilyn , Hoffman Leslie A. , Saul Melissa I. , Zullo Thomas G. , Cuneo Julie F. , Pellegrini Ronald V.
Published: November 2019

• Background Studies suggest that patients who undergo off-pump coronary artery bypass grafting (OPCABG) have fewer short-term complications and use fewer inpatient resources than do patients who undergo standard coronary artery bypass grafting (CABG) with extracorporeal circulation. However, dissimilarity between groups in risk factors for complications has hindered interpretation of results.

• Objectives To compare the prevalence of selected complications (atrial fibrillation, stroke, reoperation, and bleeding) and inpatient resource utilization (length of stay, discharge disposition, total charges) between subjects undergoing primary isolated CABG or OPCABG who were matched with respect to key risk factors.

• Methods Retrospective, causal-comparative survey conducted in 1 center for 18 months. Patients who underwent primary isolated CABG or OPCABG were matched for sex, age (within 2 years), left ventricular ejection fraction (within 0.05), and graft-patient ratio (exact match) and compared for prevalence of new-onset atrial fibrillation, stroke, reoperation within 24 hours, and bleeding. Statistical analysis included Wilcoxon and t tests for paired comparisons.

• Results The sample (107 matched pairs) was 63% male, with a mean age of 66 (SD 9.5) years, a mean left ventricular ejection fraction of 0.51 (SD 0.13), and a mean graft-patient ratio of 3.41 (SD 0.74). The 2 groups did not differ significantly in New York Heart Association class (P = .43), Acute Physiology and Chronic Health Evaluation III score (P = .22), postoperative β-blocker use (P = .73), or comorbid conditions. None of the complications examined differed significantly between pairs.

• Conclusion Patients with comparable risk profiles have similar prevalences of selected complications after CABG and OPCABG.
Management of Patients With Preformed Reactive Antibodies Who Are Awaiting Cardiac Transplantation
Authors: Ballew Carole C. , Bergin James D.
Published: November 2019

Patients with elevated levels of preformed reactive antibodies to HLA antigens have higher rates of organ rejection than do patients without such antibodies. Consequently, before proceeding with transplantation, many medical centers do prospective cross-matching, that is, mix lymphocytes from the organ donor with sera from the prospective organ recipient, to determine whether a higher rejection rate or an immediate episode of rejection will occur. The problem has been compounded by the increased frequency of preformed reactive antibodies in patients with ventricular assist devices who are awaiting cardiac transplantation. Performing a prospective cross-match can be time-consuming and often is impossible because of the unstable condition of the organ donor or travel logistics, leading to increased costs for transplantation and longer waiting times for recipients. A variety of treatments are used in cardiac transplantation programs in attempts to reduce the concentration of preformed reactive antibodies. Each of these treatments has accompanying complications and considerations for the transplant team. Each treatment must also be assessed for therapeutic response. Options for managing patients with preformed antibodies and a case report are presented.
NEC: etiology, treatment, prevention, and nursing care
Authors: Roberts PM
Published: November 2019

NEC, a highly lethal disease that affects premature/compromised infants, is characterized by ischemic necrosis of the gastrointestinal tract. While risk factors can be identified, pathogenesis is uncertain. Protective factors in breast milk promote intestinal maturation and protect the newborn gut from pathologic penetration of macromolecules. Medical and surgical treatments have improved the prognosis of those diagnosed with NEC; however, prevention appears to be the most effective way to decrease mortality rates in the ever-increasing premature population.
RATG: implications for nursing care in organ transplantation
Authors: Pezze JL
Published: November 2019

Proper immunosuppression is a key element determining the survival of patients undergoing organ transplantation. RATG is one of several immunosuppressive agents available for use. Nurses need to recognize the unique challenges that RATG poses for patient and dosage preparation, along with those affecting its administration and post administration. Doing so can effectively aid the transplanted patient in achieving optimal immunosuppression with the least amount of unpleasant effects. The hospital stay for a transplant patient can be very frustrating and exhausting. Nursing interventions that limit these effects can foster a more desirable patient experience.
Hypokalemia
Authors: DeAngelis R , Lessig ML
Published: November 2019

Hypokalemia is an electrolyte imbalance that can have serious effects on the patient if not detected early. Therefore, it is important for the nurse to: (1) be aware of those patients at risk for excess potassium loss, (2) monitor those patients' ECG to observe for any changes indicative of hypokalemia, and (3) assess for physical signs and symptoms indicative of hypokalemia. Early detection of hypokalemia and early intervention will prevent potential catastrophic events.
Caring for the victim of near drowning
Authors: Glankler DM
Published: November 2019

If no complications arise, the near-drowning victim is usually discharged within 48 hours. However, some patients require complex care because of multisystem failure. These patients challenge the critical care nurse, who must understand the interrelationships of the problems to provide quality care. The major focus of care is stabilization and normalization of the cardiovascular, respiratory and neurologic systems through accurate nursing assessments and implementation of appropriate nursing care.
Caregiver-reported health-related quality of life of children with cerebral palsy and their families and its association with gross motor function: A South Indian study
Authors: Surender S. , Gowda Vykuntaraju K. , Sanjay K. S. , Basavaraja G. V. , Benakappa Naveen , Benakappa Asha
Published: November 2019

Introduction: In children, health-related quality of life (HRQOL) includes parental impact and family functioning along with concepts of illness, functional status, mental health, and comfort. We are focusing on the impact of cerebral palsy (CP) on children’s HRQOL and their families, and its relationship with gross motor dysfunction. Subjects and Methods: CP children aged 3–10 years under regular neurology follow-up were enrolled. The HRQOL and motor severity were prospectively assessed using lifestyle assessment questionnaire-CP and gross motor function classification systems, respectively. Results: One hundred children participated in this study. Thirty-three percent of children had good, 22% had mildly affected, whereas 45% had moderately to severely affected HRQOL. A significant association is present between gross motor function classification system and HRQOL. Conclusion: HRQOL in CP and their caregivers is highly
impaired. The degree of impairment is associated with physical independence, mobility, clinical burden, and social integration dimensions. Therapies targeting these dimensions and associated comorbidities will improve the HRQOL. Gross motor function classification system is a good indicator of HRQOL.
Traumatic atlantoaxial dislocation with an odontoid fracture: A rare and potentially fatal injury
Authors: Zitouna Khaled , Riahi Hend , Lassoued Nabil , Selmene Mohamed , Barsaoui Maher , Drissi Ghassen
Published: November 2019

Traumatic dislocation of the atlanto-axial joint in combination with an odontoid fracture remains a rare entity. Beaucause of its instability, it's alsoo a seriuous injury. A fatal outcome is feared especially in elderly. We report a case of 74-year-old man who presented with neck pain Confusion and spastic tetraparesia after a low energy trauma. Radiographs and computed tomography demonstrated a C1C2 dislocation with odontoid fracture. After an unsuccessful attempt at closed reduction with halo traction, a surgical stabilisation was performed using a posterior approach. Death was occured in early postoperative due to respiratory distress.
Intraoperative management of a patient for deep brain stimulation with severe dyskinesia and tremors: Ketamine to the rescue!
Authors: Sokhal Suman , Goyal Keshav , Sokhal Navdeep , Kumar Niraj , Kedia Shweta
Published: November 2019

The loss of dopaminergic neurons from the substantia nigra pars compacta characterizes the classical pathology of Parkinson's disease (PD). Deep brain stimulation (DBS) has become an increasingly common treatment for PD. Sometimes excessive tremors due to exacerbated PD hinder the surgery and may almost make it impossible. This is a case report highlights use of IV ketamine for intraoperative sedation of a patient with PD, with severe dyskinesia & tremors, posted for DBS. IV ketamine resulted in prompt abolition of tremors and dyskinesia, which were unresponsive to previous traditional sedative drugs.
A case series of craniopharyngioma: Epidemiological study and management analysis at tertiary care center
Authors: Ramanbhavana Venkata , Vara Prasad Kadali
Published: November 2019

Introduction: Debate continues as to the optimal treatment for craniopharyngioma; radical surgical resection or partial resection followed by radiotherapy. Radical surgical resection may be complicated by intraoperative injury to surrounding structures and stormy postoperative hormonal problems. This study aims to examine the result of safe maximal surgical resection. Methodology: Retrospective study of all histopathologically proven craniopharyngiomas who had undergone surgical resection over an almost 4-year period was included. Data were collected reviewing demography, clinical presentation, hormonal dysfunction, extent of resection, and visual deterioration. Outcome was measured in terms of Glasgow Outcome Scale and recurrence. Results: Of 41 patients, 20(48.8%) were male and 21(51.2%) were female. Age of patients ranged from 1 to 59 years with a mean of 15.9 years. Thirty-seven patients (90%) had headache, 32 patients (78%) had visual disturbances, 23 patients (56%) had vomiting, and 10 patients (24%) had convulsions. Six patients (15%) had memory and sleep disorders and three patients of those >15 years (12.5%) had amenorrhea/sexual dysfunction. Patients who had surgery followed by radiotherapy had better prognosis, so also those aged 18 or less compared to older, males better than females and those without headache had better prognosis, though not statistically significant. Conclusions: Gross total excision if judiciously decided intraoperatively has a favorable outcome with acceptable morbidity. Patient has better prognosis who has surgery with radiotherapy.
Large Amoebic Liver Abscess with Persistent Biliary Fistula
Authors: Shah Apurva S. , Bohra Shravan
Published: November 2019

Liver abscess with biliary communication poses management problem if percutaneous drainage is performed. We report a case of large amoebic liver abscess (ALA) with jaundice. Prolonged high‑output bile drainage after percutaneous drainage of ALA showed suspicion of communication of abscess with intrahepatic bile ducts (biliary fistula). The same was managed successfully with endoscopic biliary stent placement with medical management.
El Sahel: dimensión transfronteriza y dinámicas geopolíticas
Authors: Anguita Olmedo Concepción , González Gómez del Miño Paloma
Published: November 2019

La región del Sahel es una encrucijada de desafíos interrelacionados que acumula una amplia tipología de debilidades: subdesarrollo, pobreza, inseguridad, corrupción, conflictos étnicos, Estados frágiles y economías dependientes. Todos estos factores la convierten en una zona de fricción que puede abocar a conflictos diversos. El objetivo de este artículo es identificar los factores de índole geopolítica que caracterizan el desarrollo y la seguridad humana de esta región de frontera, que están impidiendo a los países del Sahel superar la consideración de Estados frágiles. El resultado de este estudio indica que la región no podrá transformar las vulnerabilidades que la caracterizan en dinámicas positivas si no se actúa en tres planos: participación de la población, refuerzo de las instituciones y promoción de la cooperación.
The Effect of Electronic Banking on Customer Services Delivery in Commercial Banks in Rwanda
Authors: Nyiranzabamwita Rose , Harelimana Jean Bosco
Published: November 2019

The aim of the study was to assess how electronic banking affected customer delivery channels in Rwanda commercial banks. The specific objectives include assessing the effectiveness of e-banking, analyzing the factors affecting the customer delivery system, and also finding out the affiliation that exists between customer service delivery and e-banking in the bank of Kigali. Study participants included 1215 employee and about 350000 bank clients. The total number was 351215 study participants. The sample size was 400, which included both the staff and clients. The study revealed that customer service delivery in Bank of Kigali was explained by the probability of 0.0374 for internet banking; by the probability of 0.0004 for mobile banking; by probability of 0.0010 for electronic tax and that are respectively expected to 3.74% & 0.04% & 0.1% and of probabilities which are less than 10%. If we consider the simple regression theory, there is a probability of less than 10% by each electronic banking factor, which represents functional fitness variability. The R2 is 0.969, whereas the Adjusted R2 is 0.965, which indicates estimated model goodness. Up to 96.9% of the long-run appreciation in customer service delivery is influenced by changes in internet banking; mobile banking; electronic tax as implemented by the organization. Hence, the study revealed of essential affiliation between electronic banking and the observed factors, and the customer delivery channel in Bank of Kigali. The study recommended on sensitization of clients on the utilization and advantages of electronic banking services through having public awareness programs that boost their knowledge of the service.
Do State Fiscal Constraints Affect Implementation of Highway Public-Private Partnerships? A Panel Fixed Logit Assessment
Authors: Chen Zhenhua , Daito Nobuhiko , Gifford Jonathan L.
Published: November 2019

Infrastructure public-private partnerships (“P3s”) have gained considerable recognition as useful policy tools for state and local governments to deliver critically needed infrastructure projects. The objective of this study is to empirically test one of the claims often made regarding states’ motivations for employing this procurement mechanism: P3s can help overcome fiscal constraints on state infrastructure investment. In addition, this study empirically analyzes how state P3 enabling legislation affects the behavior of both the public and private sectors. A regular logit model and a fixed effects logit panel model are employed to test the hypothesis that states with more severe fiscal constraints are more likely to seek P3s for highway infrastructure construction and finance. After controlling for such factors as state economic condition, legislative political affiliation, and highway travel demand, the empirical results indicate that states’ fiscal constraints are not associated with the propensity to use highway P3 projects.
A Continuous Professional Development Strategy for Expanded Competencies Needed by Radiographers Working in Rural Areas
Authors: Mung’omba Bernard , Botha Annali DH
Published: November 2019

INTRODUCTION: The emphasis on Primary Health Care (PHC) with a focus on preventative care offers a challenge for rural radiographers to advance solutions that are change focused. Published evidence suggest that allied health professionals such as radiographers employed in rural areas of South Africa were confronted with an assortment of challenges and responsibilities that demand a wide range of skills and competencies. Additional skills could be essential and Continuous Professional Development (CPD) strategy could be used as a vehicle to equip rural radiographers.

OBJECTIVE: To propose a CPD strategy that may support rural radiographers’ expanded and extended competency development needs.

METHODS: This research used exploratory sequential study design involving Phase I (qualitative) and Phase II (quantitative) with seven participants and 101 respondents respectively. The CPD strategy development was based on the results from data analysis of both strands. Since strategy development is based on a process of trustworthiness, six evaluators from the clinical and academia were consulted. The evaluators were purposely selected.

RESULTS: A final CPD strategy for rural radiographers was proposed. Results from a mixed method study were used in the process of developing the CPD strategy.

DISCUSSION: Radiographers working in rural areas of KwaZulu Natal (KZN) a province in South Africa are faced with emerging competency need that require both extended and expanded competencies which may be beyond those required for professional registration. This unmet competency needs can be supported by a CPD strategy that is aligned to these competency needs.
Study of Nuclear Structure of 18F Isotope by using PW and CWH Interactions
Authors: Hasan Ali K. , A. Zayed Batool
Published: November 2019

In this study, the energy levels of the 18F and electrical transitions B(E2) were calculated by applying the shell model where the calculations were carried out in the SD model space and using the OXBASH code. The theoretical results were compared with the experimental.
Jak „šla“ brněnská trestní práva
Authors: Kratochvíl Vladimír
Published: November 2019

Následující text nabízí historické, pracovní a osobní zamyšlení o tom, kdy a kde „trestní práva“ na Právnické fakultě Masarykovy univerzity vznikala, jak v průběhu času (ne)obstála mezi „mlýnskými kameny“ teorie a praxe, tedy jak „šla“ uplynulých sto let od založení Masarykovy univerzity a Právnické fakulty, implicite i její Katedry trestního práva, zejména od druhé poloviny XX. století.
Molekularnogenetski vidiki preiskav starodavne DNA
Authors: Zupanič Pajnič Irena
Published: November 2019

Prispevek na pregleden način opisuje molekularnogenetske vidike preiskav človeške starodavne DNA in uporabo molekularnogenetskih metod za preučevanje DNA, pridobljene iz človeških arheoloških bioloških materialov. V arheoloških bioloških materialih so pogosto edini vir starodavne DNA skeletni ostanki (kosti in zobje), zato se bomo osredinili na ta tkiva. Iz pregledane literature bomo povzeli, kateri skeletni elementi so najprimernejši za preiskave starodavne DNA in kako iz njih pridobimo DNA. Prav tako bomo razložili naravo starodavne DNA in njeno ohranjenost. V arheoloških bioloških materialih je zelo malo DNA in je močno poškodovana. Zato se zlasti pri delu s starodavnimi človeškimi vzorci pojavijo težave, povezane s kontaminiranjem s sodobno DNA človeka. Za zmanjšanje tega tveganja je potrebno upoštevati več standardnih previdnostnih ukrepov in preverjati avtentičnost starodavne DNA. V prispevku bomo tem ukrepom namenili posebno pozornost. Opisali bomo genetske označevalce, ki jih v arheogenetiki najpogosteje preiskujemo, in prednosti novih, visoko zmogljivih tehnik sekvenciranja za razvoj in preučevanje starodavne DNA. Danes lahko z njimi preiskujemo bolj razgrajeno DNA in s tem starejše arheološke biološke materiale. Tako pridobivamo ogromne količine kakovostnih podatkov, ki zahtevajo vključevanje strokovnjakov na področju bioinformatike. Prispevek bomo zaključili s predstavitvijo preiskav starodavne DNA v Sloveniji.
Application of open field, tonic immobility, and attention bias tests to hens with different ranging patterns
Authors: Campbell Dana L.M. , Dickson Emily J. , Lee Caroline
Published: November 2019

Assessment of negative affective states is a key component of animal welfare research. In laying hens, excessive fearfulness results in reduced production and increased sensitivity to stress. Fearfulness can be defined as a response to a known threat, but anxiety is a response to an unknown threat and may have similar negative consequences. The open field test and tonic immobility test are commonly applied to measure fearfulness in laying hens. An attention bias test that measured individual hen’s responses to playback of a conspecific alarm call in the presence of food was recently pharmacologically validated using an anxiogenic drug but was confounded by the hen’s typical motionless response in a novel environment. The current study used 56-week old free-range layers to further assess the validity of an attention bias test to differentiate ranging treatment groups in comparison with the open field and tonic immobility tests. The selected hens varied in their range use patterns as tracked by radio-frequency identification technology. ‘Indoor’ hens did not access the range and ‘outdoor’ hens ranged daily; previous research has confirmed higher fearfulness in hens that remain indoors. The tonic immobility test did not differentiate ranging groups (P= 0.34), but indoor birds were slower to first step (P= 0.03) and stepped less (P= 0.02) in the open field test. The attention bias test occurred in an isolated wooden box using a conspecific alarm call playback (a threat) and mixed grain (a positive stimulus). The behavioural response of latency to resume eating following playback of the alarm call was measured to differentiate the anxiety states of the indoor and outdoor ranging birds. Before the attention bias test could occur, birds had to be habituated to the test box across three separate 5-minute sessions to increase the willingness to feed within the novel test environment. All birds ate faster across time (P< 0.001) but the indoor birds were slower to eat than the outdoor birds (P< 0.001). In this study, the latency to resume eating following an alarm call was determined to be a poor measure for highly anxious birds as they failed to eat at all. Forty-six percent of indoor hens were excluded for not eating across the 5-minute test. Of the birds that did eat, only 7% of indoor hens ate following playback of the alarm call, compared with 36% of outdoor hens. This repetition of an attention bias test for laying hens highlights the challenges in assessing hens with extreme fearful/anxious responses and that information may be missed when non-performing hens are excluded from behavioural tests. We suggest that latency to eat in a novel arena without any alarm call playback is an informative measure of anxious state that can be applied to all hens but consideration must be made of potential differences in food motivation.
Acute Osteomyelitis of the Posterior Column of the Acetabulum: About a Case
Authors: Jlidi M. , Selim D. , Jedidi N. , Khelil K. , Trabelsi Y. , Bouzaidi K. , Khorbi A.
Published: November 2019

Introduction: Acute osteomyelitis usually occurs in the metaphysis of the long bones, the lower limb being more commonly affected than the upper limb. Pelvic localization is rare.

Observation: An 11-year-old boy with no remarkable history of illness visited our emergency room complaining from high fever and atromatic right hip pain. The orthopedic examination objectified a limitation of the right hip joint motions especially in extension, the palpation of the groinâ€™s crease was slightly painful without local inflammatory signs nor lymphadenopathies. Blood laboratory tests found an inflammatory syndrome. Hip X-rays did not show any abnormality, the ultrasound of the right hip showed a joint effusion of low abundance measuring 1 mm. Magnetic resonance imaging detected anhypointense signal on T1-weighted sequences and a high intensity signal on T2-weighted on the right acetabulum with contrast enhacement after gadolinium administration. It combines a fat infiltration and a collection of 13x6 mm in the internal obturator muscle. The diagnosis of acute osteomyelitis of the posterior column with soft tissue invasion and reactive arthritis was confirmed. The blood cultures did not isolate a germ and the urinalysis was negative. The child was given antibiotic therapy: amoxicillin clavulanic acid and fusidic acid intravenously for a period of 21 days and then orally for a total duration of 12 weeks. The evolution was marked by a clinical improvement and a negation of the CRP. A 3-month control MRI showed total regression of the soft tissue collections.

Discussion: Pelvic osteomyelitis is rare, patients with pelvic osteomyelitis can present various clinical signs, which gives place to late or erroneous diagnosis. The prognosis of pelvic osteomyelitis is very favorable. The rate of recovery without sequelae is greater than 95%, but decreases with late diagnosis and treatment failure.

Conclusion: Osteomyelitis remains an endemic pathology in Tunisia despite the development of diagnostic’ means and antibiotic therapy. Pelvic osteomyelitis is rare; it poses a diagnostic problem especially with Ewing's sarcoma. Its prognosis is favorable but decreases with a delay of antibiotic administration.
A Retrospective Study on Clinical Features of Early Neonatal Jaundice in Term Babies at Ratchaburi Hospital, Thailand
Authors: Phyu Khine Lynn , Zaw Kaung , Kyaw Soe Htoo Htoo , Than Nan Nitra , Lwin Htay , Limkittikul Kriengsak
Published: November 2019

Background: Neonatal jaundice is a common condition that sometimes lead to devastating neurological consequence such as kernicterus.

Aim: This study was aimed to find out the clinical features and etiology of neonatal jaundice in term newborn admitted to Ratchaburi Hospital.

Study Design:  Hospital-based retrospective study

Methodology: The study was conducted by reviewing 117 medical records of neonatal jaundice who were admitted at Ratchaburi Regional Hospital, Bangkok, Thailand from 1st October 2007 to 30th September 2008. Both the patient’s and their mother’s profiles, etiology and clinical features of jaundice were extracted.

Results: The results showed that the most common etiology was inconclusive jaundice (64.9%) followed by ABO incompatibility (17.9%) and breast feeding jaundice (10.2%). Other less common causes were G6PD deficiency, minor blood group incompatibility and cephalhematoma. The onset of the neonatal jaundice usually occurred on the 2nd to the 4th day of life and almost all newborns responded well to phototherapy. Most of interventions were started on the 2nd day of life. Moreover, exchange transfusion was needed in four cases. The maximum and minimum haematocrit was significantly lower while Nucleated Red Cell (NRC) count and percent of reticulocytes counts were significantly higher in haemolysis group than in non-haemolysis group,.

Conclusion: From our study, the most common etiology was inconclusive jaundice which is followed by ABO incompatibility but non-immune hemolysis and polycythemia were not encountered. There was significant difference of hematocrit, NRC and reticulocytes between hemolytic and non-hemolytic groups. Detailed approach of history taking and physical examination, early investigations of jaundice work up and septic work up are recommended in eliciting various etiologies and preventing complications.
Plan-Do-Check-Act Framework: Effects on Pediatric Students Nurses Compliance toward Using Intravenous Smart Pump
Authors: Allam Nehal. A. , AlSadhan Norah A.
Published: November 2019

Background: Using Intravenous Smart Pump by pediatric nursing students has shaped the challenge of finding innovative ways to teach clinical skills. The study aimed to assess the effect of PDSA framework on pediatric nurses compliance in using smart pump technology for intravenous medication administration in the pediatric intensive care unit.

Design: A Quasi-Experimental quantitative, pre/post-test design was used to conduct the study. A purposive sample of 90 pediatric nursing students chosen based on the simple random sample for the academic year 2016– 2017, participated in the study.

Methods: Three tools were designed by the researchers to collect the necessary data to implement the Plan Do Study Act (PDSA) framework.

Statistical Analysis: The collected data were coded, analyzed and tabulated using frequencies and percentage, mean, standard deviation & chi-square tests.

Results: There was a statistically significant difference and marked improvement in nurses students’ total knowledge and skills levels of smart pump intravenous administration (Pre and Post Plan Do Study Act (PDSA) framework) pre/post periods of assessment. It was observed that the majority of studied sample had good scores (100%, 97.8%, 97.8% & 93.3%) respectively post-intervention compared to (73.3%, 64.5%, 52.2%, 36.7%, 16.7%, 13.3%) pre-program and respectively (p<0.01).

Conclusion: Administration of intravenous therapy for neonates can be risky but when supported by the use of smart pump systems with proper programming, compliance nurses students and staff education by reporting, monitoring, it will be a valuable tool to avoid actually catastrophic damage related to medication and infusion errors.

Recommendation: Collaboration between health professionals is the key of successful implementation of smart infusion pump technology which can improve patient safety.
Spectrum of Neonatal Surgical Problems in the Newborn: Incidence, Clinical Course, Immediate Outcome, Follow up Study in a Tertiary Care NICU
Authors: Sachin K. G. , Sachin K. R. , Ramesh H. , Prasad Guru , Bullapur Harsha
Published: November 2019

Background: A congenital anomaly may be defined in terms of physical structure as a malformation, an abnormality of physical structure or form usually found at birth or during the first few weeks of life. Congenital anomalies affect approximately 1 in 33 infants and result in approximately 3.2 million birth defect-related disabilities every year. Congenital anomalies or birth defects are relatively common, affecting 3% to 5% of live births in the United States (US) and 2.1% in Europe. Congenital anomalies account for 8% to 15% of perinatal deaths and 13% to 16% of neonatal deaths in India.

Objectives: To provide an insight on the burden and types of surgical problems encountered in our NICU of Bapuji Child Health Institute & Research Center, JJM Medical College, Davangere, Karnataka, India and to study the incidence, clinical profile and outcome of surgical condition. Methodology: A total of 3820 babies were examined over a period of 2 years. The relevant information was documented on a semi-structured proforma and analysed.

Results: Overall incidence of congenital malformations at birth was 24.8 per 1000 births. The GIT system (51.58%) was most commonly involved followed by respiratory system (26.32%). The incidence of congenital malformation was more in male babies than female babies. Increased frequency was seen in babies born to mothers between 26–30 years & primigravida. The factors which significantly increased the rate of congenital malformations were consanguinity in parents & bad obstetric history. Out of 95 cases, 72% got discharged normally, 18% died in NICU and 10% got discharged against medical advise.

Conclusion: With emphasis on “small family” norms and population control it is necessary to identify malformations so that interventional programmes can be planned. Systematic clinical examination of newborns for early detection of anomalies that may warrant medical or surgical intervention. Accurate antenatal anomaly scan need to be done to identify major malformations and terminate the pregnancy.
The Dynamic Emission Zone in Sandwich Polymer Light‐Emitting Electrochemical Cells
Authors: Diethelm Matthias , Schiller Andreas , Kawecki Maciej , Devižis Andrius , Blülle Balthasar , Jenatsch Sandra , Knapp Evelyne , Grossmann Quirin , Ruhstaller Beat , Nüesch Frank , Hany Roland
Published: November 2019

In light‐emitting electrochemical cells (LECs), the position of the emission zone (EZ) is not predefined via a multilayer architecture design, but governed by a complex motion of electrical and ionic charges. As a result of the evolution of doped charge transport layers that enclose a dynamic intrinsic region until steady state is reached, the EZ is often dynamic during turn‐on. For thick sandwich polymer LECs, a continuous change of the emission color provides a direct visual indication of a moving EZ. Results from an optical and electrical analysis indicate that the intrinsic zone is narrow at early times, but starts to widen during operation, notably well before the electrical device optimum is reached. Results from numerical simulations demonstrate that the only precondition for this event to occur is that the mobilities of anions (μa) and cations (μc) are not equal, and the direction of the EZ shift dictates μc > μa. Quantitative ion profiles reveal that the displacement of ions stops when the intrinsic zone stabilizes, confirming the relation between ion movement and EZ shift. Finally, simulations indicate that the experimental current peak for constant‐voltage operation is intrinsic and the subsequent decay does not result from degradation, as commonly stated.
Exciplex Emission in Light‐Emitting Electrochemical Cells and Light Outcoupling Methods for More Efficient LEC Devices
Authors: Uchida Soichi , Nishikitani Yoshinori
Published: November 2019

Much effort has gone into research on light‐emitting electrochemical cells (LECs) in recent years. LECs have a simple structure and can be fabricated using low‐cost methods and materials and are seen as the next big thing in organic devices after organic light‐emitting diodes (OLEDs). In particular, expectations are high, in that LECs could be used to create a new generation of low‐cost lighting systems, making use of their surface‐emitting property. Getting such systems to the market will require the development of highly efficient white light‐emitting LECs. A variety of methods for obtaining white emission based on the light‐mixing principle have been explored. Among these, the use of exciplexes formed between donor‐type and acceptor‐type molecules is one of the more promising. Exciplex emission is broad in spectrum and can be used to produce LECs with a high color rendering index. In this progress report, the recent developments in research into LECs designed to utilize exciplex emission and present technologies used to obtain white emission are discussed. The potential for using thermally activated delayed fluorescence to improve efficiency is described. Finally, the latest developments in optical engineering techniques for LECs are also discussed.
Light Irradiation of Gold Nanoparticles Toward Advanced Cancer Therapeutics
Authors: Amendoeira Ana , García Lorenzo Rivas , Fernandes Alexandra R. , Baptista Pedro V.
Published: November 2019

Cancer is one of the leading causes of death in the world. To challenge this epidemic, there are growing demands for the development of new advanced and targeted therapeutics capable of effectively tackling cancer cells with improved selectivity. Nanomedicine has put forward several innovative therapeutics toward improving therapeutic efficacy while decreasing the deleterious side effects of current chemotherapy. Multifunctional gold nanoparticles (AuNPs) have been at the core of a plethora of advanced therapeutic strategies that provide selective targeting with their unique optical properties, capable to interact with the light of specific wavelength to deliver therapy with tremendous spatiotemporal precision. AuNPs have been exploited as photodynamic and photothermal therapeutic agents alone or in combination with other cancer treatment modalities with other cancer applications. Due to their exceptional physicochemical properties, they have been proven efficacious allies for photodynamic therapy and for photothermal therapy regimens. Herein, the rapidly progressing literature related to the use of these promising strategies against cancer is discussed, highlighting their possible future clinical translation.
A Tailored Multifunctional Anticancer Nanodelivery System for Ruthenium‐Based Photosensitizers: Tumor Microenvironment Adaption and Remodeling
Authors: Liang Jin‐Hao , Zheng Yue , Wu Xiao‐Wen , Tan Cai‐Ping , Ji Liang‐Nian , Mao Zong‐Wan
Published: November 2019

Ruthenium complexes are promising photosensitizers (PSs), but their clinical applications have many limitations. Here, a multifunctional nano‐platform PDA‐Pt‐CD@RuFc formed by platinum‐decorated and cyclodextrin (CD)‐modified polydopamine (PDA) nanoparticles (NPs) loaded with a ferrocene‐appended ruthenium complex (RuFc) is reported. The NPs can successfully deliver RuFc to the tumor sites. The release of RuFc from the NPs can be triggered by low pH, photothermal heating, and H2O2. The combined photodynamic and photothermal therapy (PDT‐PTT) mediated by PDA‐Pt‐CD@RuFc NPs can overcome the hypoxic environment of tumors from several aspects. First, the platinum NPs can catalyze H2O2 to produce O2. Second, vasodilation caused by photothermal heating can sustain the oxygen supplement. Third, PDT exerted by RuFc can also occur through the non‐oxygen‐dependent Fenton reaction. Due to the presence of PDA, platinum NPs, and RuFc, the nanosystem can be used in multimodal imaging including photothermal, photoacoustic, and computed tomography imaging. The NPs can be excited by the near‐infrared two‐photon light source. Moreover, the combined treatment can improve the tumor microenvironments to obtain an optimized combined therapeutic effect. In summary, this study presents a tumor‐microenvironment‐adaptive strategy to optimize the potential of ruthenium complexes as PSs from multiple aspects.
2D Materials for Large‐Area Flexible Thermoelectric Devices
Authors: Kanahashi Kaito , Pu Jiang , Takenobu Taishi
Published: November 2019

The rapid development of the concept of the “Internet of Things (IoT)” requires wearable devices with maintenance‐free batteries, and thermoelectric energy conversion based on large‐area flexible materials has attracted much attention. Among large‐area flexible materials, 2D materials, such as graphene and related materials, are promising for thermoelectric applications due to their excellent transport properties and large power factors. In this Review, both single‐crystalline and polycrystalline 2D materials are surveyed using the experimental reports on thermoelectric devices of graphene, black phosphorus, transition metal dichalcogenides, and other 2D materials. In particular, their carrier‐density dependent thermoelectric properties and power factors maximized by Fermi level tuning techniques are focused. The comparison of the relevant performances between 2D materials and commonly used thermoelectric materials reveals the significantly enhanced power factors in 2D materials. Moreover, the current progress in thermoelectric module applications using large‐area 2D material thin films is summarized, which consequently offers great potential for the use of 2D materials in large‐area flexible thermoelectric device applications. Finally, important remaining issues and future perspectives, such as preparation methods, thermal transports, device designs, and promising effects in 2D materials, are discussed.
Hemoglobin S polymerization and sickle cell disease: A retrospective on the occasion of the 70th anniversary of Pauling's Science paper
Authors: Eaton William A.
Published: November 2019

70 years ago, Linus Pauling, the legendary genius of 20th century chemistry, published his famous work on the molecular cause of sickle cell disease, a paper that gave birth to what is now called molecular medicine. In this paper, Pauling left important questions unanswered that have motivated an enormous amount of scientific and clinical research since then. This retrospective discusses the basic science studies that have answered those questions directly related to the kinetics and thermodynamics of hemoglobin S polymerization.
X‐linked duplication copy number variation in a familial overgrowth condition
Authors: Ha Thoa K. , Mardy Anne H. , Beleford Daniah , Spanier Andrew , Wayman Brette V. , Penon‐Portmann Monica , Wiita Arun P. , Shieh Joseph T.
Published: November 2019

We describe an overgrowth condition associated with X‐linked copy number variation. Three brothers displayed an overgrowth pattern at birth that continued postnatally. Clinical findings included macrocephaly, distinctive facial features, developmental delay and variable clubfoot. Normal fetal growth was noted until the third trimester by Hadlock standards, revealing a late gestational overgrowth pattern. Microarray analysis in the family showed a maternally inherited 680 kb copy number duplication at Xq26.1‐q26.2 in all three brothers. Molecular sequencing for known overgrowth conditions including GPC3, Sotos 1 (NSD1), Malan (NFIX), Perlman (DIS3L2), Weaver (EZH2), Opitz–Kaveggia (MED12) loci were negative. BWS IC1 and IC2 methylation and CDKN1C testing was also negative. Normal IGF1 levels excluded X‐linked acrogiantism. The duplicated region Xq26.1‐q26.2 contained IGSF1 and at least part of the lncRNA FIRRE. IGSF1, a highly expressed pituitary immunoglobulin superfamily gene, was recently implicated in a genome‐wide association study of canine size. IGSF1 variants were associated with large canine breeds compared to smaller breeds. Our findings support the hypothesis that an X‐linked variant encompassing the IGSF1 region may be associated with body size. Although IGSF1 loss has been noted in human hypothyroidism, this is the first reported phenotype in a family with copy number duplication in the region. Our findings suggest that prenatal evaluation, cross‐species evaluation, Mendelian, and GWAS studies may describe a distinctive familial condition and its corresponding phenotypic features.
Spectroscopic characterization, thermogravimetric and antimicrobial studies of some new metal complexes derived from4‐(4‐Isopropyl phenyl)‐2‐oxo‐6‐phenyl 1,2‐dihyropyridine‐3‐carbonitrile (L)
Authors: Sadeek S.A. , Mohamed A.A. , El‐Sayed H.A. , El‐Attar M.S.
Published: November 2019

A new series of Fe (III), Co (II), Zn (II), Y (III), Zr (IV) and La (III) complexes derived from the novel ligand 4‐(4‐Isopropyl phenyl)‐2‐oxo‐6‐phenyl 1,2‐dihyropyridine‐3‐carbonitrile (L) were synthesized and characterized. The mode of bonding of L and geometrical structures of their metal complexes were elucidated by different micro analytical and spectral methods (FT‐IR,UV–visible,1H NMR and Mass spectra) as well as thermal analysis (TG and DTG), and differential scanning calorimetry (DSC). The results of analytical and spectroscopic equipments revealed that L acts as bidentate through nitrogen of carbonitrile group and oxygen of keto group. The conductivity measurement results deduced that these chelates are electrolyte with 1:2 for Co (II), Zn (II), and Zr (IV) and 1:3 for Fe (III), Y (III), and La (III). The results of magnetic moment measurements supported paramagnetic for some complexes (Fe (III), Co (II) and Cu (II)) and diamagnetic phenomena for the other complexes (Y (III), Zr (IV) and La (III)). Thermodynamic parameters such as energy of activation E*, entropy ΔS*, enthalpy ΔH* and Gibss free energy ΔG* were calculated using Coats‐Redfern and Horowitz‐Metzeger methods at n = 1 or n#1. Some results of bioactivity tests for ligands and their metal complexes were recorded against Gram‐positive, Gram‐negative bacteria and antifungal. The complexes showed significant more than free ligand.