bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estudio hematológico en monos cariblancos (Cebus albifrons) en condiciones de cautiverio en Colombia
Authors: Castañeda-Herrera Fabián Enrique , Cortés-Vera Michael , Vélez-García Juan Fernando 
Published: December 2020

El objetivo del presente estudio fue realizar la valoración hemática de primates Cebus albifrons mantenidos en cautiverio en el Centro de Atención y Valoración de Fauna Silvestre (C.A.V) de la ciudad de Ibagué, Colombia. Se extrajo sangre (~2 ml) mediante la punción de las venas femoral o axilar bajo restricción química en nueve machos (seis castrados) y cinco hembras. Se obtuvieron resultados para el hematocrito de 40.75±3.91%, hemoglobina 15.2±1.4 g/dl, recuentos eritrocitarios 5 200 714±510 331/mm3, hemoglobina corpuscular media [HCM] 29.22±1.46 pg, concentración de hemoglobina corpuscular media [CHCM] 37.26±0.73 g/dl, volumen corpuscular medio [VCM] 78.61±4.46 fl, recuento leucocitario 8328.6±2993.7/mm3, neutrófilos segmentados 43.56±10.31%, monocitos 28.11±5.28%, linfocitos 23.54±7.45%, eosinófilos 4.79±1.14% y plaquetas 276 857±71 889/mm3. No se evidenciaron diferencias significativas entre sexos.
Variación en el diámetro de fibra por efecto de la medulación en vellones finos de alpacas Huacaya de tres grupos etarios
Authors: Guillén P. Ana Luz , Leyva V. Víctor 
Published: December 2020

El objetivo del estudio fue evaluar el efecto de la medulación y la edad en la variación del diámetro de las fibras de vellón fino. Se evaluaron 24 703 fibras obtenidas del flanco de 186 alpacas Huacaya hembra, color blanco, de 1.5-2 años (dos dientes), 3-4 años (cuatro dientes) y más de 4 años (boca llena). Se categorizó las fibras según su diámetro como extrafinas, finas, media finas y gruesas, y según la medulación como médula completa, partida y sin médula. El diámetro promedio de las fibras dentro de cada categoría y tipo de medulación fue similar entre los grupos etarios. El efecto simple entre las categorías de las fibras y los tipos de medulación resultó en una dependencia significativa (p<0.01), donde el diámetro de la fibra incrementa por la presencia de médula (partida y completa) y disminuye en su ausencia. Se concluye que la medulación causa variación en el diámetro de las fibras, y la presencia de fibras con médulas partidas es el paso intermedio en la disminución del diámetro y frecuencia de fibras meduladas. Por otro lado, la ausencia del efecto edad asociado al efecto medioambiental del número de esquilas en las alpacas de mayor edad sugiere la expresión de un potencial genético que podría ser usado en programas de mejora genética.
National Prevalence of Donor Milk Use Among Level 1 Nurseries
Authors: Parker Margaret G. , Burnham Laura A. , Kerr Stephen M. , Belfort Mandy B. , Perrin Maryanne T. , Corwin Michael J. , Heeren Timothy C. 
Published: December 2020

BACKGROUND AND OBJECTIVES:
Donor milk use has increased among very preterm infants because of mounting evidence of health benefits; however, the extent that donor milk is used among healthy term infants in level 1 nurseries is unclear. We aimed to determine (1) national prevalence of and (2) hospital factors associated with donor milk use in level 1 nurseries.

METHODS:
Among 3040 US birthing hospitals, we randomly selected hospitals from each of 4 US regions (119 in northeast, 120 in Midwest, 116 in west, and 103 in south) for a total of 458 hospitals. We surveyed the nursing leaders of these hospitals from October to December 2017 regarding routine use of donor milk in the level 1 nursery (yes or no). To estimate national prevalence, we weighted responses according to the number of birthing hospitals within each region. We examined relationships between routine donor milk use in the level 1 nursery and hospital characteristics using multivariable logistic regression.

RESULTS:
In total, 214 of 458 (47%) nursing leaders responded. The national prevalence of routine donor milk use in level 1 nurseries was 17.6%. Eighty-five percent of donor milk programs were ≤5 years old. Donor milk use occurred more often in hospitals with ≥1500 annual births (41.7%), compared to ≤500 annual births (6.3%) (adjusted odds ratio 7.8; 95% confidence interval 1.8–34.4), and in the west (30.9%), compared to the northeast (10.5%) (adjusted odds ratio 4.1; 95% confidence interval [1.1–14.9]).

CONCLUSIONS:
Although there is limited evidence to support donor milk for healthy infants in the nursery, nearly one-fifth of level 1 US nurseries routinely used donor milk in 2017.
Pediatric Project ECHO: Implementation of a Virtual Medical Education Program to Support Community Management of Children With Medical Complexity
Authors: Lalloo Chitra , Diskin Catherine , Ho Michelle , Orkin Julia , Cohen Eyal , Osei-Twum Jo-Ann , Hundert Amos , Jiwan Annie , Sivarajah Senthoori , Gumapac Alyssa , Stinson Jennifer N. 
Published: December 2020

OBJECTIVES:
Health care providers (HCPs) require ongoing support to meet the evolving care needs of children with medical complexity (CMC). Project Extension for Community Healthcare Outcomes (ECHO) is a model for delivering technology-enabled medical education and cultivating a community of practice. In this study, we focused on developing, implementing, and evaluating the first ECHO program dedicated to the care of CMC. Specific objectives were to evaluate the program feasibility (participation and acceptability) and impact on perceived HCP knowledge, self-efficacy, and clinical practice after 6 months.

METHODS:
A needs assessment was conducted to inform an interprofessional CMC curriculum. This curriculum was delivered through monthly virtual TeleECHO clinics (didactic and case-based learning) from January 2018 to 2020. The program was available at no cost to HCPs throughout Ontario. Surveys were distributed at baseline and 6 months to assess program acceptability, knowledge, self-efficacy, and practice impact by using 7-point Likert scales. Descriptive and inferential data analyses were conducted.

RESULTS:
Twenty-four clinics were completed with a mean of 19 ± 6 attendees. Acceptability scores (n = 27) ranged from 5.0 ± 1.1 to 6.4 ± 0.6. Participants reported an improvement in their knowledge and self-efficacy across all probed topics and skills (P values ranged from &lt;.001 to .006). These knowledge and self-efficacy scores related to “complex care support,” “feeding support,” and “respiratory support.” The majority of participants reported positive or very positive practice impacts, including enhanced ability to provide quality care to CMC.

CONCLUSIONS:
Project ECHO is a feasible and acceptable model for virtual education of interprofessional HCPs in managing CMC. This program has the potential to increase system capacity to provide quality care to CMC close to home.
Long-Term Impact of a Clinical Care Guideline for Pediatric Acute Musculoskeletal Infections: Are Improved Outcomes Sustainable?
Authors: DeVine Mackenzie N. , MacBrayne Christine E. , Williams Manon C. , Pearce Kelly , Wickstrom Kaylee , Donaldson Nathan , Parker Sarah K. , Searns Justin B. 
Published: December 2020

BACKGROUND:
Acute hematogenous musculoskeletal infections are a common cause of hospitalization in children. A locally developed clinical care guideline (CCG) for acute musculoskeletal infections was implemented at our quaternary care pediatric hospital in July 2012. The purpose of this study was to evaluate the long-term sustainability of previously described improvements after CCG implementation.

METHODS:
Clinical outcomes for children hospitalized with musculoskeletal infections at Children’s Hospital Colorado from June 2009 through September 2018 were retrospectively reviewed. Patients were included if they had an International Classification of Diseases, Ninth Revision or International Classification of Diseases, 10th Revision discharge diagnosis of acute osteomyelitis, septic arthritis, or pyomyositis and were between 6 months and 18 years of age at admission. Patients with underlying medical complexity or nonhematogenous musculoskeletal infections were excluded. Patients were categorized by date of admission as either “pre-CCG” (June 2009 to June 2011) or “sustain-CCG” (July 2014 to September 2018). Primary outcomes were hospital length of stay and intravenous antimicrobial length of therapy.

RESULTS:
From pre-CCG to sustain-CCG, median length of stay decreased by 1.29 days (5.56 vs 4.27; P &lt; .004) and median length of therapy decreased by 5.04 days (8.33 vs 3.29; P &lt; .0001). Statistical process control charts support that these were sustained improvements many years after CCG implementation. Additional secondary clinical improvements were observed in the sustain-CCG group including faster fever resolution, more consistent blood and source culture acquisition, and decreased central line placement. There was no increase in related readmissions or therapeutic failures in the sustain-CCG group.

CONCLUSIONS:
Implementation of a CCG to standardize care for musculoskeletal infections can be sustained many years after implementation.
Saline-Lock Versus Continuous Infusion: Maintaining Peripheral Intravenous Catheter Access in Children
Authors: Yeung Frances , Miller Michael R. , Ojha Rahul , McKelvie Brianna , Poonai Naveen , Bock Dirk E. , Cameron Saoirse , Taheri Sepideh 
Published: December 2020

OBJECTIVES:In children, peripheral intravenous catheters (PIVs) are maintained by either a continuous infusion of fluid “to keep vein open” (TKO) or a saline lock (SL). There is a widespread perception that TKO prolongs PIV patency, but there is a lack of evidence for this. We hypothesized that there would be no significant difference in duration of PIV patency between TKO and SL.PATIENTS AND METHODS:This prospective, time-allocated study included patients from newborn to 17 years of age admitted to our pediatric ward. Patients enrolled in the first 3 months were assigned to TKO, and patients in the latter 3 months were assigned to SL. Primary outcome was duration of functional patency of the first PIV during the time of TKO or SL. Secondary outcomes included PIV-related complications and patient and caregiver satisfaction.RESULTS:Complete PIV data were available on 172 (n = 85 TKO, n = 87 SL) of 194 enrolled patients. The mean (SD) duration of PIV patency was 41.68 (41.71) hours in the TKO group and 44.05 (41.46) hours in the SL group, which was not significantly different (P = .71). There were no significant differences in complication rates or overall patient and caregiver satisfaction. One patient in the TKO group had their PIV removed because of risk of strangulation from tubing.CONCLUSION:There were no significant differences between TKO and SL in the duration of PIV patency, complication rates, and overall patient and caregiver satisfaction in our pediatric population. Overall, SL is a safe and reasonable alternative to TKO in maintaining PIV patency in children.
Predictors of Quality Improvement in Pediatric Asthma Care
Authors: Kaiser Sunitha , Gupta Nisha , Mendoza Joanne , Azzarone Gabriella , Parikh Kavita , Nazif Joanne , Cattamanchi Adithya 
Published: December 2020

BACKGROUND:
Little is known about what hospital and emergency department (ED) factors predict performance in pediatric quality improvement efforts.

OBJECTIVES:
Identify site characteristics and implementation strategies associated with improvements in pediatric asthma care.

METHODS:
In this secondary analysis, we used data from a national quality collaborative. Data on site factors were collected via survey of implementation leaders. Data on quality measures were collected via chart review of children with a primary diagnosis of asthma. ED measures included severity assessment at triage, corticosteroid administration within 60 minutes, avoidance of chest radiographs, and discharge from the hospital. Inpatient measures included early administration of bronchodilator via metered-dose inhaler, screening for tobacco exposure, and caregiver referral to smoking cessation resources. We used multilevel regression models to determine associations between site factors and changes in mean compliance across all measures.

RESULTS:
Sixty-four EDs and 70 inpatient units participated. Baseline compliance was similar by site characteristics. We found significantly greater increases in compliance in EDs within nonteaching versus teaching hospitals (12% vs 5%), smaller versus larger hospitals (10% vs 4%), and rural and urban versus suburban settings (6%–7% vs 3%). In inpatient units, we also found significantly greater increases in compliance in nonteaching versus teaching hospitals (36% vs 17%) and community versus children’s hospitals (23% vs 14%). Changes in compliance were not associated with organizational readiness or number of audit and feedback sessions or improvement cycles.

CONCLUSIONS:
Specific hospital and ED characteristics are associated with improvements in pediatric asthma care. Identifying setting-specific barriers may facilitate more targeted implementation support.
Oil price and urgency towards economic diversification through effective reforms and policies in Caspian Basin
Authors: Yasmin Tahira , El  Refae Ghaleb A. , Eletter Shorouq 
Published: December 2020

This paper highlights that oil price fluctuations cast negative impact on oil exporting economies of Caspian Basin namely as; Azerbaijan, Kazakhstan and Russia. These resource abundant economies faced revenue contraction and dwindling budget expenditures due to oil price change. To justify underlined reasons, current study examined export and economic diversification analysis for all three economies. It can be concluded that these countries unable to achieve economic diversification due to over dependence on oil revenues. Most of the export oriented sectors consists of minerals, oil and gas by neglecting the more sustainable growth of non-resource tradable sectors. As a result, these countries have huge share in exports mainly as natural resources. In terms of economic diversification which is based on sectoral value added also indicates that these countries are showing some signs of diversity but still there is need to have structural reforms and policy instruments to diversify their revenue stream.
İki farklı histerektomi cerrahisi yönteminin solunum fonksiyonuna etkisinin karşılaştırılması: Laparoskopik veya abdominal
Authors: KARAKUŞ Resul , ÖZKAYA Enis , TAYYAR Ahter , YILDIRIM Doğukan , ÇÖĞENDEZ Ebru 
Published: December 2020

Amaç:Laparoskopik veya abdominal histerektomi uygulanan kadınlarda ameliyat öncesi ve sonrası solunum fonksiyonlarını karşılaştırmayı amaçladık.
Metot:Ocak 2015 - Kasım 2016 tarihleri ​​arasında Sağlık Bilimleri Üniversitesi Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesinde prospektif olarak veri topladık. Histerektomi endikasyonu ile Kadın Hastalıkları ve Doğum kliniğine başvuran hastalar, hasta öncelikleri ve cerrahların tercihine göre rastgele olarak laparoskopi grubu (n = 24) ve açık cerrahi grubu (n = 26) olmak üzere 2 gruba ayrıldı. Karın ameliyatı geçiren hastalar ve sistemik bozukluklar çalışma dışı bırakıldı. Solunum fonksiyon testleri değerlendirildi ve ameliyat öncesi ve ameliyat sonrası 5. gündeki değerler karşılaştırıldı.
Sonuç:Total abdominal histerektomi uygulanan kadınlarda PaCO2, PaO2 ve SaO2 düzeyleri hariç cerrahi sonrası solunum fonksiyon testi parametrelerinin çoğunda bazal ölçümlere göre anlamlı değişiklikler vardı. Total laparoskopik histerektomi uygulanan kadınlarda PaCO2 düzeyleri hariç cerrahi sonrası solunum fonksiyon testi parametrelerinin çoğunda bazal ölçümlere göre anlamlı değişiklikler vardı
Karar:Hem laparoskopik hem de abdominal histerektomiler bozulmuş solunum fonksiyon testleri ile ilişkiliydi.
Requisitos Necesarios Para Acceder al Beneficio Tributario de Iva Exento Para Turistas no Residentes.
Authors: Peña Sanchez Alcides De Jesus 
Published: December 2020

Existe consenso de que el turismo constituye una de las actividades económicas más importantes del Siglo XX y XXI. Según los investigadores J.L. Nieto, I.M. Román, D. Bonillo, N. Paulova. (2016) el turismo internacional a mediados del Siglo XX en la década los años 50, movía una cantidad estimada de unos veinticinco millones de turistas; sin embargo, el crecimiento de esta cifra ha evolucionado de manera importante, para el año 2000 el número de turistas entre países era de 678 millones, para el año 2010 esta suma alcanzó los 950 millones, y las proyecciones para el 2030 se estiman en 1.800 millones de turistas.
Cada país diseña políticas públicas que le permitan participar a nivel mundial del turismo receptivo, porque esta importante actividad es una exportación de servicios que permite ayudar a equilibrar la balanza comercial de las naciones, además del importante flujo de divisas que genera, es una fuente de empleo y un dinamizador de los demás sectores económicos como servicios, comercio e industria.
IMPLEMENTASI KELAS VIRTUAL DENGAN GOOGLE CLASSROOM UNTUK MENINGKATKAN HASIL BELAJAR KIMIA DI SMA NEGERI BEKASI
Authors: Bintarawati Dwining , Citriadin Yudin 
Published: December 2020

Penelitian ini bertujuan untuk mengidentifikasi implementasi kelas virtual dengan Google Classroom dalam meningkatkan hasil belajar kimia. Metode penelitian yang digunakan dalam penelitian ini merupakan penelitian tindakan kelas yang dilaksanakan dalam 2 siklus. Setiap siklus terdiri atas 4 tahapan yaitu: perencanaan, pelaksanaan, pengamatan, dan observasi. Subjek penelitian adalah seluruh siswa kelas XI-MIPA 1 SMAN 1 Serang Baru. Teknik pengumpulan data dilakukan melalui observasi aktivitas pembelajaran dan hasil tes siswa pada mata pelajaran kimia. Setelah semua data terkumpul, analisis data dengan menggunakan rumus persentase. Berdasarkan hasil penelitian diperoleh aktivitas siswa dalam impelemntasi kelas virtual dengan Google Classroom mengalami peningkatan dari siklus I dan siklus II dengan persentase 92,31% menjadi 94,23%. Sedangkan hasil belajar siswa mengalami peningkatan secara klasikal dari 70, 94% pada siklus I menjadi 88,88% pada siklus II. Dari hasil penelitian dan analisis data dapat disimpulkan bahwa impelemntasi menggunakan kelas virtual dengan Google Classroom dapat meningkatkan aktivitas dan hasil belajar kimia di SMAN 1 Serang Baru. Kelas virtual melalui Google Classroom dapat dijadikan solusi dalam pembelajaran daring di tengah wabah pandemik Covid-19.
PENGARUH MENDENGARKAN AYATUSSYIFA DAN RELAKSASI OTOT PROGRESIF TERHADAP TEKANAN DARAH PADA LANSIA DENGAN HIPERTENSI
Authors: Wijaya Dimas Satrya Sukma , Bakar Abu , Wahyuni Erna Dwi 
Published: December 2020

Pendahuluan: Terapi mendengarkan Al-Qur’an dan Teknik Relaksasi Otot Progresif merupakan metode non-farmakologi yang dapat menurunkan tekanan darah. Tujuan penelitian ini adalah untuk mengetahui pengaruh terapi mendengarkan bacaan Al-Qur’an (Ayatussyifa) dan relaksasi otot progresif terhadap tekanan darah pada penderita hipertensi. Metode: Penelitian ini menggunakan quasy-experiment dengan pretest – posttest control group design dengan total sampel sebanyak 50 responden penderita hipertensi dengan menggunakan teknik non-probability sampling dengan tipe purposive sampling. Variabel independen dalam penelitian ini yaitu terapi mendengarkan bacaan Al-Qur’an (Ayatussyifa) dan relaksasi otot progresif sedangkan variabel dependennya yaitu tekanan darah sistolik dan diastolik lansia dengan hipertensi dengan menggunakan lembar observasi sebagai instrument penelitiannya. Analisis penelitian ini menggunakan Wilcoxon Signed Rank Test dan Mann-Whitney U Test (p=<0,05). Hasil: Hasil penelitian menunjukkan adanya pengaruh pada kelompok perlakuan (sistolik p=0,000), (diastolik p=0,000). Hasil uji Mann Whitney kelompok perlakuan dan kontrol menunjukkan hasil Pre-Sistolik (p=0,739) dan Post-Sistolik (p=0,006) sedangkan Pre-Diastolik (p=0,001) dan Post-Diastolik (p=0,410). Diskusi: Terapi mendengarkan Al-Qur’an (Ayatussyifa) dan relaksasi otot progresif dapat menjadi stimulus baik yang dapat berpengaruh terhadap tekanan darah baik sistolik maupun diastolik pasien hipertensi. Perawat dapat memberikan terapi tersebut sebagai salah satu pilihan dalam menurunkan tekanan darah para lansia penderita hipertensi.
Upaya Membangun Strategic Marketing Outcomes Berbasis Pada Relationship Marketing Dan Power
Authors: Riva’i Alimuddin Rizal 
Published: December 2020

This study is developed by proposing a grand theoretical model and empirical models: The impact of Coercive Power in Relationship Marketing and Strategic Marketing Outcomes based on Relationship Marketing Theory and Power-Dependence Theory. Spesifically, to investigates the issue of power in business-to-business relationships and the impacts of coercive power to the key variables in the Commitment-Trust Theory (Trust, Relationship Commitment, Cooperation); to integrate Relationship Outcomes variables (loyalty, strong relationship, positive word of mouth) as a value of lifetime relationships, and to builds the strategic marketing outcomes (cooperation synergy, competitive positional advantages, marketing performance). This study was conducted by proposing three empirical models and was tested successfully on Indonesia tourism industry. There are 190 respondents as managers of tourism organization. The data was tested using several statistical tools such as SPSS and Structural Equation Modeling (SEM). The finding of this research are as follows :(1) Coercive Power has no significant association between trust, and positive-significant between relationship commitment and cooperation; 2) This study shows that the coercive power does not destroye a relationship but has a capability to control the interaction process; (3) This suggests that there are other variables of driving relationships besides the trust-commitment-based relationships suggested by Morgan dan Hunt (1994). There are both trust-based and power-based relationships.However, coercive power it self is not found to be driver of relationship outcomes. The Suggested coercive power and trust are the relationship bases of relationship marketing; (4) Value of Lifetime Relationships (Loyalty, Strong Relationship, Positive “WoM”) as a relationship outcomes, and important variables cause to grow up cooperation synergy. This is one spesific research finding.; (5) and the last, The Cooperation Synergy as an important variable will in crease the competitive positional advantages and marketing performance. The result of the study is important to develop and maintain relationship with stakeholders (partners, competitors, complementary organization) in tourism industry which based on market-based views and resources-based views. This integrated approach can achieve greater outcomes in relationship marketing of business-to-business relationship activities. In tourism policy, it is important to formulate “The Grand Tourism Strategy Based on Local Resources and Cultures”.
Diversifikasi Investasi Saham: Perbandingan Risiko Total Portofolio Melalui Diversifikasi Domestik Dan Internasional
Authors: Auruma S Tyas , Sudana I Made 
Published: December 2020

This study aims to obtain two empirical proofs, are about the difference of total portfolio risk between internationally diversification and domestically diversification, then, the influence of the number of shares in the portfolio toward the total risk of portfolio. The model analysis used in this study is the difference t test on average two independent sample groups and for effect estimation, using simple regression equation. There were 21 blue chips stocks( LQ45 Indonesia;DAX30 German;FTSE100 UK;DJA – USA) choosen randomly, and used as sampel for both of internationally diversification and domestically diversification within period beginning January until December 2011. The results show that there are a difference in the total risk of the portfolio which is generated through internationally diversification and domestically diversification .Total risk of portofolio internationally diversification is smaller than total risk of portfolio domestically diversification, and the number of shares in portfolio affect significant negative toward the total risk of portfolio.