bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic Management Practices in Patients with Viral Respiratory Infections
Authors: Serbanescu Claudiu , Irfan Neal , Mertz Dominik , Ahmed Amna 
Published: October 2022

ObjectivesTo identify patient characteristics associated with physicians’ decision to continue empiric antibiotics in patients with a lower respiratory tract infection and a positive nasopharyngeal swab (NPS).MethodsA retrospective cohort study of inpatient adults empirically treated with antibiotics and subsequent positive NPS during 2018. We compared patients whose antibiotics were stopped within 48 hours of a positive NPS with those whose antibiotics continued.ResultsEmpiric antibiotics were continued despite confirmation of a viral respiratory infection in 54 (54%) patients. Consolidation on a chest X-ray (odds ratio [OR], 3.6; 95% confidence intervals [CI], 1.5–8.3; P = 0.003) and a respiratory rate of ≥ 22 breaths per minute at the time of diagnosis (OR, 2.4; 95% CI, 1.1–5.4; P =0.03) were associated with continuation of antibiotics.ConclusionAn increased respiratory rate upon diagnosis and consolidation on chest X-ray were associated with the physicians’ decisions to continue empiric antibiotics after diagnosis of a viral infection.

Objectifs
Déterminer les caractéristiques des patients associées à la décision des médecins de poursuivre le traitement empirique par antibiotiques chez les patients atteints d’une infection des voies respiratoires inférieures et ayant un résultat positif par écouvillonnage nasopharyngé (ENP).
Méthodologie
Une étude de cohorte rétrospective menée chez des adultes hospitalisés recevant un traitement empirique par antibiotiques et ayant obtenu un résultat positif par ENP a été réalisée au cours de l’année 2018. Nous avons comparé les patients qui ont cessé la prise d’antibiotiques dans les 48 heures suivant un résultat positif par ENP et ceux qui ont poursuivi le traitement par antibiotiques.
Résultats
Le traitement empirique par antibiotiques s’est poursuivi chez 54 patients (54 %) malgré la confirmation d’une infection respiratoire virale. La présence d’une consolidation sur la radiographie pulmonaire (rapport de cotes [RC] de 3,6; intervalle de confiance [IC] à 95 % de 1,5 à 8,3; P = 0,003) et la fréquence respiratoire égale ou supérieure à 22 respirations par minute au moment du diagnostic (RC de 2,4; IC à 95 % de 1,1 à 5,4; P = 0,03) sont associées à la poursuite du traitement par antibiotiques.
Conclusion
Une fréquence respiratoire accélérée au moment du diagnostic et la présence d’une consolidation sur la radiographie pulmonaire sont associées aux décisions des médecins de poursuivre le traitement empirique par antibiotiques après le diagnostic d’une infection virale.
First-Generation H1-Antihistamine Prescribing in Hospitalized Patients
Authors: Lohrenz Sarah , Yatham Kavya , Kassir Sandy , Fong Andrea 
Published: October 2022

First-generation H1-antihistamines are commonly utilized in hospital, however, these agents are associated with a number of undesirable adverse effects such as central nervous system (CNS) depression, cardiotoxicity and death in overdose.We performed a retrospective analysis of all first-generation antihistamine prescriptions at the Regina General Hospital over the past year from January 1, 2019 – January 1, 2020. A total of 6,972 prescriptions were written during the study period, 6,692 (96%) of which were for first-generation antihistamines. The largest number of prescriptions for first generation antihistamines was in surgery, followed by internal medicine, and obstetrics and gynecology.Physicians, pharmacists, and nurses in these areas may benefit from education around the potential for serious harm of first-generation antihistamines and the availability of safer alternatives. Additionally, limiting access to first-generation antihistamines in hospital would encourage safer prescribing habits and familiarity with second-generation agents.
RésuméLes antihistaminiques H1 de première génération sont couramment utilisés en milieu hospitalier. Toutefois, ces agents sont associés à un certain nombre d’effets indésirables comme la dépression du système nerveux central (SNC), la cardiotoxicité et le décès causé par une surdose.Nous avons effectué une analyse rétrospective de toutes les ordonnances d’antihistaminiques de première génération délivrées à l’hôpital régional de Régina au cours d’une année, soit du 1er janvier 2019 au 1er janvier 2020. Au total, 6972 ordonnances ont été rédigées au cours de la période à l’étude, dont 6692 (96 %) pour des antihistaminiques de première génération. Le plus grand nombre d’ordonnances d’antihistaminiques de première génération ont été rédigées en chirurgie, suivie de la médecine interne et de l’obstétrique et de la gynécologie.Les médecins, les pharmaciens et les infirmières de ces secteurs pourraient tirer profit d’une formation sur le potentiel de dangerosité des antihistaminiques de première génération et sur l’existence de solutions de rechange plus sûres. En outre, le fait de limiter l’accès aux antihistaminiques de première génération en milieu hospitalier favoriserait des habitudes d’ordonnance plus sûres et la familiarisation avec les agents de deuxième génération.
Barriers to Implementing Internist Recommendations for Perioperative Anticoagulation Management by Surgical Teams
Authors: Flemons Kristin , Bosch Michael , Marcil Gabriel , Kachra Rahim , Zarnke Kelly , Skeith Leslie , Ruzycki Shannon Marie 
Published: October 2022

Introduction: In our center, half of all recommendations made by an internist about perioperative anticoagulation management are not followed by surgical team members. We aimed to understand the barriers to implementing perioperative anticoagulation recommendations.Methods: This was a prespecified analysis of interviews with surgical team members about individual- and systems-level drivers of missed perioperative anticoagulation recommendations. Interviews and analysis were guided by the Theoretical Domains Framework and the Consolidation Framework for Implementation Research.Results: We interviewed 16 surgical team members and 2 internists. Surgical team members intentionally did not follow recommendations about perioperative anticoagulation management when they felt that the bleeding risk outweighed the risk of thrombosis. This assessment of risk was driven by emotion and previous experience, even among participants who were familiar with perioperative literature.Conclusions: Development of study outcomes and guideline recommendations for perioperative anticoagulation management should include surgical team members in order to address the acceptability of these recom-mendations and increase adoption.
RésuméIntroduction : Dans notre centre, la moitié des recommandations formulées par un interniste concernant la prise en charge de l’anticoagulation périopératoire ne sont pas suivies par les membres de l’équipe chirurgicale. Nous avons cherché à comprendre les obstacles à l’application des recommandations relatives à l’antico-agulation périopératoire.
Méthodologie : Il s’agit d’une analyse prédéterminée d’entrevues menées auprès des membres de l’équipe chirurgicale au sujet des facteurs individuels et systémiques de l’insuccès des recommandations relatives à l’anticoagulation périopératoire. Les entrevues et l’analyse ont été guidées par le Theoretical Domains Framework et le Consolidation Framework for Implementation Research.Résultats : Nous avons interrogé 16 membres de l’équipe chirurgicale et 2 internistes. Intentionnellement, les membres de l’équipe chirurgicale ne suivent pas les recommandations concernant la prise en charge de l’anti-coagulation périopératoire lorsqu’ils estiment que le risque d’hémorragie l’emporte sur le risque de thrombose. Cette évaluation du risque est dictée par l’émotion et l’expérience antérieure, même parmi les participants qui connaissent bien la documentation du domaine périopératoire.Conclusions : La mise en application des résultats des études et des recommandations formulées par les lignes directrices pour la prise en charge de l’anticoagulation périopératoire devrait comprendre des membres de l’équipe chirurgicale pour aborder l’acceptabilité de ces recommandations et augmenter l’adoption.
General Internal Medicine (GIM): do the Puzzle Pieces Portray the Picture? A Continuous Quality Improvement Process for Entrustable Professional Activities (EPAs)
Authors: Halman Samantha , Marcotte Laura , Elizov Michelle , Stroud Lynfa , Karpinski Jolanta , Card Sharon E 
Published: October 2022

Defining General Internal Medicine (GIM) has been difficult due to the tension between ensuring flexibility for varied environments and the need for national standards. With the launch of competency-based medical education, the Royal College of Physicians and Surgeons of Canada Specialty Committee in GIM (SCGIM) (national standard-setting body) had the opportunity to explicitly define the discipline via elaboration of the GIM competencies and Entrustable Professional Activities (EPAs). Defining the EPAs is the essence of defining the tasks of the discipline. We describe our SCGIM approach to the continuous review of the theoretical written documentation around EPAs in the “real world environment” in order to continuously refine the EPAs and ensure they are facilitating skill attainment. Major lessons learned (1) centralized feedback with simple reporting and multiple input is best; (2) there is tension between theory (perfect EPAs) and practical implementation; (3) it takes time to see how the EPAs are performing.
RésuméIl a été difficile de définir la médecine interne générale (MIG) en raison de la tension entre la nécessité d’assurer la souplesse pour des environnements variés et le besoin de normes nationales. Grâce au lancement de la formation médicale par compétences, le comité de spécialité en MIG (CSMIG) du Collège royal des médecins et chirurgiens du Canada (organisme national de normalisation) a eu l’occasion de définir explicitement la discipline en élaborant les compétences en MIG et les activités professionnelles confiables (APC). Définir les APC consiste essentiellement à définir les tâches de la discipline. Nous décrivons notre approche du CSMIG de l’examen continu de la documentation théorique écrite concernant les APC « en situation réelle » pour améliorer continuellement les APC et veiller à ce qu’elles facilitent l’acquisition des compétences. Principales leçons apprises : a) la rétroaction centralisée avec des rapports simples et des commentaires multiples convi-ent le mieux; b) il existe une tension entre la théorie (APC parfaites) et l’application dans la pratique; c) il faut du temps avant de constater le rendement des APC.
GERMLINE GENOMIC FINDINGS IN CHILDREN AND YOUNG ADULTS WITH MELANOCYTIC TUMORS
Authors: Nagel Margaret , Perrino Melissa R. , Nuccio Regina , Blake Alise , Harrison Lynn , Nichols Kim , Pappo Alberto 
Published: October 2022

In this retrospective study, we examined the prevalence and spectrum of
germline variants in cancer predisposition genes in 38 children and
young adults with melanocytic lesions who underwent germline genetic
testing at St. Jude Children’s Research Hospital. Diagnoses included
malignant melanoma (n=19; 50%), spitzoid melanoma (n=14; 37%), and
uveal melanoma (n=5; 13%). Five patients (13%) harbored
pathogenic variants: one with bi-allelic PMS2, and one each with
heterozygous 17q21.31 deletion, TP53,BRIP1, and
ATM pathogenic In this convenience
cohort, 13% of children and young adults with melanoma who underwent
germline testing harbored an underlying cancer predisposition syndrome.
Fully Integrated downstream process to enable Next Generation Manufacturing
Authors: Ramos Irina , Sharda Nikunj , Villafana Ramon , Hill-Byrne Kevin , Cai Kang , Pezzini Joanna , Coffman Jon 
Published: October 2022

Next generation manufacturing (NGM) has evolved over the past decade to
a point where large biopharmaceutical organizations are making large
investments in the technology and considering implementation in clinical
and commercial processes. There are many well-considered reasons to
implement NGM. For the most part, organizations will not fund NGM unless
the implementation benefits the funding organization by providing
reduced costs, reduced time or additional needed capabilities.
Productivity improvements gained from continuous purification are shown
in this work, which used a new system that fully integrates and
automates several downstream unit operations of a biopharmaceutical
process to provide flexibility and easy implementation of NGM. The
equipment and automation supporting NGM can be complicated and
expensive. Biopharmaceutical Process Development considered
two options: (1) design its own NGM system or (2) buy a pre-built
system. PAK BioSolutions (Virginia, US), provides a turn-key automated
and integrated system that can operate up to four continuous
purification stages simultaneously, while maintaining a small footprint
in the manufacturing plant. The PAK system provides significant cost
benefits (~10x lower) compared to the alternative –
integration of many different pieces of equipment through a Distributed
Control System (DCS) that would require significant engineering time for
design, automation and integration. Integrated and Continuous
Biomanufacturing can lead to significant reductions in facility size,
reduced manufacturing costs, and enhanced product quality when compared
to the traditional batch mode of operation. The PAK system uses new
automation strategies that robustly link unit operations. We present the
optimized process fit, sterility and bioburden control strategy, and
automation features (such as pH feedback control and in-line detergent
addition) that enabled continuous operation of a 14 day end-to-end
monoclonal antibody purification process at the clinical manufacturing
scale.
Strategies in Preventing the Transmission of Covid-19 a Quarantine, Isolation, Lockdown, Tracing, Testing and Treatment (3T) : Literature review
Authors: Amir Haeril 
Published: October 2022

SARS -Cov-2 is the seventh member of the coronavirus family that can infect humans after the emergence of severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). This disease first occurred in Wuhan, a province in Hubei China. The virus is endemic throughout the world and was categorized as a pandemic by the World Health Organization (WHO). This virus can spread through direct contact, droplets due to coughing or sneezing, and even through air or airborne spreading according to the latest findings.
The purpose of this literature review was to conduct a review about the government strategy of various countries in dealing with COVID-19. The method used was a search using PubMed, Science Direct, ProQuest databases with the PICO search question development technique based on the " COVID-19" and "Pandemic" and "lockdown" keywords. The results of the literature search found five publications between the years 2010 to 2020 that provided, full text and open access, in addition the results of the literature review confirmed various efforts have been made by the governments in various countries considering the increasing number of sufferers. These could include social distancing and physical distancing, in which some countries even implemented lockdown to prevent the second waves of COVID-19, and specifically in Indonesia which implemented the large-scale social restrictions (LSSR). Based on this literature review findings.
This virus can be prevented by regular hand washing, wearing of personal protective equipment (PPE) such as masks and gloves, avoid shaking hands and staying at home.
DETEKSI KONDISI AMBANG BATAS DALAM TEKNIK FABRIKASI LASER MENGGUNAKAN FOTOLUMINESENSI
Authors: Yulianto Edy 
Published: October 2022

Mengetahui kondisi ambang batas dalam fabrikasi laser sangat penting untuk memastikan keberhasilan fabrikasi. Pada saat ini, kondisi ambang batas dalam fabrikasi laser ditentukan dengan mengkarakterisasi struktur yang dikembangkan hasil dari proses fabrikasi laser pada fabrikasi awal. Dalam penelitian ini, kami memperkenalkan teknik yang mudah dan cepat untuk menentukan kondisi ambang batas yang dapat dilakukan pada saat proses fabrikasi dengan laser. Sehingga teknik ini dapat digunakan untuk memastikan pembentukan struktur dengan cepat pada saat proses fabrikasi sedang berlangsung.
RANCANG BANGUN SISTEM KONTROL PADA FLEXSTEP UNTUK PENYANDANG DISABILITAS
Authors: Lutfiyanto Fahresya Dwi , Winarso Rochmad , Qomaruddin Qomaruddin 
Published: October 2022

ABSTRAK Tangga flexstep dirancang untuk berfungsi baik sebagai tangga biasa maupun sebagai lift kursi roda. FlexStep fleksibel dan sama-sama bermanfaat bagi para pejalan kaki dan pengguna kursi roda. FlexStep adalah solusi 2-in-1 yang inovatif dan menghemat ruang dibandingkan dengan menginstal tangga dan lift terpisah. Tujuan yang ingin dicapai dalam rancang bangun program sistem kontrol untuk mendapatkan gerakan yang terkonsep. Hasil rancang bangun sistem kontrol pada flexstep didapatkan nilai Perhitungan gerak flexstep dengan beban rangka adalah 50,66 detik sedangkan untuk menurunkannya membutuhkan waktu selama 47,79 detik. Semakin berat beban yang diangkat oleh flexstep maka semakin lama waktu yang dibutuhkan. Waktu untuk menurunkan flexstep dengan beban hampir sama dengan waktu menurunkan flexstep tanpa beban. Kata Kunci: Disabilitas, Aksesibilitas, Fasilitas Publik. ABSTRACT The flexstep ladder is designed to function both as a regular ladder and as a wheelchair lift. Flexstep is flexible and equally beneficial for pedestrians and wheelchair users. Flexstep is an innovative 2-in-1 solution that saves space compared to installing separate stairs and lifts. The goal to be achieved in the design of the control system program is to get the conceptualized movement. The results of the control system design on the flexstep value obtained. Calculation of flexstep motion with frame load is 50.66 seconds, while it takes 47.79 seconds to reduce it. The heavier the load lifted by the flexstep, the longer it will take. The time for lowering the flexstep with a load is almost the same as the time for lowering the flexstep without a load. Keywords: Disability, Accesibility, Public Facilities.
Key nutrients important in the management of canine myxomatous mitral valve disease and heart failure
Authors: Laflamme Dorothy P. 
Published: October 2022

Abstract
The most common cause of heart failure in dogs is myxomatous mitral valve disease (MMVD), which accounts for approximately 75% of canine heart disease cases and is especially common in smaller dogs. Although low-sodium diets have been recommended for humans with heart diseases for decades, there is little evidence to support this practice in dogs. In recent years, however, it has become clear that other nutrients are important to heart health. Dogs with heart disease secondary to MMVD experience patterns of metabolic changes that include decreased mitochondrial energy metabolism and ATP availability, with increased oxidative stress and inflammation. These changes occur early in disease and progress with worsening heart disease. Key nutrients that may support normal function and address these changes include omega-3 fatty acids, medium-chain triglycerides, magnesium, antioxidants including vitamin E and taurine, and the amino acids methionine and lysine. The long-chain omega-3 fatty acids provide anti-inflammatory, antithrombotic, and other benefits. Medium-chain fatty acids and ketones derived from medium-chain triglycerides provide an alternative energy source for cardiac mitochondria and help reduce free radical production. Magnesium supports mitochondrial function, normal cardiac rhythm, and provides other benefits. Both vitamin E and taurine counter oxidative stress, and taurine also has direct cardiac benefits. Dogs with MMVD have reduced plasma methionine. Methionine and lysine are important for carnitine production as well as other functions. This article reviews the evidence supporting the functions and benefits of these and other nutrients in MMVD and other cardiac conditions.
Municipal Civil Engineering Construction Based on Finite Element Differential Equations
Authors: Yu Linlin , Wan Fengming , Salama Mohamed 
Published: October 2022

Abstract
This paper establishes a risk model in constructing municipal civil engineering buildings based on finite element differential equations. At the same time, we set up a dynamic differential equation for the hidden danger of accidents in municipal engineering construction. This paper combines the differential game model of government intervention coordination and enterprise construction dynamics. In this way, we obtain the feedback Nash equilibrium solution under government intervention. The research results show that government subsidies can promote cooperation between the two sides of the construction industry chain. This paper points out that the optimal control strategy should consider the strategy choice of the regulatory authorities.
Analysis and Research on Influencing Factors of Ideological and Political Education Teaching Effectiveness Based on Linear Equation
Authors: Huang Jinghui , Aldada Ali 
Published: October 2022

Abstract
Ideological and political education as the basic curriculum of talent cultivation in China, to improve the effectiveness of ideological and political education in colleges and universities, education departments and professional colleges should explore the theoretical knowledge of ideological and political education in colleges and universities on the basis of empirical analysis combined with practical education results. Therefore, on the basis of understanding the analytical process of linear multivariate equation, this paper systematically studies the influence of students, teachers and teaching on the teaching effectiveness of ideological and political education in colleges and universities by using structural equation model analysis and questionnaire survey. The final results show that teaching plays a positive role in the effectiveness of ideological and political education. Therefore, in the educational innovation of the new era, based on the requirements of ideological and political education in colleges and universities, it is necessary to build an effective mechanism of subject interaction, continuously optimize practical teaching content, constantly innovate ideological and political education methods, and pay attention to the formation of symbiotic mechanism for teaching organization and learning atmosphere