bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phenobarbital and Clonidine as Secondary Medications for Neonatal Opioid Withdrawal Syndrome
Authors: Merhar Stephanie L. , Ounpraseuth Songthip , Devlin Lori A. , Poindexter Brenda B. , Young Leslie W. , Berkey Sean D. , Crowley Moira , Czynski Adam J. , Kiefer Autumn S. , Whalen Bonny L. , Das Abhik , Fuller Janell F. , Higgins Rosemary D. , Thombre Vaishali , Lester Barry M. , Smith P. Brian , Newman Sarah , Sánchez Pablo J. , Smith M. Cody , Simon Alan E. ,   FOR THE EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT NEONATAL RESEARCH NETWORK AND THE NIH ENVIRONMENTAL INFLUENCES ON CHILD HEALTH OUTCOMES (ECHO) PROGRAM INSTITUTIONAL DEVELOPMENT AWARDS STATES PEDIATRIC CLINICAL TRIALS NETWORK
Published: February 2021

BACKGROUND AND OBJECTIVES:
Despite the neonatal opioid withdrawal syndrome (NOWS) epidemic in the United States, evidence is limited for pharmacologic management when first-line opioid medications fail to control symptoms. The objective with this study was to evaluate outcomes of infants receiving secondary therapy with phenobarbital compared with clonidine, in combination with morphine, for the treatment of NOWS.

METHODS:
We performed a retrospective cohort study of infants with NOWS from 30 hospitals. The primary outcome measures were the length of hospital stay, duration of opioid treatment, and peak morphine dose. Outcomes were compared by group by using analysis of variance and multivariable linear regression controlling for relevant confounders.

RESULTS:
Of 563 infants with NOWS treated with morphine, 32% (n = 180) also received a secondary medication. Seventy-two received phenobarbital and 108 received clonidine. After adjustment for covariates, length of hospital stay was 10 days shorter, and, in some models, duration of morphine treatment was 7.5 days shorter in infants receiving phenobarbital compared with those receiving clonidine, with no difference in peak morphine dose. Infants were more likely to be discharged from the hospital on phenobarbital than clonidine (78% vs 29%, P &lt; .0001).

CONCLUSIONS:
Among infants with NOWS receiving morphine and secondary therapy, those treated with phenobarbital had shorter length of hospital stay and shorter morphine treatment duration than clonidine-treated infants but were discharged from the hospital more often on secondary medication. Further investigation is warranted to determine if the benefits of shorter hospital stay and shorter duration of morphine therapy justify the possible neurodevelopmental consequences of phenobarbital use in infants with NOWS.
Rapid Implementation of Telehealth Services in a Pediatric Pulmonary Clinic During COVID-19
Authors: Davis Jaclyn , Gordon Rachel , Hammond Adam , Perkins Ryan , Flanagan Frances , Rabinowitz Elliot , Simoneau Tregony , Sawicki Gregory S. 
Published: February 2021

OBJECTIVES
The coronavirus pandemic created significant, abrupt challenges to the delivery of ambulatory health care. Because tertiary medical centers limited elective in-person services, telehealth was rapidly enacted in settings with minimal previous experience to allow continued access to care. With this quality improvement (QI) initiative, we aimed to achieve a virtual visit volume of at least 75% of our prepandemic volume. We also describe patient and provider experience with telehealth services.

METHODS
Our QI team identified the primary drivers contributing to low telehealth volume and developed a telehealth scheduling protocol and data tracking system using QI-based strategies. Patients and providers were surveyed on their telehealth experience.

RESULTS
At the onset of the pandemic, weekly visit volume dropped by 65% (99 weekly visits; historical average of 281). Over the subsequent 3 weeks, using rapid Plan-Do-Study-Act cycles, we achieved our goal volume. In surveys, it was indicated that most participants had never before used telehealth (71% of patients; 82% of providers) yet reported high satisfaction (90% of patients; 81% of providers). Both groups expressed concern over the lack of in-person assessments. Most respondents were interested in future use of telehealth.

CONCLUSIONS
With a QI-based approach, we successfully maintained access to care via telehealth services for pediatric pulmonary patients during the coronavirus pandemic and found high rates of satisfaction among patients and providers. Telehealth will likely continue to be a part of our health care delivery platform, expanding the reach of our services. Further work is needed to understand the effects on clinical outcomes.
“Caínes despiadados… Caínes invasores”. La invasión del 10 de diciembre de 1948 a Costa Rica en perspectiva nacional y transnacional
Authors: Ugalde Quesada Alexia 
Published: February 2021

Este artículo estudia la invasión del 10 de diciembre de 1948 a Costa Rica en sus dimensiones de conflicto nacional, es decir, como consecuencia de la guerra civil del mismo año y de conflicto transnacional que involucra a otros países de la región así como la intervención de la Organización de Estados Americanos. Para ello se consultaron fuentes históricas del Archivo Nacional de Costa Rica, documentos de la Central Intelligence Agency y de los Archivos Nacionales de los Estados Unidos, así como prensa. Se plantea que durante la posguerra costarricense la violencia política permaneció debido a que los vencedores crearon instituciones y legislación para perseguir a sus enemigos, lo que a su vez causó una inminente invasión.

Palabras claves: Costa Rica, Nicaragua, Legión Caribe, comunistas, Cruz Roja, Organización de Estados Americanos, TIAR.
Estilo de vida e nível de atividade física de indivíduos portadores de miocardiopatia chagásica
Authors: Soares Neila Silva , Santos Batista Anne Karine Menezes , Aras Roque , Rosa Camelier Fernanda Warken 
Published: February 2021

INTRODUÇÃO: A doença de Chagas (DC) constitui uma infecção parasitária causada pelo protozoário flagelado Tripanosoma cruzi. Estimativas apontam a existência de, aproximadamente, cinco milhões de indivíduos infectados, principalmente, na América Latina, com o Brasil datando entre 1,9 a 4,6 milhões de indivíduos sob o mesmo aspecto infeccioso. O desfecho cardíaco configura um dos aspectos mais importantes, com manifestações condizentes à disfunção ventricular sistólica ou diastólica, disfunção autonômica cardíaca e morte súbita. OBJETIVO: correlacionar o estilo de vida e o nível de atividade física de indivíduos portadores de miocardiopatia chagásica (MC). MATERIAL E MÉTODOS: Realizou-se um estudo analítico, de corte transversal, em ambulatório de referência para Miocardiopatias, com abrangência estadual. Utilizou-se formulário próprio construído pelas autoras, o qual contemplava além das variáveis clínicas e demográficas, variáveis relativas à análise do estilo de vida e atividade física dos participantes, sendo esse aplicado em sala de espera, enquanto os sujeitos aguardavam atendimento médico. RESULTADOS: Foram selecionados 74 indivíduos portadores de MC. A média de idade da amostra foi de 61,2 ± 8,5 anos, sendo que 50 (68,0%) indivíduos eram do sexo feminino. Em relação ao nível de atividade física, houve predomínio da categoria “não ativo”, correspondendo a 60 indivíduos (71,0%). O estilo de vida foi classificado como “muito bom” para 41 (55,0%) participantes e “bom” para 22 (30,0%) participantes, não havendo indivíduos alocados na categoria “necessita melhorar” do questionário. CONCLUSÃO: Os resultados obtidos permitem concluir que, de modo geral, o estilo de vida e o nível de atividade física de indivíduos portadores de MC caracterizaram-se como “bom” / “muito bom” e não ativos, respectivamente.
Otonomi Internal dan Eksternal Guru serta Pengaruhnya terhadap Partisipasi Mereka dalam Pembuatan Keputusan di Sekolah
Authors: Intifadhah Intifadhah , Wirza Yanty 
Published: February 2021

Rasa otonomi internal dan eksternal guru berkaitan erat dengan pemberdayaan diri guru. Hal ini berfokus pada bagaimana guru memandang kekuatan pribadi atau internal mereka dan bagaimana mereka mengekspresikan otonomi mereka melalui interaksi dengan orang lain. Namun, hubungan antara rasa otonomi guru dan partisipasi guru dalam pengambilan keputusan di sekolah masih jarang diamati, khususnya dalam konteks pendidikan di Indonesia. Oleh karena itu, tujuan utama dari penelitian ini adalah untuk mengukur rasa otonomi internal dan eksternal guru dan bagaimana pengaruhnya terhadap partisipasi guru dalam pengambilan keputusan di sekolah. Dua puluh empat guru Bahasa Inggris dari berbagai tingkat sekolah menengah berpartisipasi dalam penelitian ini. Data dikumpulkan dengan menggunakan Indeks Pemberdayaan Diri Internal (ISEI) dan Indeks Pemberdayaan Diri Eksternal (ESEI) yang dikembangkan oleh Wilson. (1993) dan wawancara terbuka. Temuan ini mengungkapkan bahwa guru dengan tingkat otonomi yang tinggi lebih banyak berpartisipasi dalam pengambilan keputusan di sekolah. Dalam hal ini, kekuatan otonomi internal dan eksternal mereka memberdayakan mereka untuk mengekspresikan pikiran dan perasaan, mengambil risiko, terbuka untuk belajar dari orang lain dan berpartisipasi lebih banyak dalam diskusi yang intens dengan kolega dan administrator sekolah.
Pengembangan Keterampilan Berbahasa Lisan Pada Anak dengan Hambatan Pendengaran melalui Program Terpadu
Authors: Hernawati Tati , Aprilia Imas Diana , Gunawan Dudi 
Published: February 2021

Anak dengan hambatan pendengaran mengalami hambatan dalam keterampilan berbahasa lisan sebagai dampak langsung dari kehilangan ketajaman pendengarannya. Keterampilan berbahasa lisan ini penting dimiliki anak tersebut agar mereka dapat berkomunikasi dengan lingkungan orang mendengar pada umumnya. Oleh karena itu keterampilan berbahsa lisan ini penting untuk ditingkatkan melalui program yang teruji efektivitasnya. Kegiatan penelitian dilakukan untuk mengetahui efektivitas program terpadu dalam mengembangkan keterampilan berbahasa lisan anak dengann hambatan pendengaran. Metode yang digunakan adalah metode eksperimen dengan posttest design. Jumlah sampel adalah 3 orang, yaitu siswa kelas 3 SLB Negeri Cicendo Bandung, sedangkan teknik pengolahan datanya menggunakan Metode Uji Tanda Median. Hasil penelitian menunjukan bahwa program terpadu dapat meningkatkan keterampilan berbahasa lisan pada anak dengan hambatan pendengaran kelas 3 SLB Negeri Cicendo Bandung, Indonesia. Berdasarkan hasil penelitian ini, guru direkomendasikan untuk mengimplementasikan program terpadu dalam meningkatkan keterampilan berbahasa lisan pada anak dengan hambatan pendengaran, dengan terlebih dahulu melakukan asesmen dan analisis hasil asesmen serta melakukan adaptasi program.
Hysterectomy for benign conditions in a tertiary care centre: a clinical audit
Authors: Hymavathi K. , Madhuri P. V. Sreeleena , Brahmini Maddipudi , Madhubala Sakthi 
Published: February 2021

Background: This clinical audit is to determine the indications, type, and outcome of hysterectomy performed for benign gynaecological conditions in two years and to identify the problem or issue (if any) in planning the hysterectomy for benign conditions.Methods: The present study is a hospital-based prospective study conducted in the Department of Obstetrics and Gynaecology, Narayana Medical College and Hospital, a tertiary care centre, Nellore, AP. Six hundred women, who underwent the hysterectomy during the study period are recruited into this study after obtaining hospital ethical committee approval and informed consent. Among the total of 50,450 women attended our OPD for gynaecological complaints, 600 patients underwent the hysterectomy. Thus 9.6% of total gynaecological admissions ended up with the hysterectomy.Results: The mean age group of the study is 49.07±8.0 years. Majority of women belonged to low socio-economic status. Predominant age group underwent hysterectomy was 40-49 years. Majority (78.2%; 469 cases) of hysterectomies were done in multiparous women. Chief complaints were menstrual irregularities. Abnormal uterine bleeding -leomyoma (AUB-L) (228 cases; 38%) was the most common indication for hysterectomy. Most commonly done procedure was total abdominal hysterectomy TAH (60.5%; 363 cases). 306 cases (51%) had oophorectomy (beyond the age of 45 years).The various complications (hemorrhage, sepsis etc..) found to happen mainly in hysterectomies done through abdominal route. 95% of hysterectomised histopathological specimen’s histopathology reports correlated with the pre-operative biopsy reports.Conclusions: In proved benign conditions, women were counselled and encouraged for medical and conservative methods. Hysterectomies should be decided in those situations where the above measures fail and also where it was found to be the definitive management in the first instance. Woman’s option has also to be considered in certain cases. The route of hysterectomy has to be decided case to case basis and choice of the attending clinician. Oophorectomy was decided in the premenopausal women depending on the condition of the ovaries witnessed at the time of surgery.
A prospective study on feto-maternal outcome in patients with premature rupture of membranes at tertiary care center
Authors: S. A. Patil , B. H. Gaikwad , P. Purohit , Upadhyay Chintan 
Published: February 2021

Background: PROM is associated with increased risk of chorioamnionitis, unfavorable cervix and dysfunctional labour, increased cesarean rates, postpartum hemorrhage and endometritis in the mother. Possible neonatal outcomes in cases of PROM may include respiratory distress syndrome, hypothermia, hypoglycemia, intraventricular hemorrhage, broncho pulmonary dysplasia etc. Objective of this study the maternal and perinatal outcomes in premature rupture of membranes at term.Methods: This prospective study was done among 100 pregnant women with premature rupture of membranes after 37 completed weeks visited at department of obstetrics & Gynecology in RCSM Hospital, Kolhapur during June 2014 and June 2015. Inclusion Criteria was Gestational age of >37 weeks confirmed by dates, clinical examination or ultrasound, cervical dilatation of <3 cms, Lack of uterine contractions for atleast 1 hour from PROM, Single live pregnancy in vertex presentation and PROM confirmed by Direct visualization or Litmus.Results: Present study found highest number of cases among age group 20-24 years and mean age was 22 years. Almost 70% cases were un-booked. Average duration to PROM to hospital admission was 9.6 hours. Most common maternal outcome was febrile illness Most common perinatal outcome was birth asphyxia and 3 perinatal death.Conclusions: Pregnancies complicated with PROM should have supervised labor preferably in an institution. Management of each case has to be individualised. A combined effort of obstetrician and neonatalogist is necessary. A good neonatal intensive care unit can be instrumental in reducing the perinatal morbidity and mortality.
The correlation between body mass index and the type of foot arches with the risk of hallux valgus in children aged 13–14 years old
Authors: Vittala Govinda , Sundari Luh Putu Ratna , Bhakti Krisnanda I Putu Radhe , Semariasih Ni Komang Dewi 
Published: February 2021

Background: Hallux valgus is a deformity characterized by a change in the shape of the thumb with symptoms of swelling, redness and pain. Hallux valgus is progressive where there is a lump at the base of the thumb which can occur due to the weakness of the muscles and ligaments around the first metatarsophalangeal joint. The purpose of this study was to determine the relationship between body mass index and the type of foot arches on the risk of hallux valgus in children aged 13–14 years. Methods: This research is a cross sectional analytic study with simple random sampling technique. The number of samples are 99 children (39 males, 60 females) aged 13–14 years. The variables measured were body mass index using body weight scales and a stature meter, the type of foot arches using a wet footprint test, and hallux valgus with a goniometer.Results: Our study shows that there is no significant correlation between body mass index and hallux valgus at the level of 0.157. However, there is a significant correlation between the type of foot arches and hallux valgus at the 0.003 level. In addition, there is a significant correlation between body mass index and foot arches. Conclusions: There was a significant relationship between body mass index and foot arches and foot arches with the risk of hallux valgus. However, body mass index is not directly related to hallux valgus condition.
Seasonal variation and role of meteorological conditions in reported chicken pox cases in a residential hostel of Ramgarh
Authors: Gupta Vivek , Kumar Surinder , Mahajan Saurabh 
Published: February 2021

Background: Chicken pox is an acute, common, and highly contagious disease caused by the varicella zoster virus (VZV). Chicken pox is predominantly a childhood disease characterized by pruritic vesicular exanthema with systemic symptoms such as fever, loss of appetite, and malaise. Primary infection tends to occur at a younger age and is usually benign in immunocompetent children but can be life-threatening in adults and immunocompromised individuals, with an attack rate approaching >85% after exposure. This study attempts to evaluate the trend of chickenpox cases in a residential hostel in Ramgarh.Methods: This was a record based descriptive study done using reported Chicken Pox cases in the OPDs during the period from January 2015 to December 2018. Monthly average for meteorological data (Min and Max temperature, Precipitation and Humidity) for Ramgarh was recorded for the study period. Seasonality and trend was identified for chicken pox cases during this period by plotting the monthly number of clinically diagnosed cases over time period to identify any repeated pattern. Poisson’s distribution was used to estimate association between meteorological variables and incidence of chickenpox cases.Results: Analysis revealed strong correlations (r=0.7553, p<0.0001) between humidity and precipitation. There was a significant correlation between Incidence of varicella and meteorological factors under study (all p<0.05).Conclusions: The findings of this study will aid in forecasting epidemics and in preparing for the impact of climate change on the varicella epidemiology through the implementation of public health preventive measures such as promoting good hygiene practices, temporary closure of educational institutions, active vaccination and campaigns that include press releases and media events to encourage preventive activities.
Impact of COVID-19 on mental health of healthcare professionals working in COVID-19 designated clinical areas in India
Authors: Sharma Kamlesh Kumari , Kaur Ravneet , Srinivasan Muthuvenkatachalam , Sarkar Siddarth , Mani Kalaivani , Sharma Yamya , Gupta Sandhya 
Published: February 2021

Background: In the wake of the pandemic of coronavirus disease 2019, there are reports of its impact on psychological wellbeing of the health care workers.Methods: This cross-sectional survey was conducted in June 2020 in a tertiary care hospital in Delhi, India among conveniently sampled 93 participants i.e. doctors and nurses directly engaged in clinical activities in COVID-19 designated areas. A self-administered questionnaire through Google forms elicited symptoms of depression, anxiety, insomnia, and distress measured using the 9-item patient health questionnaire, 7-item generalized anxiety disorder scale, 7-item insomnia severity index, and 22-item impact of event scale-revised respectively.Results: Majority (53.8%) of the participants were male and their mean age was 30.2 years. Most (72%) were nurses, the rest being doctors. A substantial proportion of the participants had depression (47.4% of the sample), anxiety (29.0%), insomnia (32.3%) and distress (22.6%). Symptoms were disproportionately higher in female and single participants, nurses; those with history of chronic illness, staying in institute provided temporary accommodation, working on regular basis and perceiving lack of adequate personal protective equipment. Taking prophylactic hydroxychloroquine was associated with lower symptom rates.Conclusions: This survey revealed a considerable prevalence of mental health outcomes in HCWs demonstrating an association with age, gender; marital, professional and employment status, history of chronic illness, access to PPE, stay at institute provided temporary accommodation and prophylactic hydroxychloroquine use.
La protesta feminista #8M 2020 en México a través de la participación de comentarios en YouTube
Authors: García-González Lidia A. , Bailey Guedes Olga 
Published: February 2021

El presente artículo es un estudio de corte cuantitativo de los comentarios generados y publicados por usuarios el 8 y 9 de marzo en la plataforma YouTube sobre la marcha #8M en Ciudad de México del 8 de marzo de 2020. Su propósito es conocer qué tipo de temáticas, discusiones y percepciones giran en torno a una de las más concurridas manifestaciones feministas en contra de la violencia de género y la impunidad ante una creciente ola de feminicidios en México. Asimismo, presenta una discusión sobre las potencialidades y riesgos de YouTube para el ciberfeminismo y la protesta a partir de los comentarios generados por los usuarios. Los resultados muestran un espacio en el que se manifiestan una fuerte misoginia, una alta incomprensión del feminismo y la imposibilidad de una conversación productiva y dialógica.
Social skills and cyberbullying behavior among students in Hail from the perspective of social work
Authors: Albantan Mishal Alasmar Radhi 
Published: February 2021

This study aimed at identifying social skills and their relationship to cyberbullying behaviors among students in the Hail region in the Kingdom of Saudi Arabia. The study was conducted on a sample of (398) male and female students (191 males and 207 females). The study used the descriptive method and developed two questionnaires as instruments of the study, the first on social skills and the second on cyberbullying. The results of the study indicated that the level of social skills of secondary school students in the Hail region was high. There were differences due to the influence of gender in all areas, except for the area of social participation, and the differences were in favor of females in all fields. The results also showed the existence of differences in the level of “social skills” attributed to the “level of academic achievement,” and the differences were in favor of those with higher achievement. The results did not show any differences attributable to "grade" in all areas, except for the field of "social participation," and the differences were between the tenth and eleventh grades. The results found a negative relationship between the level of "social skills" and "bullying behaviors" among secondary school students in the Hail region.

Keywords. Cyberbullying, social skills, teenagers, bullying behaviors.