Impact of Neonatal Nurses’ Guidelines on Improving Their Knowledge, Attitude and Practice Toward Kangaroo Mother's Care

Kangaroo care is a technique practiced on newborn and seeks to provide restored closeness of the newborn with mother or father by placing the infant in direct skin to skin contact with one of them. The study aimed to evaluate the impact of neonatal nurses' guidelines on improving their knowledge, attitude and practice toward kangaroo mother care. Quasi experimental design was conducted for this study. The study was conducted in the neonate and neonatal intensive care unit in   Mansura university children hospital Egypt. This is a convenient sample of 60 registered nurses who's worked in the mentioned above setting. For data collection an interview questionnaire (pre/post test format) was used to assess nurses knowledge, attitude and practice as regard to kangaroo care promote bonding, it have positive effect on physical wellbeing of infant, it improve breast feeding, kangaroo care should begin within few hours after birth, also all parents should be given relevant information on kangaroo care and nurses should remain with parent support and assistance during kangaroo care. The result of the study showed the effectiveness of neonatal nurses guideline on improving their knowledge and practice toward kangaroo mother care as a means of facilitating parent – infant attachment, and provides valuable insights into the attitudes and practices of neonatal nurses in promoting KMC within the highly specialized NICU environment.  According to this study it is recommended to establish education program for all mothers about the benefits and management of KMC through booklets, posters. Hospital support for the mothers is needed to facilitate and continues early initiation of KMC through allowing the mother to visit her premature infants' all of the time without restrictions

Modified extended complex Kalman filter for DC offset and distortion rejection in grid-tie transformerless converters

Proper operation of the grid-tie transformerless converters under unbalanced and distorted conditions entails a precise detection of the frequency and fundamental component of the grid voltage. One of the main problems that could arise during the estimation of grid parameters is the existence of a DC offset generated from measurement and A/D conversion. This undesirable induced DC offset could appear as a part of the reference sinusoidal current of grid-tie converters. Although literature has proposed the use of an extended complex Kalman filter (ECKF) for the estimation of positive and negative sequence voltage components as a promising competitor to phase locked loops, mitigating the effect of possible DC offsets when a Kalman filter is employed remains scarce. This paper proposes a new extended complex Kalman filter to improve the filter stability for estimating the frequency and the fundamental positive and negative symmetrical components of the grid voltages, where DC offset, scaling error, and noise can successfully be rejected. The theoretical findings are experimentally validated

Bacterial translocation in an experimental intestinal obstruction model: C-reactive protein reliability? Translocação bacteriana no modelo experimental de obstrução intestinal: A proteína C-reativa é confiável?

BACKGROUND: Bacterial translocation occurs in preseptic conditions such as intestinal obstruction through unclear mechanism. The C-reactive protein is an acute phase reactant and a marker of ischemia. METHODS: 45 albino male rats were divided into 3 groups each 15 rats. GI control, GII simple intestinal-obstruction and GIII strangulated obstruction. Outcome measures were: (1) Bacteriologic count and typing for intestinal contents, intestinal wall, liver, mesenteric lymph nodes and blood (cardiac and portal) (2) Histopathologic: mucosal injury score, inflammatory cell infiltrate in the wall, MLN, liver, (3) Biochemical: serum CRP, IL-10, mucosal stress pattern (glutathione peroxidase-malonyldialdhyde tissue levels). RESULTS: (1) Intestinal obstruction associates with BT precursors (Bact-overgrowth, mucosal-acidosis, immuno-incomptence), (2) Bacterial translocation (frequency and density) was found higher in strangulated I.O, that was mainly enteric (aerobic and anaerobic) and mostly E.coli, (3) The pathogen commonality supports the gut origin hypothesis but the systemic inflammatory response goes with the cytokine generating one. (4) The CRP median values for GI, II, III were 0.5, 6.9, 8.5 mg/L, for BT +ve 8 mg/L and 0.75 mg/L for BT -ve rats. CONCLUSION: Bacterial translocation occurs bi-directional (systemic-portal) in intestinal obstruction and the resultant inflammatory response pathogenesis is mostly 3 hit model. The CRP is a non selective marker of suspected I.O cases. However, it is a reliable marker of BT, BT density and vascular compromise during I.O.<br>OBJETIVO: Translocação bacteriana ocorre em condições pré-sépticas como na obstrução intestinal por mecanismo não esclarecido. A proteína C-reativa é um marcador de ischemia em fase aguda. A proposição é investigar os possíveis efeitos da obstrução intestinal no equilíbrio ecológico microbiano. MÉTODOS: 45 ratos machos albinos foram distribuídos em três grupos de 15 ratos. GI controle, GII obstrução intestinal simples e GIII obstrução estrangulada. As medidas adotadas foram: (1) Contagem bacteriológica do conteúdo intestinal, parede intestinal, fígado, linfonodos mesentéricos e sangue (coração e portal) (2) Avaliação histopatológica da lesão da mucosa, infiltrado celular inflamatório da parede, linfonodos mesentéricos, fígado, (3) Avaliação bioquímica. RESULTADOS: (1) Obstrução intestinal está associada a precursora translocação bacteriana (crescimento bacteriano, acidose da mucosa, imuno-incompetência), (2) Translocação bacteriana (freqüência e densidade) foi maior na obstrução intestinal estrangulada, principalmente entérica (aeróbios e anaeróbios), sobretudo E.coli, (3) A ocorrência comum é de origem intestinal. CONCLUSÃO: A translocação bacteriana na obstrução intestinal é bi-direcional (sistêmica e portal) A proteina C-reativa não é um marcador seletivo na suspeita de obstrução intestinal. Contudo é marcador confiável da translocação bacteriana, na densidade e comprometimento durante a obstrução intestinal

Space vector-based model predictive current controller for grid-connected converter under unbalanced and distorted grid without a phase-locked loop

This paper presents an improved current control strategy for a three-phase voltage source converter connected to distorted grid. The proposed controller can successfully compensate the induced harmonic currents, while suppressing possible active power ripple. To manage various objectives and deal with tough restrictions, model predictive control can offer a promising solution. However, a modified extended complex Kalman filter is introduced to estimate the positive and negative fundamental components of the grid voltages which are used with the real and reactive power references to generate pure sinusoidal reference currents without the need for a phase-locked loop (PLL), avoiding its challenges under abnormal grid conditions. An improved space vector-based model predictive control (SVM-MPC) is proposed to regulate the real and reactive power components. The main target of this controller is to maintain harmonic free grid currents, even in unbalanced and distorted grid conditions, with enhanced performance in terms of fast dynamic response and good steady-state behavior. The proposed SVM MPC uses Pythagoras theorem to determine duty factors, avoiding trigonometric functions, which improves the computational burden and implementation complexity. In addition, fixed switching frequency can be ensured. Simulation and experimental results are carried out to validate the effectiveness and the practical feasibility of the proposed controller under distorted grid conditions

Is music intervention effective in reducing anxiety and pain during breast biopsy procedure? A systematic review and meta-analysis of randomized controlled trials

PURPOSE: To evaluate the evidence from randomized clinical trials (RCTs) about the effect of music intervention in reducing patients\u27 anxiety during breast biopsy. METHODS: Electronic databases including PubMed, Cochrane Library, Scopus, and Web of Science were searched using the relevant MeSH terms. The inclusion criteria were all RCTs assessing the effect of music therapy versus no music in reducing anxiety during breast biopsy. The extracted outcomes were anxiety and pain during breast biopsy. They were pooled as mean difference (MD) with a 95% confidence interval (CI) in a fixed-effects model, using Review Manager 5.3 software for windows. The quality of included studies was assessed with the Cochrane risk of bias assessment tool (RoB 1.0). Then, the outcomes of our meta-analyses were independently evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) to know the grade of their evidence. RESULTS: The final analysis included five RCTs. We found a positive effect of music therapy in reducing anxiety levels compared with control group (MD =  - 2.11; 95% CI (- 4.16 to - 0.06); p = 0.04). No difference between music and control groups regarding pain associated with breast biopsy (MD = 0.22; 95% CI (- 0.81 to 1.25); p = 0.68). The GRADE rating of our outcomes was low for anxiety levels and very low for pain during the biopsy. CONCLUSIONS: Music therapy could be an effective, simple, non-pharmacological option in relieving anxiety during breast biopsy; however, it had no effect on procedure-associated pain. More large and high-quality studies are needed to confirm our results

QTRAP LC/MS/MS of Garlic Nanoparticles and Improving Sunflower Oil Stabilization during Accelerated Shelf Life Storage

The purpose of this research was to assess and utilize the bioactive compounds of garlic nanoparticles (Ga-NPs) as a natural antioxidant in sunflower oil (SFO) stored at 65 &plusmn; 1 &deg;C for 24 days. The garlic nanoparticles (Ga-NPs) from the Balady cultivar were prepared, characterized, and added to SFO at three concentrations: 200, 600, and 1000 ppm (w/v), and they were compared with 600 ppm garlic lyophilized powder extract (Ga-LPE), 200 ppm BHT, 200 ppm &alpha;-tocopherol, and SFO without Ga-NPs (control). The QTRAP LC/MS/MS profile of Ga-NPs revealed the presence of four organosulfur compounds. Ga-NPs exhibited the highest capacity for phenolic, flavonoid, and antioxidant compounds. In Ga-NP SFO samples, the values of peroxide, p-anisidine, totox, conjugated dienes, and conjugated trienes were significantly lower than the control. The antioxidant indices of SFO samples containing Ga-NPs were higher than the control. The Ga-NPs enhanced the sensory acceptability of SFO treatments up to day 24 of storage. The shelf life of SFO treated with Ga-NPs was substantially increased (presuming a Q10 amount). The results show that Ga-NPs are a powerful antioxidant that improves SFO stability and extends the shelf life (~384 days at 25 &deg;C)