bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safe handovers for every patient: an interrupted time series analysis to test the effect of a structured discharge bundle in Dutch hospitals
Authors: van Seben Rosanne , Geerlings Suzanne E , Maaskant Jolanda M , Buurman Bianca M 
Published: May 2020

ObjectivePatient handovers are often delayed, patients are hardly involved in their discharge process and hospital-wide standardised discharge procedures are lacking. The aim of this study was to implement a structured discharge bundle and to test the effect on timeliness of medical and nursing handovers, length of hospital stay (LOS) and unplanned readmissions.DesignInterrupted time series with six preintervention and six postintervention data collection points (September 2015 to June 2017).SettingInternal medicine and surgical wardsParticipantsPatients (≥18 years) admitted for more than 48 hours to surgical or internal medicine wards.InterventionThe Transfer Intervention Procedure (TIP), containing four elements: planning the discharge date within 48 hours postadmission; arrangements for postdischarge care; preparing handovers and personalised patient discharge letter; and a discharge conversation 12–24 hours before discharge.Outcome measuresThe number of medical and nursing handovers sent within 24 hours. Secondary outcomes were median time between discharge and medical handovers, LOS and unplanned readmissions.ResultsPreintervention 1039 and postintervention 1052 patient records were reviewed. No significant change was observed in the number of medical and nursing handovers sent within 24 hours. The median (IQR) time between discharge and medical handovers decreased from 6.15 (0.96–15.96) to 4.08 (0.33–13.67) days, but no significant difference was found. No intervention effect was observed for LOS and readmission. In subgroup analyses, a reduction of 5.6 days in the median time between discharge and medical handovers was observed in hospitals with high protocol adherence and much attention for implementation.ConclusionImplementation of a structured discharge bundle did not lead to improved timeliness of patient handovers. However, large interhospital variation was observed and an intervention effect on the median time between discharge and medical handovers was seen in hospitals with high protocol adherence. Future interventions should continue to create awareness of the importance of timely handovers.Trial registration numberNTR5951; Results.
Adapting the ToyBox obesity prevention intervention for use in Scottish preschools: protocol for a feasibility cluster randomised controlled trial
Authors: Malden Stephen , Hughes Adrienne R , Gibson Ann-Marie , Bardid Farid , Androutsos Odysseas , De Craemer Marieke , Manios Yannis , Summerbell Carolyn , Cardon Greet , Reilly John J 
Published: May 2020

IntroductionThere is an increasing need for the adoption of effective preschool obesity prevention interventions to combat the high levels of early-childhood obesity in the UK. This study will examine the feasibility and acceptability of the adapted version of the ToyBox intervention—a preschool obesity prevention programme—for use in Scotland (ToyBox-Scotland). This will inform the design of a full-scale cluster randomised controlled trial (RCT).Methods and analysisThe ToyBox-Scotland intervention will be evaluated using a feasibility cluster RCT, which involves children aged 3–5 years at six preschools in Glasgow, three randomly assigned to the intervention group and three to the usual-care control group. The original ToyBox intervention was adapted for the Scottish context using a coproduction approach. Within the 18-week intervention, physical activity and sedentary behaviour will be targeted in the preschool through environmental changes to the classroom, physical activity sessions and movement breaks. Parents will receive home activity packs every 3 weeks containing sticker incentives and interactive parent–child games that target sedentary behaviour, physical activity, eating/snacking and water consumption. As this is a feasibility study, parameters such as recruitment rates, attrition rates and SDs of outcome measures will be obtained which will inform a power calculation for a future RCT. Additional variables to be assessed include accelerometer-measured physical activity, sedentary behaviour and sleep, body mass index, home screen time, eating/snacking and water consumption. Outcomes will be assessed at baseline and 14–17 weeks later. Intervention fidelity will be assessed using questionnaires and interviews with parents and practitioners, observation and session delivery records.Ethics and disseminationThis study was granted ethical approval by the University of Strathclyde’s School of Psychological Sciences and Health Ethics Committee. Results will be disseminated through publication in peer-reviewed journals, presentation at conferences and in lay summaries provided to participants.Trial registration numberISRCTN12831555.
High-flow nasal cannula oxygen therapy alone or with non-invasive ventilation during the weaning period after extubation in ICU: the prospective randomised controlled HIGH-WEAN protocol
Authors: Thille Arnaud W , Muller Grégoire , Gacouin Arnaud , Coudroy Rémi , Demoule Alexandre , Sonneville Romain , Beloncle François , Girault Christophe , Dangers Laurence , Lautrette Alexandre , Cabasson Séverin , Rouzé Anahita , Vivier Emmanuel , Le Meur Anthony , Ricard Jean-Damien , Razazi Keyvan , Barberet Guillaume , Lebert Christine , Ehrmann Stephan , Picard Walter , Bourenne Jeremy , Pradel Gael , Bailly Pierre , Terzi Nicolas , Buscot Matthieu , Lacave Guillaume , Danin Pierre-Eric , Nanadoumgar Hodanou , Gibelin Aude , Zanre Lassane , Deye Nicolas , Ragot Stéphanie , Frat Jean-Pierre 
Published: May 2020

IntroductionRecent practice guidelines suggest applying non-invasive ventilation (NIV) to prevent postextubation respiratory failure in patients at high risk of extubation failure in intensive care unit (ICU). However, such prophylactic NIV has been only a conditional recommendation given the low certainty of evidence. Likewise, high-flow nasal cannula (HFNC) oxygen therapy has been shown to reduce reintubation rates as compared with standard oxygen and to be as efficient as NIV in patients at high risk. Whereas HFNC may be considered as an optimal therapy during the postextubation period, HFNC associated with NIV could be an additional means of preventing postextubation respiratory failure. We are hypothesising that treatment associating NIV with HFNC between NIV sessions may be more effective than HFNC alone and may reduce the reintubation rate in patients at high risk.Methods and analysisThis study is an investigator-initiated, multicentre randomised controlled trial comparing HFNC alone or with NIV sessions during the postextubation period in patients at high risk of extubation failure in the ICU. Six hundred patients will be randomised with a 1:1 ratio in two groups according to the strategy of oxygenation after extubation. The primary outcome is the reintubation rate within the 7 days following planned extubation. Secondary outcomes include the number of patients who meet the criteria for moderate/severe respiratory failure, ICU length of stay and mortality up to day 90.Ethics and disseminationThe study has been approved by the ethics committee and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.Trial registration numberNCT03121482.
Rationale and design of a prospective, multicentre, randomised, conventional treatment-controlled, parallel-group trial to evaluate the efficacy and safety of ulinastatin in preventing acute respiratory distress syndrome in high-risk patients
Authors: Wang Zongyu , Tao Liyuan , Yan Yingying , Zhu Xi 
Published: May 2020

IntroductionAcute respiratory distress syndrome (ARDS) is challenging in the intensive care unit (ICU). Although pharmacotherapy for ARDS has gained increasing attention, most trials have yielded negative results. Patients with ARDS have usually been recruited as subjects; the inflammatory reaction has already expanded into a cascade at this point, and its severity is sufficient to damage the lung parenchyma. This raises the question of whether early treatment can prevent ARDS and the associated lung injury. We hypothesise that ARDS is preventable in high-risk patients by administration of ulinastatin as an anti-inflammatory drug before ARDS onset, and we are performing a study to test ulinastatin, a protease inhibitor, versus treatment-as-usual in a group of patients at increased risk for ARDS.Methods and analysisThis report presents the protocol for a multicentre, randomised, conventional treatment-controlled, parallel group study to prevent the development of ARDS using ulinastatin in high-risk patients. The study population will comprise patients at risk of ARDS in the ICU (≥18 years of age and Lung Injury Prediction Score of >4); patients with confirmed ARDS and some other conditions (immunodeficiency, use of some drugs, etc.) will be excluded. The enrolled patients will be randomly allocated to an ulinastatin group (ulinastatin will be intravenously administered every 8 hours for a total of 600 000 U/day for five consecutive days) or control group. The efficacy of ulinastatin in preventing ARDS development will be evaluated by the incidence rate of ARDS as the primary outcome; the secondary outcomes include the severity of ARDS, clinical outcome, extrapulmonary organ function and adverse events incurred by ulinastatin. Based on the results of preliminary studies and presuming the incidence of ARDS will decrease by 9% in high-risk patients, 880 patients are needed to obtain statistical power of 80%.Ethics and disseminationThis study has been approved by the Peking University Third Hospital Medical Science Research Ethics Committee. The findings will be published in peer-reviewed journals and presented at national and international conferences.Trial registration numberNCT03089957; Pre-results.
British OsteoNEcrosis Study (BONES) protocol: a prospective cohort study to examine the natural history of osteonecrosis in older children, teenagers and young adults with acute lymphoblastic leukaemia and lymphoblastic lymphoma
Authors: Amin Nadia , Kinsey Sally , Feltbower Richard , Kraft Jeannette , Whitehead Elizabeth , Velangi Mark , James Beki 
Published: May 2020

IntroductionOsteonecrosis is a well-recognised treatment-related morbidity risk in patients diagnosed with acute lymphoblastic leukaemia (ALL) and lymphoblastic lymphoma (LBL), with a high rate of affected patients requiring surgical intervention. Patients may have asymptomatic changes on imaging studies that spontaneously regress, and little is known about the natural history of osteonecrotic changes seen. The main aim of the British OsteoNEcrosis Study (BONES) is to determine the incidence of symptomatic and asymptomatic osteonecrosis in the lower extremities of survivors of ALL or LBL diagnosed aged 10–24 years in the UK at different time points in their treatment. This study also aims to identify risk factors for progression and the development of symptomatic osteonecrosis in this population, as well as specific radiological features that predict for progression or regression in those with asymptomatic osteonecrosisMethods and analysisBONES is a prospective, longitudinal cohort study based at principal treatment centres around the UK. Participants are patients aged 10–24 years diagnosed with ALL or LBL under standard criteria. Assessment for osteonecrosis will be within 4 weeks of diagnosis, at the end of delayed intensification and 1, 2 and 3 years after the start of maintenance therapy. Assessment will consist of MRI scans of the lower limbs and physiotherapy assessment. Clinical and biochemical data will be collected at each of the time points. Bone mineral density data and vertebral fracture assessment using dual-energy X-ray absorptiometry will be collected at diagnosis and annually for 3 years after diagnosis of malignancy.Ethics and disseminationEthical approval has been obtained through the Yorkshire and Humber Sheffield Research Ethics Committee (reference number: 16/YH/0206). Study results will be published on the study website, in peer-reviewed journals and presented at relevant conferences and via social media.Trial registration numberNCT02598401; Pre-results.
Reducing caesarean rates in a public maternity hospital by implementing a plan of action: a quality improvement report
Authors: Negrini Romulo , Ferreira Raquel Domingues da Silva , Albino Renata Silva , Daltro Carol Amaral Tavares 
Published: May 2020

BackgroundCaesarean rates increased in different parts of the world, rising from 20% to 33% in the USA and from 40% to 55% in Brazil between 1996 and 2011; however, there was no reduction in morbimortality rates. Several factors have been suggested as responsible for this increase, such as health judicialisation, fear of the painful process on the patients’ part and reduction of medical training in vaginal delivery and labour complications. It is urgent to reverse this process and, therefore, a model of actions was created with the intention of engaging the team in order to reduce caesarean rates in a Brazilian hospital.MethodologyThe model was based on the following actions: encouragement of labour analgesia; execution of written reports of any cardiotocographic examination; plan-do-study-act cycles for nursing orientations about the positions that favour pregnant women during labour; creation of a birth induction form; monthly feedback with physicians and nurses on caesarean rates achieved; verification of the caesarean rate by medical staff with individual feedback; daily round of medical coordination for case discussions; disclosure of caesarean rates on hospital posters; and constant dissemination of literature with strategies to reduce caesarean delivery. This plan of action started in January 2016. The mean caesarean section rate in the 31 months preceding the interventions (period A) was then compared with the 31 subsequent months (period B).ResultsBoth periods presented caesarean rates with normal distribution. The mean caesarean rate was 29.24% (range: 38.69%–23.89%, SD 3.24%) vs 25.84% (range: 17.96%–34.97%, SD 3.92%, p<0.05), respectively, for periods A and B.ConclusionAfter the implementation of the plan of action, there was a reduction in caesarean rates in this hospital.
New limits on the resonant absorption of solar axions obtained with a $$^\mathbf {169}$$Tm-containing cryogenic detector
Authors: Abdelhameed A. H. , Bakhlanov S. V. , Bauer P. , Bento A. , Bertoldo E. , Canonica L. , Derbin A. V. , Drachnev I. S. , Iachellini N. Ferreiro , Fuchs D. , Hauff D. , Laubenstein M. , Lis D. A. , Lomskaya I. S. , Mancuso M. , Muratova V. N. , Nagorny S. , Nisi S. , Petricca F. , Proebst F. , Rothe J. , Ryabchenkov V. V. , Sarkisov S. E. , Semenov D. A. , Subbotin K. A. , Trushin M. V. , Unzhakov E. V. , Zharikov E. V. 
Published: May 2020

AbstractA search for resonant absorption of solar axions by $$^{169}\mathrm {Tm}$$169Tm nuclei was carried out. A newly developed approach involving low-background cryogenic bolometer based on $$\mathrm {Tm}_{3} \mathrm {Al}_{5} \mathrm {O}_{12}$$Tm3Al5O12 crystal was used that allowed for significant improvement of sensitivity in comparison with previous $$^{169}\mathrm {Tm}$$169Tm based experiments. The measurements performed with 8.18 g crystal during 6.6 days exposure yielded the following limits on axion couplings: $$|g_{A\gamma } (g_{AN}^0 + g_{AN}^3) \le 1.44 \times 10^{-14}\,{{\mathrm{GeV}}^{-1}}$$|gAγ(gAN0+gAN3)≤1.44×10-14GeV-1 and $$|g_{Ae} (g_{AN}^0 + g_{AN}^3) \le 2.81 \times 10^{-16}$$|gAe(gAN0+gAN3)≤2.81×10-16.
A toy model for a baby universe inside a black hole
Authors: Chakrabarty Hrishikesh , Abdujabbarov Ahmadjon , Malafarina Daniele , Bambi Cosimo 
Published: May 2020

AbstractWe present a dynamical toy model for an expanding universe inside a black hole. The model is built by matching a spherically symmetric collapsing matter cloud to an expanding Friedmann–Robertson–Walker universe through a phase transition that occurs in the quantum-gravity dominated region, here modeled with semi-classical corrections at high density. The matching is performed on a space-like hyper-surface identified by the co-moving time at which quantum–gravity induced effects halt collapse. The purpose of the model is to suggest a possible reconciliation between the observation that black holes are well described by the classical solutions and the fact that the theoretical resolution of space–time singularities leads to a bounce for the collapsing matter.
Estimation of the refractivity gradient from measured essential climate variables in Iyamho-Auchi, Edo State, South-South Region of Nigeria
Authors: Ukhurebor Kingsley Eghonghon , Nwankwo Wilson 
Published: May 2020

<p>Meteorological variables are crucial constituents in the estimation of refractivity disseminations and the uncharacteristic radio wave propagation situations of the troposphere as a result of their impact on radio wave communication relations over the atmosphere. In this study the measurement and assessment of air temperature, relative humidity and atmospheric pressure was carried out for a period of one year; 2018, so as to estimate the refractivity gradient over Iyamho-Auchi, Edo State, Nigeria using a self-implemented inexpensive portable meteorological monitoring device. The measurements of the essential climate variables were done at the administrative building of Edo University Iyamho by placing the meteorological monitoring device on a fixed position. The results show that the monthly estimated refractivity gradient values which would be useful in the prediction of the local radio propagation range from -20.00 N-units/km to -190.00 N-units/km with an average value of -60.67 N-units/km for the period under consideration. The findings also show that the months with limited relative humidity have greater refractivity gradient values compared to the ones with higher relative humidity. It was also observed from the results that the measured essential climate variables were having significant impacts on the estimated refractivity gradient during all the months in 2018, and these impacts were more noticeable in the months with higher relative humidity compared with the months that were having limited relative humidity. </p>
An optimal nonlinear control for anti-synchronization of Rabinovich hyperchaotic system
Authors: Al-hayali Shaymaa , AL-Azzawi Saad Fawzi 
Published: May 2020

This work derives new results for the anti-synchronization of 4D identical Rabinovich hyperchaotic systems by using two strategies: active and nonlinear control. The stabilization results of error dynamics systems are established based on Lyapunov second method. Control is designed via the relevant variables of drive and response systems. In comparison with previous strategies, the current controller (Nonlinear control) focused on the minimum possible limits for relevant variables. The better performance is realizing the anti- synchronization by designing a control with low terms. After obtaining analytical results of the proposed controller, numircal simulation is carried out using Matlab. The graphical results prove validity and applicability of proposed control without know any parameter.The proposed control has certain significance for reducing the time and complexity for strategy implementation.
E-PAC: efficient password authentication code based RMPN method and diffie-hellman algorithm
Authors: Refish Salah H. Abbdal , Shneen Salam Waley 
Published: May 2020

<p>Users need more efficient and more secure when they use the Internet. Password authentication code (PAC) is the critical issue in many applications such as web-sites and data base systems etc. In this paper, PAC between two users to confirm authentication between them based two factors has presented.. Two factors is the most good solution in this field. A legitimate user needs to make sure about his partner to ensure their communication. So, this solution produces two important algorithms, the first one is utilized the Diffie-Hellman which considered the base of this work. The second is routing in message passing networks<strong><em> </em></strong>(RMPN) algorithm which determine the positions of bits which sent to specific party. The overall of this method convincingly to be more secure against both online and offline attacks. This scheme has some advantages such as secrecy of session key, password privacy, and mutual authentication. The performance and security analyses prove that the scheme is very efficient and mathematically immune for attackers.</p>
Gesture recognition vehicle using PIC microcontroller
Authors: Selvakumar K. , R Palanisamy , Doss M.Arun Noyal , Gopi P. , Esakkipandi A. , Mathivadhanam L. , Asath T. Abul Kalam 
Published: May 2020

<p>In this paper we introduce a hand controlled robotic vehicle. Hand control robotic vehicle consists of a transmitter module and a receiver module. The transmitter will be placed on a hand glove and the receiver will be placed on the motor drive along with PIC microcontroller and motor driver IC. The RF transmitter sends commands to the IC which then forwards the commands to RF receiver. The RF receiver then sends the commands to PIC microcontroller on the vehicle which processes the commands so that the vehicle moves in the specified direction. It is having proposed utility in field ofconstruction, hazardous waste disposal and field survey near borders etc. This project is developed as a travel buddy and industrial uses. Having future scope of advanced robotics that are designed and can be easily controlled using hand gesture only.</p>