bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital Observation Status and Readmission Rates
Authors: Synhorst David C. , Hall Matt , Harris Mitch , Gay James C. , Peltz Alon , Auger Katherine A. , Teufel Ronald J. , Macy Michelle L. , Neuman Mark I. , Simon Harold K. , Shah Samir S. , Lutmer Jeffrey , Eghtesady Pirooz , Pavuluri Padmaja , Morse Rustin B. 
Published: October 2020

BACKGROUND:In several states, payers penalize hospitals when an inpatient readmission follows an inpatient stay. Observation stays are typically excluded from readmission calculations. Previous studies suggest inconsistent use of observation designations across hospitals. We sought to describe variation in observation stays and examine the impact of inclusion of observation stays on readmission metrics.METHODS:We conducted a retrospective cohort study of hospitalizations at 50 hospitals contributing to the Pediatric Health Information System database from January 1, 2018, to December 31, 2018. We examined prevalence of observation use across hospitals and described changes to inpatient readmission rates with higher observation use. We described 30-day inpatient-only readmission rates and ranked hospitals against peer institutions. Finally, we included observation encounters into the calculation of readmission rates and evaluated hospitals’ change in readmission ranking.RESULTS:Most hospitals (n = 44; 88%) used observation status, with high variation in use across hospitals (0%–53%). Readmission rate after index inpatient stay (6.8%) was higher than readmission after an index observation stay (4.4%), and higher observation use by hospital was associated with higher inpatient-only readmission rates. When compared with peers, hospital readmission rank changed with observation inclusion (60% moving at least 1 quintile).CONCLUSIONS:The use of observation status is variable among children’s hospitals. Hospitals that more liberally apply observation status perform worse on the current inpatient-to-inpatient readmission metric, and inclusion of observation stays in the calculation of readmission rates significantly affected hospital performance compared with peer institutions. Consideration should be given to include all admission types for readmission rate calculation.
A survey of South African Maxillofacial & Oral Surgeon opinions regarding the academic education in the field of cleft lip/palate and craniofacial deformities
Authors: Ghabrial Emad , Bütow Kurt W 
Published: October 2020

Maxillofacial and oral surgeons (MFOS) are trained to manage hard and soft tissue conditions affecting the orofacial region. They, therefore, play an essential role in the health care of cleft lip/palate (CLP) and craniofacial deformities (CFD) patients. The complex and lengthy nature of CLP and CFD management requires collaboration between different disciplines. Consequently, it becomes increasingly important that the academic education available to MFOS provides in-depth knowledge, multidisciplinary participation and adequate clinical exposure provided by field experts. This study aimed to investigate the exposure and knowledge level of MFOS regarding the management of CLP and CFD. A second objective was to obtain an opinion from practising MFOS about the academic educational needs of those working with CLP and CFD. An online survey and telephone interviews (using a structured questionnaire) were used to investigate the level and scope of the MFOS academic education and to determine their academic needs. The questionnaire was completed by 53 (of 121) of practising MFOS on the Medpages health care provider database, 64.8% of whom had more than 10 years of professional experience. Of the respondents, 60% showed a good general knowledge of CLP and CFD. However, 66.5% acknowledged that they had received only limited clinical training and exposure, which prevented them from providing adequate services to CLP/CFD patients. Only 41% of the respondents offered primary and/or only secondary treatment for both CLP and CFD patients, and 53.8% of them had participated in multidisciplinary teams. All the respondents agreed on the need for a dedicated training programme(s) in CLP and CFD management, and the majority recommended a subspecialty training either by degree courses or clinical fellowship and / or certification. This study demonstrates that postgraduate academic training and clinical exposure are limited in the CLP and CFD fields. All the respondents agreed that an educational strategy to meet the needs of MFOS providing CLP and CFD care should be established. Participants suggested that part-time clinical and/or degree courses should be developed.
Efficacy of Intravenous Acetaminophen as Adjunct Post-Operative Analgesic in Cardiac Surgery: A Retrospective Study
Authors: Almoghrabi Omar , Brungardt Joseph , Helmer Stephen , Reyes Jared , Grizzell Brett 
Published: October 2020

Introduction. The dose-dependent adverse events associated with post-operative opioid use may be reduced when opioids are used in conjunction with intravenous acetaminophen. The purpose of this study was to compare outcomes in median sternotomy patients receiving intravenous acetaminophen in addition to intravenous opioids versus intravenous opioids only.
Methods. A retrospective study was conducted on 122 adult patients undergoing median sternotomy at a regional tertiary-referral center. Data collected included patient demographics, length of stay, opioid and intravenous acetaminophen use, adverse effects, and transition time to oral pain medication.
Results. There was no difference between groups in demographics, preoperative risk scores, operative procedures, intravenous opioid consumption, transition time to oral pain medications, or length of stay. Acetaminophen use was associated with lower rates of atrial fibrillation (7.0% vs. 24.6%, p = 0.009) and nausea/vomiting (8.9% vs. 32.3%, p = 0.002), but higher rates of urinary retention (15.8% vs. 3.1%, p = 0.014), constipation (50.0% vs. 20.0%, p = 0.001) and respiratory depression (7.1% vs. 0.0%, p = 0.043).
Conclusion. Intravenous acetaminophen was not associated with a reduction in length of stay or opioid consumption, but was associated with lower rates of atrial fibrillation, nausea, and vomiting. Additional studies are needed to determine if intravenous acetaminophen administration reduces atrial fibrillation in this population.
Nutrition Self-Efficacy and Dietary Patterns among Older African American Women in Kansas
Authors: Nassim Grace , Redmond Michelle , Ofei-Dodoo Samuel , Benton Mary , Lu Kelsey 
Published: October 2020

Introduction. Nutrition is the key contributor to disparities in many chronic diseases. However, little is known about the dietary habits and nutrition self-efficacy beliefs of older African American women with chronic diseases. This study looked at the relationship between nutrition self-efficacy and dietary patterns among older African American women.
Methods. A total of 115 African American women 55 years and older, with one or more chronic diseases such as hypertension, diabetes, and hyperlipidemia, were recruited from a midwestern city in Kansas. Participants completed a survey comprised of dietary intake items and the Physical Activity and Nutrition Self-Efficacy (PANSE) scale. Data were analyzed with descriptive statistics, Spearman correlation, and Wilcoxon rank sum test (Mann-Whitney U Test).
Results. There was a 79% (91/115) participation rate. Participants were confident in their ability to maintain healthy behaviors (57.67/72; SD = 11.22). The mean dietary score for fats and carbohydrate consumption was 32.67 ± 2.48 compared to 5.89 ± 3.52 for fruit and vegetable intake. A significant positive correlation was observed between fruit and vegetable intake and nutrition self-efficacy. A higher fruit and vegetable intake were observed among married women (mean = 7.35; SD = 4.45).
Conclusion. Our findings shed new light on older African American women’s perceptions of healthy eating and the confidence to eat heathy. Based on these results, older African American women met the daily fruit and vegetable recommendations; however, more work is needed to understand how to intervene to improve dietary behaviors regarding fat and carbohydrate consumption in this population. While more research is needed, the findings indicated behavioral theories such as nutrition self-efficacy may have utility in tailoring nutrition interventions in an older African American population.
Possibilities of supportive therapy in patients with blood system tumors and malignant neoplasms
Authors: Larionova V. B. , Snegovoy A. V. 
Published: October 2020

Finding opportunities to improve treatment outcomes of cancer patients remains a difficult and unresolved problem. Modern anticancer treatment due to the intensity and molecular biological orientation allows achieving higher efficiency and theoretically reducing the complications frequency. At the same time, the “increase in efficiency” in the modern oncology really exists, but a “decrease in the incidence of complications” is far from its solution. In many ways, the problems of diagnosis, treatment and monitoring of complications are associated with the impact on complex physiological processes in the body of an oncological patient. Timely implementation of modern and adequate programs for the prevention and treatment of these complications defines the concept of “supportive therapy”, which provides at least half of the effectiveness of anticancer treatment.The Multinational Association of Supportive Care in Cancer (MASCC) was formed in 1990. The main tasks of the association were the creation of supportive care system, its popularization and accumulation of scientific data. The MASCC was used not only oncologists experience, but also of specialists working in almost all areas of medicine. Supportive therapy provides prevention and treatment of complications from the moment of malignant disease develops, at all stages of anticancer treatment, during the rehabilitation period, and in patients in the terminal phase.An important stage in the development of maintenance care in Russia was the holding of annual conferences in Moscow with the support of MASCC. Russia is included in the European MASCC group and in working group on supportive therapy and palliative care of the Chemotherapists Society (ESMO). The Russian Society of Supportive care in Oncology (RASSC) was organized In Russia on June 1, 2017. In recent years, the main directions of supportive care have been developed in our country. Today, supportive therapy is an obligatory component of anticancer programs, which allows the patient to cope with severe but potentially reversible disorders of vital organs at all stages of treatment. This is a real way to increase the treatment efficacy and improve the quality of life of cancer patients.
Pediatric acute lymphoblastic leukemia treatment protocols improvement: emphasis on minimal residual disease
Authors: Shervashidze M. A. , Valiev T. T. 
Published: October 2020

Treatment of acute lymphoblastic leukemia (ALL) in children during the last 50 years has changed significantly, which has increased the survival of patients from 10–15 % in the early 60s to 80–85 % by the mid-2000s. Such results have been achieved through the development of new polychemotherapy regimens, the introduction of neuroleukemia prophylaxis, the strengthening of standard chemotherapy by increasing the dose and / or frequency of chemotherapeutic drugs administration, and the definition of criteria for patient stratification into prognostic risks groups and the development of principles of risk-adopted therapy.However, inspite of the overall success of pediatric acute lymphoblastic leukemia therapy, some variants of acute lymphoblastic leukemia associated with poor prognosis, especially acute lymphoblastic leukemia with BCR-ABL1 and MLL rearrangements. Besides the prolonged persistence of minimal residual disease is also an unfavorable prognostic factor requiring therapy intensification.In the current issue we present the main steps in the evolution of programmed chemotherapy of children with acute lymphoblastic leukemia. Great attention was paid for modern risk-stratifying criteria with an emphasis on minimal residual disease.
Prognostic value of the modified multiple myeloma comorbidity index in real clinical practice
Authors: Skvortsova N. V. , Kovynev I. B. , Loginova A. B. , Halzov K. V. , Pospelova T. I. 
Published: October 2020

Background. An increase in the number of patients with multiple myeloma (MM) necessitates the creation of reliable tools for assessing their somatic status (comorbidity) in order to personalize the optimal treatment regimen that helps to minimize its toxicity, improves survival and patients quality of life.The objective of this study was to modify the MM comorbidity index (MCI) by adding an additional variable reflecting the biological properties of the tumor, and to determine the informativeness of the new scale – a modified MM comorbidity index (M-MCI), to predict the outcome and select personalized therapy in patients with MM in real clinical practice.Materials and methods. From January 2012 to December 2017 the study included 369 patients with newly diagnosed MM (134 men and 235 women) who were hospitalized in the hematology department of the City Clinical Hospital No. 2, Novosibirsk. The median age of the patients was 67 (32–82) years. The prognostic value of concomitant diseases and individual prognostic factors in relation to the overall survival of patients with MM was evaluated.Results. Cox multivariate analysis showed that the most significant predictors of reduced overall survival of patients with MM are impaired renal function (glomerular filtration rate <30 ml / min / 1.73 m2 (according to the CKD-EPI formula), general condition according to the Karnowski scale ≤70 %, chronic obstructive pulmonary disease with moderate (50 % ≤ forced expiratory volume in 1 second <80 %) and severe (30 % ≤ forced expiratory volume in 1 second <50 %) severity of bronchial obstruction and the ratio κ / λ free light chains <0.04 or >65. These factors were combined into a weighted 5‑point scale M-MCI. A comparative analysis of survival depending on the value of the M-MCI allowed us to distribute patients with MM into groups of high (M-MCI 3–4 points) and standard (M-MCI 0–2 points) risk with significantly different indicators of overall survival (median overall survival amounted to 15.5 months in the high and 60 months in the standard risk group; χ2 = 58, p <0.016) and confirm the prognostic value of M-MCI in relation to the outcome of MM.Conclusion. In terms of its prognostic significance in predicting an adverse outcome, the proposed M-MCI scale is superior to its prototype – the MCI. The median overall survival in the high-risk group according to the M-MCI was 15.5 months compared to 20 months according to the MCI; the median overall survival in the group the standard risk was 60 and 50 months, respectively (χ2 = 58 (M-MCI) versus χ2 = 42 (MCI); p <0.001). The advantages of M-MCI are also its more accurate assessment of the physical condition of patients with MM and its simple clinical applicability.
A 6-year experience of the Ross procedure in children with congenital aortic valve disease
Authors: Akatov D. S. , Belov V. A. , Khomich D. E. , Bukhareva O. N. , Makarov A. A. , Kotov S. N. , Schneider Yu. A. 
Published: October 2020

Background: The choice of an optimal method for correction of aortic valve stenosis or insufficiency remains the matter of debate. Some clinicians prefer transluminal balloon angioplasty, some would perform an open type commissurotomy, or aortic valve replacement, or to valve leaflets repair with various materials, while others opt for the Ross procedure. Each of these techniques has its advantages and disadvantages both in the early postoperative period and in the long-term.Aim: To assess the results of the Ross procedure, its complications, survival, and probability of reoperations in the long-term.Materials and methods: We retrospectively analyzed the results of 32 Ross procedures performed from the end of 2012 to the beginning of 2019 in children aged from 3 days to 18 years. Eight children were below 1 year of age, including one newborn. A pulmonary autograft was placed into the aortic position in all children. In 31 children, a homograft was placed into the pulmonary artery. In one patient, an aortic autograft was implanted instead of the pulmonary artery valve. The mean patient age was 6.8 years, mean bodyweight 27.7 kg (range, 3.9–74.6 kg).Results: Two patients died in the early postoperative period (mortality 6.25%). We examined 26 patients at the follow-up, with its mean duration of 2.5 years. There were no indications for replacement of the homograft during the follow-up. One patient, in whom we had implanted an aortic autograft into the pulmonary position, required its replacement after 4.5 years. We have no data on death rates in the long-term.Conclusion: The Ross procedure provides satisfactory results in the early and intermediate postoperative period. Continuous follow-up is needed to determine the time points and the proportion of repeated interventions with a pulmonary homograft and aortic valve.
AKUPUNKTUR TITIK SISHCENCHONG PADA PENDERITA INSOMNIA PADA LANJUT USIA DI YAYASAN DIAKONIA GPIB RUMAH ASUH ANAK & LANSIA (RAAL)
Authors: Mahadini Chantika 
Published: October 2020

Latar Belakang: Insomnia pada lansia merupakan keadaan dimana individu mengalami suatu perubahan dalam kuantitas dan kualitas pola istirahat yang menyebabkan rasa tidak nyaman atau mengganggu gaya hidup yang di inginkan. Gangguan tidur pada lansia jika tidak segera ditangani akan berdampak serius dan akan menjadi gangguan tidur yang kronis. Secara fisiologis, jika seseorang tidak mendapatkan tidur yang cukup untuk mempertahankan kesehatan tubuh dapat terjadi dampak-dampak seperti pelupa, gelisah dan disorientasi (Asmadi, 2008). Tujuan: untuk mengetahui pengaruh akupunktur titik Sisenchong terhadap insomnia pada lansia. Metode: Metode penelitian menggunakan quasi eksperimen dengan penelitian pre test dan post tes design with control group. Jumlah sampel adalah 20 orang terdiri dari 10 orang kelompok eksperimen dan 10 orang kelompok kontrol. Hasil: menunjukkan pada kelompok eksperimen terdapat perbedaan signifikan antara skor post test dan pretest (p=0,005), kelompok kontrol diperoleh nilai p= 0.008 yang berarti tidak ada perbedaan yang signifikan antara skor pretest dan posttest. Kesimpulan: akupunktur pada titik sisenchong berpengaruh terhadap insomnia pada lansia di yayasan DIAKONIA GPIB Rumah asuh anak dan lansia (RAAL).
HUBUNGAN PERSEPSI TERHADAP LINGKUNGAN PEMBELAJARAN DENGAN HASIL BELAJAR MAHASISWA PENDIDIKAN DOKTER FKIK UIN MAULANA MALIK IBRAHIM MALANG
Authors: Sp.OG Nurfi Indriana , Novianto Muhammad Rizal 
Published: October 2020

Lingkungan pembelajaran suatu institusi pendidikan menjadi bagian penting dalam meningkatkan kualitas pendidikan. Persepsi mahasiswa terhadap lingkungan pembelajaran dapat menggambarkan iklim belajar yang dimiliki suatu institusi pendidikan. Persepsi mahasiswa terhadap lingkungan pembelajaran inilah yang menentukan perilaku dari mahasiswa sehingga dapat mempengaruhi hasil belajar. Tujuan penelitian ini ingin melihat bagaimana persepsi terhadap lingkungan pembelajaran memberikan pengaruh hasil belajar mahasiswa pendidikan dokter UIN Maulana Malik Ibrahim Malang. Survei cross-sectional dilakukan kepada seluruh mahasiswa pendidikan dokter (n=148) untuk mengukur persepsi mahasiswa terhadap lingkungan pembelajaran menggunakan instrumen John Hopkins Learning Environment Scale (JHLES) yang tersusun dari 7 komponen. Setiap komponen dianalisa hubungannya dengan hasil belajar mahasiswa menggunakan metode Structural Equation Modeling-Partial Least Square (SEM-PLS). Dari 145 responden yang mengisi kuesioner secara lengkap (98%) didapatkan hasil bahwa hubungan mahasiswa dengan dosen, mentoring, iklim pendidikan, pelibatan mahasiswa, inklusi dan rasa aman serta interaksi antar mahasiswa memiliki pengaruh positif terhadap hasil belajar mahasiswa. Sedangkan lingkungan fisik tidak berpengaruh terhadap hasil belajar. Dapat disimpulkan bahwa faktor non fisik dari lingkungan pembelajaran lebih memberikan pengaruh terhadap hasil belajar mahasiswa kedokteran dibandingkan dengan lingkungan fisik.Kata kunci : lingkungan pembelajaran, hasil belajar, pendidikan kedokteran
Sexual Orientation and Hypertension Risk Reduction Behaviors Among Adults With High Blood Pressure
Authors: Veliz Philip T. , McCabe Sean Esteban , Hughes Tonda L. , Everett Bethany G. , Caceres Billy A. , Arslanian-Engoren Cynthia 
Published: October 2020

IntroductionHypertension is a significant modifiable risk factor for cardiovascular disease (CVD), the leading cause of death in the United States. Evidence is emerging showing disparities in CVD risk between sexual minorities and heterosexuals. Engagement in CVD risk reduction behaviors may account for differences. We examined CVD risk reduction for hypertension between sexual minorities and heterosexuals using data from the 2017 Behavioral Risk Factor Surveillance System.MethodsUsing bivariate and multivariable logistic regression analyses, we compared medical advice and actions taken (taking medicine, changing eating habits, cutting down on sale, reducing alcohol, and exercising) to control blood pressure in sexual minority and heterosexual respondents. Analyses were conducted in 2019.ResultsApproximately 35% of the sample indicated being told by a health professional they had high blood pressure. Sexual minorities were less likely to report reduced alcohol intake to lower their blood pressure (AOR = .52, 95% CI = .30, .88). One sex-specific difference between sexual minority women and heterosexual women was found; sexual minority women were less likely to indicate being advised by a health professional to take medications to lower blood pressure when compared to heterosexual women.ConclusionsStrategies are needed to reduce alcohol consumption in sexual minority individuals. Uncovering the reasons for the lack of adherence by both sexual minority patients and healthcare providers can guide future interventions to improve adherence and reduce hypertension as a CVD risk.
Pompa Air Harapan: Upaya Penanggulangan Kekeringan dan Pengembangan Usaha Mandiri Masyarakat Desa Kwadungan Lor, Kabupaten Ngawi
Authors: Sari Churnia , Fandidarma Bayu , Solikin Nur 
Published: October 2020

Ngawi adalah salah satu kota di Jawa Timur yang terletak di dataran rendah dan merupakan satu dari lima kota pemasok padi terbanyak. Sehingga nilai lahan di Kabupaten Ngawi menjadi sangat penting, sebagai penunjang ekonomi masyarakat. Namun berdasarkan observasi dan pemberitaan pada media elektronik, beberapa lahan di Ngawi tidak dapat diolah secara maksimal ketika musim kemarau, dan belum ada solusi yang ditawarkan terkait masalah tersebut. Program pendistribusian air dari Pemerintah Kabupaten (Pemkab) Ngawi sudah dijalankanetapi belum merata di seluruh wilayah terutama desa-desa yang secara geografis cukup sulit untuk dijangkau. Alasan ini mendasari Pengabdian Masyarakat dilaksanakan di Kabupaten Ngawi. Dari hasil observasi, dipilih desa Kwadungan Lor sebagai lokasi Pengabdian Masyarakat. Dengan adanya Program Pompa Air Harapan, masyarakat Kwadungan Lor menjadi lebih semangat dalam mengelola lahannya sekaligus bisa memperoleh keuntungan dari hasil bercocok tanam.