bluuebunny/crossref_metadata_2025_split huggingface dataset:
SCRATCH Trial: An Initiative to Reduce Excess Use of High-Flow Nasal Cannula
Authors: Noelck Michelle , Foster Alex , Kelly Serena , Arehart Ashley , Rufener Christina , Wagner Tamara , Ibsen Laura , Burns Erin 
Published: April 2021

OBJECTIVES:
We aimed to reduce unnecessary use of high-flow nasal cannula (HFNC) at lower flow rates through the implementation of a standard daily trial off HFNC at a medium-sized academic center.

METHODS:
We used an interprofessional quality improvement collaboration to develop and implement interventions to reduce HFNC waste in children aged 1 month to 24 months with bronchiolitis who were admitted to the inpatient ward or ICU. Key interventions included development and implementation of the Simple Cannula/Room Air Trial for Children (SCRATCH Trial), a standard trial off HFNC for eligible infants. Process measures were selected as metrics of use of the newly developed trial. The primary outcome measure was hours of treatment with ≤8 L per minute (LPM) of HFNC. Additional outcome measures included total hours of treatment with HFNC and length of stay.

RESULTS:
A total of 271 patients were included in this study, 131 in the preimplementation group and 140 in the postimplementation group. The mean hours of treatment below our a priori determined waste line (≤8 LPM of HFNC) decreased from 36.3 to 16.8 hours after SCRATCH Trial implementation, and mean length of stay decreased from 4.1 to 3.0 days.

CONCLUSIONS:
The SCRATCH Trial was successfully implemented across hospital units, with a significant reduction in hours on ≤8 LPM of flow. Rapid discontinuation of HFNC appears feasible and may be associated with a shorter length of stay.
Quality Initiative to Reduce High-Flow Nasal Cannula Duration and Length of Stay in Bronchiolitis
Authors: Charvat Courtney , Jain Shabnam , Orenstein Evan W. , Miller Laura , Edmond Mary , Sanders Rebecca 
Published: April 2021

OBJECTIVES:
High-flow nasal cannula (HFNC) use in bronchiolitis may prolong length of stay (LOS) if weaned more slowly than medically indicated. We aimed to reduce HFNC length of treatment (LOT) and inpatient LOS by 12 hours in 0- to 18-month-old patients with bronchiolitis on the pediatric hospital medicine service.

METHODS:
After identifying key drivers of slow weaning, we recruited a multidisciplinary “Wean Team” to provide education and influence provider weaning practices. We then implemented a respiratory therapist–driven weaning protocol with supportive sociotechnical interventions (huddles, standardized orders, simplification of protocol) to reduce LOT and LOS and promote sustainability.

RESULTS:
In total, 283 patients were included: 105 during the baseline period and 178 during the intervention period. LOT and LOS control charts revealed special cause variation at the start of the intervention period; mean LOT decreased from 48.2 to 31.2 hours and mean LOS decreased from 84.3 to 60.9 hours. LOT and LOS were less variable in the intervention period compared with the baseline period. There was no increase in PICU transfers or 72-hour return or readmission rates.

CONCLUSIONS:
We reduced HFNC LOT by 17 hours and LOS by 23 hours for patients with bronchiolitis via multidisciplinary collaboration, education, and a respiratory therapist–driven weaning protocol with supportive interventions. Future steps will focus on more judicious application of HFNC in bronchiolitis.
Readiness of Health Workers to Provide Pregnancy Planning Program for Women Infected with Human Immunodeficiency Virus: A Case Study in Surabaya, East Java, Indonesia
Authors: Marheni Putri Made Chindy Dwiyanti , Lestari Pudji , Akbar Muhammad Ilham Aldika 
Published: April 2021

Background: The prevalence of human immunodeficiency virus (HIV) mother-to-child infection, or vertical transmission of HIV, in Indonesia is about 90%. Ministry of Health of the Republic of Indonesia Regulation No. 21 of 2013 stated that HIV infection in sexual productive age needs integrative professional help to lower the transmissions, including voluntary counseling and testing for pregnant women as well as all people at risk. This study aimed to determine the readiness of health workers to provide pregnancy planning program service for women with HIV.Methods: This study was a descriptive study involving 30 obstetricians and 30 residents of Obstetrics and Gynecology specialist education in Surabaya, Indonesia. The respondents’ knowledge on pregnancy planning for HIV-infected women based on based on guidance released by the Ministry of Health of Indonesia in 2017 and Regulation of Ministry of Health no. 52 the year 2017, as well as their attitude and readiness to provide pregnancy planning services, was explored. Questionnaires were distributed from August to December 2019 and the data collected were analyzed using Statistical Package for the Social Science (SPSS) version 17.0 and results were described in percentage.Results: Most health workers (80%) had good knowledge on providing pregnancy planning program for HIV positive women; however, only 63.3% had good attitude towards it. The majority of respondents (90%) were ready to help HIV patients in planning their pregnancy. Conclusion: Health workers in Surabaya are ready to provide services related to pregnancy planning for women infected with HIV.
Grãos Secos de Destilaria na Alimentação de Frangos de Corte
Authors: Valentim Jean Kaique , D’Ávila Lima Heder José , Marques Bittencourt Tatiana , Matos e Silva Nayara Emanoelle , De Castro Burbarelli Maria Fernanda , Garófallo Garcia Rodrigo , De Carvalho Pantoja Jessica , Barbosa Deivid Kelly 
Published: April 2021

O uso de coprodutos agroindustriais na alimentação animal promove a diminuição dos custos de produção com insumos básicos como o milho e a soja, evitando os impactos causados pelo descarte desta matéria orgânica no ambiente, além de ser fonte nutricional de qualidade. Dessa forma, os grãos secos de destilaria com solúveis (DDGS) se tornam uma alternativa lucrativa em função de baixo custo, qualidade proteica e apelo sustentável, por ser oriundo da produção de biocombustíveis. Em contrapartida, em decorrência da variabilidade da composição nutricional deste ingrediente, sua adição em dietas avícolas deve ser realizada com cautela, minimizando perdas no desempenho das aves. Dessa forma se buscou avaliar por meio de um artigo de revisão de literatura a utilização de grãos secos de destilaria na dieta de frango de corte. É importante reiterar que os componentes nutricionais podem variar, sendo maior para coprodutos do que para os alimentos convencionais, podendo causar distúrbios nutricionais, se análises frequentes não forem realizadas e se as dietas não forem adequadamente balanceadas, de acordo com a qualidade nutricional do alimento. O DDGS possui grande potencial no uso da alimentação de frango de corte, em função da qualidade nutricional, podendo minimizar custos dentro dessa cadeia.

Palavras-chave: Aves de Corte. Biocombustíveis. Coprodutos. DDGS. Milho

Abstract
The use of agro-industrial co-products in animal feed promotes the reduction of production costs with basic inputs such as corn and soybeans, avoids the impacts caused by the disposal of this organic matter in the environment, besides being a nutritional source of quality. Thus, dry grains of soluble distillery (DDGS) become a profitable alternative due to the low cost, protein quality and sustainable appeal, because it comes from biofuel production. On the other hand, due to the variability of the nutritional composition of this ingredient, its addition in poultry diets should be performed with caution, minimizing losses in the poultries’ performance. Thus, it was sought to evaluate through a literature review article the use of dry distillery grains in the broilers’ diet. It is important to reiterate that nutritional components may vary, being higher for co-products than for conventional foods, and may cause nutritional disorders, if frequent analyses are not performed and if diets are not properly balanced, according to the food nutritional quality. DDGS has great potential in the use of chicken feeding, due to its nutritional quality, and can minimize costs within this chain.

Keywords: Biofuels. Co-Products. DDGS. Corn.
Communication Patterns and Related Factors among Iranian Couples: A Cross-sectional Study
Authors: HasaniMoghadam Sedigheh , Ganji Jila , Nia Hamid Sharif , Aarabi Mohsen , Khani Soghra 
Published: April 2021

Background: Given the effect of various factors on the use of communication patterns by couples, this study aimed to determine the most common communication pattern among couples and related factors in Sari, northern Iran.
Methods: This cross-sectional study was performed on 520 people (260 couples) in Sari. Data were collected using a demographic–fertility factors questionnaire, Enrich couple scale, communication patterns questionnaire, general health questionnaire (GHQ-28), and NEO personality inventory. Data analysis was performed in SPSS version 25 using descriptive and inferential statistics (multiple regression model).
Results: While the mean (standard deviation) age of women included in the study was 34.08 (7.71) years, the mean age of men was 39.13 (9.18) years. The most common communication patterns in both women and men was the mutual constructive communication, whereas the lowest frequent communication pattern was the demand/withdraw communication in both men and women. Marital satisfaction had a significant positive correlation with mutual constructive communication pattern in women and men (P = 0.001). In addition, a significant inverse correlation was observed between the number of marriage to date, women’s age, and spouses' demand/withdraw communication pattern with mutual constructive communication pattern in women. Also, a significant inverse correlation was observed between flexibility (P = 0.047), number of marriages (P = 0.013), and the wives' age (P = 0.005) with mutual constructive communication pattern in men.
Conclusion: According to the results of the study, it is necessary to recognize the factors related to couples’ communication patterns in order to improve the communication patterns so that marital conflicts could be avoided while a more effective communication is established.
Keywords: communication patterns, couples, personality characteristics, marital satisfaction, public health
The Effect of Innovative Teach-back Tool Kit Session on the Postgraduate Nursing Students’ Knowledge About Injectable Artesunate
Authors: Ahmed Sahar , Eisa Eiman , Mohammed Montaha , Abdalla Samah 
Published: April 2021

Background: Injectable artesunate (inj AS) is a new anti-malarial treatment recently introduced in Sudan for the treatment of severe malaria . Inj AS has demonstrated its superiority over injectable quinine in African and Asian patients. This study aimed to evaluate the outcome of innovative teach-back tool kit session on the knowledge of inj AS among the postgraduate nursing students at the University of Khartoum, Sudan.
Methods: This interventional pre–posttest studyincluded30postgraduatenursing students selected though a full-coverage sampling method and meeting the selection criteria. Data were collected using standardized self-administered questionnaire after taking a written approval from the participants. The pretest included an initial assessment followed by implementation of interactive session about new anti-malaria treatment using an innovative teach-back toolkit, and the final assessment was conducted after two weeks (posttest). The collected data were then analyzed and interpreted using descriptive and inferential statistics based on the objective and hypothesis of the study. A two-tailed p-value at 0.05 was considered as the level of significance using SPSS version 20.
Results:
Majority of the participants were aged between 20 and 30years; of them, 26 (87%) were female and 4(13%) male, and all of them had >1year of experience. The findings of the study showed that half of the participants (15[50%]) had a good knowledge score, 12 (40%) had a poor knowledge, and 3(10%) had a very poor knowledge score in the pretest. However, the knowledge scores increased significantly to 86.7% posttest, which is very good. The overall mean of pretest knowledge scores regarding inj AS was7.4 with a statically significant difference (p=0.000). The mean score was increased to 12 with a statically significant difference posttest (p=0.000).
Conclusion:
There was a statistically significant improvement in the knowledge scores of the postgraduate nursing students about inj AS after the implementation of interactive teaching session using innovative teach-back tool kit.
Keywords:inj artesunate, teach back-toolkit, nursing students, session
Venice from Another Perspective
Authors: Cataluccio Francesco M. 
Published: April 2021

This essay with a clearly personal touch is a narrative anchored in cultural texts which deals with experiencing Venice in a multi-faceted way. Talking about his many years of wandering around the city (in the company of, for instance, Joseph Brodsky) and describing places and architectural details important to him, the author argues that especially the mediation of painting, which also documented the history of Venice, allows for a better understanding of the phenomenon of the city. This fusion of the two modalities of experience is also reflected in the structure of the text, which closes the reflection on the contemporary condition of the city and various threats which Venice has to face.
Development of the Perception of Opioid Use Survey (POUS) Instrument
Authors: Burton Alison , Barnett Scott , Wood Elyssa , Smolsky Alison , Stanger Debra , Friesen Mary Ann , Schoem Lindsay , Mueller Scott , Metcalfe Stacey 
Published: April 2021

Background and PurposeA new instrument was designed specifically to evaluate nurses' knowledge, attitude, and practice toward patients who use opioids. This study team developed and tested the psychometric properties of the Perception of Opioid Use Survey (POUS) instrument.MethodsThe instrument was tested among 306 nurses at a 183 bed acute care community hospital, with psychometric evaluation for validity, reliability, and exploratory factor analysis.ResultsInternal consistency results were Cronbach's alpha = .550 for the overall scale and each subscale: Self-Efficacy = .796, Attitudes = .744, Community Impact = .806, and Causative Factors = .763.ConclusionsPsychometric testing results support that the POUS is valid, reliable, and significantly correlated with theoretically selected variables.
Assessment of prevalence and risk factors of varicosis
Authors: Morozov A. M. , Sergeev A. N. , Askerov E. M. , Malkarov H. S. , Zhukov S. V. , Belyak M. A. , Peltikhina O. V. 
Published: April 2021

Chronic venous insufficiency (CVI) of the lower extremities is characterized by a wide clinical spectrum, – asymptomatic manifestation in the stage of compensation, after a decade it acquires the shape of decompensation, aggravating complications. This disease is associated with a deterioration in the standard of living and working capacity of patients, is of particular social and economic importance. Varicose veins are a consequence of CVI, therefore, can be prevented in the early stages, through preventive measures. However, VVV is most often detected at later stages.The aim of this study is to determine the most significant risk factors for the development of varicose veins, including the peculiarity of the influence of gender.Material and methods. A survey of 470 people was conducted, and a statistical analysis of the results was carried out.Results. The prevalence of varicose veins is distributed as follows: from 18 to 35 years – in 2.1 % of women, from 36 to 65 years – in 16 %, over 65 years – in 20.3 %. It can be noted that the increase in incidence increases with an increase in the age category, reaching significant values in the range from 36 to 65 years in women. This disease is more commonly diagnosed in women who have a hereditary predisposition to it. Alcohol consumption and being overweight had a lesser effect on the onset of symptoms. There is a high percentage of morbidity among workers who spend a long time at work in a static position (6 % spend time standing or sitting). Among them, 44.7 % of women have a hereditary predisposition with diagnosed VVV in 14.9 % of cases, with signs of VVV class C1 and higher – 23.4 %.Findings. Women who have a hereditary predisposition to the disease and spend most of their time in a static position were at greater risk of developing varicose veins. Another predisposing factor was smoking among the respondents who did not have a genetic predisposition. As a preventive measure to maintain health, the greatest preference is given to regular walking and rest with the position of the legs located above the level of the heart. However, there is a significant number of women who do not carry out any preventive measures; more active sanitary and educational work should be carried out in these groups.
Intravenous paracetamol vs. ketoprofen for pain management after the abdominal aortic surgery – pharmacokinetics and therapeutics
Authors: Rosada-Kurasińska Jowita , Bartkowska-Śniatkowska Alicja , Bienert Agnieszka , Grześkowiak Małgorzata , Sobczyński Paweł , Zielińska Marzena 
Published: April 2021

Introduction. Acute postoperative pain continues to be a dilemma to patients and clinicians.Aim. To define the efficacy, tolerability and pharmacokinetics of paracetamol and ketoprofen in patients after the abdominal aortic surgery. Setting and design in University hospital – intensive therapy unit (clinical part), clinical pharmacy and biopharmacy unit (biochemical part), and pharmaceutical company (statistical part). Prospective randomized study.Material and Methods. 40 adult patients (50–84 years) undergoing abdominal aortic surgery were randomized equally into two groups. After extubation the patients in group 1 (G1) were administered a 1 g paracetamol infusion, and in group 2 (G2) – a 100 mg ketoprofen infusion, both within 15 minutes. All the patients received an epidural infusion of bupivacaine with fentanyl. The following parameters were recorded: mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), plasma concentration of paracetamol and ketoprofen. Postoperative pain was assessed with the visual analogue scale (VAS).Results. The mean values of the MAP, HR and CVP were within normal limits in the both groups. No significant differences were noticed in the assessment of postoperative pain and total use of an opioid. The mean therapeutic plasma concentration of paracetamol and ketoprofen remained up to 180 minutes and up to 120 minutes, respecively.Conclusions. The study enabled us to conclude that intravenous paracetamol as well as ketoprofen have good effectiveness and tolerability. There is no need to modify dosage of these drugs to elderly patients. After paracetamol infusion the therapeutic plasma concentration remains longer than after the ketoprofen infusion.
Genetic variants and magnetic resonance imaging measures in multiple sclerosis: a systematic review
Authors: Nowak Jan Krzysztof , Guzikowska-Ruszkowska Izabela , Łopaciuch Jadwiga , Jankowska Wiesława , Piotrowska Ewa , Dziedzic-Szeszuła Ewa , Kapecka Kinga , Walkowiak Jarosław 
Published: April 2021

Introduction. Although environmental factors play the major role in the etiopathogenesis of multiple sclerosis (MS), genetic factors are implicated as well. We aimed to summarize the current knowledge on the relationship between genetic variants and magnetic resonance (MR) imaging measures in MS.Material and Methods. A systematic review. In December 2016, Scopus (since the year 1980; including MEDLINE) was searched for studies meeting predefined criteria designed to identify articles regarding: multiple sclerosis, genetic variants, and MR imaging. These were then analyzed to identify publications linking polymorphisms and MR findings.Results. The search yielded 290 items; 26 were included in the final analysis. Two genome-wide association studies (GWAS) and two projects employing panels of a few dozen of genes of interest provided most of the data. The other publications concerned no more than 5 genes at a time. Twenty studies reported positive findings. The relationship between HLA-DRB1*15:01 or BDNF rs6265 (Val66Met) and the radiologic course of MS was not consistent across the studies. An intersection of the results of the two GWAS yielded: OPCML (rs11223055), PTPRD (rs1953594), and WWOX (rs11150140, rs1116525) (brain atrophy) as well as CDH13 (rs692612) and PLCB1 (rs6118257) (lesion load).Conclusions. Genetic variants were shown to correlate with MS-related brain atrophy and lesion load. Further research in the field is required.
Complete Balanced Atrioventricular Septal Defect – Results of Bi-ventricular Surgical Correction
Authors: Sobieraj Michał , Szemień Michał , Bednarek Marcin , Wojtalik Michał , Mrówczyński Wojciech 
Published: April 2021

Aim. The aim of this study was to analyze the results of surgical treatment of balanced AVSD during 10-year period in a single center. The adequacy of atrioventricular valves reconstruction was scrutinized as well as risk factors for mortality, redo surgery, pulmonary hypertension incidence were assessed.Materials and method. One hundred twenty one patients underwent surgical correction of AVSD between 2004 and 2013. All patients were operated by double patch technique with the apposition zone closure. Patients’ median age was: 109 (86–151) days, body weight: 4.5 (4–5.5) kg. Down syndrome was present in 100 (82.6%) patients. Results. Early mortality equaled 17.3% (21 patients) and late mortality was 1.7% (2 patients). Pulmonary hypertension (42.9%) and heart failure (33.3%) were the main causes. Cardiopulmonary bypass time (p < 0.0001), aortic cross-clamping time (p = 0.003), inotropic index value (p < 0.0001), maximal mean pulmonary artery pressure (p = 0.008) were significantly higher in the group of patients who died. Ten patients (8.3%) required early reoperation and nine (9%) required late reoperation. Early postoperative mitral valve regurgitation of III-rd or higher degree was risk factor for early and late reoperations (p = 0.0002). The probability of freedom from all reoperations at 6 months, 1 and 5 years was respectively: 0.83; 0.80 and 0.71.Conclusions. Pulmonary hypertension and low cardiac output syndrome have significant influence on results of AVSD treatment. The predisposing risk factors are prolonged time of surgical procedure and presence of pneumonia. Mitral valve reconstruction quality has an influence for early and late results.
The impact of factors in work environment (especially shift and night work) on neoplasia of female reproductive organs
Authors: Bilski Bartosz , Rzymski Paweł , Tomczyk Katarzyna , Rzymska Izabela 
Published: April 2021

Shift work, due to disruption of circadian rhythms, can interfere with a number of physiological functions. It may lead to multiple pathologies (functional gastrointestinal disorders, peptic ulcer disease, hormonal disorders – including impaired melatonin secretion, cardiovascular disease, mental disabilities, neurological disorders etc.). In the last few years, we started to think about the association between disruption in melatonin secretion and the occurrence of certain malignancies. Authors describe and discuss pathophysiology, epidemiological and clinical data concerning influence of shift work to occurrence of some neoplasms.