bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep and interrogation: does losing sleep impact criminal history disclosure?
Authors: Krizan Zlatan , Miller Anthony J , Meissner Christian A 
Published: May 2021

Abstract

Study Objectives
Despite centuries of using sleep deprivation to interrogate, there is virtually no scientific evidence on how sleep shapes behavior within interrogation settings. To evaluate the impact of sleeplessness on participants’ behavior during investigative interviews, an experimental study examined the impact of sleep restriction on disclosure of past illegal behavior.

Methods
Healthy participants from a university community (N = 143) either maintained or curbed their sleep (up to 4 h a night) across 2 days with sleep monitored via actigraphy. They were then asked to disclose past illegal acts and interviewed about them. Next, they were reinterviewed following an example of a detailed memory account (model statement). Disclosures were blindly coded for quantity and quality by two independent raters.

Results
Sleep-restricted individuals reported similar offenses, but less information during their disclosure with slightly less precision. Model statement increased disclosure but did not reduce the inhibiting impact of sleep loss. Mediation analysis confirmed the causal role of sleep as responsible for experimental differences in amount of information, and participants’ reports suggested impaired motivation to recall information played a role.

Conclusions
The findings suggest that even moderate sleep loss can inhibit criminal disclosure during interviews, point to motivational factors as responsible, and suggest investigators should be cautious when interrogating sleepy participants.
Supplementation of protease to low amino acid diets containing superdose level of phytase for wean-to-finish pigs: effects on performance, postweaning intestinal health and carcass characteristics
Authors: Perez-Palencia J Y , Samuel R S , Levesque C L 
Published: May 2021

Abstract
This experiment investigated the effects of protease supplementation to low amino acid (AA) diets containing phytase on pig growth performance, postweaning intestinal health and carcass characteristics. A total of 936 weaned pigs (21 d of age, initial BW 5.87 ± 0.31 kg) were used in a 2 × 2 factorial design comparing the main effects of AA supply [standard feeding program: balanced for all nutrients with adjustment of Ca and P due to inclusion of phytase (2,500 FTU/kg in Phase 1 to 4; 500 FTU/kg in Phase 5 to 9) vs. low AA feeding program: 15% lower standardized ileal digestible lysine with relative reduction of all other essential AA] and protease level (0 vs. 0.0125%). Pens were assigned to dietary treatment according to a randomized complete block design with 26 pigs per pen and nine replicates per dietary treatment. Feed and water were provided on an ad libitum basis for all phases throughout the wean-to-finish period. Feed intake and body weight were determined every 2 wk during nursery period and monthly in the grow-finish period. Intestinal health in the first 17 d was assessed based on lactulose:mannitol ratio (L:M), serum IgA, and pen diarrhea assessment. Overall, pigs fed standard wean-to-finish diets had greater (P &lt; 0.05) ADG and G:F than pigs fed low AA diets. Pig growth performance was not different throughout the wean-to-finish period with or without protease supplementation and with no interaction between AA supply and protease supplementation. There were no differences among dietary treatments for carcass characteristics. No difference was observed for urinary L:M and serum IgA; however, the L:M ratio was approximately 32% lower in pigs fed low AA diets + protease compared with pigs fed standard and low AA diets at d 5 and d 17 postweaning. Pigs fed protease supplemented diets had lower incidence of diarrhea (χ2 &lt; 0.05) compared with pigs fed diets without protease. Results of the experiment indicate that dietary protease supplementation benefits intestinal health of nursery pigs.
Comparison of monensin sodium sources for finishing beef cattle
Authors: Husz Taylor C , Smith Wyatt N , Lockard Caleb G , Homolka Megan N , Anderson Peter T , Gentry Wes W , Sugg Joel D , Casey Kenneth D , Jennings Jenny S 
Published: May 2021

Abstract
The objective of this study was to evaluate the ruminal fermentation characteristics of ruminally fistulated beef steers consuming a steam-flaked corn (SFC) or dry-rolled corn (DRC) based diet containing either Rumensin 90 (RUM; Elanco, Greenfield, IN), or Monovet 90 (MV; Huvepharma, Peachtree City, GA). Six ruminally fistulated steers (657.7 kg ± 72.6) housed individually were used in a 6 × 6 Latin square design with 2 × 3 factorial treatment arrangement. Each of the 6 periods were 15 d with 14 d for diet adaptation and 1 d of rumen fluid collections. Dietary treatments were DRC without monensin sodium (DRC-C), SFC without monensin sodium (SFC-C), DRC with Rumensin 90 (DRC-R), DRC with Monovet 90 (DRC-MV), SFC with Rumensin 90 (SFC-R), and SFC with Monovet 90 (SFC-MV). Rumen contents and fluid were collected through the fistula of each animal at 0, 3, 6, 12, and 24 h on d 15 of each period. Rumen fluid collected at 6 h post-feeding each period was used for in vitro analyses. Steer was the experimental unit and the model included fixed effects of grain processing, additive, and grain processing × additive. Total gas produced was composited from each in vitro bottle into a gas collection bag for the 48-h determination of methane concentration. No differences were detected for DMI (P = 0.81). Ruminal pH did not differ for the control or additive treatments (P = 0.33). However, ruminal pH was lower (P &lt; 0.01) with SFC compared to DRC. There was a significant difference in acetate to propionate ratio for grain type (P = 0.01) and a tendency for additive inclusion (P = 0.06). Additive inclusion reduced methane proportion of total gas compared to control treatments (P ≤ 0.01). Overall, monensin sodium reduced methane concentration though source had no effect on DMI or ruminal pH.
Retrospective hospital-based study on snakebite envenomation in Sudan
Authors: Khalid Huda , Azrag Rasha S 
Published: May 2021

Abstract

Background
Snakebite statistics are lacking in Sudan despite the high estimated burden. In this study we aimed to describe the incidence of snakebite envenomation and death in Sudan and to show the state-wise distribution of snakebite episode.

Methods
We retrospectively analyzed hospital-based data on snakebite for 2014–2018. Data were obtained from the annual health statistical reports of the Ministry of Health. Descriptive statistics were used to illustrate the results.

Results
A total of 63 160 people were envenomed during 2014–2018 with an average of 12 632 cases/year. The death rate between inpatient cases was 2.5%. The annual incidence was 18– 47 cases/100 000 population. Gadarif state recorded the highest incidence (132/100 000 population) of snakebite envenomation in Sudan whereas Northern state had the least incidence (5/100 000 population). The 15–24 y age group experienced the highest risk of snakebite and males were more exposed to snakebites than females.

Conclusions
Although hospital-based records underestimate the burden of snakebite, they can still provide an insight regarding the actual numbers. Here, we highlight the at-risk states in Sudan to be targeted for further questionnaire-based epidemiological studies and to guide health authorities to reduce the burden of snakebite envenomation by insuring proper antivenom distribution to the highly affected areas.
Original Research: Oral Care as Prevention for Nonventilator Hospital-Acquired Pneumonia
Authors: Giuliano Karen K. , Penoyer Daleen , Middleton Aurea , Baker Dian 
Published: May 2021

ABSTRACT

Background:
Nonventilator hospital-acquired pneumonia (NV-HAP) presents a serious and largely preventable threat to patient safety in U.S. hospitals. There is an emerging body of evidence on the effectiveness of oral care in preventing NV-HAP.

Purpose:
The primary aim of this study was to determine the effectiveness of a universal, standardized oral care protocol in preventing NV-HAP in the acute care setting. The primary outcome measure was NV-HAP incidence per 1,000 patient-days.

Methods:
This 12-month study was conducted on four units at an 800-bed tertiary medical center. Patients on one medical and one surgical unit were randomly assigned to receive enhanced oral care (intervention units); patients on another medical and another surgical unit received usual oral care (control units).

Results:
Total enrollment was 8,709. For the medical control versus intervention units, oral care frequency increased from a mean of 0.95 to 2.25 times per day, and there was a significant 85% reduction in the NV-HAP incidence rate. The odds of developing NV-HAP were 7.1 times higher on the medical control versus intervention units, a significant finding. For the surgical control versus intervention units, oral care frequency increased from a mean of 1.18 to 2.02 times per day, with a 56% reduction in the NV-HAP incidence rate. The odds of developing NV-HAP were 1.6 times higher on the surgical control versus intervention units, although this result did not reach significance.

Conclusions:
These findings add to the growing body of evidence that daily oral care as a means of primary source control may have a role in NV-HAP prevention. The implementation of effective strategies to ensure that such care is consistently provided warrants further study. It's not yet known what degree and frequency of oral care are required to effect favorable changes in the oral microbiome during acute care hospitalization.
Exanthematous reactions to drugs in children
Authors: Atanaskovic-Markovic Marina , Tsabouri Sophia 
Published: May 2021

Purpose of review
The true exanthematous reactions to drugs in children are rare and overdiagnosed. Drugs may cause exanthema either due to inducing an immune response or because of their interaction with viruses, if drugs are taken in the course of a viral infection. Also, viral infections are very often in children and they can provoke an exanthema which is difficult to differentiate from exanthematous reactions to drugs. Consequently, the majority of children are incorrectly labeled as ‘allergic’.

Recent findings
The correct diagnosis of exanthematous drug reactions in children is still an important and hot topic. Most information about the approach and management of drug hypersensitivity in children is applied from available guidelines and consensus statement for adults. Recently, a systematic clinical approach for timely differential diagnosis and management of rashes in children who present a cutaneous exanthema while receiving a drug, is proposed.

Summary
It is important to consider the detailed clinical history of appearing and developing exanthematous drug reaction, as well as physical examination which includes the description and the distribution of exanthema and at the end making the appropriate diagnosis. Thus, it could reduce overdiagnosis and promote appropriate procedures, that will prevent the overlabeling of drug hypersensitivity in children.
Evidence-based management of eczema: five things that should be done more and five things that should be dropped
Authors: Olabi Bayanne , Williams Hywel C. 
Published: May 2021

Purpose of review
We provide readers with an evidence-informed opinion on current treatments for eczema (atopic dermatitis) with the intention of improving patient care. We suggest five treatment aspects that should be promoted and five that should be demoted. Evidence sources include key randomized controlled trials and systematic reviews.

Recent findings
Under-treatment of eczema can be countered by more aggressive use of topical therapies including the ‘get control then keep control’ regimen, and systemics for severe disease, supplemented with good patient education. Topical corticosteroids should be used once daily rather than twice daily. Topical calcineurin inhibitors are useful for sensitive sites. There is little evidence to support the continued use of oral antihistamines, oral or topical antistaphylococcal treatments for infected eczema or probiotics for treating eczema. Nonpharmacological treatments including silk clothing, ion-exchange water softeners and emollient bath additives have not been shown to benefit eczema patients. Despite promising pilot studies, large trials suggest that emollients from birth do not prevent eczema and may result in harms such as increased skin infections and food allergy.

Summary
New evidence-based insights on existing and newer treatments allow clinicians the opportunity to change their practice in a way that enhances patients’ quality of life.
Improving Family-Centered Care for Infants in Neonatal Intensive Care Units
Authors: Franck Linda S. , Bisgaard Robin , Cormier Diana M. , Hutchison Jennifer , Moore Dishon , Gay Caryl , Christensen Holly , Kriz Rebecca M. , Mora Jennifer , Ekno Mary , Hackett Heather , Lare Natasha 
Published: May 2021

Background:
Family-centered care is a philosophy and healthcare delivery model adopted by many neonatal intensive care units (NICUs) worldwide, yet practice varies widely.

Purpose:
The aim of this study was to synthesize recommendations from frontline NICU healthcare professionals regarding family-centered care.

Methods:
Data were obtained from the baseline phase of a multicenter quasi-experimental study comparing usual family-centered NICU care (baseline) with mobile-enhanced family integrated care (intervention). Members of the NICU clinical care team completed a family-centered care survey and provided free-text comments regarding practice of family-centered care in their NICU and recommendations for improvement. The comments were analyzed using a directed content analysis approach by a research team that included NICU nurses and parents.

Results:
Of the 382 NICU healthcare providers from 6 NICUs who completed the survey, 68 (18%) provided 89 free-text comments/recommendations about family-centered care. Almost all comments were provided by nurses (91%). Six main themes were identified: language translation; communication between staff and families; staffing and workflow; team culture and leadership; education; and NICU environment. The need for greater resources for staffing, education, and environmental supports was prominent among the comments, as was team culture and staff–parent communications.

Implications for Practice:
The NICU healthcare professionals identified a range of issues that support or impede delivery of family-centered care and provided actionable recommendations for improvement.

Implications for Research:
Future research should include economic analyses that will enable determination of the return on investment so that NICUs can better justify the human and capital resources needed to implement high-quality family-centered care.
Term Newborn Care Recommendations Provided in a Kenyan Postnatal Ward
Authors: Reid Davika D. , García Alexandra A. , Zuñiga Julie A. , Mercer Tim , Gulbas Lauren , Walker Lorraine O. , Chelagat Dinah 
Published: May 2021

Background:
Neonatal mortality (death within 0-28 d of life) in Kenya is high despite strong evidence that newborn care recommendations save lives. In public healthcare facilities, nurses counsel caregivers on term newborn care, but knowledge about the content and quality of nurses' recommendations is limited.

Purpose:
To describe the term newborn care recommendations provided at a tertiary-level, public referral hospital in Western Kenya, how they were provided, and related content taught at a university nursing school.

Methods:
A rapid, focused ethnographic assessment, guided by the culture care theory, using stratified purposive sampling yielded 240 hours of participant observation, 24 interviews, 34 relevant documents, and 268 pages of field notes. Data were organized using NVivo software and key findings identified using applied thematic analysis.

Results:
Themes reflect recommendations for exclusive breastfeeding, warmth, cord care, follow-up examinations, and immunizations, which were provided orally in Kiswahili and some on a written English discharge summary. Select danger sign recommendations were also provided orally, if needed. Some recommendations conflicted with other providers' guidance. More recommendations for maternal care were provided than for newborn care.

Implications for Practice:
There is need for improved consistency in content and provision of recommendations before discharge. Findings should be used to inform teaching, clinical, and administrative processes to address practice competency and improve nursing care quality.

Implications for Research:
Larger studies are needed to determine whether evidence-based recommendations are provided consistently across facilities and other populations, such as community-born and premature newborns, who also experience high rates of neonatal mortality in Kenya.
Reconstruction of Septic Tibial Bone Defects With the Masquelet Technique and External Ring Fixation—A Low Healing Rate and High Complication and Revision Rates
Authors: Lotzien Sebastian , Rosteius Thomas , Reinke Charlotte , Behr Björn , Lehnhardt Marcus , Schildhauer Thomas Armin , Gessmann Jan 
Published: May 2021

Objectives:
To evaluate the results of a series of septic tibial bone defects treated with the Masquelet technique and external ring fixation as a standardized treatment procedure.

Design:
Retrospective study.

Setting:
Level one trauma center.

Patients/Participants:
All patients 18 years of age or older with septic diaphyseal bone defects of the tibia who underwent induced membrane treatment with ring fixation at our institution between June 1, 2012, and November 31, 2017.

Intervention:
Staged management as described by Masquelet using an external ring fixator for definitive fixation.

Main Outcome Measurements:
Bony healing at the last follow-up and the time to healing in months. Functional results were assessed according to the scoring system of the Association for the Study and Application of Methods of Ilizarov. The secondary outcome measures were treatment failure and complications.

Results:
Thirty-one patients were treated, with a mean follow-up period of 33 months (range, 13–69 months). Overall, among 14 patients assessed as having achieved bone healing, an average of 3.7 surgical revisions were required. The mean healing time was 15.5 months (range, 6–49 months). According to the Association for the Study and Application of Methods of Ilizarov criteria, 7 patients were rated as “excellent” and 6 patients were rated as “good”; one patient showed “poor” functional results. A total of 17 cases of treatment failure and 36 complications were detected.

Conclusions:
The combination of the Masquelet technique and external fixation yielded a low healing rate and was associated with a significant number of cases of treatment failure.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Retrograde Intramedullary Nailing of Pediatric Femoral Shaft Fractures Does Not Result in Growth Arrest at the Distal Femoral Physis—A Retrospective Cases Series
Authors: Benedick Alex , Bazar Batzorig , Zirkle Lewis G. , Liu Raymond W. 
Published: May 2021

Objective:
To evaluate femoral growth after placement of retrograde intramedullary nails in the treatment of pediatric femoral shaft fractures.

Design:
Retrospective case series.

Setting:
Large urban trauma center in Mongolia.

Patients/Participants:
Twenty-nine pediatric patients who sustained a diaphyseal femoral shaft fracture were included in the study.

Intervention:
Retrograde intramedullary nail fixation with the standard, fin, or pediatric fin Surgical Implant Generation Network nail across an open distal femoral physis.

Main Outcome Measures:
The main outcome measure was the distance traveled by the intramedullary nail with respect to the distal femoral condyles and distal femoral physis from initial surgery to follow-up.

Results:
The mean age of patients was 10.7 years (range: 7–14 years). Follow-up occurred at a mean of 292 days (range: 53–714 days). Both condyle distance and physis distance were significantly positively correlated with follow-up days, with Pearson R values of 0.90 (P < 0.001) and 0.84 (P < 0.001), respectively. Multiple regression analysis revealed that follow-up days was the only significant predictor of physis distance, whereas age, sex, percent growth plate violation, and nail fully traversing physis were not significant predictors. The nail completely crossed the physis in 5 patients and no growth arrests were found.

Conclusions:
This is the first study, to our knowledge, to evaluate treating femoral shaft fractures with a retrograde nail across an open distal femoral physis. In the pediatric population, the use of a retrograde femoral intramedullary nails does not seem to cause growth arrest of the injured femur during the postoperative period and may be a reasonable treatment option when other surgical options are not available. Additional study is necessary to further evaluate the safety profile.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Is the Iliac Cortical Density Similarly Positioned in the Developing Pediatric Pelvis?
Authors: Watzig Benjamin F. , Peterson Danielle F. , Thompson Austin R. , Friess Darin M. , Working Zachary M. , Yang Scott S. 
Published: May 2021

Objectives:
The iliac cortical density (ICD) is a critical fluoroscopic landmark for pelvic percutaneous screw placement. Our purpose was to evaluate the ICD as a landmark in pediatrics and quantify the diameter of osseous pathways for 3 screw trajectories: iliosacral (IS) at S1 and transiliac–transsacral (TSTI) at S1 and S2.

Methods:
Two hundred sixty-seven consecutive pelvic CT scans in children 0–16 years of age were analyzed. ICD and S1 vertebral heights were measured at multiple regions along S1. Their height and corresponding ratios, as well as osseous screw corridor dimensions were compared between age groups and by the dysmorphic status.

Results:
In the nondysmorphic pelvises, S1 height, ICD height, and the ICD to S1 height ratio increased across age groups for all locations (P < 0.001). All 3 screw pathway diameters increased with age (P < 0.001). In the dysmorphic group, there was no increase in ICD to S1 height ratio with age. Except for the age 0–2 group, the ICD to S1 height ratios were significantly larger in the nondysmorphic group. In the dysmorphic group, S1 TSTI pathway remained narrow with age, whereas IS at S1 and TSTI at S2 had a significant increased diameter with age (P < 0.001).

Conclusion:
The ICD is a useful fluoroscopic landmark for percutaneous screw placement in the pediatric pelvis. For nondysmorphic pelvises, the ICD to S1 height ratio, as well as osseous corridors for IS, TSTI at S1, and TSTI at S2 screw trajectories increase significantly with age. The margin for safe screw placement in S1 is smaller for younger and dysmorphic pelvises.