bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of pharmacological labour analgesia: a survey of obstetric care providers in eastern Ethiopia
Authors: Eyeberu Addis , Getachew Tamirat , Debella Adera , Balis Bikila , Eshetu Bajirond , Mesfin Sinetibeb , Bekele Habtamu , Tamiru Dawit , Tiruye Getahun , Degefa Meron , Alemu Addisu , Dheressa Merga , Dessie Yadeta 
Published: September 2022

Abstract

Background
Despite a crucial role played by obstetric care providers (OCPs) in providing pain relief methods during labour, the evidence suggests that there is a large number of women in Ethiopia who did not have access to pain relief methods. Moreover, to the best of the investigators’ knowledge, evidence is scarce regarding the utilization of pharmacological labour pain management methods in the study area. Thus this study was carried out to determine the practice of pharmacological labour pain management methods among OCPs in Harari regional state health facilities in Ethiopia.

Methods
A facility-based cross-sectional study was conducted from 20 May to 10 June 2021 in Harari regional state health facilities. All (n=464) OCPs in Harari regional state health facilities were included in the study. Data were collected using a structured questionnaire adapted from previous studies. The data were entered into Epi-data version 3.1 statistical software. Statistical analysis was carried out using SPSS for Windows version 22. Bivariate and multivariate logistic regression analyses were employed to determine the association between independent variables and the outcome variable. A p-value &lt;0.05 was used to establish statistical significance.

Results
In this study, 464 OCPs participated. The overall utilization of pharmacological labour pain relief methods was 50.9% (95% confidence interval [CI] 45.8 to 55.8). The main barriers to labouring mothers receiving pain relief include high patient flow (54.4%), the limited number of staff (51.9%) and a lack of knowledge and skill (32.9%). Being female (adjusted odds ratio [AOR] 2.07 [95% CI 1.31 to 3.26]), not having training (AOR 1.60 [95% CI 1.02 to 2.53]) and having an unfavourable attitude (AOR 9.1 [95% CI 5.34 to 15.35]) were the predictors of utilization of pharmacological labour pain management methods.

Conclusions
The study revealed that half of the OCPs utilized the pharmacological labour pain management method. In general, this study identified that variables like sex, training and the attitude of OCPs were factors associated with the utilization of pharmacological labour pain management methods. The health facilities should provide training to enhance the skill of OCPs and equip themselves with sufficient analgesic drugs.
Impact of a continuous quality improvement program on contrast-induced nephropathy in outpatients with chronic kidney disease: an interrupted time-series study
Authors: Hirano Keita , Kobayashi Daiki , Shimbo Takuro , Komatsu Yasuhiro 
Published: September 2022

ABSTRACT

Background
Contrast-induced nephropathy (CIN) caused by exposure to radioactive contrast media can cause acute kidney injury in patients with chronic kidney disease (CKD). We developed a multifaceted approach in a CIN-quality improvement (QI) program based on a shorter saline hydration protocol for the prevention of CIN in outpatients and assessed the effect of our CIN-QI program on decreasing both the incidence rate of CIN and overall use of contrast agents in patients undergoing contrast-enhanced computed tomography (CT).

Methods
We conducted a multi-center prospective interrupted time-series study from 2006 to 2018 investigating the efficacy of a CIN-QI program in preventing CIN among outpatients with CKD. An automatic medical record system alert was implemented to instruct physicians to consult a nephrologist and administer prophylactic hydration and follow-up when ordering contrast-enhanced imaging in patients with an estimated glomerular filtration rate (eGFR) &lt;45 mL/min/1.73 m2. The primary outcomes were the rates of prophylactic hydration and follow-up kidney function assessment, and the incidence of CIN for eligible patients. The usage rate of contrast-enhanced CT was also examined.

Results
A total of 95 594 patients who underwent contrast-enhanced CT were included in the study. The annual prophylactic hydration rate before the CIN-QI program ranged from 2.0% to 23.2% but increased to 59.2%–75.2% during the CIN-QI program (P &lt; .001). The annual rate of follow-up kidney function testing also improved from 18.6%–25.8% to 34.1%–42.5% after implementation of the CIN-QI program (P &lt; .001). The rate of CIN significantly declined in level by 10.0% at the start of the CIN-QI program (P = .002) and in trend by 2.9%/year (P &lt; .001). The number of contrast-enhanced CT orders showed a positive level change in patients with advanced CKD, who were the CIN-QI program target group of patients with eGFR &lt;45 mL/min/1.73 m2, at the start of the implementation of the CIN-QI program. After implementing the CIN-QI program, the number of contrast-enhanced CT orders showed a negative trend change across all patients, which decreased from −1.4%/year to −10.0%/year for patients with advanced CKD.

Conclusion
The multifaceted approach in the CIN-QI program may be associated with the decreased incidence of CIN and increased rates of prophylactic hydration and follow-up kidney function testing.
Amikacin Liposomal Inhalation Suspension in the Treatment of Mycobacterium abscessus Lung Infection: A French Observational Experience
Authors: Chiron Raphael , Hoefsloot Wouter , Van Ingen Jakko , Marchandin Hélène , Kremer Laurent , Morisse-Pradier Hélène , Charriot Jeremy , Mallet Jean-Pierre , Herrmann Jean-Louis , Caimmi Davide , Moreau Johan , Dumont Yann , Godreuil Sylvain , Bergeron Anne , Drevait Margot , Bouzat-Rossigneux Elodie , Terrail Nicolas , Andrejak Claire , Veziris Nicolas , Grenet Dominique , Coudrat Alexandre , Catherinot Emilie 
Published: September 2022

Abstract

Background
Mycobacterium abscessus infections remain difficult to manage in both cystic fibrosis (CF) and non-CF patients and reported clinical outcomes are largely unsatisfactory. Clinical trial data are limited and no approved therapies are currently available for the management of M abscessus lung diseases. As an alternative, cohort studies may provide insightful information into the management of M abscessus pulmonary disease.

Methods
Based on a retrospective observational cohort study, we investigated the safety and efficacy of amikacin liposome inhaled suspension (ALIS) as an adjunct to a standard antibiotic regimen for M abscessus lung infection in both CF and non-CF patients. We also assessed the association of patient drug compliance with culture conversion and clinical outcomes.

Results
Twenty-six patients had long-term follow-up data available. Culture conversion was achieved in 54% (14/26) of the patients with no difference between CF and non-CF patients after an average treatment duration of 10 months. Patient treatment compliance was significantly better in the converter group compared to nonconverters with an odds ratio of 44.78 associated with good compared to poor patient compliance. Overall, 9 patients (35%) experienced an adverse event that led to treatment discontinuation.

Conclusions
ALIS appears beneficial in both CF and non-CF populations with M abscessus lung disease.
Impact of a Pharmacist-Managed Procalcitonin Program on COVID-19 Respiratory Tract Infection Outcomes and Health Care Resource Utilization
Authors: Fratoni Andrew J , Kois Abigail K , Colmerauer Jessica L , Linder Kristin E , Nicolau David P , Kuti Joseph L 
Published: September 2022

Abstract
Patients hospitalized with coronavirus disease 2019 (COVID-19) often receive empiric antibiotic coverage. Procalcitonin (PCT) is a biomarker with Food and Drug Administration–approved guidance cutoffs for antibiotic use in lower respiratory tract infections. Herein we describe the implementation and impact of a pharmacist-managed PCT monitoring program in hospitalized patients with COVID-19. In this quasi-experimental, single-center, retrospective study of a prospective antimicrobial stewardship pharmacist-managed program, inpatients who were severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction positive were reviewed during weekday working hours and evaluated for appropriateness of antibiotic treatment by utilizing the PCT biomarker. As needed, the infectious diseases pharmacist offered feedback around antibiotic discontinuation in patients with PCT values ≤0.25 ng/mL. Adherence to PCT cutoffs, clinical outcomes, and utilization of health care resources were quantified and compared with a time frame immediately preceding the program's implementation. A total of 772 patients hospitalized with COVID-19 were analyzed. The pre-intervention cohort was comprised of 519 patients, and 253 patients were included after program implementation. Antibiotics were prescribed within 72 hours of admission to 232 (44.7%) and 108 (42.7%) patients during the control and intervention phases, respectively. There was no difference in the primary outcome of percentage of patients who received &gt;1 day of antibiotic therapy (23.5% vs 21.7%; P = .849) or in any secondary outcome including hospital length of stay, 30-day readmission rates, or discharge disposition. In a hospital where the majority of COVID-19 patients did not receive empiric antibiotics, the implementation of a pharmacist-managed PCT monitoring program did not significantly decrease antibiotic use or health care resource utilization.
COVID-19 Vaccine Effectiveness Against Progression to In-Hospital Mortality in Zambia, 2021–2022
Authors: Chanda Duncan , Hines Jonas Z , Itoh Megumi , Fwoloshi Sombo , Minchella Peter A , Zyambo Khozya D , Sivile Suilanji , Kampamba Davies , Chirwa Bob , Chanda Raphael , Mutengo Katongo , Kayembe Mazinga F , Chewe Webster , Chipimo Peter , Mweemba Aggrey , Agolory Simon , Mulenga Lloyd B 
Published: September 2022

Abstract

Background
Coronavirus disease 2019 (COVID-19) vaccines are highly effective for reducing severe disease and mortality. However, vaccine effectiveness data are limited from Sub-Saharan Africa. We report COVID-19 vaccine effectiveness against progression to in-hospital mortality in Zambia.

Methods
We conducted a retrospective cohort study among admitted patients at 8 COVID-19 treatment centers across Zambia during April 2021 through March 2022, when the Delta and Omicron variants were circulating. Patient demographic and clinical information including vaccination status and hospitalization outcome (discharged or died) were collected. Multivariable logistic regression was used to assess the odds of in-hospital mortality by vaccination status, adjusted for age, sex, number of comorbid conditions, disease severity, hospitalization month, and COVID-19 treatment center. Vaccine effectiveness of ≥1 vaccine dose was calculated from the adjusted odds ratio.

Results
Among 1653 patients with data on their vaccination status and hospitalization outcome, 365 (22.1%) died. Overall, 236 (14.3%) patients had received ≥1 vaccine dose before hospital admission. Of the patients who had received ≥1 vaccine dose, 22 (9.3%) died compared with 343 (24.2%) among unvaccinated patients (P &lt; .01). The median time since receipt of a first vaccine dose (interquartile range) was 52.5 (28–107) days. Vaccine effectiveness for progression to in-hospital mortality among hospitalized patients was 64.8% (95% CI, 42.3%–79.4%).

Conclusions
Among patients admitted to COVID-19 treatment centers in Zambia, COVID-19 vaccination was associated with lower progression to in-hospital mortality. These data are consistent with evidence from other countries demonstrating the benefit of COVID-19 vaccination against severe complications. Vaccination is a critical tool for reducing the consequences of COVID-19 in Zambia.
The colorful world of cryptophyte phycobiliproteins
Authors: Richardson Tammi L 
Published: September 2022

AbstractCryptophytes are flagellated, eukaryotic phytoplankton found in environments ranging from tea-colored ponds to the blue-water open ocean. Cryptophytes vary in color from green to red, a trait that is imparted primarily by their phycobiliprotein (PBP) accessory pigments. These PBPs have likely played a key role in the diversification of cryptophytes into a wide range of aquatic environments over their evolutionary history. This review covers the current knowledge of the origin, structure and function of cryptophyte PBPs and presents evidence for remarkable phenotypic plasticity of PBP absorption, which may help cryptophytes acclimate to changes in their environment like eutrophication (“greening”), permafrost melting (“browning”) or deforestation.
River discharge-related nutrient effects on North Sea coastal and offshore phytoplankton communities
Authors: Groß Elisabeth , Di Pane Julien , Boersma Maarten , Meunier Cédric L 
Published: September 2022

Abstract
As a result of climate change, an increasing number of extreme weather events can be observed. Heavy precipitation events can increase river discharge which causes an abrupt increase of nutrient-rich freshwater into coastal zones. We investigated the potential consequences of nutrient-rich freshwater pulses on phytoplankton communities from three stations in the North Sea. After incubating the phytoplankton cultures with a gradient of nutrient-rich freshwater, we analyzed changes in community diversity, average cell size, growth rate and elemental stoichiometry. Pulses of nutrient-rich freshwater have caused an increase in the growth rate of the phytoplankton communities at two of the three stations and a decrease in cell size within the taxonomic groups of flagellates and diatoms at all stations, indicating a positive selection in favor of smaller taxa. In addition, we observed a decrease in the molar N:P ratio of the phytoplankton communities. Overall, the response of phytoplankton was highly dependent on the initial community structure at each sampling site. Our study demonstrates that the biomass and functional structure of North Sea phytoplankton communities could be altered by an abrupt increase in river discharge, which could have further consequences for higher trophic levels and short-term food web dynamics in the North Sea.
Utility of Erector Spinae Plane Blocks for Postoperative Pain Management and Opioid Reduction Following Lumbar Fusions
Authors: Makanji Heeren S. , Solomito Matthew J. , Maffeo-Mitchell Carla , Esmende Sean , Finkel Kevin 
Published: September 2022

Study Design:
Retrospective.

Objective:
The purpose of this study was to determine the utility of the erector spinae plane regional anesthesia (ESP) block in reducing opioid medication usage and postanesthesia care unit length of stay (PACU-LOS) for patients undergoing either a posterior or transforaminal lumbar interbody fusions (PLIF/TLIF).

Summary of Background Data:
Posterior lumbar spine fusion is a common surgical procedure typically associated with significant postoperative pain. Poorly controlled postoperative pain can lead to a number of poor outcomes. Although opioids are a mainstay for pain control, they are associated with adverse effects and a risk of dependence. Therefore, multimodal pain control has become more prevalent in orthopedics and combines traditional opioid and nonopioid pain mediation with general anesthesia protocols and regional nerve blocks.

Materials and Methods:
A retrospective chart review was conducted for patients undergoing PLIFs or TLIFs between 2019 and 2021. Patients were placed into 2 groups, those receiving an ESP block and those that did not. T tests assuming unequal variances were used to assess differences in pain scores, opioid consumption, and PACU-LOS between groups.

Results:
The study group demonstrated a 35% reduction in opioid use (P=0.016), a 16% reduction in pain with activity (P=0.042), and a 9.7% reduction in pain at rest (P=0.219) compared with the control group. There were no significant differences in PACU-LOS between groups (P=0.314).

Conclusion:
The use of an ESP block for patients undergoing PLIFs and TLIFs appears to be a safe and effective means to manage postoperative pain and reduce opioid consumption.
Wave propagation in the marginal ice zone: connections and feedback mechanisms within the air–ice–ocean system
Authors: Thomson Jim 
Published: September 2022

The propagation of ocean surface waves within the marginal ice zone (MIZ) is a defining phenomenon of this dynamic zone. Over decades of study, a variety of methods have been developed to observe and model wave propagation in the MIZ, with a common focus of determining the attenuation of waves with increasing distance into the MIZ. More recently, studies have begun to explore the consequences of wave attenuation and the coupled processes in the air–ice–ocean–land system. Understanding these coupled processes and effects is essential for accurate high-latitude forecasts. As waves attenuate, their momentum and energy are transferred to the sea ice and upper ocean. This may compact or expand the MIZ, depending on the conditions, while simultaneously modulating the wind work on the system. Wave attenuation is also a key process in coastal dynamics, where land–fast ice has historically protected both natural coasts and coastal infrastructure. With observed trends of increasing wave activity and retreating seasonal ice coverage, the propagation of waves within the MIZ is increasingly important to regional and global climate trends.This article is part of the theme issue ‘Theory, modelling and observations of marginal ice zone dynamics: multidisciplinary perspectives and outlooks’.
Floes, the marginal ice zone and coupled wave-sea-ice feedbacks
Authors: Horvat Christopher 
Published: September 2022

Marginal ice zones (MIZs) are qualitatively distinct sea-ice-covered areas that play a critical role in the interaction between the polar oceans and the broader Earth system. MIZ regions have high spatial and temporal variability in oceanic, atmospheric and ecological conditions. The salient qualitative feature of MIZs is their composition as a mosaic of individual floes that range in horizontal extent from centimetres to tens of kilometres. Thus the floe size distribution (FSD) can be used to quantitatively identify and describe them. Here, the history of FSD observations and theory, and the processes (particularly the impact of ocean waves) that determine floe sizes and size distribution, are reviewed. Coupled wave-FSD feedbacks are explored using a stochastic model for thermodynamic wave-sea-ice interactions in the MIZ, and some of the key open questions in this rapidly growing field are discussed.This article is part of the theme issue ‘Theory, modelling and observations of marginal ice zone dynamics: multidisciplinary perspectives and outlooks’.
Marginal ice zone dynamics: history, definitions and research perspectives
Authors: Dumont Dany 
Published: September 2022

Despite enormous scientific and technological progress in numerical weather and climate prediction, sea ice still remains unreliably predicted by models, both in short-term forecasting and climate projection applications. The total ice extent in both hemispheres is tied to the location of the ice edge, and consequently to what happens in the portion of the ice cover immediately adjacent to the open ocean that is called the marginal ice zone (MIZ). There is mounting evidence that processes occurring in the MIZ might play an important role in the polar climate of both hemispheres, yet some key physical processes are still missing in models. As sea ice models developed for climate studies are increasingly used for operational forecasting, the missing physics also impede short-term sea ice prediction skills. This paper is a mini-review that provides a historical perspective on how MIZ research has progressed since the 1970s, with a focus on the fundamental importance of the interactions between sea ice and surface gravity waves on sea ice dynamics. Completeness is not achieved, as the body of literature is huge, scattered and rapidly growing, but the intention is to inform future collaborative research efforts to improve our understanding and predictive capabilities of sea ice dynamics in the MIZ.This article is part of the theme issue ‘Theory, modelling and observations of marginal ice zone dynamics: multidisciplinary perspectives and outlooks’.
Wave-in-ice: theoretical bases and field observations
Authors: Shen Hayley H. 
Published: September 2022

There has been a significant increase of studies on wave–ice interactions in the past decades. Through a close look at a representative set of theories, this paper investigates different physical processes that have produced different wave dispersion and attenuation. The existing theories have considered four major processes: scattering, flexural damping, viscoelastic damping and basal friction. Each theory looked into one of these processes and used a different mathematical formulation to model these processes. The low-frequency behaviours of the resulting spectral attenuation in these theories are fundamentally different from each other. Recent field observations have produced a large amount of data to calibrate and validate these theories. The uncertainties in using field measurements to determine attenuation due to ice covers are discussed. Both observational data and applications of these theories in field conditions suggest a multi-physics approach. A number of studies to further the theoretical development are recommended. It will take time for wave-in-ice models to reach the same level of performance as wave models for the open ocean, relying on the combined effort of theoretical, modelling and observational studies.This article is part of the theme issue ‘Theory, modelling and observations of marginal ice zone dynamics: multidisciplinary perspectives and outlooks’.
Modelling attenuation of irregular wave fields by artificial ice floes in the laboratory
Authors: Toffoli A. , Pitt J. P. A. , Alberello A. , Bennetts L. G. 
Published: September 2022

A summary is given on the utility of laboratory experiments for gaining understanding of wave attenuation in the marginal ice zone, as a complement to field observations, theory and numerical models. It is noted that most results to date are for regular incident waves, which, combined with the highly nonlinear wave–floe interaction phenomena observed and measured during experimental tests, implies that the attenuation of regular waves cannot necessarily be used to infer the attenuation of irregular waves. Two experiments are revisited in which irregular wave tests were conducted but not previously reported, one involving a single floe and the other a large number of floes, and the transmission coefficients for the irregular and regular wave tests are compared. The transmission spectra derived from the irregular wave tests agree with the regular wave data but are overpredicted by linear models due to nonlinear dissipative processes, regardless of floe configuration.
This article is part of the theme issue ‘Theory, modelling and observations of marginal ice zone dynamics: multidisciplinary perspectives and outlooks’.