bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using a Collaborative Weaning Plan to Decrease Duration of Mechanical Ventilation and Length of Stay in the Intensive Care Unit for Patients Receiving Long-Term Ventilation
Authors: Henneman Elizabeth , Dracup Kathleen , Ganz Tomas , Molayeme Orna , Cooper Christopher B. 
Published: November 2019

• Background Patients requiring mechanical ventilation for prolonged periods typically are sicker and have more comorbid illnesses than do patients who can be weaned more rapidly. As a result, the weaning process is often complex, requiring shared decision making by a skilled, multidisciplinary team. Unfortunately, many of the structures used in critical care units to plan and evaluate care do not lend themselves to collaborative management of patients.
• Objective To evaluate the effect of a collaborative weaning plan on outcomes, including duration of mechanical ventilation, for patients treated with mechanical ventilation for 7 days or more.
• Methods A collaborative weaning plan (weaning board and flow sheet) was introduced into the medical intensive care unit at the University of California Los Angeles, Medical Center. A historical design was used to compare outcomes before and after the plan was used. The primary outcome variable was duration of mechanical ventilation. Other outcomes studied included length of stay in the unit, cost, prevalence of complications (ie, reventilation, readmission to the intensive care unit), and mortality rate.
• Results The collaborative weaning plan decreased duration of ventilation by 4.9 days (P = .02) and decreased median length of stay in the unit by 4.5 days (P = .004). The median cost per stay in the unit decreased from $50 462 to $37 330 (P = .004). The prevalence of complications did not differ significantly between groups.
• Conclusions Collaborative structures (eg, weaning boards, flow sheets) are useful in decreasing duration of mechanical ventilation for patients receiving long-term ventilation.
Effect of an Outcomes-Managed Approach to Care of Neuroscience Patients by Acute Care Nurse Practitioners
Authors: Russell Dale , VorderBruegge Mary , Burns Suzanne M. 
Published: November 2019

• Objective To improve clinical and financial outcomes for neuroscience patients by using an “outcomes-managed” model of care delivery and 2 acute care nurse practitioners as outcomes managers.• Methods Baseline data from the year before implementation of the care model were compared with data from the first 6 months of implementation. A random list of 122 adult patients admitted to the neuroscience intensive care unit or the acute care neurosurgery unit of a university teaching hospital between January and December 1998 was generated to provide the baseline data. The prospective sample included 402 patients admitted to either unit during the first 6 months of the project (January through June 1999). The acute care nurse practitioners used an evidence-based multidisciplinary plan of care to manage all patients.• ResultsNo differences were found in age, sex, or ethnicity between groups. Patients managed by acute care nurse practitioners had significantly shorter overall length of stay (P = .03), shorter mean length of stay in the intensive care unit (P&lt;.001), lower rates of urinary tract infection and skin breakdown (P&lt;.05), and shorter time to discontinuation of the Foley catheter and mobilization (P &lt; .05). The outcomes-managed group was hospitalized 2306 fewer days than the baseline group, at a total cost savings of $2 467 328.• Conclusions Clinical and financial outcomes are improved significantly by identifying patients at risk, monitoring for complications, and having acute care nurse practitioners manage the patients.
Outcomes of and Resource Consumption by High-Cost Patients in the Intensive Care Unit
Authors: Welton John M. , Meyer Anthony A. , Mandelkehr Larry , Fakhry Samir M. , Jarr Sandra 
Published: November 2019

• Background Care of patients in an intensive care unit is among the most costly in hospitals. Little is known about high-cost patients within the intensive care unit or their outcomes of care.• Objectives To examine outcomes of and resource consumption by high-cost adult patients who received care in an intensive care unit at an academic medical center.• Methods Data on patients admitted during the period January 1, 1995, through June 30, 1999, were analyzed retrospectively. An intensive care unit database, the hospital discharge data set, and a cost-accounting data set were used to determine the total intensive care unit cost for the hospitalization. Patients were then stratified into cost deciles. Hospital and intensive care unit outcomes for patients in the top decile were compared with those of patients in the other deciles.• Results Cost data were available on 10606 of the 11244 patients who received care in an intensive care unit. Patients in the top decile accounted for 48.7% of all intensive care unit costs, and 67.6% of this group survived to discharge despite prolonged care. Patients transferred from an outside hospital were more likely to be in the top decile, have a longer stay in the intensive care unit, or die than were the other patients.• Conclusions A small group of patients accounts for a disproportionately higher amount of intensive care unit resources but has a relatively high survival rate. This cohort should be treated as an intact group that is not amenable to traditional cost-cutting measures.
Preventing Ventilator-Associated Pneumonia Through Oral Care, Product Selection, and Application Method
Authors: Hillier Bianca , Wilson Christine , Chamberlain Di , King Lindy 
Published: November 2019

Objective:Review the literature to identify the most effective method of oral hygiene to reduce the incidence of ventilator-associated pneumonia (VAP).Background:Ventilator-associated pneumonia is the most common nosocomial infection in patients being treated with mechanical ventilation.Method:This study is a systematic literature review. The databases searched included Web of Science, Cumulative Index to Nursing and Allied Health Literature, Ovid, and MEDLINE.Results:Implementation of oral care protocols and nurse education programs reduced VAP. Although chlorhexidine was the most popular oral care product, no consensus emerged on concentration or protocols for oral care.Conclusion:No consensus on best practice for oral hygiene in patients being treated with mechanical ventilation was found. Chlorhexidine was the most popular oral care product. Implementation of an oral care protocol, ongoing nurse education, and evaluation were important in reducing the incidence of VAP. Future research should analyze chlorhexidine concentration, application techniques, and frequency of oral care, to optimize VAP prevention.
Breast and Axillary Lymph Node Metastases from Advanced Non-small Cell Lung Carcinoma
Authors: Al-Maghrabi Jaudah A. , Elamin Elshami M. , Abdel-Rahman Hossam A. 
Published: November 2019

Lung cancer metastasizing to the breast is rare. Only few published case reports can be found in the literature. Metastatic lung cancer to the breast and its ipsilateral axillary lymph node is extremely unusual. No awareness of any prior case reports of lung cancer with such a presentation is known. Herein, this study reports an unusual case of a middle aged Saudi female with non-small cell lung cancer that has metastasized, not only to the lungs and the breast, but also to the ipsilateral axillary lymph nodes. It is important for the oncologists to be mindful of rare presentations for such a common malignancy as lung cancer.
Collecting Prints, Posters, and Ephemera
Authors: Iskin Ruth E. , Salsbury Britany 
Published: November 2019

Why did collectors seek out posters and collect ephemera during the late-nineteenth and the twentieth centuries? How have such materials been integrated into institutional collections today? What inspired collectors to build significant holdings of works from cultures other than their own? And what are the issues facing curators and collectors of digital ephemera today?
These are among the questions tackled in this volume—the first to examine the practices of collecting prints, posters, and ephemera during the modern and contemporary periods. A wide range of case studies feature collections of printed materials from the United States, Latin America, France, Germany, Great Britain, China, Japan, Russia, Iran, and Cuba. Fourteen essays and one roundtable discussion, all specially commissioned from art historians, curators, and collectors for this volume, explore key issues such as the roles of class, politics, and gender, and address historical contexts, social roles, value, and national and transnational aspects of collecting practices. The global scope highlights cross-cultural connections and contributes to a new understanding of the place of prints, posters and ephemera within an increasingly international art world.
Mapping Queer Space(s) of Praxis and Pedagogy
Authors: Gogats Jake 
Published: November 2019

In this re-view of Mapping Queer Space(s) of Praxis and Pedagogy, I eschew standards of book reviewing and instead aim to provide a pedagogical model for reading the text in question. By writing in a "scattered" format inspired by one of the text's chapters, I both show and tell the reader the effect the text has had on me. Rather than focusing on summary and evaluation, then, I write primarily about the different uses of "queer" in different chapters as a way of introducing the reader to queer studies and exemplifying a genuine response to the experience of reading the book.
White Fears of Dispossession: Dreyer's English, The Elements of Style, and the Racial Mapping of English Discourse
Authors: Lisabeth Laura 
Published: November 2019

Dreyer's English, by Benjamin Dreyer, the Senior Copy Editor for Random House, and Strunk and White's The Elements of Style are two extraordinarily popular and commercially successful guides to English language usage that belong to a genre best described as discursive maps for language as racialized, classed and gendered territory. This review traces the history of these books to the nineteenth century "conversation handbooks" and etiquette guides that became popular in a time of shifting class boundaries Precise prescriptives for behavior and for polite conversation helped the aspirational middle-class groom themselves for genteel company. Many of these guides were published during the Reconstruction Era, and were filled with dispositions toward correct language that communicate a kind of outrage from fear of social, cultural and economic dispossession, a telltale mark of White Supremacy. These dispositions still exist in the rhetoric of both Dreyer and E.B. White and are carried through the structural racism of standardized English into educational spaces. Discourses of meritocracy are found in both the classroom and the global neoliberal workplace where "English has been turned into a product (in all senses of the word)..."Though the promotion of English is presented as a way of expanding one’s multilingual resources, it reduces one’s repertoire, as it is often learned/taught at the cost of local languages” (Canagarajah 13). As Canagarajah sees "multilingual communities [finding] spaces for voice, renegotiation, and resistance” (Translingual Practices 56), so can we make students aware of the gatekeeping and power of English by sharing its historical context.
“Distinguishing ourselves from the other Religions”: Confessional Conflicts and Their Influence on the Early Moravian Danish West Indies Mission
Authors: Marquardt Frank 
Published: November 2019

ABSTRACT
Beginning in the 1740s, an increasing amount of anti-Moravian polemics was published through the eighteenth century. Scholars from various denominations marked many of Zinzendorf’s theological ideas as controversial or even heretical. The question arises: how did disputes in Europe influence Moravian missions overseas? With a micro-historical perspective this article focuses on how local missionaries’ decisions in the Danish West Indies were impacted by struggles between Moravians and members of the Reformed and the Danish Lutheran churches. Suggestions and guidelines from leading figures like August Gottlieb Spangenberg, David Nitschmann, and Johannes von Watteville played an important role in the way the missionaries tried to cope with these disputes and reflected on their own Moravian identity. By tracing the missionaries’ self-representation as well as adaptations to their religious practices, this article develops a better understanding of the Moravians’ entanglement in a dynamic colonial setting.
“As on the day of Pentecost”: Revivalism, John Greenfield, and the Memory of August 13, 1727
Authors: Burkholder Jared S. 
Published: November 2019

ABSTRACT
As a central part of the Moravian Church’s origin story, the experience of renewal that took place in Berthelsdorf on August 13, 1727, has become part of the Moravians’ collective memory. Imbued with spiritual significance, the event has often been compared to the biblical Pentecost. In commemorating the event, Moravians have continued to draw meaning from the story of August 13, though its significance at times reflected differing impulses. In the American context, August 13 has served as a precedent for seeking experiences of revival. As some Moravian congregations, particularly in the south, organized protracted meetings, revivals could coincide with August 13 commemoration. In the twentieth century, proponents of evangelistic campaigns, who worked to establish institutional support for their activity, also used the memory of August 13 to support evangelical methods and a greater emphasis on the Holy Spirit’s Pentecostal power. Perhaps the best example is John Greenfield, a minister and traveling evangelist who adopted evangelical revival techniques and authored a popular book on August 13. Greenfield, and others during this time, not only used a revival and Holiness paradigm to interpret the events of 1727, but conceived of the Moravian tradition as historically aligned with Anglo-American evangelicalism.
Regressie en progressie in beleidsevaluatie
Authors: Mevissen Jos 
Published: November 2019

Regressie en progressie in beleidsevaluatie
Beleidsevaluatie richt zich steeds naar informatiebehoeften en technische mogelijkheden. Hierdoor is het gebruik van cijfermatige informatie toegenomen. Met name bestaande data worden, met steeds betere analysetechnieken, ingezet omdat ze beschikbaar zijn en relatief goedkoop. Dit gaat echter ten koste van de validiteit en diepgang van onderzoek. Dat is in zekere zin een regressie, een achteruitgang. We zien echter ook progressie in het beleidsonderzoek. In de eerste plaats komt er steeds meer belangstelling voor de zogenoemde mixed methods-benadering. Ten tweede is er een groeiende belangstelling voor participerende, interactieve en responsieve vormen van onderzoek. Er ontstaat weer meer oog voor de wereld achter de cijfers, het hoe en waarom van beleid, en vooral voor de mensen in die wereld.
Participatie en de energietransitie: juridisch instrumentarium in een veranderende context
Authors: Akerboom S. (Sanne) 
Published: November 2019

Participatie en de energietransitie: juridisch instrumentarium in een veranderende context
Dit artikel gaat in op het belang van participatie in de energietransitie, de wijze waarop participatie thans is geïmplementeerd en beoordeeld wordt door de rechter, de nieuwe participatie-instrumenten zoals die worden voorgesteld in de Omgevingswet, de Klimaatwet en het Klimaatakkoord en een analyse van deze instrumenten.
Bosque semántico: ¿educación/enseñanza/aprendizaje a distancia, virtual, en línea, digital, eLearning…?
Authors: García Aretio Lorenzo 
Published: November 2019

Ya desde sus inicios, la educación a distancia se mostró con unas bases teóricas débiles. Esa problemática se agrandó con la integración en los procesos educativos de las tecnologías avanzadas. De ahí surgió un bosque semántico que ha venido enredando cada vez más todo el armazón teórico de esta modalidad educativa. Desde las últimas décadas del siglo pasado, han proliferado denominaciones en torno a este concepto de educación a distancia que con las tecnologías digitales no hizo más que crecer. Partimos en nuestro trabajo de revisar esas múltiples denominaciones del fenómeno educativo no presencial para derivar hacia la que nos parece más adecuada, “educación a distancia”. Analizamos los dos términos que componen ese concepto, “educación”, frente a enseñanza, aprendizaje o instrucción, y “distancia”, frente a electrónico, en línea, virtual o digital, argumentando en cada caso su vigencia total en la sociedad actual. Finalmente, tratamos de ofrecer una definición de este concepto que pretendemos integradora de otras formas actuales de educar mediante el soporte digital, destacando las ideas del diálogo (comunicación e interacción educativas), didáctico (visión pedagógica de logros de aprendizajes valiosos) y mediado (componente tecnológico necesario al producirse el acto educativo con separación física). Así, definimos la educación a distancia como diálogo didáctico mediado entre docentes de una institución y los estudiantes que, ubicados en espacio diferente al de aquellos, pueden aprender de forma independiente o grupal.
En sang til (livs)motet - en undring omkring fenomenet livsmot
Authors: Thorsen Rolf 
Published: November 2019

Reflections on life courage
This essay addresses various aspects of the phenomenon of “life courage”. The approach is phenomenological and draws on a Danish tradition of life philosophy. The aim is not to find definitions, but to approach the topic cautiously to reveal new aspects of the phenomenon. The text is an outer and inner journey through experience, art, literature and poetry. This journey starts by dwelling on the apparent absence of courage for life in situations of extreme darkness. Later in the essay, light gradually appears, accompanied by increased life courage.
Heritability and Correlations for Agronomic and Physiologic Traits of Maize under Deficit Irrigation at Two Growth Stages
Authors: Al-Naggar A. M. M. , Shafik M. M. , Elsheikh M. O. A. 
Published: November 2019

Strong associations between agronomic and physiologic traits and drought tolerance, high heritability and high genetic advance for such traits would allow plant breeder to use such traits as selection criteria for selecting drought tolerant genotypes. The objectives of the present investigation were: (i) to explain the relationships between the drought tolerance index (DTI) and 14 agronomic and physiologic traits of 22 maize genotypes and (ii) to estimate the broad-sense heritability (h2b) and genetic advance (GA) from selection for such traits, in order to determine the selection criteria for DTI. A two-year experiment was carried out using a split plot experiment with three replications. The main plots were devoted to irrigation regimes, i.e. well watering (WW), water stress at flowering (WSF) and at grain filling (WSG), and sub plots to maize genotypes. It is evident from results that the best selection criteria for drought tolerance in our study were: 100-kernel weight (100KW) and chlorophyll concentration index (CCI) under WSF and WSG, anthesis-silking interval (ASI), upper stem diameter (SDU) and lower stem diameter (SDL) under WSF and kernels/row (KPR) and ear leaf area (ELA) under WSG, since they show high correlation (r) values with grain yield/plant (GYPP), high h2b and high GA estimates under the respective environments. Under well watering conditions, KPR, 100KW, CCI, and SDL traits showed high (r) values, high h2b and high GA estimates and therefore could be considered selection criteria for GYPP under non-stressed environment. The results concluded that predicted selection gain would be higher if selection was practiced under WW for lower values of days to silking and higher values of ears/plant, rows/ear, KPR, 100KW, SDU and SDL, under WSF for lower values of ASI and higher values of GYPP and under WSG for lower values of plant height, ear height, and barren stalks, and higher values of CCI and ELA.
Measurement of Serum Lipid Profile Parameters, Blood Urea Nitrogen, Serum Uric Acid and Serum Creatinine Levels for Children with Acute Lymphoblastic Leukemia
Authors: Hantoosh Sundus Fadhil , Al Jumaili Farah T. O. , Zageer Dheaa Shamikh 
Published: November 2019

Introduction: Leukemia is the commonest malignancy of childhood and is the causative of a third of childhood cancer deaths. Lipid abnormalities have been recognized in children with acute lymphoblastic leukemia (All). Kidney involvement in leukemia can be quite immense.
Aim: This study aimed to investigate impact of childhood acute lymphoblastic leukemia and chemotherapy on serum lipid profile parameters and serum renal function tests and on body function.
Study Design: This study is carried out on pediatric patients with all.
Place and Duration of Study: The study was done on children diagnosed with all attended between October 2015 to December 2016 the Central Child Hospital in Baghdad, Iraq.
Methodology: Eighteen pediatric ALL patients were enrolled. Serum blood lipid profile, blood urea nitrogen (BUN), serum uric acid (UA), and serum creatinine levels were measured during treatment.
Results: ALL was more among boys (61.11%) than girls. Of 18 cases, 14 (77.78%) were with low total cholesterol (TC), 2 (11.11%) with low triglycerides (TGs), all (100%) with low high-density-lipoprotein cholesterol (HDL-C), 14 (77.78%) with low blood urea nitrogen (BUN), and 2 (11.11%) with low serum uric acid (UA). Four (22.22%) were with high serum TGs, 6 (33.33%) with high serum very-low-density-lipoprotein (VLDL), 12 (66.67%) with high BUN, and 2 (11.11%) with high creatinine.
Conclusions: Malignancies and chemotherapy recognizably affected serum lipid profile and serum renal function measurements and consequently adversely affected body. The specialist physician should be very careful in determining the dose of chemotherapy treatment, otherwise the specialist physician may be held accountable and accounting in case of serious damage to health or death of patients.
Effect of Elapsed Time after Blood Collection on the Viability and Mitotic Index of Human Lymphocytes during Karyotype Analysis
Authors: El-Khateeb Doaa Hussein , Khalil Ashraf Abd Elraouf , El Sayed Ibrahim Tantawy , EL-Said Hala Hany 
Published: November 2019

Background: Chromosome staining using G banding is a commonly used technique during karyotyping, however, a limited number of laboratories carries out the test. Blood samples must be sent to the laboratory on the same day of sample collection.
Aim: To assess the effect of time passed from sample withdrawal to the beginning of lymphocyte culture on lymphocyte viability and the mitotic index of chromosomal spread.
Methods: Collected peripheral venous blood samples were either processed for chromosome analysis within 2h of samples collection or stored at 4°C then processed at 24h and 48h. Lymphocytes viability was determined by trypan blue and mitotic cells were visualized by the lighted microscope at the 40x objective lens. Mitotic index was calculated per 1000 cell count.
Results: Delay in sample processing more than 24h have a deleterious effect on lymphocyte viability with a significant reduction in mitotic index relative to the freshly processed sample.
Conclusion: Culturing of cells within 24h of sample collection is highly recommended whenever possible and delay more than 48h should be avoided.