bluuebunny/crossref_metadata_2025_split huggingface dataset:
High prevalence of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae fecal carriage among children under five years in Addis Ababa, Ethiopia
Authors: Tola Mekdes Alemu , Abera Negga Asamene , Gebeyehu Yonas Mekonnen , Dinku Surafel Fentaw , Tullu Kassu Desta 
Published: October 2021

BackgroundExtended-spectrum beta-lactamase (ESBL) producing bacteria present an ever-growing burden in the hospital and community settings. Data on the prevalence of ESBL fecal carriage remain scarce in Ethiopia. Therefore, this study aimed to determine the prevalence of ESBL producingEscherichia coliandKlebsiella pneumoniaefecal carriage among children under five years in Addis Ababa, Ethiopia.MethodsA facility-based cross-sectional study was conducted from April to May 2017. A total of 269 fecal/rectal swab samples were cultured on MacConkey agar. All positive cultures were characterized by colony morphology, Gram stain, and standard biochemical tests. Further, bacteria identification, antimicrobial susceptibility testing, and phenotypic detection of ESBL production were performed using VITEK 2 Compact as per the instruction of the manufacturer. Socio-demographic and risk factors data were collected using questionnaires. Data were entered by EPI INFO version 7.2.1.0 and analyzed by SPSS version 20.ResultsThe overall prevalence of ESBL-producingE.coliandK.pneumoniaewas 17.1% (46/269; 95% CI: 12.9%–22.7%). A total of 47 isolates were ESBL-positive, of which, 83.0% wereE.coliand 17.0% wereK.pneumoniae. ESBL producingE.coliandK.pneumoniaeisolates were also showed high levels of MDR (93.6%) and high rates of co-resistance to aminoglycosides, fluoroquinolones, and trimethoprim-sulfamethoxazole. However, all isolates were carbapenem susceptible. In the risk factors analysis, Children’s mothers who had lower educational level (primary school) (OR: 2.472, 95% CI: 1.323–4.618, P = 0.0062) and children who used tap water for drinking (OR: 1.714, 95% CI: 1.001–3.659, P = 0.048) were found to be significantly associated with higher ESBL fecal carriage.ConclusionsIn this study, the high prevalence rate of ESBL producingE.coliandK.pneumoniaefecal carriage and high level of multidrug resistance among ESBL producingE.coliandK.pneumoniaewere demonstrated. This suggested that the necessity of routine screening of ESBL is crucial for the early detection and appropriate antibiotics selection for infection caused by ESBL producing pathogens.
PDL1 expression on monocytes is associated with plasma cytokines in Tuberculosis and HIV
Authors: Tamene Wegene , Abebe Meseret , Wassie Liya , Mollalign Helina , Bauer Katrin , Kebede Amha , Marconi Vincent C. , Howe Rawleigh , Sack Ulrich 
Published: October 2021

Introduction
PDL1 and its interaction with PD1 is implicated in immune dysfunction in TB and HIV. The expression of PDL1 on multiple subsets of monocytes as well as their associations with cytokines and microbial products have not been well studied.

Method
HIV (TB-HIV+), TB (TB+HIV-) and TB/HIV co-infected (TB+HIV+) patients as well as apparently healthy controls (TB-HIV-) were recruited. TB and HIV patients were treatment naïve while TB/HIV patients were both ART naïve and experienced but not yet started TB therapy. Monocyte subsets were evaluated for PDL1 expression by flow cytometry; plasma TNFα, IL6, IP10, IFNγ and IL10 were measured by Luminex; and cytokine mRNA from purified monocytes quantitated by qPCR. The association of PDL1 with cytokines, clinical and microbial indices, including HIV viral load, TB smear microscopy and TB urinary lipoarabinomannan (LAM) were assessed.

Results
Monocyte expression of PDL1 was significantly higher in TB, HIV and TB/HIV co-infected patients compared with healthy controls (p = 0.0001), with the highest levels in TB/HIV co-infected patients. The highest expression of PDL1 was on intermediate (CD14+CD16+) monocytes in all participant groups. PDL1 strongly correlated with HIV viral load in TB/HIV while weakly correlated in HIV. PDL1 levels moderately correlated with plasma TNFα, IL6, IP10, IFNγ and IL10 level in TB subjects whereas weakly correlated with TNFα and IP10 in HIV patients. However, cytokine mRNA from purified monocytes showed no association with either plasma cytokines or monocyte PDL1 expression, implying that if cytokines modulate PDL1, they are likely not originating from circulating monocytes themselves. These results underscore the importance of further characterization of multiple monocyte subsets and their phenotypic and functional differences in different disease states.
Números racionais no contexto das medidas
Authors: Aloise de Assis Alessandro , De Arruda Camargo Sylvia , Azeredo Noguchi Viviane 
Published: October 2021

O trabalho tem como objetivo avaliar de que maneira a realização de medidas favorece a compreensão e o uso dos números racionais a partir de elementos visuais e problemáticas relacionadas a uma possível situação real. As atividades foram propostas a alunos de 4o ano de uma escola da rede privada em São José dos Campos (SP). A investigação realizada durante o trabalho foi estruturada na concepção metodológica da chamada pesquisa-ação. As formulações e reformulações foram pautadas tanto na observação e reflexão em relação às respostas dos alunos em cada aula quanto na análise das consignas utilizadas na atividade proposta. As atividades, análises e os encaminhamentos foram pautados em pressupostos da Teoria das Situações Didáticas, de Guy Brousseau. O trabalho mostra que a proposta aplicada auxiliou os alunos na compreensão dos números racionais por meio das medidas.
Juízos de educadores do Ensino Fundamental: análise do contexto de uma escola municipal de Vitória-ES
Authors: Gama de Lima Mayara , Moulin de Alencar Heloisa , Moraes Couto Leandra Lúcia 
Published: October 2021

Este artigo buscou descrever o contexto escolar de uma instituição pública de Ensino Fundamental por meio dos juízos de educadores acerca das características da escola e seu entorno, bem como da qualidade das relações sociais, dos principais problemas da instituição e de suas possíveis resoluções. A pesquisa é de delineamento qualitativo e os dados apresentados são provenientes de entrevistas com 14 educadores. A análise do contexto escolar possibilitou a identificação e compreensão de elementos que contribuem para a qualidade da atmosfera e ambiente escolar, destacando os aspectos do cotidiano da instituição que, juntamente da proposição de ações que promovam a qualidade do convívio escolar e o desenvolvimento moral dos alunos, merecem maior atenção.
Matemática lúdica com pessoas idosas: Estimulando a memória, compartilhando aprendizagens
Authors: De Figueirêdo Maria de Fátima Caldas , Santiago Zélia Maria de Arruda 
Published: October 2021

Este trabalho discute resultados de atividades lúdicomatemáticas provenientes da realização de uma oficina pedagógica com jogos educativos com mulheres idosas frequentadoras de um Grupo de Convivência Clube de Mães (Campina Grande-PB). A proposta é baseada em reivindicações próprias evidenciadas ao participarem de ações socioeducativas desenvolvidas no Projeto de Extensão “Práticas de letramentos de pessoas idosas no cotidiano: traçando letras, esculpindo textos” (UEPB-PB), como o uso da Matemática para estimular a memória. Pretende-se suscitar reflexões sobre a questão: Os jogos matemáticos (“Jogo da velha”, “Caça números”, “Hexágono mágico” e “Corrida aos trinta”) estimulam as funções cognitivas das participantes? Essa discussão funda-se nas contribuições da Educação Gerontológica (KACHAR, 2001; CACHIONI, 2003) e da Educação Inclusiva (CARVALHO, 2004), ao considerar saberes da Matemática que, usado em jogos, estimulam a memória e compartilham aprendizagens. A discussão norteia-se pela abordagem qualitativa interpretativa ao analisar a participação lúdica das idosas quanto ao desempenho individual e avaliação coletiva. Os encontros revelaram expectativas em relação ao exercício da memória, com atividades lúdico-matemáticas e a reelaboração de saberes matemáticos compartilhados na interação.
Homogeneous and inhomogeneous isoparametric hypersurfaces in rank one symmetric spaces
Authors: Díaz-Ramos José Carlos , Domínguez-Vázquez Miguel , Rodríguez-Vázquez Alberto 
Published: October 2021

Abstract
We conclude the classification of cohomogeneity one actions on symmetric spaces of rank one by classifying cohomogeneity one actions on quaternionic hyperbolic spaces up to orbit equivalence. As a by-product of our proof, we produce uncountably many examples of inhomogeneous isoparametric families of hypersurfaces with constant principal curvatures in quaternionic hyperbolic spaces.
Effect of Neutral, Internal, and External Focus on Drop Jump Performance: Is Drop Jump Performance Affected by Plyometric Training Experience?
Authors: Furuhashi Yuki , Hioki Yusuke , Yoshimoto Syohei , Hayashi Ryohei 
Published: October 2021

Abstract
Furuhashi, Y, Hioki, Y, Yoshimoto, S, and Hayashi, R. The effect of neutral, internal, and external focus on drop jump performance: is drop jump performance affected by plyometric training experience? J Strength Cond XX(X): 000–000, 2021—Providing an external focus of attention through verbal instructions can improve the drop jump (DJ) performance, which differs based on the skill level of athletes. The purpose of this study was to assess the effect of change of focus of attention on the performance of DJs in experienced and inexperienced athletes. Thirty-eight male collegiate athletes divided into the experienced group (E group: age, 21.5 ± 1.4 years; height, 173.4 ± 5.7 cm; and body mass, 65.7 ± 6.2 kg) and the inexperienced group (I group: age, 21.9 ± 1.5 years; height, 172.8 ± 5.1 cm; and body mass, 68.7 ± 5.5 kg) performed 2 trials of DJs after listening to instructions designed to evoke a neutral, internal, or external focus of attention. Contact time (CT), jump height (JH), reactive strength index (RSI), and leg-spring stiffness (kvert) were recorded during DJ and compared between the 2 groups using a repeated-measures analysis of variance. In the E group, the neutral condition was associated with a significantly higher RSI, JH, and kvert than the internal and external conditions (p < 0.05). In the I group, the external condition was associated with significantly higher RSI and kvert and shorter CT than other conditions (p < 0.05). Therefore, this suggests that attentional focus strategies need to be selected depending on DJ experience: A neutral focus may be preferable for athletes experienced in DJs, whereas an external focus may be more suitable for athletes with lesser DJ experience.
A PANDEMIA DO NOVO CORONAVÍRUS (COVID-19): considerações sobre o neoliberalismo e o estado de bem-estar social nas ações governamentais
Authors: De Pádua Cavalcanti Bastos Marcus Alexandre , Tenório Cavalcanti Eliane Cristina , Da Silva Elisabeth Almenara , Bastos Nathan Da Costa Cavalcanti 
Published: October 2021

A crise gerada pelo novo coronavírus traz preocupações cada vez maiores entre as nações de todos os continentes e já altera profundamente as relações políticas e econômicas em escala global. Os impactos causados pela pandemia do coronavírus têm feito com que os países revejam as suas políticas publicas e levantem questionamentos sobre o sistema capitalista enquanto sistema social predominante. Há um reposicionamento de alguns Estados no sentido de adotar um modelo social, político e econômico que garanta a todos os cidadãos padrões mínimos de saúde e seguridade social. Destarte, o presente artigo tem como objetivo apontar a importância do Estado de Bem-estar Social, seus benefícios em relação às políticas públicas, como é o caso do serviço de saúde pública. Nesse artigo, partimos do pressuposto de que a pandemia gerada pelo coronavírus expõe a fragilidade do modelo neoliberal brasileiro na contenção da crise, uma vez que esse modelo preconiza uma drástica redução do papel do estado na economia favorecendo o setor privado. Com o objetivo de abrir caminho para uma reflexão acerca desta problemática tomaremos como base o materialismo dialético que propõe busca pela explicação dos fenômenos da realidade a partir de condições estritamente concretas. O artigo foi desenvolvido a partir de pesquisa bibliográfica com abordagem qualitativa.
EFECTOS DE LA MARCHA NÓRDICA SOBRE LA RESISTENCIA AERÓBICA DE ADULTOS MAYORES
Authors: Jódar Reverte M. , Paredes Ruiz M.J. , Martínez González-Moro I. , Ferrer López V. 
Published: October 2021

Introducción: El Objetivo fue evaluar los efectos sobre la resistencia aeróbica de un programa de ejercicio físico basado en la marcha nórdica para la mejora de la condición física en adultos mayores. Metodología: La población se compuso de 29 sujetos, los cuales realizaron un programa de marcha nórdica de doce semanas de duración, con un mínimo de dos sesiones semanales. Se llevaron a cabo dos mediciones; una previa y otra posterior, mediante prueba de esfuerzo. Resultados: La población mostró mejoras significativas en cuanto a la intensidad alcanzada durante la prueba de esfuerzo. Así mismo se observaron aumentos significativos (p<0,05) en las variables consumo de oxígeno y frecuencia cardíaca. Conclusiones: El programa de marcha nórdica ha aumentado la condición física de nuestra población, encontrando mejoras a nivel cardiorrespiratorio tanto en hombres como mujeres.
Quality Improvement of Primary Care Provider Communication on Hospital Discharge
Authors: Goodrich Nathaniel , Dolter Stephen , Snow Joseph , Stoolman Sharon , Kerns Ellen , McCulloh Russell 
Published: October 2021

BACKGROUND AND OBJECTIVESEffective communication between inpatient and primary care providers (PCPs) is important for safe transition of care for hospitalized patients. In 2017, communication with PCPs was prioritized for the pediatric hospital medicine division. Our primary aim was to improve documented attempted communication with PCPs within 72 hours of discharge from 41% to at least 60% by January 1, 2018, and maintain this performance through 2019.METHODSThis study included all inpatient encounters discharged by a pediatric hospital medicine provider from March 2017 to April 2020. An electronic health record phrase debuted March 2017. Successful documentation was defined as any attempt to contact the PCP, regardless of whether actual communication occurred. Group and individual audit and feedback occurred in July 2017 to April 2020. Provider communication was financially incentivized in July 2018 to June 2019. An annotated P-chart for the proportion of encounters with documented PCP communication occurring within 72 hours was established. Special-cause variation was determined by using Shewhart rules.RESULTSThe mean proportion of encounters with documented PCP communication increased from 41% at baseline (March 2017 through July 2017) to 60% in August 2017 and 66% in December 2017. After the financial incentive was removed in July 2019, documentation decreased to 54%. Phone calls with clinic staff were the most common communication method (40% to 71%). Direct conversations with the PCP occurred rarely (0% to 3%).CONCLUSIONSEven when coupled with audit and feedback with EHR interventions, our work suggests that shifting to external financial motivation may hinder sustainability of behavior change to improve attempted documented PCP communication.
Improving Efficiency of Primary Care Provider Communication for Uncomplicated Admissions
Authors: Ostermeier Austin , Ferro Erica , Voet Shelly , Warniment Amanda , Albrecht Jennifer , Manfroy Pierre , Gosdin Craig 
Published: October 2021

BACKGROUND
Communication between inpatient pediatric hospital medicine (HM) and primary care providers (PCPs) is important for quality care. As provider workload increases, it is important to focus on a means to improve communication efficiency. Our goal was to increase the percentage of HM admissions using 1-way communication from 0% to 35% over a 16-month period.

METHODS
HM providers and PCPs collaborated to identify 12 admission diagnoses for which 1-way communication could be used. Using quality improvement methods, we studied the implementation of “Leave a Message” (LAM) calls for 1-way communication and providing PCPs with the option to place a return call. Control charts were used to track LAM call use and balancing measures of PCP return phone calls, additional PCP communications, and 7-day readmissions over time.

RESULTS
A total of 778 LAM calls were placed by HM providers over 16 months. The percentage of LAM calls out of all PCP calls placed ranged from 0% to 35% during this time, increasing significantly during winter months and before the coronavirus disease 2019 pandemic. Only 0.4% (n = 3) of LAM calls were returned by PCPs. Estimated PCP return phone calls were reduced by 11.1 calls per week.

CONCLUSIONS
We created a system for 1-way telephone communication between HM providers and PCPs for common, simple admissions and reduced the need for PCP return phone calls. The low percentage of LAM calls returned by PCPs may suggest that 1-way communication is adequate for most simple admissions.
Targeted Clinical Interventions for Reducing Pediatric Readmissions
Authors: Pugh Karen , Granger David , Lusk Jennifer , Feaster William , Weiss Michael , Wright Dominique , Ehwerhemuepha Louis 
Published: October 2021

BACKGROUNDIn this interventional study, we addressed the selection and application of clinical interventions on pediatric patients identified as at risk by a predictive model for readmissions.METHODSA predictive model for readmissions was implemented, and a team of providers expanded corresponding clinical interventions for at-risk patients at a freestanding children’s hospital. Interventions encompassed social determinants of health, outpatient care, medication reconciliation, inpatient and discharge planning, and postdischarge calls and/or follow-up. Statistical process control charts were used to compare readmission rates for the 3-year period preceding adoption of the model and clinical interventions with those for the 2-year period after adoption of the model and clinical interventions. Potential financial savings were estimated by using national estimates of the cost of pediatric inpatient readmissions.RESULTSThe 30-day all-cause readmission rates during the periods before and after predictive modeling (and corresponding 95% confidence intervals [CI]) were 12.5% (95% CI: 12.2%–12.8%) and 11.1% (95% CI: 10.8%–11.5%), respectively. More modest but similar improvements were observed for 7-day readmissions. Statistical process control charts indicated nonrandom reductions in readmissions after predictive model adoption. The national estimate of the cost of pediatric readmissions indicates an associated health care savings due to reduced 30-day readmission during the 2-year predictive modeling period at $2 673 264 (95% CI: $2 612 431–$2 735 364).CONCLUSIONSA combination of predictive modeling and targeted clinical interventions to improve the management of pediatric patients at high risk for readmission was successful in reducing the rate of readmission and reducing overall health care costs. The continued prioritization of patients with potentially modifiable outcomes is key to improving patient outcomes.
Deployed: One Pediatric Department’s Experience of Adult Care During COVID-19
Authors: Hodo Laura Nell , Douglas Lindsey C. , Lee Diana S. , Bhadriraju Srividya , Wilson Karen M. 
Published: October 2021

OBJECTIVES
The number of hospitalized coronavirus disease 2019 patients in March 2020 to April 2020 in our New York City hospital required increased physician staffing, including deployment of pediatricians to adult care. To improve the deployment process, we sought to understand the mindset, preparations for, and experience during deployment of pediatric faculty in our institution.

METHODS
Faculty members of the Department of Pediatrics completed pre- and postsurveys evaluating perspectives, fears, and preparations relevant to deployment. Demographic characteristics of the faculty members were collected. Survey questions included Likert scale, multiple choice, and free-text responses. Descriptive statistics, Fisher’s exact test, and χ2 test were used to compare groups. Free-text responses were categorized by topic. Survey responses were shared with leadership in real time and adjustments to the deployment process made.

RESULTS
The predeployment survey was sent to 202 pediatric faculty members, with a 29% (n = 59) completion rate. Of the 36 deployed faculty, 29 (81%) completed all items of the postsurvey. The majority (74%, n = 42) expressed discomfort with care of adults and fear and/or nervousness about deployment (61%, n = 35). Most faculty (88%, n = 52) prepared for deployment and cited local guidelines and published literature as helpful preparation materials (55%, n = 16). Dissemination of details about schedules and role clarification before deployment were areas for improvement.

CONCLUSIONS
Pediatric faculty facing deployment to adult care have concerns about the process of deployment as well as the work itself. Specific information distributed in advance, along with consistent and frequent communication, may help mitigate these fears.
Changes in Antibiotic Treatment for Children With Lyme Meningitis 2015–2020
Authors: Roelf Kelly M. , Garro Aris , Monuteaux Michael C. , Nigrovic Lise E. 
Published: October 2021

OBJECTIVESAlthough ceftriaxone has been the first-line treatment of Lyme meningitis, the 2020 Infectious Disease Society of America, American College of Rheumatology, and American Academy of Neurology guideline recommends either doxycycline or ceftriaxone. Our objective was to explore recent trends in enteral antibiotic treatment of children with Lyme meningitis.METHODSUsing International Classification of Diseases, 10th Revision codes for case identification, we performed a multicenter retrospective study of patients ≤21 years of age presenting to a pediatric hospital contributing to the Pediatric Health Information System who were diagnosed with Lyme meningitis from 2015 to 2020. Our primary outcome was treatment with parenteral antibiotics, defined by either a procedure code for indwelling catheter placement or &gt;7 days of inpatient parenteral Lyme disease–specific therapy. To examine trends over the study period, we used a generalized estimating equation, with parenteral antibiotics as the dependent variable and study year as the independent variable, adjusted for patient age, sex, race, ethnicity, and insurance status clustered by hospital.RESULTSWe identified 239 patients with Lyme meningitis treated at 24 participating centers. Overall, 48 (20.0%) were treated with parenteral antibiotics, with a declining rate over the study period (43.8% in 2015 to 8.9% in 2020). After adjustment, the odds of treatment with a parenteral antibiotic decreased over the study period (adjusted odds ratio 0.57; 95% confidence interval 0.41–0.80).CONCLUSIONSParenteral antibiotic treatment of children with Lyme meningitis has been on the decline in advance of the published clinical guideline. Carefully designed comparative effectiveness studies are needed to examine the effect of oral versus parenteral treatment regimens on clinical outcomes.