bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of blended learning in pharmacy education: An experimental study using clinical research modules
Authors: Balakrishnan Athira , Nair Sreedharan , Kunhikatta Vijayanarayana , Rashid Muhammed , Unnikrishnan M. K. , Jagannatha P. S. , Chandran Viji P. , Khera Kanav , Thunga Girish 
Published: September 2021

Background &objectivesThough there are studies to evaluate the effectiveness of blended learning in pharmacy education, most of them originate from USA and have used previous year students’ scores as control. Also there is less research in comparing use of self -regulated learning strategies between blended and other learning strategies. Primary aim was to evaluate the effectiveness of blended learning on knowledge score using clinical research modules. Secondary objective was designed to compare the use of self-regulated learning strategies between blended learning, web-based e-learning and didactic teaching.Materials and methodsA prospective cluster randomized trial was conducted with didactic teaching as control and web-based e-learning and blended learning as interventions. The target population was final year Pharm D students. Outcome was assessed using a validated knowledge questionnaire, a motivated strategies for learning questionnaire and a feedback form. All statistical analyses were carried out using Statistical Package for Social Science (SPSS) Version 20.ResultsA total of 241 students from 12 colleges completed the study. Mean knowledge score of students in blended learning group was higher than those in the didactic teaching and web- based e- learning program (64.26±18.19 Vs 56.65±8.73 Vs 52.11±22.06,p<0.001).Frequency of use of learning strategies namely rehearsal, elaboration, organization and critical thinking was statistically significantly higher in the blended learning group compared to those of didactic and web-based e-learning group (p<0.05) But there were no statistically significant difference of motivational orientations between didactic and blended learning group except strategies of extrinsic goal orientation and self-efficacy. Students preferred blended learning (86.5%) over didactic and web-based e-learning.ConclusionBlended learning approach is an effective way to teach clinical research module. Students of blended learning group employed all motivational and learning strategies more often than students of the didactic and web- based e-learning groups except strategies of intrinsic goal orientation, task value, control of learning belief and help seeking.
A harmful religio-cultural practice (Chhaupadi) during menstruation among adolescent girls in Nepal: Prevalence and policies for eradication
Authors: Thakuri Dipendra S. , Thapa Roshan K. , Singh Samikshya , Khanal Geha N. , Khatri Resham B. 
Published: September 2021

Background
Chhaupadi is a deeply rooted tradition and a centuries-old harmful religio-cultural practice. Chhaupadi is common in some parts of Karnali and Sudurpaschim Provinces of western Nepal, where women and girls are considered impure, unclean, and untouchable in the menstrual period or immediately following childbirth. In Chhaupadi practice, women and girls are isolated from a range of daily household chores, social events and forbidden from touching other people and objects. Chhaupadi tradition banishes women and girls into menstruation huts’, or Chhau huts or livestock sheds to live and sleep. These practices are guided by existing harmful beliefs and practices in western Nepal, resulting in poor menstrual hygiene and poor physical and mental health outcomes. This study examined the magnitude of Chhaupadi practice and reviewed the existing policies for Chhaupadi eradication in Nepal.

Methods
We used both quantitative survey and qualitative content analysis of the available policies. First, a quantitative cross-sectional survey assessed the prevalence of Chhaupadi among 221 adolescent girls in Mangalsen Municipality of Achham district. Second, the contents of prevailing policies on Chhaupadi eradication were analysed qualitatively using the policy cube framework.

Results
The current survey revealed that most adolescent girls (84%) practised Chhaupadi in their most recent menstruation. The Chhaupadi practice was high if the girls were aged 15–17 years, born to an illiterate mother, and belonged to a nuclear family. Out of the girls practising Chhaupadi, most (86%) reported social and household activities restrictions. The policy content analysis of identified higher-level policy documents (constitution, acts, and regulations) have provisioned financial resources, ensured independent monitoring mechanisms, and had judiciary remedial measures. However, middle (policies and plans) and lower-level (directives) documents lacked adequate budgetary commitment and independent monitoring mechanisms.

Conclusion
Chhaupadi remains prevalent in western Nepal and has several impacts to the health of adolescent girls. Existing policy mechanisms lack multilevel (individual, family, community, subnational and national) interventions, including financial and monitoring systems for Chhaupadi eradication. Eradicating Chhaupadi practice requires a robust multilevel implementation mechanism at the national and sub-national levels, including adequate financing and accountable systems up to the community level.
Making use of non-invasive prenatal testing (NIPT): rethinking issues of routinization and pressure
Authors: Schöne-Seifert Bettina , Junker Chiara 
Published: September 2021

Abstract
First mapping the main ethical issues surrounding prenatal testing, we then analyze which concerns are specific to non-invasive methods. Presupposing the privatization premise for reproductive autonomy in fundamentally liberal societies, we go on to specify common concerns about non-invasive prenatal testing (NIPT) covered by the term ‘routinization’, and conceptually unravel the frequently expressed worry of increasing ‘pressure’ to test and/or terminate affected pregnancies. We argue that mindful decision-making should be a key educational goal (not only) of NIPT counseling which could be achieved through stepwise disclosure. In addition, we identify indirect social pressure as the most plausible threat to reproductive freedom. While continuous efforts need to be made to prevent such pressure – not least by ensuring balanced availability of options –, restricting testing options, and thus freedom of choice, cannot be the answer to this concern. Lastly, we suggest abandoning the vague term ‘routinization’ and instead focusing on specified concerns to enable a fruitful debate.
Thermal stability, mechanical properties, and gamma radiation shielding performance of polyvinyl chloride/Pb(NO3)2 composites
Authors: Waly Sayed A. , Abdelreheem Ahmed M. , Shehata Mohamed M. , Ghazy Omayma A. , Ali Zakaria I. 
Published: September 2021

Abstract
Radiation shielding composites based on polyvinyl chloride (PVC) reinforced with different weight ratios of Pb(NO3)2 (5, 10, and 20 wt%) were prepared using the solution-casting technique. Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), thermogravimetric analysis (TGA), scanning electron microscopy, and tensile testing method were used to characterize the PVC composite films. FTIR and XRD investigations illustrate the structural change and modification of the as-prepared PVC composites. The morphological analysis of the composite revealed that Pb(NO3)2 was dispersed uniformly within PVC polymer matrix. TGA revealed that the incorporation of Pb(NO3)2 improved the thermal stability of the investigated composites, whereas adding Pb(NO3)2 to the polymer matrix worsened its tensile properties. The as-prepared composite films were investigated for radiation-shielding of gamma-rays radioactive point sources (241Am, 133Ba, 137Cs, and 60Co). Linear attenuation coefficient (μ, cm−1), mass attenuation coefficient (μ/ρ, cm2/g), and half-value layer (HVL, cm) have been estimated from the obtained data using the MicroShield program. Reasonable agreement was attended between theoretical and experimental results. The deviation between the experiment and theoretical values of mass attenuation coefficient is being to be lower than 9%, and this can be correlated to the good distribution of Pb(NO3)2. The results revealed that adding Pb(NO3)2 to PVC polymer composites improved their mass attenuation coefficient.
Posterodorsal Medial Amygdala Regulation of Female Social Behavior: GABA versus Glutamate Projections
Authors: Johnson Caroline S. , Hong Weizhe , Micevych Paul E 
Published: September 2021

Social behaviors, including reproductive behaviors, often display sexual dimorphism. Lordosis, the measure of female sexual receptivity, is one of the most apparent sexually dimorphic reproductive behaviors. Lordosis is regulated by estrogen and progesterone (P4) acting within a hypothalamic-limbic circuit, consisting of the arcuate, medial preoptic, and ventromedial nuclei of the hypothalamus. Social cues are integrated into the circuit through the amygdala. The posterodorsal part of the medial amygdala (MeApd) is involved in sexually dimorphic social and reproductive behaviors, and sends projections to hypothalamic neuroendocrine regions. GABA from the MeApd appears to facilitate social behaviors, while glutamate may play the opposite role. To test these hypotheses, adult female vesicular GABA transporter (VGAT)-Cre and vesicular glutamate transporter 2 (VGluT2)-Cre mice were transfected with halorhodopsin (eNpHR)-expressing or channelrhodopsin-expressing adeno-associated viruses (AAVs), respectively, in the MeApd. The lordosis quotient (LQ) was measured following either photoinhibition of VGAT or photoexcitation of VGluT2 neurons, and brains were assessed for c-Fos immunohistochemistry (IHC). Photoinhibition of VGAT neurons in the MeApd decreased LQ, and decreased c-Fos expression within VGAT neurons, within the MeApd as a whole, and within the ventrolateral part of the ventromedial nucleus (VMHvl). Photoexcitation of VGluT2 neurons did not affect LQ, but did increase time spent self-grooming, and increased c-Fos expression within VGluT2 neurons in the MeApd. Neither condition altered c-Fos expression in the medial preoptic nucleus (MPN) or the arcuate nucleus (ARH). These data support a role for MeApd GABA in the facilitation of lordosis. Glutamate from the MeApd does not appear to be directly involved in the lordosis circuit, but appears to direct behavior away from social interactions.SIGNIFICANCE STATEMENTLordosis, the measure of female sexual receptivity, is a sexually dimorphic behavior regulated within a hypothalamic-limbic circuit. Social cues are integrated through the amygdala, and the posterodorsal part of the medial amygdala (MeApd) is involved in sexually dimorphic social and reproductive behaviors. Photoinhibition of GABAergic neurons in the MeApd inhibited lordosis, while photoactivation of glutamate neurons had no effect on lordosis, but increased self-grooming. These data support a role for MeApd GABA in the facilitation of social behaviors and MeApd glutamate projections in anti-social interactions.
Developmental Effects of Oxytocin Neurons on Social Affiliation and Processing of Social Information
Authors: Nunes Ana Rita , Gliksberg Michael , Varela Susana A. M. , Teles Magda , Wircer Einav , Blechman Janna , Petri Giovanni , Levkowitz Gil , Oliveira Rui F. 
Published: September 2021

Hormones regulate behavior either through activational effects that facilitate the acute expression of specific behaviors or through organizational effects that shape the development of the nervous system thereby altering adult behavior. Much research has implicated the neuropeptide oxytocin (OXT) in acute modulation of various aspects of social behaviors across vertebrate species, and OXT signaling is associated with the developmental social deficits observed in autism spectrum disorders (ASDs); however, little is known about the role of OXT in the neurodevelopment of the social brain. We show that perturbation of OXT neurons during early zebrafish development led to a loss of dopaminergic neurons, associated with visual processing and reward, and blunted the neuronal response to social stimuli in the adult brain. Ultimately, adult fish whose OXT neurons were ablated in early life, displayed altered functional connectivity within social decision-making brain nuclei both in naive state and in response to social stimulus and became less social. We propose that OXT neurons have an organizational role, namely, to shape forebrain neuroarchitecture during development and to acquire an affiliative response toward conspecifics.SIGNIFICANCE STATEMENTSocial behavior is developed over the lifetime of an organism and the neuropeptide oxytocin (OXT) modulates social behaviors across vertebrate species, and is associated with neuro-developmental social deficits such as autism. However, whether OXT plays a role in the developmental maturation of neural systems that are necessary for social behavior remains poorly explored. We show that proper behavioral and neural response to social stimuli depends on a developmental process orchestrated by OXT neurons. Animals whose OXT system is ablated in early life show blunted neuronal and behavioral responses to social stimuli as well as wide ranging disruptions in the functional connectivity of the social brain. We provide a window into the mechanisms underlying OXT-dependent developmental processes that implement adult sociality.
Strategies to Improve the Quality of Team-Based Care for Neonatal Abstinence Syndrome
Authors: McDaniel Corrie E. , Jacob-Files Elizabeth , Deodhar Parimal , McGrath Caitlin L. , Desai Arti D. 
Published: September 2021

BACKGROUND
Prioritizing nonpharmacologic care for neonatal abstinence syndrome (NAS) requires a team-based care (TBC) approach to facilitate staff and family engagement. We aimed to identify the important structures and processes of care for TBC of infants with NAS and quality of care outcomes that are meaningful to care team members (including parents).

METHODS
Using a Donabedian framework, we conducted semistructured interviews from May to October 2019 with care team members at 3 community hospitals, including parents, nurses, social workers, physicians, lactation nurses, child protective services, volunteers, and hospital administrators. We used thematic analysis to identify important structures, processes of care, and outcomes.

RESULTS
We interviewed 45 interprofessional care team members: 35 providers and 10 parents. Structures critical to providing TBC included (1) building a comprehensive network of interprofessional team members and (2) creating an NAS specialized unit. Necessary processes of care included (1) prioritizing early involvement of interprofessional team members, (2) emphasizing nonjudgmental incorporation of previous experience with addiction, (3) establishing clear roles and expectations, and (4) maintaining transparency with social services. Lastly, we identified 9 outcomes resulting from these identified structures and processes that are meaningful to care team members to assess the quality of care for infants with NAS.

CONCLUSIONS
In this study, we identify important structures, processes of care, and meaningful outcomes to enhance and evaluate TBC for infants with NAS. Hospitals that adopt and implement these structures and processes have the potential to improve the quality of care for infants, caregivers, and providers who care for these infants.
Well-Newborn Unit Director Experiences During the COVID-19 Pandemic: A BORN Study
Authors: Aragona Elena , West Dennis , Loyal Jaspreet 
Published: September 2021

BACKGROUND
As coronavirus disease 2019 (COVID-19) spread across the country, well-newborn unit medical directors developed newborn care plans as guidelines and evidence evolved. We chose to examine approaches to newborn care during these early phases of the COVID-19 pandemic.

METHODS
An electronic survey was administered to well-newborn unit directors in a national network of US well-newborn units in May 2020. Respondents were asked about their approaches to testing, infection prevention, routine newborn care, discharge planning, breastfeeding, rounding, and teaching.

RESULTS
Of 107 sites, 65 (61%) respondents completed the survey. Respondents estimated a 1% positivity rate of 1198 newborns tested for COVID-19. Most sites (86%) performed universal maternal COVID-19 testing, and most (82%) tested newborns of COVID-19-positive mothers at 24 hours of life (75%). Infection prevention and visitation policies varied. Of respondents, in COVID-19-positive mothers, 28% permitted no visitors, 54% recommended rooming-in with the newborn, 55% encouraged breastfeeding at the breast, 38% deferred routine circumcisions of the newborn, 74% initiated immediate bathing of the newborn, 68% continued standard newborn screening, and 55% modified newborn follow-up plans. Medical directors reported adjustments to rounding and teaching workflow. Content analysis of free-text responses revealed themes related to challenges with changing recommendations, discomfort with mother-infant separation recommendations, innovations, and stress management.

CONCLUSIONS
Well-newborn units quickly adopted universal maternal testing and testing of exposed newborns. Despite guidelines, we identified variation in the care of newborns of COVID-19-positive mothers. Further investigation of these differences and newborn outcomes is warranted to develop best practices.
Influenza Antiviral Treatment and Length of Stay
Authors: Campbell Angela P. , Tokars Jerome I. , Reynolds Sue , Garg Shikha , Kirley Pam Daily , Miller Lisa , Yousey-Hindes Kimberly , Anderson Evan J. , Oni Oluwakemi , Monroe Maya , Kim Sue , Lynfield Ruth , Smelser Chad , Muse Alison T. , Felsen Christina , Billing Laurie M. , Thomas Ann , Mermel Elizabeth , Lindegren Mary Lou , Schaffner William , Price Andrea , Fry Alicia M. 
Published: September 2021

BACKGROUND
Antiviral treatment is recommended for hospitalized patients with suspected and confirmed influenza, but evidence is limited among children. We evaluated the effect of antiviral treatment on hospital length of stay (LOS) among children hospitalized with influenza.

METHODS
We included children &lt;18 years hospitalized with laboratory-confirmed influenza in the US Influenza Hospitalization Surveillance Network. We collected data for 2 cohorts: 1 with underlying medical conditions not admitted to the ICU (n = 309, 2012–2013) and an ICU cohort (including children with and without underlying conditions; n = 299, 2010–2011 to 2012–2013). We used a Cox model with antiviral receipt as a time-dependent variable to estimate hazard of discharge and a Kaplan–Meier survival analysis to determine LOS.

RESULTS
Compared with those not receiving antiviral agents, LOS was shorter for those treated ≤2 days after illness onset in both the medical conditions (adjusted hazard ratio: 1.37, P = .02) and ICU (adjusted hazard ratio: 1.46, P = .007) cohorts, corresponding to 37% and 46% increases in daily discharge probability, respectively. Treatment ≥3 days after illness onset had no significant effect in either cohort. In the medical conditions cohort, median LOS was 3 days for those not treated versus 2 days for those treated ≤2 days after symptom onset (P = .005).

CONCLUSIONS
Early antiviral treatment was associated with significantly shorter hospitalizations in children with laboratory-confirmed influenza and high-risk medical conditions or children treated in the ICU. These results support Centers for Disease Control and Prevention recommendations for prompt empiric antiviral treatment in hospitalized patients with suspected or confirmed influenza.
Analysis of several techno-functional and sensory attributes upon egg allergen ingredient substitution by blood plasma powder in sponge cake
Authors: Csurka Tamás , Szücs Fanni , Csehi Barbara , Friedrich László Ferenc , Pásztor-Huszár Klára 
Published: September 2021

AbstractAnimal blood is a by-product, which can be utilized in a value-adding way instead of being wasted. Allergen substitution is an obvious possibility because many properties of blood plasma are similar to egg white. Techno-functional and sensory attributes (water activity, moisture content, colour and texture related properties) were measured by instrumental methods. The allergenic egg powder can be substituted by non-allergenic blood plasma powder in sponge cakes, but the change in the ingredient has an effect on hardness and tolerating compressive stress until the breaking. In the case of water activity and moisture content, sponge cakes with blood plasma were as desirable as sponge cakes with egg.
Revisitando o conceito de cidadania organizacional: uma nova proposição envolvendo direitos e deveres do trabalhador
Authors: Zarife Pricila De Sousa , Paz Maria das Graças Torres da 
Published: September 2021

Os termos cidadania organizacional e civismo nas organizações são empregados de forma recorrente na literatura para nomear o mesmo construto. A adoção do termo cidadania organizacional para indicar as ações espontâneas dos trabalhadores não formalmente reconhecidas pela organização, apesar de bastante difundida, tem sido alvo de críticas, visto que etimologicamente cidadania não compartilha deste significado. Diante destas questões, o presente ensaio teórico teve por objetivos discutir a pertinência da adoção dos termos cidadania organizacional e civismo nas organizações, e propor uma definição de cidadania organizacional embasada etimologicamente, envolvendo direitos e deveres do trabalhador na relação com a organização. A proposição de um novo conceito para cidadania organizacional, na perspectiva de direitos e deveres, colabora para a abertura de uma nova linha de investigação e sugere a realização de estudos empíricos para investigar sua relação com outras variáveis, especialmente evidências de validade discriminante com civismo nas organizações.
Patient Perspectives of Rural Kansas Maternity Care
Authors: Blythe Meghan , Kathryn Istas  , Shane Johnston  , Jasmine Estrada  , Maci Hicks  , Michael Kennedy, M.D.  
Published: September 2021

Introduction. Pregnant women in rural areas face a unique set of challenges due to geographic maldistribution of obstetric services. The perspectives of rural Kansas women were sought regarding experience of birth and satisfaction with maternity care.
Methods. Medical student research assistants facilitated discussion groups in rural Kansas communities with women who had given birth in the last 24 months. Guiding questions were used to facilitate discussion. Survey instruments were used to gather information about satisfaction with maternity care. Data for qualitative and quantitative analysis was aggregated using Rural Urban Commuting Area (RUCA) codes.
Results. 14 groups with 47 total participants completed the survey and discussion. Participants were representative of a variety of Large Rural, Small Rural, and Isolated areas in Kansas as described by RUCA Code Four Category Classification. Survey results indicate that satisfaction with maternity care in participants’ home county was significantly higher in Small Rural and Isolated compared to Large Rural RUCA. Qualitative analysis results show positive experiences related to: doctor characteristics, relationship with doctor, doctor’s involvement with care, alternative labor options, and distance convenience. Negative experiences were related to: doctor bedside manner, doctor not there until delivery, and staff related complaints.
Conclusions. Women in Small Rural and Isolated RUCA codes appear to be more satisfied with care contrary to previous study findings.