bluuebunny/crossref_metadata_2025 huggingface dataset:
TÜRKİYE’DE PALYATİF BAKIM HİZMETLERİNİN ORGANİZASYONUNA YÖNELİK BİR DEĞERLENDİRME
Authors: EKİNCİ Gülay
Published: October 2022

Amaç: Palyatif bakım; tedavisi olmayan ya da uzun süreli tedaviye ihtiyaç duyulan kronik hastalıklarda, bireyin mevcut hastalıkla uyumunu sağlayarak yaşam kalitesini optimal düzeye çıkarmaya ve/veya optimal düzeyde idamesini sağlamaya dönük çabalar bütünüdür. Bu çalışma ile palyatif bakım ile ilişkili uluslararası düzenlemelerde yer verilen öneriler ile ülkemizde mevcut mevzuat çerçevesince yürütülmeye çalışılan palyatif bakım hizmetlerine ait değerlendirmenin yapılması ve gereksinimler çerçevesince bir model önerisinde bulunulmaya çalışılacaktır.

Yöntem: Bu araştırma ile palyatif bakım hizmetlerine ait mevcut durumun yorumlanması amaçlandığı için nitel araştırma türlerinden durum çalışması ile desenlenmiştir. Araştırmada veri toplama yöntemi olarak doküman analizi kullanılmıştır. Bu araştırmada “Palyatif Bakım Hizmetlerinin Uygulama Usul ve Esasları Hakkında Yönerge” ile Dünya Sağlık Örgütünün “Palyatif bakımın ve semptomların giderilmesinin temel sağlık hizmetlerine entegre edilmesi: planlayıcılar, uygulayıcılar ve yöneticiler için bir kılavuz” resmi belgeleri kullanılarak değerlendirme yapılmıştır.

Bulgular: Çalışmaların değerlendirilmesinde kullanılan alt başlıklar politika/yasal düzenlemeler, eğitim, hizmet sunumu, ilaç yönetimi, araç/ekipman yönetimi, insan kaynakları yönetimi, hizmete erişim, yasal yükümlülükler ve çıktılar kapsamında değerlendirilecektir. Bu kapsamda yazar tarafından dokuz ana başlıkta toplamda yirmi dört alt gösterge belirlenmiştir. Belirlenen 24 alt göstergenin %54’üne kısmen ya da tamamen uyum sağlandığı, %25’inde uyumsuz olduğu, %21’inde ise belirsizlik tespit edilmiştir.

Sonuç: Çalışmadan elde edilen sonuçlar ışığında, palyatif bakım hizmetlerinin uluslararası düzenlemelerde önerilen veriler ile mevcut ulusal mevzuatımız değerlendirildiğinde palyatif bakım hizmetlerinin işleyişinin büyük ölçüde önerilen standartlara uygun olmadığı; hizmetin geliştirilmesine yönelik ulusal düzenlemelerin ivedilikle ele alınıp plan ve programların hayata geçirilmesi önerilir.
Lifestyles of Kaliningrad youth
Authors: Poliakov Sviatoslav I.
Published: October 2022

Based on an analysis of leisure and consumer practices of students of two leading Kaliningrad universities, this paper attempts to reconstruct the actual space of Kaliningrad youth lifestyles, as well as to identify and describe groups following these lifestyles in socio-­economic and demographic terms. Five style groups are identified: the party people who prefer to spend their free time in bars and clubs; the hipsters who frequent theatres and lecture halls, whilst being staunch upholders of the consumerist culture promoted via social media; the ‘normal’ young people choosing physical exercise and standard weekend leisure activities; the young adults combining Soviet leisure heritage with creative and do-it-yourself practices; the homebodies opting for stay-at-home entertainment. Drawing on the discussion about the significance of lifestyle for modern society, the author concludes that lifestyles do not replace the usual socio-­economic stratification markers, and their capacity to differentiate youth groups with unequal access to economic and cultural resources of youth is also limited. Youth leisure lifestyles form an independent system of stratification, which partially coincides with existing social boundaries and partially overlaps with them. The main dividing line runs between the young people who can afford to choose from a ‘supermarket of styles’ and those deprived of such an opportunity.
Utility of repeated drug level measurements after high dose methotrexate infusion for treatment planning in pediatric leukemia
Authors: Terzi Özlem , Aycicek Ali , Uysalol Ezgi , Yildirgan Duygu , Sek Fatma , Bayram Cengiz
Published: October 2022

Introduction: Although high-dose Methotrexate (MTX) is a successful chemotherapeutic agent used in the treatment of acute lymphoblastic leukemia in childhood, life-threatening toxic effects are rarely seen. Therefore, frequent follow-up of drug levels is recommended. The study researched the necessity of drug level measurement and a minimum safe number of measurements. Materials and Methods: The files of pediatric patients with Acute Lymphoblastic Leukemia receiving high-dose MTX treatment in a single center between 2018 and 2021 were retrospectively reviewed. The treatment protocol was: 3000 mL/m2 alkaline hydration fluid was continued until the 72nd hour together with 2 gr/m2 continuous MTX infusion in the low-risk group and 5 gr/m2 in moderate and high-risk groups, and 15 mg/m2 /dose folinic acid was given at the 42nd, 48th and 54th hours. Findings: 456 MTX treatments were evaluated in 114 patients. Similar results (p > 0.05) were obtained in the MTX level measurements performed at the 24th, 42nd, 48th, and 54th hours after MTX administration. In the repeated measurements, the data at the 42nd hour were similar (p = 0.021). The number of cases that were > 150 µmol/L at the 24th hour of methotrexate infusion and above 1 µmol/L at the 42nd, 48th, and 52nd hours were found to be similar in the repeated measurements. Conclusion: Although recommended, frequent follow-up of MTX levels might not always indicate toxicity. In centers with limited laboratory facilities, the MTX level measured at the 42nd hour in the first treatment might be a practical approach to guide the management of other MTX treatments.
Parameter Identification of Ships Maneuvering (An ID-Posed Problem Formulation)
Authors: Zilman G.
Published: October 2022

Attempts to reduce the difference between the results of mathematical simulations and ship maneuvering trials by means of solving the inverse problem of dynamics generally encounter considerable difficulties. Maybe the main obstacle for system identifiability problems is their instability, which results in the nonrealistic values of the hydrodynamical coefficients.

A practical method for estimating parameters of the mathematical model of the ship by means of solving the consequence of direct problems is here proposed. The method is based on minimazing the vector of cost functions, which represents the '"distance” between the object and it's mathematical model. This method allows to take into account the physical restrictions imposed on the hydrodynamical coefficients and to select the Pareto-optimal solution which satisfy all required functional constraints and thus, to avoid the occurrence of "cancellation effects.
On the Full Scale Maneuvering Characteristics of the SWATH Fishing Vessel Ali
Authors: McGregor R. C. , Miller A. F.
Published: October 2022

This paper describes a series of experiments relating to the manoeuvring of the 22 tonne SWATH fishing vessel ALI. The results are related to the output of a manoeuvring prediction program resulting from the adaptation of monohull manoeuvring techniques to SWATH ships.
Experiments and Predictions of the Resistance Characteristics of a Wave Cancellation Multihull Ship Concept
Authors: Wilson M. B. , Hsu C. C. , Jenkins D. S
Published: October 2022

This paper presents results of both analytical predictions and towing basin validation experiments for the basic resistance characteristics of a new small waterplane area, tri hull ship concept termed the Wave Cancellation Multihull (WCM). This is a variant of the O'Neill Hull form (OHF) type arrangement but which exploits extensive wave cancellation effects between the various hull elements: the center body, the center strut, and the two outer hulls. Significant reductions in total ship wave making resistance have been predicted in a high speed range normally associated only with fine form monohull ships. A tapered-strut-type center body shape bas been developed as an alternative to the original OHF center body and-strut configuration. Towing basin tests confirm the predictions of the thin ship theory wave making resistance variations. The resulting complete ship wavemaking resistance can be reduced to such an extent that the total resistance of a WCM ship geometry is comparable to that of a monohull at high ship speeds, despite the substantially larger wetted surface area. Summary comparison plots are presented for BHP/Displacement versus speed for several 4300 LT ship forms, including a candidate WCM arrangement.These show, for example, that at 30 knots it is possible to achieve a 28% reduction of effective horsepower with a realistic WCM configuration compared with the SWATH VII performance (best performing SWATH to date). It is also shown that the candidate WCM form bas about the same effective horsepower as a slim combatant monohull form at the speed in the neighborhood of 30-32 knots, despite 88% more wetted surface area.
Experience with Hot-Film Anemometry for Ship Model Nominal Wake Survey in a Towing Tank
Authors: Wu S. , Bose N.
Published: October 2022

Problems with the calibration and operation of hot-film anemometers in water have prevented their widespread application for towing tank measurements. The potential advantages of their use, in terms of their accuracy compared with pitot tubes and their low coot compared with laser-doppler anemometry, have yet to be fully exploited. Calibration experiments with several hot-film probes were done in a towing tank to investigate their characteristics. After an initial 'burn in' period of about 100 hours of operation, their calibration was found to be stable and repeatable, although it varied with the ambient water temperature.

Nominal wake survey experiments were conducted be hind a model of a Newfoundland fishing vessel form by using a wedge-shaped single sensor hot-film probe and a dual sensor vee hot-film probe respectively. The model was towed at a speed of l.45m/s, which corresponded to a Froude number of 0.33 and full scale vessel speed of 6.4 knots. Levels of turbulence as well as mean velocity values in the wake were obtained. A comparison is made between sample results obtained by the use of the two different probes.
CD Model Ice - Preliminary Observations on the Effect of Density on Tank Testing
Authors: Spencer D.
Published: October 2022

A brief description of the apparatus for producing controllable density (CD) model ice is given. Ice density is shown to affect nearly all aspects of ice tank testing. Some preliminary results are given for ice-propeller interaction, presawn ice resistance, rubble ice resistance and level ice resistance. The level of ice-propeller interaction is reduced using low density level ice primarily by increasing the minimum model speed before ice in ingested in to the propellers. This leads to a significant reduction in propeller milling at low speed. Rubble ice resistance is shown to be dominated by the ice buoyancy with an approximate 400% increase in resistance as ice density was reduced from 930 kg/m3 to 750 kg/m3. Presawn ice resistance has a buoyancy dependent component which is important at low speed. Ice buoyancy is seen to significantly increase this component. The effect of ice density on level ice resistance is quite insidious in that it can alter the icebreaking process significantly increasing the resistance of certain bow forms. The increased buoyancy of the broken ice cusps causes them to float higher as they are rotated by the advancing bow. These pieces may then have a higher incidence of jamming between the hull and the unbroken ice sheet leading to crushing events and large loads in the shoulder region.
Discussion of the Origins of the Frigate and the Sloop Constellation
Authors: Lynaugh K. M.
Published: October 2022

Alleged to have been built in Baltimore, Maryland in 1797, the USS CONSTELLATION was transferred in 1955 to a group of Baltimore citizens for preservation and display. Initiating a protracted, vitriolic and public dispute, some maritime historians have claimed since 1947 that the ship presently exhibited is another warship with the same name built near Norfolk, Virginia in 1855. Has the ship had a continuous identity since 1797 or are those claims a mistake or a hoax? In March 1989 the U.S. Navy's Curator of Ship Models, situated at the David Taylor Research Center, located and identified in the Navy's vast collection, the 1853 designer's half hull model representing the design for a new CONSTELLATION. Further investigation by the Curator's office indicated that essentially all of the historical records cited, clearly substantiating the 1797 origin of the present ship, had probably been forged by a CONSTELLATION employee between 1956 and 1965. 1 (for a copy of the complete report "FOULED ANCHORS").
Scaling of Main Spray Generated by Planing Surfaces
Authors: Ryan S. , Latorre R.
Published: October 2022

This paper presents the application of the Latorre-Ryan spray scaling relationship to the Geosim tests of eleven semi-planing hulls tested at Froude Number F = 1.0. Using the results of the spray scaling, it is possible to collapse the spray measurements into a single curve.
Ethnography in the Whirls of Its Centenary
Authors: Šidiškienė Irma
Published: October 2022

2018 m. Lietuvos nacionaliniame muziejuje įvykusi konferencija „Šimtmečio etnografija 1918–2018“ kėlė tikslą retrospektyviai apžvelgti etnografinio darbo šimtmetį, o skaitytų pranešimų pagrindu išleistas atskiras leidinys Etnografijos metraščių serijoje ir buvo skirtas Lietuvos valstybės atkūrimo šimtmečiui paminėti. Džiugu, kad konferencijoje draugėn suburti mokslininkai, muziejininkai, kraštotyrininkai turėjo progą pasidalyti savomis įžvalgomis, patirtimis.
La fabrique du “héros” Simón Bolívar entre 1810 et 1930. Étapes politiques vénézuéliennes et modalités propagandistes
Authors: Balutet Nicolas
Published: October 2022

Through various textual and iconographic supports (poems and other literary works, political and historical speeches, paintings, statues, films), this article analyses the process that led to the political and nationalist recovery of the figure of Simón Bolívar. It shows the extent to which the independence leader has been transformed into a hero, with its share of exaggerations, to the point that a form of mythification has sometimes taken place that is more akin to poetry and the sacred than to historical reality.

A través de diferentes soportes textuales (poemas y otras obras literarias, discursos políticos e históricos) e iconográficos (pinturas, estatuas, películas), este artículo analiza el proceso que llevó a la recuperación política y nacionalista de la figura de Simón Bolívar. Muestra hasta qué punto se ha transformado al líder independentista en un héroe, con su cuota de exageraciones, hasta el punto de que a veces se ha producido una forma de mitificación más parecida a la poesía y a lo sagrado que a la realidad histórica.

À travers différents supports textuels (poèmes et autres œuvres littéraires, discours politiques et historiques) et iconographiques (peintures, statues, films), le présent article analyse le processus qui a conduit à la récupération politique et nationaliste de la figure de Simón Bolívar. Il montre combien le leader indépendantiste a été transformé en héros, avec son lot d’exagérations, au point que s’est opéré parfois une forme de mythification relevant davantage de la poésie et du sacré que de la réalité historique.
La memoria de la independencia de Cuba a través de los egodocumentos.
Authors: Bravo García Eva
Published: October 2022

Egodocuments are an excellent documentary type for the study of social and linguistic history. As they are not subject to mediation, correction, or interference by a secondary author, they are texts in which the author expresses his or her feelings just setting the pen to paper. On the other hand, as their execution is focused on immediate communication, their dissemination is not considered, so they lack the filters of social or formal conventions. The aim of this research is to show the importance of considering egodocuments as a valuable material for the reconstruction of identity and the role played by the popular classes in Cuba, concentrating on the decades before Independence, in those accurate moments when the social and linguistic identity of a new nation was being formed.

Los egodocumentos son un excelente tipo documental para estudiar la historia social y lingüística. Al no estar sometidos a mediación, corrección o injerencia de autor secundario, son textos en los que el autor plasma sus sentimientos y experiencias en el correr de la pluma. De otra parte, como su ejecución se centra en una comunicación inmediata, no se considera su difusión, por lo que carecen de los filtros propios de las convenciones sociales o formales. El objetivo de esta investigación es mostrar la importancia de considerar los egodocumentos como material valioso para la reconstrucción de la identidad y del papel representado por las clases populares en Cuba, ciñéndonos a las décadas previas a la Independencia, en esos precisos momentos en que se está configurando la identidad social y lingüística de una nueva nación.
Forensic Turning Points: Exhumations, Dignity, and Iconoclasm
Authors: Palacios Gonzalez Daniel
Published: October 2022

Between 100,000 and 130,000 people were murdered during the war and dictatorship in Spain from 1936 onward. Thousands of bodies were buried in mass graves which were then monumentalized decades later. Since the year 2000, the commemorative practices surrounding the victims of the war and dictatorship changed radically: hundreds of exhumations took place and the rhetoric on human rights and dignity was generalized in the discourses. This phenomenon is associated with the idea of the “forensic turn”. However, the situation presents a double crisis: that of the popular forms of memorial based on honour and the monument, threatened by the scientific paradigm, and the lack of social recognition of the victims, of which the exhumations are not part of a judicial process, and how the ratios of identifications are low in the current model. Therefore, by means of an interdisciplinary approach to the context, this article contributes to the debate on the current crisis of the memory policies in the Kingdom of Spain demonstrating the limits of the “forensic turn” and the exhumation-based model promoted by the government of Spain.
Crisi. Quale crisi? Stabilizzazione e caos
Authors: Pedretti Roberto
Published: October 2022

This essay aims to reflect on the concept of crisis by focusing on the centrality this term has assumed in the context of contemporary public and political debate, and on the ambiguities that accompany its use in an attempt to normalise its ideological function and role. The ambiguity and conceptual density of the word “crisis” and the multiplicity of meanings that make it versatile and adaptable to the most diverse contexts contribute to fuelling a mechanism of naturalisation, even though its deployment is normally associated with conditions of extraordinariness, exceptionality, and unpredictability. In this perspective, the crisis, a constant and pervasive presence invading every area of social space and life, is unveiled as being the product of specific ideological and political practices, and social conflicts, representing multiple interests coagulated around the needs and objectives of global capitalism. The naturalisation and normalisation of the crisis do not seem to completely close off, however, the possibility of producing the conditions to imagine incisive forms of resistance and opposition. To achieve this aim, it seems imperative to recover the reasons and motivations for a cultural battle that looks at knowledge, in its manifold meanings, as a primary tool for emancipation and liberation.
Songs without Sunrise: Irish Victorian Poetry and the Risorgimento
Authors: Van Dam Frederik
Published: October 2022

While the Risorgimento had a profound impact on the shape of English literature, this geopolitical crisis did not leave a similar imprint on Irish literature. Historical circumstances can explain why the nineteenth-century struggle for the unification of Italy did not lead to rapprochement between Italy and Ireland: support for the Italian cause put Irish nationalists in opposition with Catholic interests at home, while in the eyes of Italian nationalists the Irish question weakened the function of Britain as a liberalising power. Even so, a few Irish poets did address the Risorgimento. This article shows how poems by Thomas Davis, James Clarence Mangan, Jane Francesca Elgee, and Aubrey de Vere express a variety of positions (isolationism, catastrophism, liberalism, realism) that are informed by a complex constellation of geopolitical factors. By means of a series of close readings, the present inquiry aims to shed new light on the geopolitical form of Irish poetry in the Victorian age.
Awkward Intelligence
Authors: Zweig Katharina A.
Published: October 2022

An expert offers a guide to where we should use artificial intelligence—and where we should not.

Before we know it, artificial intelligence (AI) will work its way into every corner of our lives, making decisions about, with, and for us. Is this a good thing? There's a tendency to think that machines can be more “objective” than humans—can make better decisions about job applicants, for example, or risk assessments. In Awkward Intelligence, AI expert Katharina Zweig offers readers the inside story, explaining how many levers computer and data scientists must pull for AI's supposedly objective decision making. She presents the good and the bad: AI is good at processing vast quantities of data that humans cannot—but it's bad at making judgments about people.

AI is accurate at sifting through billions of websites to offer up the best results for our search queries and it has beaten reigning champions in games of chess and Go. But, drawing on her own research, Zweig shows how inaccurate AI is, for example, at predicting whether someone with a previous conviction will become a repeat offender. It's no better than simple guesswork, and yet it's used to determine people's futures.

Zweig introduces readers to the basics of AI and presents a toolkit for designing AI systems. She explains algorithms, big data, and computer intelligence, and how they relate to one another. Finally, she explores the ethics of AI and how we can shape the process. With Awkward Intelligence, Zweig equips us to confront the biggest question concerning AI: where we should use it—and where we should not.
Visual Plague
Authors: Lynteris Christos
Published: October 2022

How epidemic photography during a global pandemic of bubonic plague contributed to the development of modern epidemiology and our concept of the “pandemic.”

In Visual Plague, Christos Lynteris examines the emergence of epidemic photography during the third plague pandemic (1894–1959), a global pandemic of bubonic plague that led to over twelve million deaths. Unlike medical photography, epidemic photography was not exclusively, or even primarily, concerned with exposing the patient's body or medical examinations and operations. Instead, it played a key role in reconceptualizing infectious diseases by visualizing the “pandemic” as a new concept and structure of experience—one that frames and responds to the smallest local outbreak of an infectious disease as an event of global importance and consequence.

As the third plague pandemic struck more and more countries, the international circulation of plague photographs in the press generated an unprecedented spectacle of imminent global threat. Nothing contributed to this sense of global interconnectedness, anticipation, and fear more than photography. Exploring the impact of epidemic photography at the time of its emergence, Lynteris highlights its entanglement with colonial politics, epistemologies, and aesthetics, as well as with major shifts in epidemiological thinking and public health practice. He explores the characteristics, uses, and impact of epidemic photography and how it differs from the general corpus of medical photography. The new photography was used not simply to visualize or illustrate a pandemic, but to articulate, respond to, and unsettle key questions of epidemiology and epidemic control, as well as to foster the notion of the “pandemic,” which continues to affect our lives today.
Combining transgenesis with paratransgenesis to fight malaria
Authors: Huang Wei , Vega-Rodriguez Joel , Kizito Chritopher , Cha Sung-Jae , Jacobs-Lorena Marcelo
Published: October 2022

Malaria is among the deadliest infectious diseases, and Plasmodium, the causative agent, needs to complete a complex development cycle in its vector mosquito for transmission to occur. Two promising strategies to curb transmission are transgenesis, consisting of genetically engineering mosquitoes to express antimalarial effector molecules, and paratransgenesis, consisting of introducing into the mosquito commensal bacteria engineered to express antimalarial effector molecules. Although both approaches restrict parasite development in the mosquito, it is not known how their effectiveness compares. Here we provide an in-depth assessment of transgenesis and paratransgenesis and evaluate the combination of the two approaches. Using the Q-system to drive gene expression, we engineered mosquitoes to produce and secrete two effectors – scorpine and the MP2 peptide – into the mosquito gut and salivary glands. We also engineered Serratia, a commensal bacterium capable of spreading through mosquito populations to secrete effectors into the mosquito gut. Whereas both mosquito-based and bacteria-based approaches strongly reduced the oocyst and sporozoite intensity, a substantially stronger reduction of Plasmodium falciparum development was achieved when transgenesis and paratransgenesis were combined. Most importantly, transmission of Plasmodium berghei from infected to naïve mice was maximally inhibited by the combination of the two approaches. Combining these two strategies promises to become a powerful approach to combat malaria.
Governance Mode and Formation Mechanism of Continuing Education in Colleges and Universities from the Perspective of Stakeholders
Authors: Changfu Yuan
Published: October 2022

Governance mode and formation mechanism of continuing education in colleges and universities from the perspective of stakeholders is studied in the paper. Continuing education is a kind of post-degree education, which is the extension and development of academic education; its main body of learning is adults, and it is a lifelong learning activity for social members who have received a certain degree of education or vocational education. Strengthening the technological innovation of enterprises is an important link to enhance the competitiveness of enterprises, and participating in the technological transformation of enterprises and developing new products and processes is an important content of university-industry research cooperation. Hence, this paper gives the novel ideas for improving the educational performance.
Strategic Regimen in the Management of Uterine Fibroid and It’s Complications on Women in Abia State, Nigeria
Authors: P. Emeonye Odochi , S. Nwatu Madukaibeya , Chinwendu J. Felix , Odochi Nwakanma , Maduforo Jombo Israel , Ijeoma Odumishi , Akunna Okore
Published: October 2022

Uterine fibroid poses a lot of threat to women even in pregnancy presenting with lower abdomen pain and excessive menstruation, bearing down sensation in the pelvis, infertility, vomiting, fever, and leucocytosis. Before the treatment of uterine fibroid commences, a diagnosis must be made.

Objective: To ascertain various management and post operation complications in uterine fibroid on women in Nigerian Christian Hospital Nlagu.

Methodology: A total of 60 participants were included and recruited in the study particularly with women who had their operation done in the same hospital. The files of the women were monitored from time of admission till discharge.

Results: The study showed that surgery is the most common method of treatment of uterine fibroid. Out of the total respondents, 69% of the patients had myomectomy, 30% of the patient had total abdominal hysterectomy with or without salpingo-oophorectomy while 1% had vaginal hysterectomy. None of the patients opted for the use of drugs, this could be due to the fact that surgical treatment is the most effective method for the management of uterine fibroid. Since the p-value = 1.000 is greater than the 0.05 level of significance, we accept H1, and concluded that, the treatment option for uterine fibroid is not significant.

Conclusion: The most common treatment method for uterine fibroid is myomectomy and the preference for myomectomy is largely due to the strong reproductive desire of women and the need to keep their fertility after surgery.
The Role of Information in Management of Modern Hospital: Experience of Medical Reform in Shenmu, China
Authors: Wang Qiang , Song Zhenyu , Li Jing , Du Meiyun
Published: October 2022

Objective: The objective of this review is to explore the role of information technology in the construction and management of modern hospitals, and how to use information technology to promote the development and management of hospitals.

Methods: The relevant medical information and data at home and abroad were collected from the Internet, and the actual situation of the hospital, the diagnosis, treatment and management of outpatients were compared and analyzed to compare the role of medical information in hospital development.

Results: After the effective implementation of medical information in the hospital, the technical level and efficiency of diagnosis, treatment and management technology in the hospital were obviously improved, so that patients could see a doctor more conveniently, and doctors and nurses could have a higher level of diagnosis and treatment.

Conclusions: The use of medical information can significantly improve the overall management level of the hospital, make it more convenient for patients to see a doctor, and improve the construction and management of modern hospitals, which is of great significance to the improvement of the level of medical technology.
Profile of Blood Donors and Deferral Reasons in a Tertiary Care Centre in South India
Authors: Rajan Reeba Mary , Anu J. , Mathew Apuca Susan
Published: October 2022

Aim: To assess the demographic profile of blood donors and determine the frequency and causes for deferral.

Study Design: Retrospective cross-sectional study.

Place and Duration of Study: Department of Pathology, Blood Centre at Dr. SMCSI medical college, Karakonam, Trivandrum. January 2018 to September 2022.

Methodology: This study was done to analyze the various causes of deferral and the profile of donors. 8064 donors from the study period were analyzed and their demographic profile was recorded. The deferred donors were analyzed according to their age, sex, type of donor, type of deferral and reasons for deferral.

Results: 8064 donors came to our center for donation of which 7682 (95.3%) were males and 382 (4.7%) were females. Majority of blood donors belonged to age group 18-25 years (50.6%). Replacement donors accounted for 6596 donors (81.8%). Voluntary donors were only 940 (11.7%). 1541 (19.1%) donors were deferred from donating. Out of these, 1186(77%) were replacement donors, 198(12.8%) were voluntary donors and 160(10.2%) were family donors. The most frequent causes of temporary deferrals: Hypertension 314(20.2%), Hypotension 82(5.3%), low hemoglobin 110(7.1%), On medication 104(6.7%), Tattoo/ ear piercing/smoking/pan chewing 154(10%), previous recent illness/surgery 190(12.3%) and alcoholism 46(3%). Permanent deferrals were done for only 68 donors (0.7%). They included 21 high risk donors and 47 donors who were serology positive.

Conclusion: Deferral pattern analysis can help the medical personnel in knowing the common causes of deferral and be more focused in screening. Determination of cause and rate donor deferral can help in preventing loss of precious blood and components.
Comparative Study of the Compressive Strength of Concrete made from Different Brands of Cements in Ghana
Authors: Thomas Akyen , Kankam Charles Kwame
Published: October 2022

There is an on-going debate about the strength and durability of the different brands of cements used for construction in Ghana. This has raised doubts on the quality and performance of the strength of the different brands of cements. Concrete is a composite material made of aggregates such as sand and stone that are mixed uniformly in the required proportion together with water for it to achieve the desired strength in its development. Cement is an important ingredient that binds together other building materials by a combination of chemical processes known as setting. Among the various physical properties of cement, compressive strength is the most vital property which gives an overall assessment of quality of concrete as the strength of concrete shows the ability of the structure to withstand various loads during it lifelong performance after construction. This research investigated the compressive strength of six different brands of 32.5R and 42.5R cements used for construction works in Ghana, namely, CIMAF cement, DIAMOND cement, GHACEM cement, SOL cement, SUPACEM cement and DANGOTE cement. Among the 32.5R brands, GHACEM cement developed the highest 28th day compressive strength of 30.96 N/mm2 and CIMAF cement the lowest strength of 25.89 N/mm2. In the 42.5R group, DANGOTE had the highest 28th compressive strength of 37.19N/mm2 while SOL produced the lowest with 31.11N/mm2.
Transition of care for stomatic patients: convergent care research contributions / Transição do cuidado de pacientes estomizados: transição do cuidado de estomizados
Authors: Alievi Mariana Frölich , Loro Marli Maria , Flôres Gabriela Ceretta , Lorenzini Elisiane , Domenico Edvane Birelo Lopes de , Kolankiewicz Adriane Cristina Bernat
Published: October 2022

Objetivo: descrever uma intervenção multidimensional educativa realizada com enfermeiros, acerca da transição do cuidado de pacientes estomizados na Rede de Atenção à Saúde, no sul do Brasil. Método: pesquisa convergente assistencial realizada com enfermeiros da Rede de Atenção à Saúde de município do estado do Rio Grande do Sul, Brasil. Dados coletados por meio de observação participante e oficina educativa, embasadas no cuidado ao estomizado. Técnica de análise temática. Resultados: principais fragilidades: dificuldade em referenciar e contrarreferenciar, falta de comunicação e lacunas no conhecimento. As atividades resultaram em proposições construídas dialogicamente para superação das fragilidades: organização de cronograma de atualizações; criação de protocolos de referência/contrarreferência, transferência do paciente por telefone, agendamento da consulta na unidade referência; uso de aplicativos digitais para comunicação. Conclusões: a estratégia resultou na participação ativa e reflexão sobre as práticas profissionais e permitiu identificação das fragilidades do processo de transição do cuidado e possibilidades de melhorias.
Association of Hospital Participation in Bundled Payments for Care Improvement Advanced With Medicare Spending and Hospital Incentive Payments
Authors: Shashikumar Sukruth A. , Gulseren Baris , Berlin Nicholas L. , Hollingsworth John M. , Joynt Maddox Karen E. , Ryan Andrew M.
Published: October 2022

Importance

Bundled Payments for Care Improvement Advanced (BPCI-A) is a Centers for Medicare & Medicaid Services (CMS) initiative that aims to produce financial savings by incentivizing decreases in clinical spending. Incentives consist of financial bonuses from CMS to hospitals or penalties paid by hospitals to CMS.

Objective

To investigate the association of hospital participation in BPCI-A with spending, and to characterize hospitals receiving financial bonuses vs penalties.

Design, Setting, and Participants

Difference-in-differences and cross-sectional analyses of 4 754 139 patient episodes using 2013-2019 US Medicare claims at 694 participating and 2852 nonparticipating hospitals merged with hospital and market characteristics.

Exposures

BPCI-A model years 1 and 2 (October 1, 2018, through December 31, 2019).

Main Outcomes and Measures

Hospitals’ per-episode spending, CMS gross and net spending, and the incentive allocated to each hospital.

Results

The study identified 694 participating hospitals. The analysis observed a −$175 change in mean per-episode spending (95% CI, −$378 to $28) and an aggregate spending change of −$75.1 million (95% CI, −$162.1 million to $12.0 million) across the 428 670 episodes in BPCI-A model years 1 and 2. However, CMS disbursed $354.3 million (95% CI, $212.0 million to $496.0 million) more in bonuses than it received in penalties. Hospital participation in BPCI-A was associated with a net loss to CMS of $279.2 million (95% CI, $135.0 million to $423.0 million). Hospitals in the lowest quartile of Medicaid days received a mean penalty of $0.41 million; (95% CI, $0.09 million to $0.72 million), while those in the highest quartile received a mean bonus of $1.57 million; (95% CI, $1.09 million to $2.08 million). Similar patterns were observed for hospitals across increasing quartiles of Disproportionate Share Hospital percentage and of patients from racial and ethnic minority groups.

Conclusions and Relevance

Among US hospitals measured between 2013 and 2019, participation in BPCI-A was significantly associated with an increase in net CMS spending. Bonuses accrued disproportionately to hospitals providing care for marginalized communities.
Menstrual Cycle Regularity and Length Across the Reproductive Lifespan and Risk of Cardiovascular Disease
Authors: Wang Yi-Xin , Stuart Jennifer J. , Rich-Edwards Janet W. , Missmer Stacey A. , Rexrode Kathryn M. , Farland Leslie V. , Mukamal Kenneth J. , Nelson Scott M. , Solomon Caren G. , Fraser Abigail , Chavarro Jorge E.
Published: October 2022

Importance

Menstrual cycle characteristics may be associated with an increased risk of cardiovascular disease (CVD). However, existing studies are limited, and few have explored the mediating role of established CVD risk factors.

Objective

To explore the associations of menstrual cycle characteristics across the reproductive lifespan with the risk of CVD and to what extent these associations were mediated by hypercholesterolemia, chronic hypertension, and type 2 diabetes.

Design, Setting, and Participants

This cohort study prospectively followed Nurses’ Health Study II participants between 1993 and 2017 who reported menstrual cycle regularity and length for ages 14 to 17 years and 18 to 22 years at enrollment in 1989 and updated current cycle characteristics in 1993 (at ages 29 to 46 years). Data analysis was performed from October 1, 2019, to January 1, 2022.

Exposures

Menstrual cycle regularity and length across the reproductive lifespan.

Main Outcomes and Measures

Incident CVD events of interest, including fatal and nonfatal coronary heart disease (CHD; myocardial infarction [MI] or coronary revascularization) and stroke.

Results

A total of 80 630 Nurses’ Health Study II participants were included in the analysis, with a mean (SD) age of 37.7 (4.6) years and body mass index of 25.1 (5.6) at baseline. Over 24 years of prospective follow-up, 1816 women developed their first CVD event. Multivariable Cox proportional hazards models showed that, compared with women reporting very regular cycles at the same ages, women who had irregular cycles or no periods at ages 14 to 17, 18 to 22, or 29 to 46 years had hazard ratios for CVD of 1.15 (95% CI, 0.99-1.34), 1.36 (95% CI, 1.06-1.75), and 1.40 (95% CI, 1.14-1.71), respectively. Similarly, compared with women reporting a cycle length of 26 to 31 days, women reporting a cycle length 40 days or more or a cycle too irregular to estimate from ages 18 to 22 or 29 to 46 years had hazard ratios for CVD of 1.44 (95% CI, 1.13-1.84) and 1.30 (95% CI, 1.09-1.57), respectively. Mediation analyses showed that subsequent development of hypercholesteremia, chronic hypertension, and type 2 diabetes only explained 5.4% to 13.5% of the observed associations.

Conclusions and Relevance

In this cohort study, both irregular and long menstrual cycles were associated with increased rates of CVD, which persisted even after accounting for subsequently established CVD risk factors.
Banoxantrone Coordinated Metal−Organic Framework for Photoacoustic Imaging‐Guided High Intensity Focused Ultrasound Therapy
Authors: Sun Tingyu , Li Jingnan , Zeng Chao , Luo Chengyan , Luo Xirui , Li Huanan
Published: October 2022

Photoacoustic (PA) imaging with high spatial resolution has great potential as desired monitoring means in the high‐intensity focused ultrasound (HIFU) surgery of tumor. However, its penetration depth in the tissue is insufficient for achieving accurate intraoperative navigation, leading to residual tumor tissue. Nanomedicine provides a new opportunity for PA imaging to guide HIFU surgery. Studies have found that the hypoxic heterogeneity of tumor is effectively reversed by HIFU. Herein, a specific metal−organic framework nanosystem, constructed by coordination of banoxantrone (AQ4N) and Mn2+, is designed based on HIFU to reverse the hypoxic heterogeneity of tumors. It can provide exogenous light‐absorbing substances, thus improving the penetrability of PA imaging signal through the deep tissue and achieving clearer PA imaging for guiding HIFU surgery. In turn, AQ4N, in the hypoxic homogenous environment of the tumor provided by HIFU, is activated sequentially to specifically treat the residual hypoxic tumor cells. This combination treatment manifests higher tumor suppressors activation and lower expression of genes related to tumor progression. This strategy addresses the dissatisfaction with PA imaging‐guided HIFU therapy and is promising for translation into a clinical combination regimen.
Controlling Mineralization with Protein‐Functionalized Peptoid Nanotubes
Authors: Ma Jinrong , Jin Biao , Guye Kathryn N. , Chowdhury Md. Emtias , Naser Nada Y. , Chen Chun‐Long , De Yoreo James J. , Baneyx François
Published: October 2022

Sequence‐defined foldamers that self‐assemble into well‐defined architectures are promising scaffolds to template inorganic mineralization. However, it has been challenging to achieve robust control of nucleation and growth without sequence redesign or extensive experimentation. Here, peptoid nanotubes functionalized with a panel of solid‐binding proteins are used to mineralize homogeneously distributed and monodisperse anatase nanocrystals from the water‐soluble TiBALDH precursor. Crystallite size is systematically tuned between 1.4 and 4.4 nm by changing protein coverage and the identity and valency of the genetically engineered solid‐binding segments. The approach is extended to the synthesis of gold nanoparticles and, using a protein encoding both material‐binding specificities, to the fabrication of titania/gold nanocomposites capable of photocatalysis under visible‐light illumination. Beyond uncovering critical roles for hierarchical organization and denticity on solid‐binding protein mineralization outcomes, the strategy described herein should prove valuable for the fabrication of hierarchical hybrid materials incorporating a broad range of inorganic components.
Ultrathin Cellulose Nanofiber Assisted Ambient‐Pressure‐Dried, Ultralight, Mechanically Robust, Multifunctional MXene Aerogels
Authors: Wu Na , Yang Yunfei , Wang Changxian , Wu Qilei , Pan Fei , Zhang Runa , Liu Jiurong , Zeng Zhihui
Published: October 2022

Ambient‐pressure‐dried (APD) preparation of transition metal carbide/nitrides (MXene) aerogels is highly desirable yet remains highly challenging. Here, ultrathin, high‐strength‐to‐weight‐ratio, renewable cellulose nanofibers (CNFs) are efficiently utilized to assist in the APD preparation of ultralight yet robust, highly conductive, large‐area MXene‐based aerogels via a facile, energy‐efficient, eco‐friendly, and scalable freezing‐exchanging‐drying approach. The strong interactions of large‐aspect‐ratio CNF and MXene as well as the biomimetic nacre‐like microstructure induce high mechanical strength and stability to avoid the structure collapse of aerogels in the APD process. Abundant functional groups of CNFs facilitate the chemical crosslinking of MXene‐based aerogels, significantly improving the hydrophobicity, water resistance, and even oxidation stability. The ultrathin, 1D nature of the CNF renders the minimal MXenes’ interlayered gaps and numerous heterogeneous interfaces, yielding the excellent conductivity and electromagnetic interference (EMI) shielding performance of aerogels. The synergies of the MXene, CNF, and abundant pores efficiently improve the EMI shielding performance, photothermal conversion, and absorption of viscous crude oil. This work shows great promises of the APD, multifunctional MXene‐based aerogels in electromagnetic protection or compatibility, thermal therapy, and oil‐water separation applications.
Direct Formation of Hard‐Magnetic Tetrataenite in Bulk Alloy Castings
Authors: Ivanov Yurii P. , Sarac Baran , Ketov Sergey V. , Eckert Jürgen , Greer A. Lindsay
Published: October 2022

Currently, predominant high‐performance permanent magnets contain rare‐earth elements. In the search for rare‐earth‐free alternates, body‐centered tetragonal Fe–Ni is notable. The ordering to form this phase from the usual cubic close‐packed Fe‐Ni is understood to be possible only below a critical temperature, commonly accepted to be 593 K. The ordering is first demonstrated by using neutron irradiation to accelerate atomic diffusion. The tetragonal phase, designated as the mineral tetrataenite, is found in Fe‐based meteorites, its formation attributed to ultra‐slow cooling. Despite many attempts with diverse approaches, bulk synthesis of tetrataenite has not been reported. Here it is shown that with appropriate alloy compositions, bulk synthesis of tetrataenite is possible, even in conventional casting at cooling rates 11‒15 orders of magnitude higher than in meteorites. The barrier to obtaining tetrataenite (slow ordering from cubic close‐packed to body‐centered tetragonal) is circumvented, opening a processing window for potential rare‐earth‐free permanent magnets. The formation of tetrataenite on industrially practicable timescales also throws into question the interpretation of its formation in meteorites and their associated cooling rates.
Lost time: COVID‐19 indemnity claim reporting and results in the Wisconsin workers' compensation system from March 12 to December 31, 2020
Authors: Modji Komi K. S. , Morris Collin R. , Creswell Paul D. , McCoy Katherine , Aiello Tracy , Grajewski Barbara , Tomasallo Carrie D. , Pray Ian , Meiman Jonathan G.
Published: October 2022

Background

The COVID‐19 pandemic introduced a new compensable infectious disease to workplaces.

Methods

This was a descriptive analysis of Wisconsin COVID workers' compensation (WC) claims between March 12 and December 31, 2020. The impact of the presumption law (March 12 to June 10, 2020) was also evaluated.

Results

Less than 1% of working‐age residents with COVID‐19 filed a claim. COVID‐19 WC claim rates (per 100,000 FTE) were notably low for frontline industry sectors such as Retail Trade (n = 115), Manufacturing (n = 88), and Wholesale Trade (n = 31). Healthcare workers (764 claims per 100,000 FTE) comprised 73.2% of COVID‐19 claims. Most claims (52.8%) were denied and the proportion of denied claims increased significantly after the presumption period for both first responders and other occupations.

Conclusion

The presumption law made benefits accessible primarily to first responders. Further changes to WC systems are needed to offset the individual and collective costs of infectious diseases.