bluuebunny/crossref_metadata_2025_split huggingface dataset:
A VALUE CHAIN ANALYSIS OF AGROFORESTRY PRODUCTS IN THE SOUTH-WESTERN REGION OF BANGLADESH
Authors: Nabi Md Noor Un , Afroza Akter Liza  , Islam Md Nazrul , Farzana Akther  
Published: June 2023

This study explores the market linkages in a typical agroforestry value chain in Bangladesh, particularly the participation of the micro and subsistence level farming and household-community units in this chain. The study area is Dumuria Upazila which is a 30 square km land area in the outskirt of Khulna which is the third largest city of Bangladesh located in the south-western region of Bangladesh. Agro-products produced in the Dumuria Upazila and then sold in the areas including Dumuria Bazar and Gollamari Bazar which are peri-urban locations of Khulna city. The particular objectives of this study were to identify different value chains of agroforestry products, the relationship of various intermediaries within it, and to explore the impact of agroforestry practices on the socioeconomic condition of the local population. The assessment was performed by using multistage sampling of 80 households using a semi-structured questionnaire, and 30 intermediaries were included on convenience basis for tracing the structure of market linkage and existing problems, in the marketing of agro-products in the study area. Explored network structures of the value chain have revealed that both the marketing of agroforestry crops and timber, include the intermediaries that have contributed to different forms of value-addition to the original product and produced higher gains for the participants in the value chain. Value chain participants in the point of origin of the products, farmers and households, reported being discriminated in terms of price taking while end-market intermediaries were found to absorb major shares of the total gain originated in the value chain. The farmers were neutral in terms of satisfaction in case of purchase by the government, while the intermediaries were dissatisfied with the same. Findings of this study contributes in generating understanding the process of value creation, power structure, and gain sharing in the localized natural resources-based value chains.
More than Gold: Embodying the Human Cost of Mining in Maroon Popular Music
Authors: Campbell Corinna 
Published: June 2023

AbstractMaroons (descendants of Africans who escaped enslavement) have long been locked in an antagonistic relationship with the Surinamese government over gold-mining legislation and its reinforcement. This contentious topic includes complex debates over land rights and conflicting economic and environmental priorities. This article considers how three contemporary Maroon popular musicians have gone beyond stock metaphors about gold to reference local engagements with gold and the gold-mining industry. I introduce the concept, performative figuring, as a strategy whereby a speaker or performer uses their embodied presence to assert their rights and/or self-worth against practices and policies that threaten to undermine them.
Physician-Pharmacist Collaborative Drug Therapy Management in Pediatric Hypertension
Authors: Donald Bryan J. , King Terry D. , Phillips Brandon L. , Jones Krista , Barham Anna , Watson Jennifer , Batson Jerry 
Published: June 2023

OBJECTIVE
Pediatric hypertension affects 2% to 5% of children and adolescents in the United States and is frequently undertreated. The increasing prevalence of pediatric hypertension and worsening physician shortage create difficulties in closing this treatment gap. Physician-pharmacist collaborations have been shown to improve patient outcomes in adult patients. Our aim was to demonstrate a similar benefit for pediatric hypertension.

METHODS
Pediatric patients whose hypertension was managed at a single pediatric cardiology clinic from January 2020 to December 2021 were enrolled in collaborative drug therapy management (CDTM). Patients whose hypertension was managed in the same clinic from January 2018 to December 2019 were used as a comparison group. The primary outcomes were achievement of at-goal blood pressure at 3, 6, and 12 months and time to control of hypertension. Secondary outcomes were appointment adherence and serious adverse events.

RESULTS
A total of 151 patients were included in the CDTM group, and 115 patients were included in the traditional care group. Of those, 100 CDTM patients and 78 traditional care patients were assessed for the primary outcome. Fifty-four (54%) CDTM patients and 28 (36%) traditional care patients achieved at-goal blood pressure at 12 months (OR, 2.09; 95% CI, 1.14–3.85). Appointment non-adherence was 9.4% for CDTM and 16% for traditional care (OR, 0.54; 95% CI, 0.35–0.82). Adverse events were similar between groups.

CONCLUSIONS
CDTM increased rates of at-goal blood pressure without increased adverse events. Physician-pharmacist collaboration may improve treatment of hypertension in pediatric patients.
Comparison of Antiemetics in the Management of Pediatric Cannabinoid Hyperemesis Syndrome
Authors: Geraci Emily , Cake Carrie , Mulieri Kevin M. , Fenn Norman E. 
Published: June 2023

OBJECTIVE
As a result of recent legislative changes allowing for increased access to marijuana products, there have been increasing rates of cannabis abuse among adolescents and subsequent diagnoses of cannabinoid hyperemesis syndrome (CHS). Most available literature on this syndrome exists within the adult population and describes benzodiazepines, haloperidol, and topical capsaicin as potentially efficacious in the management of CHS. The objectives of this study were to identify antiemetics and compare their efficacy and safety in the management of pediatric CHS.

METHODS
A retrospective review of Penn State Children's Hospital electronic health record was performed to identify patients 18 years or younger who had an emergency department or inpatient encounter, a cannabis hyperemesis–related diagnosis code, and met diagnostic criteria for CHS. Antiemetic efficacy was determined using subjective patient perception of nausea and objective documentation of vomiting. Benzodiazepines, haloperidol, and topical capsaicin were classified as nontraditional antiemetics, whereas all other antiemetics were classified as traditional.

RESULTS
Nontraditional antiemetic medications appeared to be more effective in resolving patient symptoms compared with traditional antiemetics. Analysis of all ordered antiemetics demonstrated a gap in partial or full symptom resolution between nontraditional and traditional agents. Reported adverse effects were minimal.

CONCLUSIONS
Cannabinoid hyperemesis syndrome is an underrecognized and underdiagnosed condition characterized by cyclic vomiting related to chronic cannabis use. Abstinence from cannabis remains the most effective approach to mitigating morbidity associated with CHS. Medications such as lorazepam or droperidol may have benefit in managing toxidrome symptoms. Traditional antiemetic prescribing remains a key barrier to effective management of pediatric CHS.
Comparison of Time Within Therapeutic Range Using Anti-Factor Xa Versus Activated Partial Thromboplastin Time Monitoring of Unfractionated Heparin in Children
Authors: Haftmann Richard J. , Pineda Erika May , Hall Brent A. , Wilson Machelle D. , Mateev Stephanie N. 
Published: June 2023

OBJECTIVE
To compare unfractionated heparin (UFH) monitoring using time in therapeutic range of activated partial thromboplastin time (aPTT) versus anti-factor Xa activity (anti-Xa) in children.

METHODS
This retrospective chart review, with data between October 2015 and October 2019, included pediatric patients younger than 18 years on therapeutic UFH infusion with aPTT or anti-Xa monitoring. Patients receiving extracorporeal membrane oxygenation, dialysis, concomitant anticoagulants, prophylactic UFH, no stated goal, and UFH administered for less than 12 hours were excluded. The primary outcome compared the percentage of time in therapeutic range between aPTT and anti-Xa. Secondary outcomes included time to first therapeutic value, UFH infusion rates, mean rate adjustments, and adverse events.

RESULTS
A total of 65 patients were included, with 33 aPTT patients and 32 anti-Xa patients, representing 39 UFH orders in each group. Baseline characteristics were similar between groups, with an overall mean age of 1.4 years and mean weight of 6.7 kg. The anti-Xa cohort demonstrated a statistically significantly higher percentage of time in therapeutic range compared with the aPTT group (50.3% vs 26.9%, p = 0.002). The anti-Xa group also demonstrated a trend toward decreased time to first therapeutic value compared with aPTT (14 vs 23.2 hours, p = 0.12). Two patients in each group experienced new or worsening thrombosis. Six patients in the aPTT cohort experienced bleeding.

CONCLUSIONS
This study demonstrated greater time was spent within therapeutic range for children receiving UFH monitored with anti-Xa compared with aPTT. Future studies should assess clinical outcomes in a larger population.
Characterization of Febrile Neutropenia Management in Children With Malignancies: A Single-Center Evaluation
Authors: Khairullah Amanie , Garner Lauren M. , DeMarco Mia , Wilson William S. 
Published: June 2023

OBJECTIVE
Current recommendations for febrile neutropenia (FN) include initiation of broad-spectrum antibiotics without clear indications of when or how to de-escalate or target therapy, especially in those without microbiologically defined bloodstream infections (MD-BSIs). The purpose of this study is to characterize a pediatric FN population, FN management, and identify the proportion of patients with MD-BSI.

METHODS
This study was a single-center, retrospective chart review of patients admitted to the University of North Carolina Children's Hospital between January 1, 2016, and December 31, 2019, with a diagnosis of FN.

RESULTS
There were 81 unique encounters included in this study. MD-BSI was the etiology of fever in 8 FN episodes (9.9%). The most common empiric antibiotic regimen was cefepime (62%) followed by cefepime and vancomycin (25%). The most common de-escalation type was the discontinuation of vancomycin (83.3%), and the most common type of escalation was the addition of vancomycin (50%). The median antibiotic total duration in patients without MDI-BSI was 3 days (IQR, 5–9).

CONCLUSIONS
In this single-center, retrospective review, most FN episodes were not due to an MD-BSI. There were inconsistencies in practice of when discontinuation of antibiotic therapy occurred in patients without MD-BSI. De-escalation or cessation of antibiotic therapy before neutropenia resolution did not result in any documented complication. These data suggest a role for implementing an institutional guideline to improve consistency in antimicrobial use in pediatric patients with febrile neutropenia.
Comparison of Dosing Accuracy Between the ENFit LDT and a Neonatal-Specific ISO-Compliant Enteral Syringe
Authors: O'Mara Keliana , Campbell Christopher , O'Mara Ryan 
Published: June 2023

OBJECTIVE
To evaluate the dosing accuracy of 2 female enteral syringe types for use in neonates.

METHODS
This was an in vitro study evaluating dosing accuracy of ENFit with low dose tip (LDT) and Nutrisafe2 (NS2) syringes. Acceptable dosing variance (DV) was +/− 10%. Outcomes included tests exceeding 10% DV and DV by syringe size, dispensing source, and intended dosing volume.

RESULTS
A total of 300 tests were performed (LDT = 150, NS2 = 150) with 3 syringe sizes (0.5, 1, 3 or 2.5 mL). Compared with NS2, LDT had significantly more tests with unacceptable DV (48% vs 4.7%, p &lt; 0.0001) and higher absolute DV (11.9% vs 3.5%, p &lt; 0.001). Dosing variance was inversely proportional to syringe size, where the smallest syringes were least accurate (0.5 mL LDT 16.1% vs 4.6%, p &lt; 0.001). The largest syringes had acceptable DV (3 mL LDT 8.8% vs 2.5 mL NS2 3.3%, p &lt; 0.001). Bulk bottle with adapters demonstrated a higher DV with LDT compared with NS2 (13.3% vs 3.9%, p &lt; 0.001). Medication cups without adapters were associated with acceptable DV for both LDT and NS2 (9.7% vs 2.9%, p &lt; 0.001).

CONCLUSIONS
The Nutrisafe2 syringe has greater dosing accuracy as compared with ENFit LDT syringe. Smaller syringes are associated with greater dosing inaccuracy, but this effect was within acceptable DV for the NS2 syringe. Bulk bottle adapters did not improve the accuracy of the LDT. More clinical evaluations are needed to determine if the ENFit can be safely used in the neonatal population.
Pharmacist Effect on Discharge Follow-Up Education in Pediatric Oncology Outpatient Clinics: A Quality Improvement Study
Authors: Drennan Chelsea N. , Pauley Jennifer L. , Christensen Anthony M. , Jacobs Timothy W. , Bragg Allison W. , Porter Jerlym S. , Bourque Melissa S. 
Published: June 2023

OBJECTIVE
We aimed to describe the effect of education provided by a clinical pharmacy specialist at a patient's follow-up appointment after discharge, and to assess caregiver satisfaction.

METHODS
A single-center, quality improvement study was conducted. A standardized data collection tool was created to characterize interventions made by clinical pharmacy specialists during an outpatient clinic appointment scheduled shortly after discharge. Pediatric patients with cancer who met the following criteria were included: 1) initial diagnosis without receiving chemotherapy, 2) first course of chemotherapy after initial diagnosis or relapsed disease, and 3) post-hematopoietic stem cell transplantation or cellular therapy. A survey was provided to families after the follow-up discharge appointment to assess the caregiver's satisfaction of the new process.

RESULTS
From January to May 2021, a total of 78 first-time discharge appointments were completed. The most common reason for follow-up was discharge after first course of chemotherapy (77%). The average duration of each appointment was 20 minutes (range, 5–65). The clinical pharmacy specialist made an intervention during 85% of appointments. The most common intervention made during the visit was reinforcement of medications (31%). Thirteen surveys were completed by caregivers; 100% of the caregivers reported the follow-up appointment was helpful. Additionally, they reported the most useful resource provided at discharge was the medication calendar (85%).

CONCLUSIONS
Investing clinical pharmacy specialist time with patients and caregiver after discharge appears to have a meaningful effect on patient care. Caregivers report this process is helpful in better understanding their child's medications.
Research on the development strategy of cross-border e-commerce of Netease Kaola Overseas shopping in China
Authors:   , Chen Yi 
Published: June 2023

In the rapid growth of cross-border e-commerce, China Kaola Overseas Shopping Platform adopts the developed model of "foreign warehouse + domestic bonded warehouse", which has become an important part of the current cross-border e-commerce field in China. However, it still suffers from poor after-sales service, uninsured processes and poor consumer perception during delivery. This paper takes China's Kaola Overseas Shopping Platform as the research object, comparing to other similar platforms in the industry, and analyzes its cross-border e-commerce business by using "SWOT", "PEST" and "Five Forces Model". This results show how the company adjust its strategies to solve the current problems. I find that in the process of cross-border e-commerce transactions, payment methods, logistics transportation and service personnel directly affect the quality of cross-border e-commerce operation, and have a great impact on its services. Although Kaola has certain advantages in technology, there are still problems in after-sales service, logistics and consumer perception. The solutions proposed in this paper are to establish the professional after-sales team, to cultivate consumer awareness, and to optimize cross-border logistics.
Reflexiones sobre el concepto de Turismo Sostenible y su integración en el actual contexto sociopolítico ecuatoriano
Authors: Hernanz Iris Martín , Martín Gil Fernando 
Published: June 2023

En las últimas décadas el Turismo Sostenible, ha tenido una amplia acogida en la política internacional, regional y nacional. Sin embargo, en la mayoría de las ocasiones apenas ha existido una reflexión sobre cuál debe ser el enfoque a seguir, ni una definición sobre sus objetivos y principios. El artículo plantea una reflexión en torno al Turismo Sostenible, partiendo del estudio sobre la evolución del Desarrollo Sostenible, el análisis teórico sobre el concepto y una revisión de documentos internacionales y sus principales aportaciones. Asimismo se analiza la integración del Turismo Sostenible en el contexto sociopolítico actual de Ecuador definido por la Constitución de 2008, el Plan Nacional del Buen Vivir y, de forma específica, el Plan estratégico de desarrollo de turismo sostenible para Ecuador.
Effect of Mutation on Seed Yield per Plant and Chlorophyll Content in M3 Generation of Green Gram [Vigna radiata (L.) R. Wilczek]
Authors: Ahir D. K. , Kumar Rajiv , Chetariya C. P. , Upadhyay Vidushi , Pandey Abhishek , Chaitanya Alamuru Krishna 
Published: June 2023

Aims: Mutation breeding used to induce quantitative variability in M3 generation of green gram of two excellent variety GM-4 and Meha with a view to study effect various mutagen and for the estimation of genetic variability parameters like GCV, PCV, Heritability and Genetic advance percent of mean for characters like as seed yield per plant and chlorophyll content.
Place and Duration of Study: The Field experiment was conducted at Instructional Farm, COA, Junagadh Agricultural University, Junagadh during the Summer-2015.
Methodology: The experimental material consisted of M2 derived M3 seeds which consists of sixty-six M3 progeny lines (64 mutant + 2 controls). The progeny lines were selected on the basis of yield and its associated characters from M2 generation.
Results: The analysis of variance between family revealed that families differed significantly for chlorophyll content while non-significant for seed yield per plant. GCV and PCV were higher in all the mutagenic family with respect to control for both the characters as well as for both the variety. For both characters, phenotypic coefficient of variation was higher than genotypic coefficient of variation indicating that there was environmental influence on these traits. Heritability exhibited higher in all the mutagenic families and also higher genetic advance was observed. The combined results for heritability showed that the high estimates of heritability and genetic advance were scored for seeds per plant indicating that these characters were under the control of additive genetic effects.
Conclusion: Mutagenic progenies with additive gene effect can be selected for improvement of desirable traits in mungbean.
Place of Death From Cancer in US States With vs Without Palliative Care Laws
Authors: Quan Vega Main Lin , Chihuri Stanford T. , Lackraj Deven , Murali Komal Patel , Li Guohua , Hua May 
Published: June 2023

ImportanceIn the US, improving end-of-life care has become increasingly urgent. Some states have enacted legislation intended to facilitate palliative care delivery for seriously ill patients, but it is unknown whether these laws have any measurable consequences for patient outcomes.ObjectiveTo determine whether US state palliative care legislation is associated with place of death from cancer.Design, Setting, and ParticipantsThis cohort study with a difference-in-differences analysis used information about state legislation combined with death certificate data for 50 US states (from January 1, 2005, to December 31, 2017) for all decedents who had any type of cancer listed as the underlying cause of death. Data analysis for this study occurred between September 1, 2021, and August 31, 2022.ExposuresPresence of a nonprescriptive (relating to palliative and end-of-life care without prescribing particular clinician actions) or prescriptive (requiring clinicians to offer patients information about care options) palliative care law in the state-year where death occurred.Main Outcomes and MeasuresMultilevel relative risk regression with state modeled as a random effect was used to estimate the likelihood of dying at home or hospice for decedents dying in state-years with a palliative care law compared with decedents dying in state-years without such laws.ResultsThis study included 7 547 907 individuals with cancer as the underlying cause of death. Their mean (SD) age was 71 (14) years, and 3 609 146 were women (47.8%). In terms of race and ethnicity, the majority of decedents were White (85.6%) and non-Hispanic (94.1%). During the study period, 553 state-years (85.1%) had no palliative care law, 60 state-years (9.2%) had a nonprescriptive palliative care law, and 37 state-years (5.7%) had a prescriptive palliative care law. A total of 3 780 918 individuals (50.1%) died at home or in hospice. Most decedents (70.8%) died in state-years without a palliative care law, while 15.7% died in state-years with a nonprescriptive law and 13.5% died in state-years with a prescriptive law. Compared with state-years without a palliative care law, the likelihood of dying at home or in hospice was 12% higher for decedents in state-years with a nonprescriptive palliative care law (relative risk, 1.12 [95% CI 1.08-1.16]) and 18% higher for decedents in state-years with a prescriptive palliative care law (relative risk, 1.18 [95% CI, 1.11-1.26]).Conclusions and RelevanceIn this cohort study of decedents from cancer, state palliative care laws were associated with an increased likelihood of dying at home or in hospice. Passage of state palliative care legislation may be an effective policy intervention to increase the number of seriously ill patients who experience their death in such locations.