bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Ventilator Associated Pneumonia Caused by Multidrug Resistant Isolates in an Intensive Care Unit Setting at a University Hospital
Authors: Kar Mitra , Singh Romya , Jamwal Ashima , Dubey Akanksha , Tejan Nidhi , Gurjar Mohan , Sahu Chinmoy 
Published: May 2024

Abstract

Background:
Ventilator-associated pneumonia (VAP) in acute respiratory distress syndrome patients is expected in the setting of prolonged mechanical ventilation due to abridged immunity and dysregulation of the microorganisms inhabiting the oral cavity. We conducted this study to identify the spectrum of microorganisms causing VAP in patients admitted to the medicine intensive care unit (MICU) and their antibiotic susceptibility patterns.

Materials and Methods:
We conducted a retrospective cross-sectional laboratory-based study from January 2021 to April 2021. Our cohort included patients with respiratory distress who were admitted to the MICU. We observed the incidence of VAP and the risk factors responsible for multidrug resistance (MDR) microorganisms in the MICU, along with 250-day survival in the existence of specific comorbidities along with VAP.

Results:
Clinical charts of patients (n = 366) admitted to the MICU between January 2021 and April 2021 were used. The mean age of patients admitted to MICU was 57.3 ± 18.7 years with a male predominance (n = 252, 68.8%). VAP was diagnosed in 69.1% (n = 253) of patients, and the most common microorganism in our cohort was Klebsiella pneumoniae (n = 78, 30.8%), followed by Acinetobacter spp. (n = 77, 30.4%). None of the K. pneumoniae isolates (n = 0/78) and only a minority of Acinetobacter spp. (n = 4/77, 5.2%) and Pseudomonas aeruginosa isolates (n = 8/54, 14.8%) were susceptible to fluoroquinolones. A higher proportion of K. pneumoniae (n = 1/78, 1.3%), Acinetobacter spp. (n = 2/77, 2.6%), and P. aeruginosa isolates (n = 9/54, 16.7%) were susceptible to aminoglycosides. The incidence rate of MDR microorganisms among the 253 patients diagnosed with VAP was 92.8% (n = 219/253).

Conclusion:
There is a high prevalence of multidrug resistance (MDR) isolates among those causing VAP in the MICU setting. Knowing the broad spectrum of causative pathogens and their susceptibility to various antibiotics may guide the physician injudicious and appropriate use of antibiotics for treatment.
Ultrasound-guided Pectoral Nerve Block in Combination with Interpleural Block for Surgical Anesthesia during Breast Cancer Surgery: A Prospective Feasibility Study
Authors: Kundra Pankaj , Raju P. G. , Vinayagam Stalin , Kate Vikram 
Published: May 2024

Abstract

Background:
The aim of this study was to evaluate the feasibility of ultrasound-guided pectoral nerve block combined with interpleural block for surgical anesthesia during the modified radical mastectomy (MRM).

Methods:
Thirty-six female patients scheduled to undergo MRM were included in this study. After taking all aseptic precautions, an ultrasound-guided pectoral nerve block and interpleural block were performed with 20 ml of 0.25% bupivacaine for each block. We started all patients on dexmedetomidine infusion to achieve conscious sedation and used injection ketamine as rescue analgesia. We recorded hemodynamic parameters throughout the surgery and visual analog scale scores of pain at baseline and after providing rescue analgesia. Postoperatively, we assessed surgeon and patient satisfaction scores.

Results:
MRM was completed in 31 (86%) out of the 36 recruited patients. Among these 31 patients, 5 (16%) did not require a rescue dose of ketamine, 14 (45%) required one rescue dose, and 12 (39%) patients required two rescue doses of ketamine. Postoperatively, the median patient and surgeon satisfaction scores were 85 (75–90) and 85 (80–90), respectively. The mean dose of dexmedetomidine was 175 (±27) μg, and the mean dose of ketamine was 32.8 (±6) mg. No serious adverse events were reported.

Conclusion:
MRM can be feasibly performed under ultrasound-guided pectoral nerve block and interpleural block, along with conscious sedation, without any significant adverse events.
Efficacy of lignocaine nebulization in patients with COVID-19 respiratory infection: An exploratory randomized double-blinded controlled trial
Authors: Talawar Praveen , Tripathy Debendra Kumar , Kaushal Ashutosh , Dhar Mridul , Vijaybabu Adabala , Tuppad Praik , Priyanka Sangadala , Kumar Deepak , Sharma Ruhi , Kumar Sumedha Suresh 
Published: May 2024

Abstract

Background and Aims:
Coronavirus disease (COVID-19)-related pneumonia is proposed to be an inflammatory process. The treatment currently includes supportive therapy and low-dose steroids. Anti-inflammatory drugs have been proposed to prevent cytokine storms and improve oxygenation in such cases. The study aimed to assess the efficacy of nebulized lignocaine in COVID-19 patients with pneumonia.

Material and Methods:
This was an exploratory randomized double-blinded control trial conducted in COVID-19 patients with respiratory failure requiring oxygen therapy either by face mask or non-invasive mechanical ventilation. Patients included were of the age of more than 18 years of either gender. The patients were randomized to receive either lignocaine or distilled water nebulization. The outcomes assessed were PaO2/FiO2 ratio, hemodynamics, respiratory parameters, and sequential organ failure score (SOFA).

Results:
The two groups were comparable concerning demographic variables. The PaO2/FiO2 were significantly higher in the lignocaine group from day 2 onward. The SPO2 was significantly higher on day 3 in the lignocaine group and thereafter there was no significant difference. Other hemodynamic, respiratory parameters, and SOFA scores showed no difference in both the groups.

Conclusion:
Lignocaine nebulization improved oxygenation in COVID-19 patients and can be used as adjunctive therapy along with other supportive medications.
Eosinophilic esophagitis: Current concepts in diagnosis and management
Authors: Alsohaibani Fahad I. , Peedikayil Musthafa C. , Alzahrani Mohammed A. , Azzam Nahla A. , Almadi Majid A. , Dellon Evan S. , Al-Hussaini Abdulrahman A. 
Published: May 2024

Abstract
Eosinophilic esophagitis is an antigen-mediated chronic inflammatory disorder that has risen in incidence and prevalence over the past 2 decades. The clinical presentation is variable and consists of mainly esophageal symptoms such as dysphagia, heartburn, food impaction, and vomiting. Current management relies on dietary elimination, proton-pump inhibitors, and topical corticosteroids with different response rates and relapses after treatment discontinuation. With a better understanding of the underlying pathophysiology, many molecules emerged recently as targeted treatment including dupilumab (IL4/IL13 blocker), as the first FDA-approved biological treatment, which has changed the management paradigm.
Impactos da pandemia da covid-19 na participação do brincar de crianças com cardiopatia: percepção de mães e crianças
Authors: Rodrigues Isabel Cristina Santos , Lima Juliana de Silva , Aita Karla Maria Siqueira Coelho , Folha Débora Ribeiro Da Silva Campos , Rodrigues Raiza Morais 
Published: May 2024

Introdução: As Cardiopatias Congênitas podem desencadear alterações relacionadas ao desenvolvimento infantil. Somando-se ao risco de desenvolvimento atípico causado pelo quadro cardiológico, no contexto pandêmico a criança pode também vivenciar alterações advindas do isolamento social. Ademais, pode ocorrer a supervalorização da doença pelo cuidador, gerando limitações na participação da criança no brincar. Objetivo: Compreender os impactos da pandemia da COVID-19 para a participação da criança com cardiopatia no brincar. Métodos: Foi realizado um estudo de abordagem qualitativa, no qual participaram seis crianças com idades entre 7 e 12 anos em atendimento ambulatorial e suas respectivas mães. Como instrumento de coleta de dados, utilizou-se a entrevista estruturada. Para a análise dos dados, foi adotada a técnica de Análise do Conteúdo. Resultados: Emergiram quatro categorias de análise a partir de elementos como as interferências da cardiopatia e da COVID-19 no brincar e na rotina das crianças. O novo cenário ocasionou mudanças na rotina da maioria das crianças participantes devido às medidas de distanciamento social e ao receio de contrair o vírus. Além disso, grande parte associou a COVID-19 com sentimentos de ansiedade e solidão, o que interferiu na motivação e participação no brincar. Conclusão: O contexto pandêmico, bem como o isolamento social advindo dele, provocaram mudanças na rotina das crianças com cardiopatia. As narrativas possibilitam notar os impactos negativos nos aspectos psicoemocionais das crianças, interferindo na participação destas no brincar.
ANIMASI DALAM PEMBELAJARAN IPS DENGAN MODEL KOOPERATIF TIPE JIGSAW : PENGARUHNYA TERHADAP HASIL BELAJAR DAN NURTURANT EFFECT
Authors: Sugiantoro Sugiantoro 
Published: May 2024

Penelitian ini dilakukan untuk mengetahui pengaruh yang signifikan model pembelajaran kooperatif tipe jigsaw berbantuan animasi pada siswa kelas VII SMP. Populasi penelitian ini adalah seluruh siswa kelas VII SMP. Jumlah responden adalah 30 siswayang mana responden merupakan populasi sekaligus sampel penelitian. Penelitian ini merupakan penelitian kuantitatif deskriptif dengan rancangan one group prestest-posttest. Dari hasil analisis diatas: (1) Perbedaan hasil belajar pada model pembelajaraan kooperatif dengan strategi jigsaw berbantuan animasi dilihat dari rerata skor pretest (69,57), dan skor posttest (84,80) dan ketuntasan individu pada saat pretest (43%) dan posttest (80%), sedangkan ketuntasan belajar secara klasikal mencapai lebih 80% sehingga mencapai Kriteria Ketuntasan Minimal (KKM), 2) Respon siswa terhadap model pembelajaran kooperatif tipe jigsaw berbantuan animasi diperoleh adalah 87% peserta didik menyukai suasana kelas, dan 96% peserta didik suka dengan cara guru mengajarkan materi, dan 88% peserta didik menganggap dirinya terbantu dan mendapatkan kesempatan yang lebih serta 89% peserta didik merasa mendapat kesempatan yang baik dalam menyatakan ide, menanggapi pertanyaan, mengajukan pertanyaan, dan mempresentasikan hasil pekerjaan sehingga menumbuhkan sikap percaya diri, mampu berpikir kritis, bersifat terbuka, motivasi diri, kerjasama, dan tanggung jawab, 3) terdapat kefektifan penerpaan model pembelajaran kooperatif tipe jigsaw dalam pembelajaran IPS yang dibuktikan dengan percentage of agreement yang diperoleh dari dua orang pengamat sebesar 97%.
Pengetahuan Politik dan Pemanfaatan Media Sosial dalam Peningkatan Partisipasi Politik Pemilih Pemula pada Pemilu 2024
Authors: Naifah Nabila Rana 
Published: May 2024

Penelitian ini bertujuan untuk menganalisis pengaruh pegetahuan politik dan manfaat media sosial terhadap partisipasi politik pemilih pemula dalam menghadapi pemilu 2024. Metode yang digunakan adalah metode kuantitatif, data dikumpulkan dengan menyebarkan kuesioner penelitian kepada pemiliih pemula (pemuda) dan data diolah menggunakan spss. Hasil penelitian menunjukkan bahwa pengetahuan politik dan manfaat media sosial tidak berpengaruh terhadap partisipasi poitik para pemilih pemula dalam menghadapi pemilu 2024.
Sergius (Stragorodsky), Archbishop of Finland and Vyborg — features of pastoral service in political and sociocultural contexts
Authors: Shevchenko Т. I. 
Published: May 2024

The article is devoted to the analysis of the “Finnish period” of the pastoral service of Sergius (Stragorodsky), future Patriarch of Moscow and All Russia. The period covers the years 1905–1917, during which there was an exacerbation of Russian-Finnish relations. In Finnish historiography, these years are referred to as another period of russification (1908–1917), while in Russian historiography, they are marked by attempts to Finnize and Lutheranize Russian Karelia. Formed in 1892 as the vicariate of the St. Petersburg diocese, the Vyborgand Finnish diocese of the Orthodox Russian Church united the parishes of the Grand Duchy of Finland, to which the Vyborg province (Old Finland) belonged, annexed to the Grand Duchy by Alexander I in 1811. In 1913, the Serdobolsk vicariate was established in the diocese for Karelian parishes. Archbishop Sergius was tasked with countering “pan-Finnish propaganda” in Karelia and defending the interests of the Russian Church in the Grand Duchy, the vast majority of whose population adhered to Lutheranism. The Karelians inhabited the eastern part of the Grand Duchy of Finland, Olonets and Belomorsk Karelia. Through joint efforts of church and provincial authorities in these regions, the process of Lutheranization of Karelians directed by Finnish nationalists was stopped. However, Archbishop Sergius policy in the Grand Duchy caused rejection from local elites and church figures. Relations with Russian politicians were also complicated for the Archbishop of Finland. This was largely due to the exacerbation of Finnish and Karelian issues. The article analyzes the political and socio-cultural contexts of the pastoral service of Archbishop Sergius, emphasizes important facts of his biography that help understand the logic of his decisions, presents preliminary conclusions based on a review of the modern historiography of the issue, which has not received sufficient attention from Russian researchers to date.
His Holiness Patriarch Sergius, Metropolitan Gregory and the Theological Schools of the Moscow Patriarchy from 1944 to 2024
Authors: Aleksandrova-Chukova L. K. 
Published: May 2024

The article commemorates two significant events marking the 80th anniversary of the Russian Orthodox Church in 2024: the passing of His Holiness Patriarch Sergius and the establishment of the first theological schools in Moscow during the Soviet era. The question of establishing theological schools was raised by Patriarch Sergius following the Council of Bishops in 1943 and his subsequent election as patriarch. These schools were inaugurated just a month after his passing. It’s emphasized that the swift preparation for the opening of the Theological Institute and Theological and Pastoral courses was facilitated by the quarter-century journey of the patriarch’s long-time faithful colleague, Archpriest Nikolay Chukov (Archbishop Gregory of Saratov and Stalingrad), who authored the project for spiritual educational institutions of the Moscow Patriarchate. He had substantial experience in establishing and overseeing higher theological institutions in Petrograd-Leningrad from 1920 to 1925. For the first time, a diary detailing the activities of Archpriest Nikolay Chukov is published in the appendix. His endeavors, undertaken with the support of Metropolitan Sergius and the Synod from 1928 to 1930, aimed to establish a Theological Institute in Leningrad. Unfortunately, his plans were thwarted by his arrest in 1930. The entries in the published diary confirm Olga Vasilyeva’s assertion that Metropolitan Sergius’ interview, which sparked widespread protests due to its denial of Church persecution in the USSR, was a quid pro quo for allowing him to submit a memo to Pyotr Smidovich. One of the memo’s points emphasized the necessity of opening a theological school. This memo played a pivotal role in obtaining permission, which, in turn, significantly hastened the process of opening theological schools in Moscow in 1943–1944. The article concludes with excerpts from books and articles by a professor from the Department of Church History at Saint Petersburg Theological Academy. This academic offers a negative and ironic assessment of both the ascetic work of Metropolitan Gregory of Leningrad and Novgorod, and the martyrdom of Patriarch Sergius, who endured humiliation primarily to preserve a legalized church organization, which was essential for the establishment of theological schools within the Patriarchate. This aspect became particularly significant when considering the pivotal choice by the authorities between the patriarchal Church and the Renovationists in 1943.
Patriarch of Moscow and All Rus’ Sergius and the Soviet State
Authors: Tsypin V. A. 
Published: May 2024

At the end of 1925, Metropolitan Sergius of Nizhny Novgorod assumed the position of Deputy Patriarchal Locum Tenens. He undertook the task of formulating the Church’s position in relation to state authorities. Its authentic expression was the draft “Appeal”. which was rejected by the government, leading to the arrest of its author. After his release, Metropolitan Sergius, together with the Synod, issued a Message referred to as a “Declaration” in journalism. It emphasized the loyalty of the clergy and the Orthodox people to the Soviet government. Some clergymen criticized the Declaration, but a significant majority of the episcopate, clergy, and church people reacted with understanding to its publication. At the end of 1936, Metropolitan Sergius assumed the position of Locum Tenens following a false report of the death of Locum Tenens Peter. In fact, the holy Martyr Peter was still alive at that time, but in October 1937, he was shot. 1937 marked the peak of the terror. A new blow struck the Orthodox Church. On September 1, 1939, the Second World War began. As a result of the expansion of the borders of the Soviet state to the west, the Moscow Patriarchate effectively gained control over the dioceses of the Baltic States, Western Belarus, Western Ukraine, and Moldova. In the new territories, churches were closed only in exceptional cases. On June 22, 1941, Germany attacked the USSR. On the first day of the war, the Locum Tenens composed a Message in which he blessed the Orthodox people for the defense of the Fatherland. From October 1941 to August 1943, the Patriarchate was located in Ulyanovsk. After its return to Moscow, Stalin and Molotov met with Metropolitans Sergius, Alexy, and Nikolai in the Kremlin. At the meeting, permission was given to convene the Council of Bishops, the most important act of which was the election of Sergius as Patriarch of Moscow and All Rus’. Patriarch Sergius died on May 15, 1944.
Detect the Cardiovascular Disease's in Initial Phase using a Range of Feature Selection Techniques of ML
Authors: Goad Prashant Maganlal , J Deore Pramod 
Published: May 2024

Heart-related conditions remain the foremost global cause of mortality. In 2000, heart disease claimed around 14 million lives worldwide, a number that surged to approximately 620 million by 2023. The aging and expanding population significantly contribute to this rising mortality trend. However, this also underscores the potential for significant impact through early intervention, crucial for reducing fatalities from heart failure, where prevention plays a pivotal role. The aim of the present research is to develop a prospective ML framework that can detect important features and predict cardiac conditions as an early stage using a variety of choice of features strategies. The Features subsets that were chosen were designated as FST1, FST2, and FST3, respectively. Three distinct methods, including correlation-based feature selection, chi-square and mutual information, were used for picking features. Next, the most confident theory & the most appropriate feature selection were identified using six alternative machine learning models: Logistical Regression (LR) (AL1), the support vector Machine (SVM ) (AL2), K-nearest neighbor (K-NN) (AL3), Random forest (RF) model (AL4), Naive Bayes (NB) model (AL5), and Decision Tree (DT) (AL6). Ultimately, we discovered that, with 95.25% accuracy, 95.11% sensitivity, 95.23% specificity, 96.96 area below receiver operating characteristic and 0.27 log loss, the random forest model offered the most excellent results for F3 feature sets. No one has investigated coronary artery disease forecasting in depth; however, our study evaluates multiple statistics (specificity, sensitivity, accuracy, AUROC, and log loss) and uses multiple attribute choices to improve algorithms success for important features. The suggested model has considerable promise for medical use to speculate CVD find in Precursor at a minimal cost and in a shorter amount of time as well as will assist limited experience physician to take right decision based on the results of the used model combined with specific criteria.
Zelf doen of laten doen?
Authors: Bokhorst Meike , 't Hart Paul , de Jonge Adriaan 
Published: May 2024

Do it yourself or outsourcing? Strategic decisions for professional internal procurement and outsourcing of decentralised performance of duties
In 2015, the Dutch government decentralised a significant part of its responsibilities in the ‘social domain’ to local governments. Faced with these new social tasks, many municipalities opted to outsource them. Not all municipalities are satisfied with the quality of public services, and some are choosing to take on some of the tasks themselves again. However, municipalities face staff shortages and increasingly choose to hire external staff when outsourcing tasks. Whichever strategy municipalities choose, the provision of public services in the social domain demands a great deal of expertise in the field of good commissioning practices. In this article, we speak to 56 principals and contractors about the conditions and pitfalls of procurement. There is a trend towards municipalities putting more limits on outsourcing and instead taking tasks in the areas of participation, integration and debt relief into their own hands. There seems to be a preference for more public ownership and more relational forms of procurement focused on long-term goals. This also requires new knowledge building. The local government should be the ‘treasurer’ of the quality of public administration directing the quality of public services.
Uma revisão sistemática dos indicadores microbiológicos para avaliar a qualidade do solo agrícola
Authors: Pereira Amanda Eustachio , Silva Junior Osvaldo Leite da , Schmidt Filho Edison , Gasparotto Francielli , Paccola Edneia Aparecida de Souza 
Published: May 2024

O solo desempenha um papel fundamental na ciclagem de nutrientes, na regulação do ciclo da água e na sustentabilidade da produção de alimentos. Preservar e melhorar a qualidade do solo é essencial para a sustentabilidade ambiental e a segurança alimentar global, pois um solo saudável é um solo biologicamente ativo, produtivo, capaz de armazenar água, sequestrar carbono, entre outros importantes serviços ambientais. O solo possui microrganismos que são essenciais nos processos de manutenção e a funcionalidade dos solos, como a degradação de compostos orgânicos, a ciclagem de nutrientes, fixação biológica de nitrogênio ou auxiliar as plantas em absorver os nutrientes. Eles podem ser utilizados como bioindicadores sensíveis da qualidade do
solo. Parâmetros como a quantidade de carbono e nitrogênio na biomassa microbiana responde rapidamente a alterações nas práticas de manejo do solo, a respiração basal do solo envolve a liberação do CO2 é produzido via decomposição da matéria orgânica do solo de forma rápida ou lenta dependendo do estresse dos microrganismos, já atividade enzimática microbiana é essencial para a ciclagem de nutrientes como por exemplo a enzimas fosfatase ácida, Arilsufatase e a β-glicosidase, os quais são responsáveis pela ciclagem do fósforo, a ciclagem do enxofre e a ciclagem de carbono respectivamente. Esses indicadores obtêm resposta rápidas das variações as quais podem ser revertidas promovendo a sustentabilidade agrícola e maior qualidade do solo.