bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nighttime Sleep Duration Is Associated With Length of Stay Outcomes Among Older Adult Survivors of Critical Illness
Authors: Elías Maya N. , Munro Cindy L. , Liang Zhan , Padilla Fortunatti Cristobal F. , Calero Karel , Ji Ming 
Published: April 2020

Background
Older adults who required mechanical ventilation while in an intensive care unit (ICU) require adequate sleep throughout recovery from critical illness. Poor post-ICU sleep quality may contribute to worsening impairments in physical, cognitive, or psychological status after critical illness, known as post-ICU syndrome. Previous research has evaluated post-ICU sleep with qualitative or mixed methods (eg, interviews, questionnaires). We proposed measurement of sleep with actigraphy. We hypothesized that nighttime sleep is associated with length of stay (LOS).

Objectives
The aims of this study were to describe sleep quality of previously mechanically ventilated older adults recently transferred out of ICU and explore relationships between sleep duration and LOS outcomes.

Methods
We enrolled 30 older adults, 65 years and older, within 24 to 48 hours after ICU discharge. We collected actigraphy data on post-ICU sleep duration (total sleep time [TST]) and sleep fragmentation (wake time after sleep onset) over 2 consecutive nights. We explored associations between TST and LOS (in days) outcomes using multivariate regression.

Results
Subjects' mean TST was 7.55 ± 2.52 hours, and mean wake time after sleep onset was 2.26 ± 0.17 hours. In exploratory regression analyses, longer ICU LOS (β = 0.543, P < .001) and longer length of mechanical ventilation (β = 0.420, P = .028) were associated with greater post-ICU TST, after adjusting for potential confounding factors. Total sleep time was prospectively associated with total hospital LOS (β = 0.535, P < .001).

Discussion
Older ICU survivors demonstrate greater sleep duration and worse sleep fragmentation. Poor sleep may contribute to longer LOS, secondary to post-ICU syndrome and sequelae. We recommend nursing interventions to promote sleep consolidation throughout transitions of care in the acute post-ICU recovery period.
Cefotiam Treatment in Children: Evidence of Subtherapeutic Levels
Authors: Kan Min , Wu Ling , Zhou Xin-Wei , Jiang Yong-Fang , Wu Yue-E , Shi Hai-Yan , Hao Guo-Xiang , Zheng Yi , Su Le-Qun , Huang Xin , Zhao Wei 
Published: April 2020

Background:
Cefotiam, a second-generation cephalosporin, is a broad-spectrum antibiotic with good antibacterial action against both gram-negative and gram-positive bacteria. It is used widely in clinical practice, although bacterial drug resistance makes its clinical use problematic. The authors hypothesized that subtherapeutic concentrations of cefotiam leads to bacterial resistance. The present study was conducted to evaluate whether the standard cefotiam dosing regimen resulted in a subtherapeutic concentrations in children.

Method:
Data were prospectively collected from pediatric patients with suspected or confirmed community-acquired pneumonia who were receiving cefotiam at the standard dosing regimen (40–80 mg/kg, 2 or 3 times daily). A blood sample was collected after 70%–100% of the dosing interval, and plasma concentrations were determined by high-performance liquid chromatography using an ultraviolet detector.

Results:
The data from 88 patients (age, 3.0 ± 2.8 years; weight, 15.4 ± 8.3 kg) were used for analysis. The average of cefotiam concentrations was 0.06 mcg/mL (range: <0.05–0.79 mcg/mL). Most patients (n = 72, 81.8%) had concentrations below 0.1 mcg/mL; only 2 patients had concentrations higher than 0.4 mcg/mL.

Conclusions:
The standard dosing regimen for cefotiam resulted in extremely low plasma concentrations in children; such low concentrations may lead to antimicrobial drug resistance. Thus, an increase in cefotiam dosage in children to 80 mg/kg 4 times daily is recommended (maximum dose on the label).
Posterior Corneal Surface Changes After Pterygium Excision Surgery
Authors: Levinger Eliya , Sorkin Nir , Sella Sara , Trivizki Omer , Lapira Matthew , Keren Shay 
Published: April 2020

Purpose:
To evaluate the effect of pterygium excision on the posterior corneal surface and analyze the factors associated with those changes.

Methods:
A prospective, interventional study including 33 eyes of 31 patients who underwent pterygium excision at the Tel Aviv Medical Center (Tel Aviv, Israel). Exclusion criteria included corneal dystrophy, pseudopterygium, corneal scarring, or previous ocular surgery in the treated eye. Data were obtained by using the Galilei dual Scheimpflug analyzer. Recorded posterior corneal data included steep keratometry, flat keratometry, mean keratometry, corneal astigmatism, best-fit sphere, and the squared eccentricity index (e2). Posterior surgically induced astigmatism (SIA) was calculated to demonstrate the astigmatic effect of surgery. Anterior-segment high resolution optical coherence tomography was used to measure pterygium dimensions (depth and horizontal/vertical size).

Results:
The mean age was 53.7 ± 16.7 years. Posterior corneal SIA was 0.9 ± 1.1 D (P < 0.001) and was significantly correlated with age (r = 0.568, P = 0.002), horizontal pterygium size (r = 0.387, P = 0.046), and preoperative posterior astigmatism (r = 0.688, P < 0.001). In a multivariable analysis, only age (coefficient = 0.010, P = 0.038) and preoperative posterior astigmatism (coefficient = 0.648, P = 0.002) remained significant. Pterygium dimensions were not significantly associated with SIA magnitude. Flat keratometry steepened by 0.5 ± 1.1 D (P = 0.019), mean keratometry steepened by 0.3 ±0.6 D (P = 0.035), posterior astigmatism was reduced by 0.4 ± 1.2 D (P = 0.072), and e2 decreased by 5.1 ± 17.3 (P = 0.021).

Conclusions:
Pterygium excision has a significant astigmatic effect on the posterior corneal surface. The astigmatic effect increases with age and with higher preoperative posterior astigmatism. Pterygium depth and size are not associated with the degree of surgical astigmatic effect.
Naloxone perspectives from people who use opioids: Findings from an ethnographic study in three states
Authors: Boeri Miriam , Lamonica Aukje K. 
Published: April 2020

ABSTRACT

Background:
Naloxone is an opioid antagonist that can reverse an opioid overdose. Increased opioid-related mortality rates led to greater distribution of naloxone without a prescription and administration of naloxone by laypersons. This study fills a gap in knowledge of naloxone experiences among active users of opioids living in suburban communities.

Purpose:
The purpose of this article is to provide nurse practitioners with an in-depth understanding of current naloxone use practices among people who experience overdose events. The specific aims are to compare access to naloxone in diverse suburban towns, to examine administration differences across settings, and to understand perspectives on naloxone experiences from people who are actively using opioids.

Methodological orientation:
The data for this analysis were drawn from an ethnographic study in the suburban towns around Atlanta, Georgia; Boston, Massachusetts; and New Haven, Connecticut. Short surveys and in-depth interviews were collected. Inductive methods were used to compare data across settings.

Sample:
The sample of 106 included 48% female, 62% White, 24% African American/Black, 13% more than one race, and 21% Hispanic/Latinx. The mean age was 41.35 years.

Conclusions:
Differences between study settings in access to naloxone, administration frequency, and delivery systems were found. Findings suggest more education and training is needed in overdose prevention and harm reduction intervention. Studies on delivery systems need to address the increase in fentanyl-related overdoses.

Implications for practice:
Nurse practitioners can help to target distribution of naloxone in local communities, facilitate collaboration with harm reduction services, and provide evidence-based education and training to laypersons.
Improving VA Whole-Person Health Care Using Functional Nutrition and Mindful Eating in Patients with SCI and Neurologic Disorders
Authors: Erickson Katelyn L. , Ringdahl Deborah , Kulzer Shelby R. , Marka Nicholas 
Published: April 2020

Abstract

Purpose
The aim of the study was to increase interprofessional functional nutrition and mindful eating education interventions that improve patient-driven/value-based Whole Health care among patients with spinal cord injury and neurologic disorders.

Design
Pilot quality improvement project, pre–post design was used in the study.

Methods
Functional nutrition and mindful eating Whole Health interventions were implemented through a preestablished education program over 6 weeks in a Veterans Affairs healthcare facility.

Findings
An increased level of participants’ self-awareness related to internal (60.6%) and external (54.5%) food environments was apparent. The evaluation of the Personal Health Inventory was indicative of value-based improvement on the “Food and Drink” component (35.7%), whereas 21.4% of participants reported a value-based improvement in “Power of the Mind.”

Conclusion
Interprofessional nutrition and mindful eating interventions, and personal health assessment tools support Whole Health care for management of chronic disease.

Clinical Relevance
Nutrition and mindfulness group education can be implemented into clinical care. The project modeled successful interprofessional collaboration.
A case of SARS-CoV-2 carrier for 32 days with several times false negative nucleic acid tests
Authors: Song Lingjie , Xiao Guibao , Zhang Xianqin , Gao Zhan , Sun Shixia , Zhang Lin , Feng Youjun , Luan Guangxin , Lin Sheng , He Miao , Jia Xu 
Published: April 2020

AbstractIn 2019, a novel coronavirus (SARS-CoV-2) was first discovered in Wuhan, Hubei, China, causing severe respiratory disease in humans, and has been identified as a public health emergency of international concern. With the spread of the virus, there are more and more false negative cases of RT-PCR nucleic acid detection in the early stage of potential infection. In this paper, we collected the epidemiological history, clinical manifestations, outcomes, laboratory results and images of a SARS-CoV-2 carrier with no significant past medical history. The patient was quarantined because of her colleague had been diagnosed. After the onset of clinical symptoms, chest CT results showed patchy ground-glass opacity (GGO) in her lungs, but it took a total of nine nucleic acid tests to confirm the diagnosis, among which the first eight RT-PCR results were negative or single-target positive. In addition to coughing up phlegm during her stay in the hospital, she did not develop chills, fever, abdominal pain, diarrhea and other clinical symptoms. Since initial antiviral treatment, the lung lesions were absorbed. But the sputum nucleic acid test was still positive. In combination with antiviral and immune therapy, the patient tested negative for the virus. Notably, SARS-CoV-2 was detected only in the lower respiratory tract samples (sputum) throughout the diagnosis and treatment period. This is a confirmed case of SARS-CoV-2 infection with common symptoms, and her diagnosis has undergone multiple false negatives, suggesting that it is difficult to identify certain carriers of the virus and that such patients may also increase the spread of the SARS-CoV-2.
Projection of COVID-19 Pandemic in Uganda
Authors: Mbabazi Fulgensia Kamugisha 
Published: April 2020

AbstractCOVID–19 (Corona Virus) is caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS–COV–2). The virus that was first discovered in China Wuhan Province about 3 months ago (first cases were reported in Wuhan on December 31st 2019) has spread world wide. The six (6) top countries (excluding China) most affected so far include; USA, Italy, Spain, Germany, France and Iran. With Italy showing the highest death toll.In Uganda where it was discovered on 19/3/2020 with one (01) case has just in nine (9) days, increased to thirty (30) infected individuals. This model is a wake up call over the rate at which COVID–19 is likely to spread throughout the country. Thus it is a guide for policymakers and planners to benchmark on for solutions to this deadly virus.
Estimating Impact of Austerity policies in COVID-19 fatality rates: Examining the dynamics of economic policy and Case Fatality Rates (CFR) of COVID-19 in OECD countries
Authors: Sherpa Dawa 
Published: April 2020

AbstractThe paper will attempt to estimate factors which determine the variability of case fatality rates of COVID-19 across OECD countries in the recent time. The objective of the paper is to estimate the impact of government health policies on fatality rates (Case fatality rates) of COVID-19 in_OECD countries while controlling for other demographic and economic characteristics. The analysis is done using non-parametric regression method, i.e. Quantile regression. The result from quantile regression analysis shows that a policy of Austerity (health expenditure cuts) significantly increases the mortality rates of COVID-19 in OECD countries. The policy implication of the study is the need for a robust public-funded health system with wider accessibility to deal with major public health crisis like COVID-19 pandemic.
Assessment of Specimen Pooling to Conserve SARS CoV-2 Testing Resources
Authors: Abdalhamid Baha , Bilder Christopher R. , McCutchen Emily L. , Hinrichs Steven H. , Koepsell Scott A. , Iwen Peter C. 
Published: April 2020

AbstractObjectivesTo establish the optimal parameters for group testing of pooled specimens for the detection of SARS-CoV-2.MethodsThe most efficient pool size was determined to be 5 specimens using a web-based application. From this analysis, 25 experimental pools were created using 50 microliter from one SARS-CoV-2 positive nasopharyngeal specimen mixed with 4 negative patient specimens (50 microliter each) for a total volume of 250 microliter l. Viral RNA was subsequently extracted from each pool and tested using the CDC SARS-CoV-2 RT-PCR assay. Positive pools were consequently split into individual specimens and tested by extraction and PCR. This method was also tested on an unselected group of 60 nasopharyngeal specimens grouped into 12-pools.ResultsAll 25 pools were positive with Cycle threshold (Ct) values within 0 and 5.03 Ct of the original individual specimens. The analysis of 60 specimens determined that two pools were positive followed by identification of two individual specimens among the 60 tested. This testing was accomplished while using 22 extractions/PCR tests, a savings of 38 reactions.ConclusionsWhen the incidence rate of SARS-CoV-2 infection is 10% or less, group testing will result in the saving of reagents and personnel time with an overall increase in testing capability of at least 69%.Key PointsSARS CoV-2, COVID-19, Group testing
Assessment of the BWB aircraft for military transport
Authors: Kissoon Sajal , Mastropierro Francesco Saverio , Nalianda Devaiah K. , Rolt Andrew , Sethi Bobby 
Published: April 2020

Purpose
The growth in air mobility, rising fuel prices and ambitious targets in emission reduction are some of the driving factors behind research towards more efficient aircraft. The purpose of this paper is to assess the application of a blended wing body (BWB) aircraft configuration with turbo-electric distributed propulsion in the military sector and to highlight the potential benefits that could be achieved for long-range and heavy payload applications.

Design/methodology/approach
Mission performance has been simulated using a point-mass approach and an engine performance code (TURBOMATCH) for the propulsion system. Payload-range charts were created to compare the performance of a BWB aircraft with various different fuels against the existing Boeing 777-200LR as a baseline.

Findings
When using kerosene, an increase in payload of 42 per cent was achieved but the use of liquefied natural gas enabled a 50 per cent payload increase over a design range of 7,500 NM. When liquid hydrogen (LH2) is used, the range may be limited to about 3,000 NM by the volume available for this low-density fuel, but the payload at this range could be increased by 137 per cent to 127,000 kg.

Originality/value
The results presented to estimate the extent to which the efficiency of military operations could be improved by making fewer trips to transport high-density and irregular cargo items and indicate how well the proposed alternatives would compare with present military aircraft. There are no existing NATO aircraft with such extended payload and range capacities. This paper, therefore, explores the potential of BWB aircraft with turbo-electric distributed propulsion as effective military transports.
Financial literacy and quality of life of consumers faced with cancer: a moderated mediation approach
Authors: Pahlevan Sharif Saeed , Naghavi Navaz , Sharif Nia Hamid , Waheed Hassam 
Published: April 2020

PurposeThe purpose of this paper is to investigate whether financial distress explains the relationship between financial literacy and quality of life (QoL) among consumers who have faced life-threatening cancer. To extend this line of research, the moderating role of social supports in the relationship between financial distress and QoL is examined.Design/methodology/approachA cross-sectional survey was utilized to collect quantitative data through a self-administered questionnaire. A total of 223 consumers diagnosed with cancer in Iran participated in the study by means of a convenience sampling technique. Using a forward–backward method the questionnaire was translated from English into Persian.FindingsThe findings highlight the importance of financial literacy in managing direct and indirect costs of chronic diseases that in turn can improve consumers' QoL. Moreover, while perceived social support improves QoL of consumers diagnosed with cancer, it strengthens the negative association between financial distress and QoL. Consequently, solely receiving of emotional support from acquaintances with no financial support might be bothersome.Practical implicationsThe findings highlight the need for interventions that target financial literacy and perceived financial distress for consumers with chronic diseases. These consumers can benefit from interventions that offer support based on accurate assessments of their needs and priorities.Originality/valueThe present study is the first of its kind to highlight the importance of financial literacy in improving the QoL of consumers with chronic diseases.
Removal of reactive black 5 dye using zero valent iron nanoparticles produced by a novel green synthesis method
Authors: Khashij Maryam , Dalvand Arash , Mehralian Mohammad , Ebrahimi Ali Asghar , Khosravi Rasoul 
Published: April 2020

Purpose
The purpose of this paper is to analyze zero valent iron nanoparticles (NZVIs) by a novel green method, taken from Thymus vulgaris (TV) plant extract, were synthesized and applied to degrade reactive black 5 (RB5) azo dye.

Design/methodology/approach
The optimum conditions for the highest removal of RB5 dye were determined. Characterization of NZVIs was done by scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier-transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM) and X-ray diffraction (XRD). The NZVIs were used for the removal of dye RB5, and the parameters affecting were discussed like pH, initial concentration, contact time and NZVIs dosage.

Findings
The characterization results of NZVIs by SEM, TEM, FTIR and XRD show that polyphenols, organic acids and proteins reduce not only the green synthesis of NZVIs but also the aggregation of nanoparticles. The maximum dye removal efficiency of 99.6 per cent occurred at pH 4, NZVIs dose of 600 mg/L, and contact time of 5 min. The adsorption of RB5 dye onto the NZVIs surface and scavenging of the azo bond (−N = N) by the strong reduction of NZVIs were the proposed mechanisms for dye removal. The application of NZVIs to treat wastewater containing reactive dye shows high degradation efficiency.

Research limitations/implications
The findings may greatly benefit the application of the NZVIs taken from Thymus vulgaris (TV) in the fields of dye adsorption.

Practical implications
The present study is novel because it incorporated the morphological and structural properties of the synthesized NZVIs using a native plant of Iran and studied the capability of green-synthesized NZVIs to remove RB5 as a water contaminant.

Social implications
The native plant presented here can be developed for reduced environmental pollution before discharge to accepted water.

Originality/value
The NZVIs is prepared via green-synthesized method, which is prepared with leaves of TV. There are two main innovations. One is that the novel NZVIs is prepared successfully by native plant via green-synthesized method. The other is that the optimized conditions were obtained for the removal of RB5 dye as a water contaminant. Furthermore, to the best of our knowledge, no study has ever investigated the removal of RB5 by NZVIs produced using a native plant in Iran.
AmNet
Authors: Harper Timothy , Norelli Barbara , Brandston Melanie , Taber Mary 
Published: April 2020

Purpose
Micro organizational behavior – an individual level of analysis (i.e. motivation, personality, attitudes, learning, etc.). Meso organizational behavior – team/group level of analysis (i.e. communication, team dynamics, power, politics, etc.). Macro organizational behavior – an organizational level of analysis (i.e. strategy, structure, culture, control, etc.). Marketplace or external environment (PESTEL analysis).

Research methodology
The research was conducted by a consultant in the role of a participant-observer.

Case overview/synopsis
The focus of the case is a disguised nonprofit organization, the American-Netherlands Foundation (AmNet), based in Chicago. The organization faced leadership and organizational challenges related to conflicting strategic and operational priorities among the board of trustees, the president and staff. An unexpected contribution of $750,000 increased the salience of these differences. The case provides students an excellent opportunity to apply their analytical skills and knowledge gained in a management and business course.

Complexity academic level
Organizational behavior; organizational design; organizational development; and organizational theory. Levels – upper-level undergraduate through first-year MBA students.