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Validity and reliability of the Neonatal Infant Acute Pain Assessment Scale (NIAPAS) in Turkish: prospective study.

Sao Paulo Med J 2021 Jul-Aug;139(4):305-311

MD, PhD. Professor, Neonatal Intensive Care Clinic, Istanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

Background: Using pain scales helps nurses in making early diagnoses and in assessing and managing pain symptoms and findings when developing a nursing care plan.

Objective: To determine the validity and reliability of the Turkish form of the Neonatal Infant Acute Pain Assessment Scale (NIAPAS).

Design And Setting: Prospective study conducted in Istanbul Bakırköy Dr. Read More

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December 2020

Smartphone Delivery of Cognitive Behavioral Therapy for Postintensive Care Syndrome-Family: Protocol for a Pilot Study.

JMIR Res Protoc 2021 Aug 4;10(8):e30813. Epub 2021 Aug 4.

Department of Surgery, Summa Health, Akron, OH, United States.

Background: Family members of critically ill patients experience symptoms of postintensive care syndrome-family (PICS-F), including anxiety, depression, and posttraumatic stress disorder. Postintensive care syndrome-family reduces the quality of life of the families of critically ill patients and may impede the recovery of such patients. Cognitive behavioral therapy has become a first-line nonpharmacological treatment of many psychological symptoms and disorders, including anxiety, depression, and posttraumatic stress. Read More

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What can we learn from the experiences and expectations of patients on growing waiting lists for planned care in the COVID-19 pandemic?

Bone Jt Open 2021 Aug;2(8):573-583

AToMS-Academic Team of Musculoskeletal Surgery, Undercroft, University Hospitals of Leicester NHS Trust, Leicester, UK.

Aims: COVID-19 has compounded a growing waiting list problem, with over 4.5 million patients now waiting for planned elective care in the UK. Views of patients on waiting lists are rarely considered in prioritization. Read More

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National multisectoral governance challenges of implementing the Philippines' Reproductive Health Law.

Health Policy Plan 2021 Aug 4. Epub 2021 Aug 4.

Philippine Institute for Development Studies, Research Department, 18th Floor Three Cyberpod Centris-North Tower, Quezon Avenue, Diliman Quezon City, Metro Manila 1100, Philippines.

In recognition of the role of reproductive health in individual and national development, the Responsible Parenthood and Reproductive Health (RPRH) Law of 2012 was passed in the Philippines after 30 years of opposition and debate. Seven years later, this article examined the cohesiveness of national multi-sectoral governance among state and non-state actors and identified challenges in coordination as part of the first comprehensive evaluation of the landmark policy. Using a qualitative intrinsic case study design and guided by the World Health Organization's systems checklist for governing health equity as our theoretical perspective, we conducted 20 semi-structured interviews with national implementers from health agencies (n = 11), non-health agencies (n = 6) and non-state actors (n = 3) that included civil society organizations (CSOs). Read More

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Carbon life cycle assessment of shelterbelts in Saskatchewan, Canada.

J Environ Manage 2021 Jul 31;297:113400. Epub 2021 Jul 31.

Sustainable Land Management, Department of Soil Science, University of Saskatchewan, Saskatoon, Canada.

Shelterbelts are rows of trees planted around farmyards and field for protection against soil erosion, promotion of biodiversity and wildlife habitat. Additionally, to carbon sequestration through growth in tree biomass and carbon sinks in agricultural soil. In recent years, removal of shelterbelts has become more common, as crop land is preferred under higher crop prices, resulting in increased GHG emissions and decreases in carbon sinks. Read More

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Assessment and improvement strategies of sustainable land management (SLM) planning initiative in Turkey.

Sci Total Environ 2021 Jul 21;797:149183. Epub 2021 Jul 21.

Faculty of Forestry and Wood Sciences, Czech University of Life Sciences Prague, Czechia; The Forest Research Centre, School of Agriculture, University of Lisbon, Portugal. Electronic address:

Holistic planning and management of landscape is a prominent challenge. This paper provides a methodological framework for the assessment of an integrated land management plan with its action plans. Based on the scientific understanding, contemporary literature and the legal documents, a set of planning principles was developed and the strengths and weaknesses of the plan highlighted. Read More

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The extract of concentrated growth factor enhances osteogenic activity of osteoblast through PI3K/AKT pathway and promotes bone regeneration in vivo.

Int J Implant Dent 2021 Aug 4;7(1):70. Epub 2021 Aug 4.

Department of Dental Implantology, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, No. 142, North Great Str, Yantai, Shandong, 264008, People's Republic of China.

Background: Concentrated growth factor (CGF) is a third-generation platelet concentrate product; the major source of growth factors in CGF is its extract; however, there are few studies on the overall effects of the extract of CGF (CGF-e). The aim of this study was to investigate the effect and mechanism of CGF-e on MC3T3-E1 cells in vitro and to explore the effect of combination of CGF-e and bone collagen (Bio-Oss Collagen, Geistlich, Switzerland) for bone formation in cranial defect model of rats in vivo.

Methods: The cell proliferation, ALP activity, mineral deposition, osteogenic-related gene, and protein expression were evaluated in vitro; the newly formed bone was evaluated by histological and immunohistochemical analysis through critical-sized cranial defect rat model in vivo. Read More

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Standardized Neurodevelopmental Surveillance of High-risk Infants Using Telehealth: Implementation Study during COVID-19.

Pediatr Qual Saf 2021 Jul-Aug;6(4):e439. Epub 2021 Jul 28.

Neonatal Network, Nationwide Children's Hospital, Columbus, Ohio.

Introduction: Neurodevelopmental surveillance is critical for high-risk infants following neonatal intensive care discharge and is traditionally performed in-person. COVID-19 interruption of regular surveillance necessitated a rapid development of telehealth models for effective and standardized care.

Methods: We used implementation science and lean methodologies to develop an effective telehealth neurodevelopmental surveillance program for high-risk infants. Read More

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A hybrid analytical model for an entire hospital resource optimisation.

Soft comput 2021 Jul 30:1-18. Epub 2021 Jul 30.

School of Management, University of Bath, Bath, BA2 7AY UK.

Given the escalating healthcare costs around the world (more than 10% of the world's GDP) and increasing demand hospitals are under constant scrutiny in terms of managing services with limited resources and tighter budgets. Hospitals endeavour to find sustainable solutions for a variety of challenges ranging from productivity enhancements to resource allocation. For instance, in the UK, evidence suggests that hospitals are struggling due to increased delayed transfers of care, bed-occupancy rates well above the recommended levels of 85% and unmet A&E performance targets. Read More

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Increasing adherence to plotting e-partograph: a quality improvement project in a rural maternity hospital in India.

BMJ Open Qual 2021 Jul;10(Suppl 1)

Obstetrics & Gynecology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India.

Abnormal prolonged labour and its effects are important contributors to maternal and perinatal mortality and morbidity worldwide. E-partograph is a modern tool for real-time computerised recording of labour data which improves maternal and neonatal outcome. The aim was to improve the rates of e-partograph plotting in all eligible women in the labour room from existing 30% to achieve 90% in 6 months through a quality improvement (QI) process. Read More

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Ensuring administration of first dose of antibiotics within the golden hour of management in neonates with sepsis.

BMJ Open Qual 2021 Jul;10(Suppl 1)

Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Administration of first dose of antibiotics within the golden hour in infants with sepsis is critical. Delays can increase mortality. During our observations as part of antibiotic stewardship programme in inborn neonatal unit, we found a significant delay in the administration of first dose of antibiotics from the decision time. Read More

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Reducing late-onset neonatal sepsis in very low birthweight neonates with central lines in a low-and-middle-income country setting.

BMJ Open Qual 2021 Jul;10(Suppl 1)

Neonatology, Kalawati Saran Children's Hospital, New Delhi, India

Background: Late-onset neonatal sepsis (LONS) is a significant contributor to morbidity and mortality in very low birthweight (VLBW) neonates with indwelling central lines. Compliance to central line care bundles is suboptimal in low-and-middle-income country settings. Point of care quality improvement (POCQI) method may be used to improve the compliance gap. Read More

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Institution of an antibiotic stewardship programme for rationalising antibiotic usage: a quality improvement project in the NICU of a public teaching hospital in rural central India.

BMJ Open Qual 2021 Jul;10(Suppl 1)

Neonatology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Antibiotic misuse is the most common cause of antimicrobial resistance-a globally declared emergency. This necessitates the introduction of rational antibiotic usage management policy. The paediatrics department of a public teaching hospital with around 500 neonatal intensive care unit (NICU) admissions annually revealed 75% of NICU admission exposure to any antibiotics. Read More

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Development of a framework of intervention strategies for point of care quality improvement at different levels of healthcare delivery system in India: initial lessons.

BMJ Open Qual 2021 Jul;10(Suppl 1)

Maternal Health Division, Ministry of Health and Family Welfare, Government of India, New Delhi, Delhi, India.

Background: Inadequate quality of care has been identified as one of the most significant challenges to achieving universal health coverage in low-income and middle-income countries. To address this WHO-SEARO, the point of care quality improvement (POCQI) method has been developed. This paper describes developing a dynamic framework for the implementation of POCQI across India from 2015 to 2020. Read More

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Advancing emergency airway management by reducing intubation time at a high-volume academic emergency department.

BMJ Open Qual 2021 Jul;10(Suppl 1)

Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India

Background: Airway management is a life-saving procedure in the emergency department (ED). Hypoxia during rapid sequence intubation (RSI) is associated with high morbidity and mortality.

Aim: To decrease the median time of intubation (time from administration of paralytic agent to the successful passage of endotracheal tube) by 40% from baseline 300 s in patients undergoing RSI in the ED. Read More

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Checklist to aid young physicians managing obstetric emergencies in rural India: a quality improvement initiative.

BMJ Open Qual 2021 Jul;10(Suppl 1)

Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India.

Background: The decision to admit or refer a patient presenting with an obstetric emergency is extremely crucial. In rural India, such decisions are usually made by young physicians who are less experienced and often miss relevant data points required for appropriate decision making. In our setting, before the quality improvement (QI) initiative, this information was recorded on loose blank sheets (first information sheets (FIS)) where an initial clinical history, physical examination and investigations were recorded. Read More

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Rationalising antibiotic use after low-risk vaginal deliveries in a hospital setting in India.

BMJ Open Qual 2021 Jul;10(Suppl 1)

Quality, Sitaram Bhartia Institute of Science and Research, New Delhi, Delhi, India

Background: In 2017, a postoperative multidrug resistant case of urinary tract infection made obstetricians at Sitaram Bhartia Institute of Science and Research introspect the antibiotic usage in labouring mothers. Random case file reviews indicated overuse and variability of practice among care providers. This prompted us to explore ways to rationalise antibiotic use. Read More

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Exploring healthcare students' interprofessional teamwork in primary care simulation scenarios: collaboration to create a shared treatment plan.

BMC Med Educ 2021 Aug 3;21(1):416. Epub 2021 Aug 3.

Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.

Background: Primary care providers assume responsibility for patients with increasingly complex problems requiring interprofessional collaboration. Introducing interprofessional education in healthcare curricula prepares healthcare students for this reality. Solving simulation scenarios as an educational strategy is promoted to support interprofessional education in health care, and is mostly used in acute clinical situations. Read More

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[Frequency characteristics of horizontal semicircular canals damage and the ultrastructure analysis of crista ampullaris in patients with Meniere's disease].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Jul;56(7):698-703

Department of Vertigo Disease, Shandong Provincial ENT Hospital, Cheeloo College of Medicine,Shandong University,Jinan 250021,China.

To investigate the frequency characteristics and the pathological characteristics of the horizontal crista ampullaris in patients with Meniere's disease,and to analyse its structural basis. Between March, 2019 and November, 2019, seventy-two patients diagnosed as Meniere's disease (27 males and 45 females, aged from 13 to 74 years, with a course of disease ranging from 4 months to 32 years)in Shandong Provincial ENT Hospital were included.Caloric test, sinusoidal harmonic acceleration test (SHA), video-head impulse test (v-HIT), Gadolinium-enhanced inner-ear 3D-FLAIR MRI and pure tone audiometry were conducted in the patients. Read More

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Impact of Daily Plan Adaptation on Organ-At-Risk Normal Tissue Complication Probability for Adrenal Lesions undergoing Stereotactic Ablative Radiation Therapy.

Radiother Oncol 2021 Jul 31. Epub 2021 Jul 31.

Department of Radiation Oncology, Amsterdam University Medical Centers - Location VUmc, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands.

Introduction: Stereotactic ablative radiotherapy (SABR) can achieve good local control for metastatic adrenal lesions. Magnetic resonance (MR)-guidance with daily on-table plan adaptation can augment the delivery of SABR with greater dose certainty. The goal of this study was to quantify the potential clinical benefit MR-guided daily-adaptive adrenal SABR using the normal tissue complication probability (NTCP) framework. Read More

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Increased modularity of the resting-state network in children with nonsyndromic cleft lip and palate after speech rehabilitation.

Brain Behav 2021 Aug 3:e02094. Epub 2021 Aug 3.

Department of Radiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.

Introduction: Speech therapy is the primary management followed the physical management through surgery for children with nonsyndromic cleft lip and palate (NSCLP). However, the topological pattern of the resting-state network after rehabilitation remains poorly understood. We aimed to explore the functional topological pattern of children with NSCLP after speech rehabilitation compared with healthy controls. Read More

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A spatial analysis of out-of-pocket payments for healthcare in Malawi.

Health Policy Plan 2021 Aug 3. Epub 2021 Aug 3.

Economics Department, University of Malawi, Chancellor College.

Out-of-pocket (OOP) expenditures on health remain high in many low- and middle-income countries despite policy efforts aiming to reduce these health costs by targeting their hotspots. Hotspot targeting remains inadequate, particularly where the OOP expenditures are related across geographic regions due to unequal demand, supply and prices of healthcare services. In this paper, we investigate the existence of geographical correlations in OOP health expenditures by employing a spatial Durbin model on data from 778 clusters obtained from the 2016 Malawi's Integrated Household Survey. Read More

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The Efficacy of Online Case-Based Assignments in Teaching Veterinary Ophthalmology.

J Vet Med Educ 2021 Aug 2:e20210005. Epub 2021 Aug 2.

Veterinarians are required to use clinical reasoning skills to successfully manage their patients with eye diseases. Case-based assignments can be an effective tool for teaching problem-solving skills. Very few models or online modules exist to deepen the instruction of veterinary ophthalmic clinical reasoning skills. Read More

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Patient Outcomes After Applied Behavior Analysis for Autism Spectrum Disorder.

J Dev Behav Pediatr 2021 Aug 2. Epub 2021 Aug 2.

School of Nursing, University of California, Los Angeles, Los Angeles, CA; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA; Kaiser Foundation Health Plan, Oakland, CA; Southern California Permanente Medical Group, Kaiser Permanente, Pasadena, CA; and Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA.

Objectives: The purpose of this study was to examine patterns of service receipt and patient outcomes for children receiving applied behavior analysis (ABA) for autism spectrum disorder (ASD) in an integrated health care system in which commercially insured children were covered by a state autism mandate.

Methods: This retrospective, observational study used a random sample of children with ASD (3-17 yrs) who were members of a large integrated health care system in Southern California and referred for ABA between January 2016 and November 2018. From the 4145 children referred, a random stratified sample of 334 was selected to extract data from clinical reports over 24 months of services. Read More

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Scaling up Business Plans in Tajikistan: a qualitative study of the history, barriers, facilitators and lessons learnt.

Glob Health Action 2021 Jan;14(1):1947552

Swiss Center for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.

Background: To improve health planning at primary health care (PHC) level, Business Plans were introduced in Tajikistan by the Enhancing Primary Health Care (EPHC) Services Project.

Objective: To describe the history and process of implementation of Business Plans and to identify barriers, facilitators and lessons learnt from scaling up Business Plans.

Methods: Set in a qualitative research design, we conducted a desk review of project and official documents and seventeen semi-structured interviews with key stakeholders at national and sub-national levels between May and July 2020. Read More

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January 2021

Medical Physics Practice Guideline (MPPG) 11.a: Plan and chart review in external beam radiotherapy and brachytherapy.

J Appl Clin Med Phys 2021 Aug 2. Epub 2021 Aug 2.

Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska, USA.

A therapeutic medical physicist is responsible for reviewing radiation therapy treatment plans and patient charts, including initial treatment plans and new chart review, on treatment chart (weekly) review, and end of treatment chart review for both external beam radiation and brachytherapy. Task group report TG 275 examined this topic using a risk-based approach to provide a thorough analysis and guidance for best practice. Considering differences in resources and workflows of various clinical practice settings, the Professional Council of the American Association of Physicists in Medicine assembled this task group to develop a practice guideline on the same topic to provide a minimum standard that balances an appropriate level of safety and resource utilization. Read More

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Are Gamma Passing Rate and Dose-Volume Histogram QA Metrics Correlated?

Med Phys 2021 Aug 3. Epub 2021 Aug 3.

Faculty of Materials Science and Physics, Cracow University of Technology, Podchorążych 1, 30-084, Krakow, Poland.

Purpose: The quality of a measured distribution of dose delivered against its corresponding radiotherapy plan is routinely assessed by gamma index (GI) and dose-volume histogram (DVH) metrics. Any correlation between error detection rates, as based on either of these approaches, while argued, has never been convincingly demonstrated. The dependence of the strength of correlation between the GI passing rate (γP) and DVH quality assurance (QA) metrics on various elements of the therapy plan has not been systematically investigated. Read More

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Rapid and specific detection nanoplatform of serum exosomes for prostate cancer diagnosis.

Mikrochim Acta 2021 Aug 2;188(8):283. Epub 2021 Aug 2.

Zhejiang Provincial Key Laboratory of Advanced Mass Spectrometry and Molecular Analysis, Institute of Mass Spectrometry, School of Material Science and Chemical Engineering, Ningbo University, Ningbo, 315211, Zhejiang, China.

Tumor exosomes that inherit specific molecules from their parent cells are emerging as ideal biomarkers in cancer diagnostics. Most currently available exosome isolation and detection methods are time-consuming and non-specific; thus, rapid and specific exosome detection methods are needed both clinically and in research. Here, a dual-functional platform is reported composed of reversible conjunction and "off-on" signal responses. Read More

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Central venous catheterization site choice based on anatomical landmark technique: a systematic review and meta-analysis.

J Anesth 2021 Aug 2. Epub 2021 Aug 2.

Department of Anesthesiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Rd, Shanghai, China.

Background: Internal jugular vein catheterization (IJVC) and subclavian vein catheterization (SCVC) have been the most preferred central venous catheterizations (CVC) clinically. Individual preference and institutional routine dominate the traditional CVC choice; however, it is lack of high-level evidence. We sought to provide better clinical strategy for CVC site choice based on anatomical landmark technique between IJVC and SCVC. Read More

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