bluuebunny/crossref_metadata_2025_split huggingface dataset:
Newly qualified primary care nurses’ preparedness to make sound clinical judgements in practice
Authors: Ndlela Mavis , Downing Charlené 
Published: October 2024

Background: The public health sector in South Africa provides care to more than 40 million people, with primary health care (PHC) clinics acting as most patients’ first contact with healthcare services; 80% of patients are treated by primary care nurses. Primary care nurses’ poor clinical judgment can result in poor patient care, complications and death. However, newly qualified primary care (NQPC) nurses’ preparedness for making sound clinical judgements in practice has not been evaluated in Gauteng province, South Africa.Objectives: To determine NQPC nurses’ level of preparedness in making sound clinical judgements in practice.Method: A quantitative, non-experimental, descriptive design was used. The target population was NQPC nurses. A census method was used to select all NQPC nurses in public PHC facilities in three health districts of Gauteng. The sample size comprised 77 NQPC nurses, and data were collected using a self-administered questionnaire.Results: The findings indicated that 83% of NQPC nurses were able to notice salient changes in patients’ conditions, 43% were able to correctly interpret the changes that were noticed, but only 42% prioritised the correct patient care.Conclusion: The results reflect that 50.2% of the NQPC nurses in public PHC facilities in the three districts in Gauteng were functioning at exemplary levels.Contribution: This article highlighted NQPC nurses’ level of preparedness to make sound clinical judgements within a year after qualifying.
To Study the Efficacy of Ultrasound Guided Pecto-Intercostal Fascial Plane Block in Patients Undergoing Midline Sternotomy in Open Cardiac Surgery: A Randomized Prospective Comparative Study
Authors: Singh Ganesh , Dhiraaj Sanjay , Shamshery Chetna , Agarwal Surendra Kumar , Goyal Puneet , Ambasta Suruchi 
Published: October 2024

ABSTRACT

Background:
The incidence of acute poststernotomy pain after cardiac surgery is 80%1. Pecto-intercostal fascial plane block (PIFB) adjacent to the sternum anesthetizes the anterior cutaneous branches of the intercostal nerves and may provide effective analgesia after sternotomy.

Methodology:
A randomized controlled, double-blinded, prospective comparative trial was conducted at a tertiary care center on patients of midline sternotomy between 18 and 65 years and NYHA Class 2 and 3 for open cardiac surgery with the primary aim to evaluate analgesia on deep breathing after 3 hours of PIFB block bilaterally. A total of 60 patients were enrolled and randomly divided into three groups. PIFB was administered bilaterally before extubation, with 15 ml 0.125% bupivacaine plain (Group B), and bupivacaine+ clonidine 0.25 mcg/kg (Group B+C). Group C did not receive any intervention. All patients received acetaminophen 1 gram three times a day and injectable tramadol 1 mg/kg as a rescue analgesic.

Results:
Baseline characteristics were similar among all the groups. The Numeric Rating Scale (NRS) for pain was statistically lower (P < 0.05) in Groups B and B+C compared to Group C at rest, deep breathing, and coughing at 3, 6, and 12 hours after extubation. NRS on deep breathing in Groups B, B+C, and C was {(2.3, 1.5, 4.4) at 3 hours, (2.3, 1.6, 4.3) at 6 hours, (2.8, 2.1, 3.9) at 12 hrs, and {(4.3, 3.5, 3.6)} at 24 hours after extubation. The peak expiratory flow rate was the highest in Group B. Rescue analgesia was not required in Group B.

Conclusion:
PIFB reduces sternotomy pain compared to the control group on deep breathing at 3 hours after block, with delayed requirement of rescue analgesia and improved respiratory mechanics in terms of peak expiratory flow rate at all time points. There is no benefit from adding clonidine.
ProtekDuo Cannula for Pre-, Intra-, and Postoperative Lung Transplantation Management
Authors: Ricks William A. , Rackauskas Mindaugas , Weir William B. , Emtiazjoo Amir M. , Saha Biplab K. , Gries Cynthia J. , Maybauer Marc O. 
Published: October 2024

ABSTRACT
We present a 61-year-old patient with pulmonary hypertension, acute respiratory failure, and acute severe right ventricular (RV) dysfunction. Preoperatively, a ProtekDuo® was inserted for extracorporeal membrane oxygenation (ECMO) and RV protection with venopulmonary (VP) ECMO in (dl) V-P ECMO configuration. Intraoperatively, it provided venous drainage for venoarterial (VA) ECMO in (dl) VP-/AO configuration for bilateral orthotopic lung transplantation (BOLT). Postoperatively, the patient remained on (dl) V-P ECMO for RV support and was decannulated with mild RV dysfunction after 5 days. This is the first description of the ProtekDuo® used in (dl) V-P to (dl) VP-/AO to (dl) V-P configuration for the entire perioperative period of BOLT.
Incidence and Risk Factors of Early-onset Sepsis among Preterm Infants in a Teaching Hospital: A Retrospective Cohort Study
Authors: Al-Wassia Heidi Kamal , Saeedi Fajr A. 
Published: October 2024

Introduction:
Early-onset sepsis (EOS) is associated with a high risk of mortality and morbidity, which are increased in preterm infants. We aim to assess the incidence and factors associated with increased risk of EOS among preterm infants.

Methods:
We conducted a retrospective cohort study at King Abdulaziz University Hospital, a tertiary and teaching hospital in Jeddah city. We included preterm infants <37 weeks of gestational age (GA) who were admitted to the neonatal intensive care unit. Those with congenital anomalies were excluded from the study.

Results:
We included 335 preterm infants, out of which 21 (6.3%) were diagnosed with EOS. Preterm infants with EOS had significantly lower GA (P < 0.001), birth weight (P = 0.024), and APGAR scores at 1 (P = 0.024) or 5 min (P = 0.007). More preterm infants with EOS were born outside the hospital (P < 0.029) and had significantly higher C-reactive protein (P = 0.016). Mortality was significantly higher in preterm infants with EOS compared to those without (42.9% vs. 7.3%, P < 0.001). Our multivariate regression analyses showed that decreased GA (P = 0.006) and delivery outside the hospital (P = 0.011) were associated with an increased risk of EOS in preterm infants.

Conclusion:
We identified risk factors that are significantly associated with EOS in preterm infants and should be considered to improve neonatal outcomes.
Positive Pressure Ventilation in Preterm Babies after Continuous Positive Airway Pressure Failure with or without a Tube? A Randomized Controlled Trial
Authors: Krishnegowda Sushma , Thandaveshwara Deepti , Shah Jacqueline Antoinette , Doreswamy Srinivasa Murthy 
Published: October 2024

Background:
Intermittent positive pressure ventilation is a nonphysiological mode of respiratory support. Clinician‐determined parameters such as peak inspiratory pressure, positive end‐expiratory pressure, and respiratory rate will drive the gas into the lungs (driving pressure). In contrast, continuous positive airway pressure (CPAP) is a physiological mode of respiratory support where normal tidal breathing of the neonate is responsible for the movement of gas into the lungs and CPAP reduces the work of breathing by improving the functional residual capacity of the lungs. In this study, we have compared two different modes of intermittent positive pressure ventilation in babies who cannot be managed on CPAP.

Objective:
The objective of the study was to find out the difference in duration of the driving pressure support between NIPPV and continuous mechanical ventilation (CMV) in babies who fail CPAP.

Methodology:
Preterm neonates with respiratory distress who failed CPAP were randomized to either NIPPV or CMV support. The duration of driving pressure support needed in these two groups was compared.

Results:
The median (interquartile range) duration of driving pressure ventilation in the CMV group was 49.5 (24–71) hours and that in the NIPPV group was 48 (29.5–62.5) hours, which was not statistically significant (P = 0.89).

Conclusion:
The duration of driving pressure support is similar in both NIPPV and CMV modes of ventilation in babies with respiratory distress beyond CPAP.
Effect of Human Milk Fortifiers, Medium-chain Triglyceride Oil, Minerals, and Vitamin Supplements on the Osmolality of Pasteurized Donor Human Milk
Authors: Basany Laxman , Ali Abid , Priyanka G. Naga , Kulkarni Ajay B. , Tabassum Mahevish 
Published: October 2024

Aim:
We aimed to study the changes in osmolality of pasteurized donor human milk (PDHM) after the addition of four human milk fortifiers (HMFs), medium-chain triglyceride (MCT) oil, minerals, and vitamin supplements commonly used in neonates.

Methods:
The osmolality of 25 ml of PDHM was measured after the addition of 1 g each of HMF and 0.5 ml of MCT oil separately with a calibrated osmometer. The osmolality of 5 ml of PDHM was measured after the addition of minerals and vitamin supplements in therapeutic doses separately. All these measurements were carried out at 10 min, 30 min, and 2 h by a technician who was blinded to the fortifiers, minerals, and vitamin supplements used.

Results:
The osmolality of PDHM was 256 mOsm/kg (range = 256–259 mOsm/kg), which increased with all four HMFs tested, but remained below 450 mOsm/kg as recommended by the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). Proprietary fortifiers increased the osmolality of PDHM to a maximum of 429 mOsm/kg (range = 306–429 mOsm/kg). However, there was no change in the osmolality with MCT oil. A maximum increase in osmolality was observed with the addition of calcium phosphate syrup to PDHM (1181 mOsm/kg). The addition of multivitamins and Vitamin D3 in therapeutic doses increased osmolality (range = 552–753 mOsm/kg) beyond the safety limits of ESPGHAN recommendation.

Conclusions:
HMFs increased the osmolality of PDHM but were within the safety limits of ESPGHAN recommendation. MCT oil did not affect the osmolality of PDHM. Minerals and vitamin supplements added in therapeutic dosages significantly increased the osmolality of PDHM. Minerals and vitamin supplements need to be appropriately diluted to keep osmolality below 450 mOsm/kg to ensure safety. Future research should focus on manufacturing fortifiers and supplements with low osmolality to ensure safety.
Prevalence and risk factors of symptomatic venous thromboembolism in distal femur fractures
Authors: Mao Wei , Lim Joel Xue Yi , Tan Jiong Hao , Chang Shi-Min , Hong Choon Chiet 
Published: October 2024

Abstract

Introduction:
There is a paucity of published research on symptomatic venous thromboembolism (sVTE) after distal femur fractures (DFFs). This study aimed to explore the prevalence and risk factors of sVTE in DFFs.

Methods:
We identified a total of 131 patients who underwent DFF surgeries without routine pharmacological thromboprophylaxis between October 2007 and November 2016. Cases of sVTE included symptomatic pulmonary embolism (sPE) and symptomatic deep vein thrombosis (sDVT). Patients with sVTE were compared to those without, and differences in demographics and fracture-related characteristics were explored. Multivariate logistic regression was used to eliminate confounding factors.

Results:
Of the 131 patients, 20 (15.3%) had sVTE, of whom 16 (12.2%) had sDVT and six (4.6%) had sPE (two patients had both sPE and sDVT). Notably, 17 (85.0%) sVTE patients were aged ≥60 years, while only 62 (55.9%) non-sVTE patients were aged ≥60 years (P = 0.014). Fourteen (82.4%) patients with sVTE had body mass index (BMI) ≥25 kg/m2, while 49 (53.3%) patients without sVTE had BMI ≥25 kg/m2 (P = 0.032). Multivariate logistic regression demonstrated that age ≥60 years (adjusted odds ratio [OR] 5.05; P = 0.040) and BMI ≥25 kg/m2 (adjusted OR 3.92; P = 0.045) were independently associated with a higher risk of sVTE after DFF.

Conclusion:
The prevalence of sVTE in DFFs is high at 15.3%. Advanced age (≥60 years) and being overweight (BMI ≥25 kg/m2) were two independent risk factors for sVTE in DFFs. The use of routine pharmacological thromboprophylaxis should be considered as a preventative measure.
Association between treatment resistance and cognitive function in schizophrenia
Authors: Sun Jiaqian , Yee Jie Yin , See Yuen Mei , Tang Charmaine , Zheng Shushan , Ng Boon Tat , Lee Jimmy 
Published: October 2024

Abstract

Introduction:
Treatment-resistant schizophrenia (TRS) affects around 30% of individuals with schizophrenia. About half of the patients with TRS who are treated with clozapine do not show a meaningful clinical response, that is, clozapine resistance. To date, the relationship between cognitive function and treatment response categories is not entirely clear. This study evaluated the cognitive performance across subgroups stratified by treatment response, and we hypothesised that cognitive impairment increases with increased treatment resistance.

Methods:
This study was conducted at the Institute of Mental Health, Singapore, and included healthy controls and people with schizophrenia categorised into these groups: antipsychotic-responsive schizophrenia (ARS), clozapine-responsive TRS (TRS-CR) and clozapine-resistant TRS (ultra-treatment-resistant schizophrenia [UTRS]). Cognitive function was assessed using the Brief Assessment of Cognition-Short Form. Symptoms were measured with the Positive and Negative Syndrome Scale (PANSS). The planned statistical analyses included adjustments for covariates such as age, sex, PANSS scores and antipsychotic dose, which might affect cognitive function.

Results:
There were significant differences in overall cognitive performance between the groups: ARS had the least impairment, followed by TRS-CR and UTRS. Antipsychotic dose, and PANSS negative and disorganisation/cognitive factors were significant predictors of overall cognitive function in all patient groups.

Conclusions:
Our study found differences in cognitive function that aligned with levels of treatment resistance: the greater the degree of treatment resistance, the poorer the cognitive function. Interventions to improve negative and disorganisation symptoms might be effective to enhance the cognitive function and treatment outcomes in schizophrenia.
Comprehensive synthesis of mHealth interventions in psychiatry: insights from systematic, scoping, narrative reviews and content analysis
Authors: Mahreen Zaakira Shahul Hameed , Zainuldin Noor Azziah , Zhang Melvyn Weibin 
Published: October 2024

Abstract

Introduction:
Mobile health (mHealth) technologies, including smartphone apps and wearables, have improved health care by providing innovative solutions for monitoring, education and treatment, particularly in mental health.

Method:
This review synthesises findings from a series of reviews on mHealth interventions in psychiatry. Publications were systematically searched in PubMed, MEDLINE, PsycINFO, ScienceDirect, Scopus, Web of Science and Cochrane Library.

Results:
Out of 2147 records, 111 studies from 2014 to 2024 focusing on anxiety and depression were included. These studies highlight the effectiveness of mHealth interventions in reducing symptoms through cognitive–behavioural therapy, mindfulness and psychoeducation, benefitting adolescents, perinatal women and marginalised groups. Additionally, mHealth shows promise in managing substance use disorders and severe mental illnesses like schizophrenia, bipolar disorder and psychosis.

Conclusion:
Despite positive outcomes, challenges such as data privacy, user engagement and healthcare integration persist. Further robust trials and evidence-based research are needed to validate the efficacy of mHealth technologies.
Knowledge, attitude, and practice study of pharmacovigilance in a dental teaching institute in Western India
Authors: Venkatesh Rashmi , Poonacha K. S. , Vassandacoumara Vishnavee , Ajithkrishnan C. G. 
Published: October 2024

ABSTRACT

Background:
India started the National Programme of Pharmacovigilance in 2005, which was renamed as Pharmacovigilance Programme of India in 2010. This is the main portal for detecting and reporting the adverse effects of drugs.

Aim:
This study aimed to evaluate the knowledge, attitude, and practice (KAP) of pharmacovigilance (Pv) in a dental teaching institute in Western India.

Materials and Methods:
The KAP questionnaire regarding Pv was distributed among the dental faculties. The knowledge-based questions were corrected and the scoring was given as excellent knowledge, good knowledge, fair knowledge, and poor knowledge for the scores between 0–5, 6–10, 11–15, and 16–20, respectively. Descriptive statistical analysis was performed which is presented as frequencies (n) and percentages (%) in all three sections of the questionnaire.

Results and Observations:
The knowledge of 24 (44%) participants was found to be fair with scores between 6 and 10. The knowledge of 23 (42%) participants was found to be poor with scores between 0 and 5 and the knowledge of 8 (14%) participants was found to be good with scores between 11 and 15. A positive and promising attitude was exhibited by the dental faculties toward reporting adverse drug reactions (ADRs). Only two study participants had reported an ADR event.

Conclusion:
The deficiencies in knowledge appear to be the underlying factor for the underreporting of adverse reactions encountered by dental practitioners.
A scoping review on the potential of three-dimensional bioprinting in auricular cartilage regeneration
Authors: Ibrahim Eman Assem , Sarhan Moamen Mohsen , Ezzelarab Salah , Marei Mona K. 
Published: October 2024

ABSTRACT

Background:
The human ear significantly influences facial appearance. Auricular abnormalities can arise from many causes, and the cartilage cannot self-regenerate. Three-dimensional (3D) printing and computer-aided design/computer-aided manufacturing technology are used to create auricular prostheses through various methods to mirror the healthy ear. Despite advancements, challenges such as natural skin tones and growth accommodation persist. Bioprinting, using “Bioink” for precise cell placement, offers promising improvements for cartilage replacement and personalized auricular tissue regeneration.

Aim:
This review discussed recent and groundbreaking research in regenerative medicine for the auricular cartilage. The clinical studies of 3D bioprinting are the main topic of this review. This review aimed to clarify the transition from 3D printing of auricular prostheses to 3D bioprinting of patient-specific auricular tissues.

Methods:
The literature underwent a scoping review, making use of the keywords “Bioink, maxillofacial prosthetics, patient need, maxillofacial, additive manufacturing, auricular prosthesis, 3D bioprinting AND auricle, 3D bioprinting, auricle, cartilage, and Clinical applications of 3D bioprinting of auricle in children’s patients. Researchers searched the Cochrane, Google Scholar, ScienceDirect, and PubMed databases. Studies using cell-laden, 3D bioprinted constructs, Bioink containing living cells, or interventions to regenerate cartilage or auricle tissue, as well as the use of tissue-engineered 3D bioprinting in the maxillofacial regions, primarily in children, were included. Full texts, abstracts, and titles were all previewed. Significant groundbreaking studies were included after reference searching. The search timeline was between 2018 and 2022.

Results:
A total of 242 papers were assessed for title and abstract, with 13 judged appropriate for inclusion. Ninety-nine articles were removed, primarily because they were off-topic (unrelated) or not in English. A total of 13 publications were considered for study.

Conclusions:
Recent research has shown the potential of 3D bioprinting for tissue regeneration in both in vitro and in animal models. Human studies that have implanted 3D bioprinted auricles are still in their initial stages; however, the results are promising.
Evaluation of content usefulness and quality of YouTube™ videos as an information source for maxillofacial prosthesis
Authors: Koul Rishu , Gowda E. Mahesh , Upadhyay Guruprasada , Kalia Deepak , Verma Kamal 
Published: October 2024

ABSTRACT

Background:
Social media platforms such as YouTube™ have become a widely popular source for information regarding health-related issues about medical and dental issues. The simplicity of online watching has concealed the drawback that these videos are not regularly reviewed or checked for their suitability as educational resources for dental professionals and students.

Aim:
The purpose of the current study was to evaluate the content and quality of videos on YouTube™ regarding maxillofacial prosthesis as a source of learning by dental professionals.

Materials and Methods:
Fifty-one videos satisfying inclusion criteria were watched and carefully reviewed. After that, the following data were recorded in terms of domain in maxillofacial prosthesis: number of views, likes, comments, subscribers of the channel, viewing rate, duration since upload of video, video length/duration, primary purpose of videos, video sources, target group of video, video content, video content usefulness score, modified discern instrument score, and global quality score.

Results:
No misleading video about said topic was uploaded during the period. Only 5.9% of the YouTube™ videos on maxillofacial prostheses were good.

Conclusions:
There is a dearth of good-quality videos and videos about maxillofacial prosthesis maintenance, which raises questions if maxillofacial videos on YouTube™ would be equally beneficial for patients.
PUSAT BACA “GEROBAK LITERASI “SEBAGAI AKSI NYATA GERAKAN LITERASI SEKOLAH DI SDN KILASAH KECAMATAN KASEMEN
Authors: Ulinnuha Ulinnuha , Hamidah Hamidah , Khoirunnisa Sri , Nur Pratama Rizky , Rahuldi Rahuldi , Kadafiah Siti 
Published: October 2024

The Literacy Ranking in Indonesia is a benchmark for the educational progress of the Indonesian nation. Meanwhile, the school literacy movement, which has long been echoed in schools throughout Indonesia, has not been running optimally. This is caused by various factors, one of which is the lack of strategies to maintain a literacy culture and the lack of availability of reading books in schools. So, this community service is carried out to provide contributions related to ideas and initiatives to realize optimal literacy strengthening strategies through literacy carts. This activity was carried out in three stages, namely the preparation stage including observations at SDN Kilasah, Kilasah sub-district, Kasemen District, coordinating with partners regarding program planning as well as procuring books and designing a reading center in the form of a literacy cart. The second stage of implementation involved bringing a literacy cart to Kilasah Elementary School and providing material and motivation regarding the school literacy movement, reading activities for 15 minutes, then the evaluation stage in the form of reflection, by opening discussions and questions and answers regarding the information and experiences they gained from the reading results. book. The results of the implementation of Community Service went according to expectations, the students at SDN Kilasah showed significant interest in the activities of reading books and processing information as well as practicing the reading content obtained from the Literacy Cart. The PkM team has contributed to strengthening literacy, so it is necessary to provide program assistance so that it is carried out in a sustainable manner, and partners are advised to create more attractive reading centers