bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of heart rate variability to predict hospital length of stay for COVID-19 patients
Authors: Khodadadi Fateme , Punait Sujata , Kolacz Jacek , Zand Farid , Foroutan Ali , Lewis Gregory F. 
Published: September 2021

Background:
As the COVID-19 pandemic continues, determining hospital demands has become a vital priority. Heart rate variability (HRV) has been linked to both the presence of viral infection and its severity. We investigate the possibility of using HRV parameters in comparison to other clinical parameters for predicting the hospital length of stay (LOS) for COVID-19 patients.

Methods:
This was a population-based cohort study. Measurements were performed in a specialized hospital for respiratory disease, dedicated to COVID-19. Patients were polymerase chain reaction positive for COVID-19 and on their 1st day of admission. Heart period, respiratory sinus arrhythmia (RSA), low frequency (LF) HRV, and vagal efficiency were calculated from electrocardiogram signals. This study investigated the correlation of HRV, demographic, and laboratory parameters with hospital LOS.

Results:
Forty-one participants were recruited, with a significant relationship, observed between hospital LOS and some demographic and clinical parameters such as lymphocyte count, age, and oxygen saturation of arterial blood. There was a negative relationship between LF and hospital LOS (r = −0.53, 95% confidence interval: −0.73, −0.24). Higher vagal efficiency predicted shorter hospital LOS in patients younger than 40 years of age (19.27% shorter hospital LOS was associated with a one SD higher value of VE, P = 0.007).

Conclusion:
HRV measurement is a non-invasive, inexpensive, and scalable procedure that produces several metrics, some of which are useful for predicting hospital LOS and managing treatment resources during COVID-19 pandemic.
Plasma from patients undergoing coronary artery bypass graft surgery does not activate endothelial cells under shear stress in vitro
Authors: Ellermann Sophie F. , L. Scheeren Thomas W. , Jongman Rianne M. , Nordhoff Katja , Schnabel Christiane L. , Molema Grietje , Theilmeier Gregor , Meurs Matijs Van 
Published: September 2021

Background:
Cardiac surgery with cardiopulmonary bypass (CPB) is commonly associated with acute kidney injury, and microvascular endothelial inflammation is a potential underlying mechanism. We hypothesized that pro-inflammatory components of plasma from patients who underwent coronary artery bypass graft surgery with CPB induce endothelial adhesion molecule expression when incorporating altered shear stress in the in vitro model.

Methods:
The clinical characteristics and markers of systemic inflammation and kidney injury were analyzed pre and postoperatively in 29 patients undergoing coronary artery bypass grafting with CPB. The effects of tumor necrosis factor (TNF)-α and patient plasma on the expression of endothelial inflammation and adhesion markers were analyzed in vitro.

Results:
Plasma TNF-α was elevated 6 h postoperation (median: 7.3 pg/ml (range: 2.5–94.8 pg/ml)). Neutrophil gelatinase-associated lipocalin in plasma peaked 6 h (99.8 ng/ml (52.6–359.1 ng/ml)) and in urine 24 h postoperation (1.6 ng/mg (0.2–6.4 ng/mg)). Urinary kidney injury molecule-1 concentration peaked 24 h postoperation (0.5 ng/mg (0.2–1.2 ng/mg). In vitro, the expression of E-selectin was induced by 20 pg/ml TNF-α. In addition, the expression of interleukin-8, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1 was induced by 100 pg/ml TNF-α. Compared to healthy control plasma exposure, postoperative plasma did not increase the expression of markers of endothelial inflammation and adhesion under shear stress in vitro.

Conclusion:
Patients undergoing CPB surgery showed mild systemic inflammation and kidney injury. However, the plasma components did not stimulate endothelial inflammation and adhesion molecule expression in vitro.
Macintosh laryngoscope versus AMBU King Vision video laryngoscope for endotracheal intubation using a COVID-19 barrier box
Authors: Sahoo Sangeeta , Singh Neha , Mohanty Chitta Ranjan , Hansda Upendra , Sahoo Jyotiranjan , Sahu Ajitesh 
Published: September 2021

Background:
Coronavirus disease 2019 (COVID-19) barrier box is being used by health-care workers for protection against aerosol-transmitted infection. Usually, a Macintosh laryngoscope (MC) or a video laryngoscope (VL) is used for endotracheal intubation (ETI). We aimed to determine the most suitable laryngoscope blade in terms of time to ETI, ease of ETI, and the first-pass success rate.

Methods:
American Society of Anesthesiologists Grade I and II patients undergoing surgery under general anesthesia were randomized into the MC and the King Vision VL groups in a 1:1 ratio. ETI was performed using either the MC (the MC group) or the King Vision VL (the VL group) with a COVID-19 barrier box. The first-pass intubation success rate, intubation time, and ease of ETI were analyzed.

Results:
The first-pass success rate was higher in the MC group (P = 0.43). The mean duration of ETI was 33 s and 47 s in the MC group and VL group, respectively. The difference was statistically significant between the groups (P = 0.002). The ease of ETI was comparable between the groups (P = 0.57), and the Cormack–Lehane grade was significantly different between the groups (P = 0.0025).

Conclusion:
ETI duration was shorter in the MC group than in the VL group. Hence, a MC can be used along with a COVID-19 barrier box by experienced operators for the prevention of aerosol spread.
Utility of early warning scores to predict mortality in COVID-19 patients
Authors: Kaeley Nidhi , Mahala Prakash , Kabi Ankita , Choudhary Suman , Hazra Anirban Ghosh , Vempalli Subramanyam 
Published: September 2021

Background:
Coronavirus disease 2019 (COVID19) has evolved as a global pandemic. The patients with COVID-19 infection can present as mild, moderate, and severe disease forms. The reported mortality of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection is around 6.6%, which is lower than that of SARS-CoV and (middle east respiratory syndrome CoV). However, the fatality rate of COVID-19 infection is higher in the geriatric age group and in patients with multiple co-morbidities. The study aimed to evaluate the utility of early warning scores (EWS) to predict mortality in patients with moderate to severe COVID-19 infection.

Methods:
This retrospective study was carried out in a tertiary care institute of Uttarakhand. Demographic and clinical data of the admitted patients with moderate-to-severe COVID-19 infection were collected from the hospital record section and utilized to calculate the EWS-National early warning score (NEWS), modified early warning score (MEWS), Rapid Acute Physiology Score (RAPS), rapid emergency medicine score (REMS), and worthing physiological scoring system (WPS).

Results:
The area under the curve for NEWS, MEWS, RAPS, REMS, and WPS was 0.813 (95% confidence interval [CI]; 0.769–0.858), 0.770 (95% CI; 0.717–0.822), 0.755 (95% CI; 0.705–0.805), 0.892 (95% CI; 0.859–0.924), and 0.892 (95% CI; 0.86–0.924), respectively.

Conclusion:
The EWS at triage can be used for early assessment of severity as well as predict mortality in patients with COVID-19 patients.
Prevalence of discharge against medical advice and its associated demographic predictors among pediatric patients
Authors: Alwallan Nesreen Suliman , Al Ibrahim Ahmad Mohammed Ishaque , Osman Homaida Wafa Elrasheed , Alsalamah Majid , Alshahrani Saeed Mastour , Al-Khateeb Badr F , Bahkali Salwa , Al-Qumaizi Khalid Ibrahim , Toivola Paivi , El-Metwally Ashraf 
Published: September 2021

Background:
Discharge against medical advice (DAMA) occurs when the patient or their caretaker leaves the hospital against the recommendation of their treating physician. DAMA may expose the children to a high risk of inadequate treatment, which may result in readmission, prolonged morbidity, and mortality. The study aimed to identify the predictors of DAMA in the emergency department (ED) within the pediatric age group.

Methods:
This was a cross-sectional study. The study used the medical records of pediatric patients (n = 5609) that were admitted to the ED of King Abdullah Bin Abdulaziz University Hospital (KAAUH) in Riyadh, Saudi Arabia, during 2017 and 2018. Descriptive statistics, Chi-square, or Fisher's exact test were used. Unadjusted and adjusted odds ratios with their 95% CI were reported by performing logistic regression modeling.

Results:
A significant interaction between age and gender was observed in the multivariate analysis after adjusting for the other covariates. The odds of DAMA for a 5-year-old female child were 4.43 times higher than those of a 5-year-old male child (P < 0.1).

Conclusions:
The public should be educated about the consequences of DAMA. Continued health education and the promotion of child survival strategies at the community level, combined with an improvement in the socioeconomic conditions of the population, may further reduce DAMA and improve the chances of survival for children. Future studies should assess the socioeconomic status of the patients and estimate the cost that is incurred by the patients.
Validation of the vasoactive-inotropic score in predicting pediatric septic shock mortality
Authors: Pudjiadi Antonius Hocky , Pramesti Dwi Lestari , Pardede Sudung O. , Djer Mulyadi M. , Rohsiswatmo Rinawati , Kaswandani Nastiti 
Published: September 2021

Introduction:
Mortality in pediatric septic shock remains very high. Vasoactive-inotropic score (VIS) is widely used to predict prognosis in patients with heart disease. It is a simple method that was initially used as a predictor of morbidity and mortality in postoperative patients with congenital heart diseases. Previous reports showed that high VIS score was associated with high mortality in pediatric sepsis. However, its discriminative value remains unclear. We aim to explore the discriminative value of VIS in predicting mortality in pediatric septic shock patients.

Methods:
We conducted a retrospective cohort study on medical records of septic shock patients who received care in the pediatric intensive care unit (PICU). We screened medical records of pediatric patients which were diagnosed with septic shock and admitted to the PICU and received vasoactive/inotropic score for more than 8 h. Other supporting examination results were recorded, such as organ function evaluation for calculation of Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score. The outcome of patients was recorded. The receiver operating curve was constructed to calculate the area under the curve (AUC), sensitivity, and specificity of each cutoff point.

Results:
We obtained the optimum cutoff point of VIS > 11 with 78.87% sensitivity and 72.22% specificity. AUC positive was 0.779 (P < 0.001); predictive value and negative predictive value were 91.80% and 46.43%, respectively.

Conclusion:
VIS > 11 has a good ability to predict mortality in children with septic shock.
The Effect of Antenatal Betamethasone on Prevention of Neonatal Respiratory Distress Syndrome before Elective Cesarean Section at Term
Authors: Sahaf Farnaz , Zakariya Nahideh Afshar 
Published: September 2021

Background:
Respiratory distress syndrome (RDS) is an important respiratory disease possibly caused by surfactant deficiency in infants and has a heavy financial burden on the country's health system. The purpose of the present study was to evaluate the relationship between RDS in neonates who were born by elective cesarean at term with and without corticosteroids.

Materials and Methods:
This randomized clinical trial study was performed on all mothers who delivered by elective cesarean section at Alzahra and Taleghani Hospital with a Pregnancy age of more than 37 weeks. After considering exclusion criteria, the patients were randomly divided into either betamethasone (IM injection of 12 mg daily for two doses) or the control group. The comparison of these two groups was in RDS, hospitalization in the neonatal ward, or admission to newborn intensive care unit (NICU).

Results:
One hundred and sixty patients participated in the study. Fifty percentage (n = 80) of them received betamethasone and 50% did not. Of all, 160 neonates, 73.8% in Group 1 and 82.5 of the Group 2 had a 1st-min Apgar score of 9.9–9.10. Significant differences were observed in neonatal Apgar score in two groups (P < 0.05). RDS was found in 11 (6.87%) neonates born from both groups. The hospitalization of neonatal in intensive care units and the time of hospitalization of infants in the betamethasone group were less than the control group and statistically significant (P < 0.05). No cases of necrotizing enterocolitis and neonatal sepsis were observed.

Conclusion:
The results of the present study represented that giving betamethasone to mothers with programmed elective cesarean at term beseem to have a beneficial effect on RDS, NICU admission, and hospitalization. More studies with a larger sample size including the effects of other steroids are recommended.
Worse Outcomes of Early Targeted Ibuprofen Treatment Compared to Expectant Management of Patent Ductus Arteriosus in Extremely Premature Infants
Authors: Termerova Jana , Kuběna Aleš Antonín , Paslerová Ráchel , Liška Karel 
Published: September 2021

Aims:
The aim of the study is to evaluate two different patent ductus arteriosus (PDA) management approaches and their impact on neonatal mortality and/or bronchopulmonary dysplasia (BPD) and 2-year outcomes.

Subjects and Methods:
For two consecutive periods, data on early mortality and morbidity were obtained retrospectively, while long-term morbidity data in children born before 28 weeks of gestation were collected prospectively. In the early targeted treatment period (TTP), ibuprofen was early indicated on patients with high clinical risk and PDA diameter of more than two millimeters in the first 3 days. In the expectant treatment period (EXP), the expectant approach was used.

Results:
A total of 201 eligible infants were screened. Of these, 99 were managed in the TTP and 102 in the EXP. From 99 infants in the TTP, 24 patients were treated early and 17 later. From 102 infants in the EXP, 17 infants with symptomatic PDA were treated. Severe BPD and/or death were more frequent in the TTP as compared to EXP (28 and 16 infants, respectively; P = 0.007; odds ratio = 2.12; confidence interval = 1.06–4.23; c = 0.216). Moreover, infants who underwent the expectant approach did not need further cardiological interventions after discharge.

Conclusions:
Early targeted treatment of large PDAs was associated with an increased risk of severe BPD and/or death. We must pay attention to the side effects of early ibuprofen treatment because these may outweigh the benefits of ductus closure, especially in the vulnerable population of extremely preterm infants.
Circulating serum miR-1246 and miR-1229 as diagnostic biomarkers in colorectal carcinoma
Authors: Rafiee Reihaneh , Razmara Ehsan , Motavaf Mahsa , Mossahebi-Mohammadi Majid , Khajehsharifi Shima , Rouhollah Fatemeh , Babashah Sadegh 
Published: September 2021

Background:
Colorectal cancer (CRC) is one of the most common cancers worldwide. Although colonoscopy is considered as the “Gold Standard” technique to detect CRC, its application is invasive and cost incurred. Thus, noninvasive or minimally invasive approaches are of utmost importance. The aberrant expression of some microRNAs (miRNAs, miRs) has been suggested in association with CRC pathogenesis. This study aimed to validate if circulating serum miR-1229 and miR-1246 are diagnostic biomarkers for CRC.

Materials and Methods:
Serum samples were isolated from 45 CRC patients and also 45 healthy controls (HC). The expression levels of circulating serum-derived miR-1229 and miR-1246 were evaluated by quantitative real-time polymerase chain reaction. Receiver operating characteristic (ROC) curves were constructed to evaluate the CRC diagnostic accuracy of selected miRNAs. Furthermore, the association of candidate miRNAs and clinicopathological characteristics were evaluated. Functional enrichment of the candidate miRNAs was applied using in silico tools.

Results:
The expression of miR-1229 and miR-1246 was significantly higher in CRC patients than HC (P < 0.0001) and also was found in association with lymph node metastasis (P < 0.05). We demonstrated a significant up-regulation of serum-derived miR-1246 in advanced tumor–node–metastasis stage III of CRC patients (P < 0.05). Areas under the ROC curve of miR-1229 and miR-1246 were 0.81 and 0.84, respectively (P < 0.0001).

Conclusion:
We confirmed the capability of circulating serum miR-1229 and miR-1246 as novel diagnostic biomarkers for CRC.
Perception of patient safety culture amongst healthcare personnel in a tertiary care hospital
Authors: Meena Keval Singh , Shetty Asha P. 
Published: September 2021

Background:
Patient safety in healthcare includes the safety of both patients (clients) and healthcare providers. It emphasizes reporting, analysis and prevention of medical errors that often lead to adverse health events and thus it becomes one of the most important aspects needed in a hospital setting.

Purpose:
The study aimed to assess the perception of patient safety culture amongst healthcare personnel in a tertiary care hospital.

Methodology:
A descriptive research design was selected as an appropriate method; 380 participants were selected through convenience sampling technique, including physicians, nursing officers and other technical staff. The setting for the study was all departments of a tertiary care hospital, All India Institute of Medical Sciences, Bhubaneswar. The Hospital Survey on Patient Safety Culture, a self-administered questionnaire, was used to assess the perception of patient safety culture.

Results:
The data were entered into SPSS version 20. The overall response rate in the present study was 84%. The average composite response rate was 57.37%. The dimension of 'teamwork within the unit', 'organisational learning' and 'feedback and communication error' showed the maximum positive responses 81.25%, 79.91% and 70.61%, respectively.

Conclusion:
Professional practice is a priority to promote patient safety culture amongst healthcare personnel. To have homogeneous patient safety culture amongst all healthcare professional, it is essential to increase awareness about patient safety amongst healthcare personnel and motivate them to participate in the service.
Adsorption of metal ions in red marine algae Lithothamnium calcareum in the treatment of industrial effluents
Authors: Silva Jaíza Ribeiro Mota e , Oliveira Luiz Fernando Coutinho de , Franco Camila Silva , Oliveira Juliano Elvis de , Silvério Bárbara Belchior 
Published: September 2021

This study investigated the adsorption capacity of the elements Chromium (Cr), Manganese (Mn) and Zinc (Zn) to marine algae Lithothamnium calcareum by means of adsorption kinetics and batch adsorption tests, with a view to the development of a simple technique for the treatment of effluents that have a high concentration of metal ions. The algae was sieved, washed and subjected to treatment. In the adsorption kinetics, 0.2 g of algae was weighed, an amount transferred to 125 mL Erlenmeyer flasks, to which was added 15 mL of solution with a concentration of 5 mg L-1 of the metal ion. The flasks were stirred at 60 rpm for 240 minutes. In batch adsorption, 0.2 g of algae was weighed, amount transferred to 125 mL Erlenmeyer flasks, to which was added 15 mL of solution with concentrations of 5, 10, 20, 50, 100, 250 e 500 mg L-1 of the metal ion. The flasks were stirred at 60 rpm for 24 hours. In the two tests, the supernatant solutions collected were centrifuged at 2000 rpm for 5 minutes and the equilibrium concentrations of metal ions were determined by atomic absorption spectrometry. It was found that, in 240 minutes of contact, the Lithothamnium calcareum removed 15.5% of Cr, 33.0% of Mn and 8.0% of Zn in solution; and that in 24 hours of contact, at a concentration of 5 mg L-1, it removed 0.4% of Cr, 52.5% of Mn and 92.6% of Zn; and, at a concentration of 500 mg L-1, it removed 20.0% of Cr, 22.6% of Mn and 40.8% of Zn. The results showed that the Lithothamnium calcareum submitted to thermochemical treatment presented potential for use in the adsorption of Cr, Mn and Zn.
PDE comparison principles for Robin problems
Authors: Langford Jeffrey J. 
Published: September 2021

AbstractWe compare the solutions of two Poisson problems in a spherical shell with Robin boundary conditions, one with given data, and one where the data have been cap symmetrized. When the Robin parameters are nonnegative, we show that the solution to the symmetrized problem has larger convex means. Sending one of the Robin parameters to
$+\infty $
, we obtain mixed Robin/Dirichlet comparison results in shells. We prove similar results on balls and prove a comparison principle on generalized cylinders with mixed Robin/Neumann boundary conditions.
EDUCATION THROUGH THEATRE: HOW THE CHILDREN DESERVE
Authors: DIDAR MUHAMMAD  
Published: September 2021

Theatre is known for entertainment but that is not the end. Theatre gives messages; it teaches the young and old through its interactive and communicative action method, easily called learning by doing. Children should not be out of this avail of pedagogy because Child Education is the potential area for entertainment education. Co-curricular Activities are the fundamental elements of teaching. These activities would be more effective if we retouch and modify by Theatrical Method. As the children love to learn by doing, thus they love the text. This paper shows how the teaching method children deserve, how this strategy of education through theatre helps them to love the textbook.
1960 COUP D’ÉTAT: THE FIRST COUP IN TURKISH REPUBLIC
Authors: SURID AKHAND SHARIF 
Published: September 2021

On May 27th the Republic of Turkey faced her first full-fledged Military takeover (Coup). As it is said, “A Coup is never just a Coup”. This review article provides a summary of the atmosphere before and after the coup of 1960 and a critical analysis of the democratic promises it brought. This Paper analyzes different terms used to identify the event such as revolution, insurrection, intervention, and coup. It also discusses the tradition of regular military intervention in the history of the Republic of Turkey. Since the transition to democracy and the multiparty system was not natural this paper also indicates the absence of democratic culture in Turkish history. After 27th May, Turkey was led to the new constitutional structure of 1961. As it is said, the 1924 Constitution that established the first Republic of Turkey was wiped out with a coup and the 1961 Constitution and the Second Republic was established (Dursun, 2005:187). Since then until recent times the military could not separate itself from the political life of Turkey. The following discussions enclose; the origin of the 1960 Coup, the Aftermath, the Conspiracies, the Civilian Military relationship, Traditional and Historical views, Kemalist Principles, Government citizen dialogues, and Socio-economic backwardness. This critical analysis went through different interesting and easily misunderstood concepts (such as Revolt, Revolution, Military takeover, etc.).