bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Team‐Based Approach to Introduce and Sustain the Use of the WHO Surgical Safety Checklist in Tanzania
Authors: Hellar Augustino , Tibyehabwa Leopold , Ernest Edwin , Varallo John , Betram Margaret Mary , Fitzgerald Laura , Giiti Geofrey , Kihundrwa Albert , Kapologwe Ntuli , Drake Mary , Zoungrana Jeremie , Troxel Alena , Lemwayi Ruth , Alidina Shehnaz , Maongezi Sarah , Makuwani Ahmad , Varallo John 
Published: November 2019

AbstractIntroductionMillions of patients worldwide suffer disability and death due to complications related to surgery. Many of these complications can be reduced by the use of the World Health Organization (WHO) Surgical Safety Checklist (SSC), a simple tool that can enhance teamwork and communication and improve patient safety. Despite the evidence on benefits of its use, introducing and sustaining the use of the checklist are challenging. We present a team‐based approach employed in a low‐resource setting in Tanzania, which resulted in high checklist utilization and compliance rates.MethodsWe reviewed reported data from facility registers supplemented by direct observation data by mentors to evaluate the use of the WHO SSC across 40 health facilities in two regions of Tanzania between January and December 2018. We analyzed the self‐reported monthly data on total number of major surgeries performed and proportion of surgeries where the checklist was used. We also analyzed the use of the SSC during direct observation by external mentors and completion rates of the SSC in a random selection of patient files during two mentorship visits between June and December 2018.ResultsDuring the review period, the average self‐reported checklist utilization rate was 79.3% (11,564 out of 14,580 major surgeries). SSC utilization increased from 0% at baseline in January 2018 to 98% in December 2018. The proportion of checklists that were completely and correctly filled out increased between the two mentor visits from 82.1 to 92.8%, but the gain was significantly greater at health centers than at hospitals (p < 0.05). Health centers (which had one or two surgical teams) self‐reported a higher checklist utilization rate than hospitals (which had multiple surgical teams), i.e., 99.4% vs 68.8% (p < 0.05).Conclusion and recommendationsOur findings suggest that Surgical Safety Checklist implementation is feasible even in lower‐resource settings. The self‐reported SSC utilization rate is higher than reported in other similar settings. We attribute this finding to the team‐based approach employed and the ongoing regular mentorship. We recommend use of this approach to scale‐up checklist use in other regions in the country as recommended in the Ministry of Health of Tanzania's National Surgical, Obstetric, and Anesthesia Plan (NSOAP).
Systemic shock propagation in a complex system
Authors: Mitic Peter 
Published: November 2019

AbstractWe study the effects of delivering a shock to a complex system comprising components (‘agents’) that interact in a pairwise fashion, independent of other parts of the system and with no central control. There are three aspects to the contribution of this paper. First, shock propagation in a network is developed purely from fundamental principles of complex systems. Second, systemic risk is shown to arise naturally in such a complex system. If a shock is delivered either to one agent or to many agents simultaneously, that shock may be transmitted further, thereby resulting in systemic risk. Third, the monetary loss to the entire system as a result of systemic shock is quantified. Simulations are used to study two particular characteristics of the interactions. The first is the resistance or susceptibility of individual agents to a shock. The second is the time it takes for the shock to affect the entire system. The results show that if a shock is applied to all agents in a network, the systemic effect of that shock is transmitted very quickly. Applying a shock to very few agents results only in an idiosyncratic effect. If an agent can transmit the shock further, a systemic effect will result. The recovery period for agents affected by a systemic shock can be orders of magnitude greater than the time taken for the shock to take effect. The overall effect of the shock on the system is quantified by formulating a ‘contagion index’, which measures the ratio of the total capital lost due to the systemic effect to the total capital before the shock was delivered. The result (approximately 7%) is consistent with other studies, but is more widely applicable because it is not based on one empirical data set.
Optimierte Polymer-Rohrwerkstoffe für effiziente Drainagesysteme in Tunnelbauwerken – PolyDrain
Authors: Arbeiter Florian , Eichinger Stefanie , Rieß Gisbert , Schachinger Tobias , Boch Ronny , Wenighofer Robert , Galler Robert , Hausberger Andreas , Strobl Elmar , Stur Michael , Saliger Florian , Steiner Michael , Dietzel Martin , Pinter Gerald 
Published: November 2019

ZusammenfassungAusgehend von der Problematik aufwändiger Instandhaltungsarbeiten für die Funktionstüchtigkeit von Drainagerohren in Tunnelbauwerken wurde das interdisziplinäre Forschungsprojekt „PolyDrain“ initiiert. Im Rahmen des Forschungsprojekts werden diesbezüglich kritische Bauwerke in Österreich erhoben und vielversprechende Methoden zur Verringerung von zumeist karbonatischen Versinterungen in Drainagerohren untersucht. Durch gezielte Materialmodifikationen der Drainagerohre soll der Instandhaltungsaufwand zukünftiger oder zu sanierender Tunnelbauwerke reduziert werden, indem Reinigungsintervalle gestreckt und/oder Reinigungen rascher durchgeführt werden können. Der gewählte Ansatz umfasst die maßgeschneiderte Modifizierung von Kunststoff-Drainagerohrmaterialien. Dadurch ist es möglich, mechanisch widerstandsfähigere Rohre zu erzeugen und/oder das Versinterungsverhalten im Drainagerohr, inklusive der Drainageschlitze, zu reduzieren. Bevor eine Umsetzung im großtechnischen Maßstab möglich ist, ist es allerdings wichtig, nicht nur die kurzzeitige Wirksamkeit – im Projekt auch im Labor – zu untersuchen.
Bromierte Flammschutzmittel in Elektroaltgeräten: Untersuchung der Brom-Konzentration nach Kunststofftypen und Gerätekategorien mittels Röntgenfluoreszenzanalyse
Authors: Jandric Aleksander , Part Florian , Fink Niklas , Huber-Humer Marion , Salhofer Stefan , Zafiu Christian 
Published: November 2019

ZusammenfassungKunststoffe in Elektroaltgeräten (EAG) enthalten häufig bromierte Flammschutzmittel (BFR), die unbeabsichtigt freigesetzt und somit zu negativen Umwelt- und Gesundheitsauswirkungen führen können. Zusätzlich vermindern BFR die Qualität von Rezyklaten, wobei Grenzwerte gemäß RoHS-Richtlinie (1000 ppm je BRF-Typ) und Abfallbehandlungspflichtenverordnung (AbfBPV) (2000 ppm Gesamtbromgehalt) eingehalten werden müssen. Für diese Studie wurden aus 11 unterschiedlichen EAG-Kategorien 467 Geräte untersucht, aus welchen wiederum insgesamt 1008 Kunststoffproben entnommen wurden. Die Kunststofftypen wurden mittels visuellem Screening des Recycling Codes sowie mittels FTIR-Spektroskopie bestimmt. Die portable Röntgenfluoreszenzanalyse (RFA) diente zur Bestimmung des Gesamtbromgehalts. In den untersuchten EAGs wurden insgesamt 27 verschiedene Kunststofftypen identifiziert, wobei Acrylnitril-Butadien-Styrol-Copolymer (ABS) der häufigste Typ ist. Die Messungen mittels RFA haben ergeben, dass in 33 % aller Proben Brom nachgewiesen werden konnte. Der durchschnittliche Bromgehalt betrug ca. 240 ppm. Der RoHS-Grenzwert wurde in 18 % aller Proben aus Netzteilen von Druckern, 10 % aus PC-Gehäusen und 9 % aus Flatscreen-Monitoren überschritten. Elektrische Zahnbürsten, Mobiltelefone (ohne Touchscreens), Smartphones und diverse Kleingeräten überschritten weder den RoHS-, noch den AbfBPV-Grenzwert. Kunststoffbauteile aus diesen brom-freien EAG würden sich somit besser für ihre Rezyklierung eignen. Da die RFA eine kostengünstige und sehr schnelle Analysemethode ist, würde sie sich dazu eignen, Kunststoffe mit hohem Bromgehalt direkt am Anfallort auszuschließen.
Alleviation of dry mouth by saliva substitutes improved swallowing ability and clinical nutritional status of post-radiotherapy head and neck cancer patients: a randomized controlled trial
Authors: Nuchit Sumalee , Lam-ubol Aroonwan , Paemuang Wannaporn , Talungchit Sineepat , Chokchaitam Orapin , Mungkung On-ong , Pongcharoen Tippawan , Trachootham Dunyaporn 
Published: November 2019

Abstract
Purpose
The aim of this study is to investigate the effect of an edible saliva substitute, oral moisturizing jelly (OMJ), and a topical saliva gel (GC) on dry mouth, swallowing ability, and nutritional status in post-radiotherapy head and neck cancer patients.

Methods
Sixty-two post-radiation head and neck cancer patients with xerostomia completed a blinded randomized controlled trial. They were advised to swallow OMJ (n = 31) or apply GC orally (n = 31) for 2 months. Outcome measures were assessed at baseline, 1, and 2 months, including subjective and objective dry mouth (Challcombe) scores, subjective swallowing problem scores (EAT-10), water swallowing time, clinical nutritional status (PG-SGA), body weight, and dietary intake.

Results
After 1 and 2 months of interventions, subjective and objective dry mouth scores, subjective swallowing problem scores, swallowing times, and clinical nutritional status in both groups were significantly improved (p < 0.0001). Compared to GC, OMJ group had higher percent improvement in all outcome measures (p < 0.001) except swallowing time and clinical nutritional status. Interestingly, subjective dry mouth scores were significantly correlated with subjective swallowing problem scores (r = 0.5321, p < 0.0001).

Conclusions
Continuous uses of saliva substitutes (OMJ or GC) for at least a month improved signs and symptoms of dry mouth and enhanced swallowing ability. An edible saliva substitute was superior to a topical saliva gel for alleviating dry mouth and swallow problems. These lead to improved clinical nutritional status. Thus, palliation of dry mouth may be critical to support nutrition of post-radiotherapy head and neck cancer patients.

Clinical trial registry
Clinicaltrials.gov NCT03035825
A probabilistic model for assigning queries at the edge
Authors: Kolomvatsos Kostas , Anagnostopoulos Christos 
Published: November 2019

AbstractData management at the edge of the network can increase the performance of applications as the processing is realized close to end users limiting the observed latency in the provision of responses. A typical data processing involves the execution of queries/tasks defined by users or applications asking for responses in the form of analytics. Query/task execution can be realized at the edge nodes that can undertake the responsibility of delivering the desired analytics to the interested users or applications. In this paper, we deal with the problem of allocating queries to a number of edge nodes. The aim is to support the goal of eliminating further the latency by allocating queries to nodes that exhibit a low load and high processing speed, thus, they can respond in the minimum time. Before any allocation, we propose a method for estimating the computational burden that a query/task will add to a node and, afterwards, we proceed with the final assignment. The allocation is concluded by the assistance of an ensemble similarity scheme responsible to deliver the complexity class for each query/task and a probabilistic decision making model. The proposed scheme matches the characteristics of the incoming queries and edge nodes trying to conclude the optimal allocation. We discuss our mechanism and through a large set of simulations and the adoption of benchmarking queries, we reveal the potentials of the proposed model supported by numerical results.
Coagulopathy after hemorrhagic traumatic brain injury, an observational study of the incidence and prognosis
Authors: van Gent Jort A. N. , van Essen Thomas A. , Bos Mettine H. A. , Cannegieter Suzanne C. , van Dijck Jeroen T. J. M. , Peul Wilco C. 
Published: November 2019

Abstract
Background
Traumatic brain injury is associated with high rates of mortality and morbidity. Trauma patients with a coagulopathy have a 10-fold increased mortality risk compared to patients without a coagulopathy. The aim of this study was to identify the incidence of coagulopathy and relate early coagulopathy to clinical outcome in patients with traumatic intracranial hemorrhages.

Methods
Between September 2015 and December 2016, 108 consecutive cranial trauma patients with traumatic intracranial hemorrhages were included in this study. To assess the relationship between patients with a coagulopathy and outcome, a chi-squared test was performed.

Results
A total of 29 out of the 108 patients (27%) with a traumatic intracranial hemorrhage developed a coagulopathy within 72 h after admission. Overall, a total of 22 patients (20%) died after admission of which ten were coagulopathic at emergency department presentation. Early coagulopathy in patients with traumatic brain injury is associated with progression of hemorrhagic injury (odds ratio 2.4 (95% confidence interval 0.8–8.0)), surgical intervention (odds ratio 2.8 (95% confidence interval 0.87–9.35)), and increased in-hospital mortality (odds ratio 23.06 (95% confidence interval 5.5–95.9)).

Conclusion
Patients who sustained a traumatic intracranial hemorrhage remained at risk for developing a coagulopathy until 72 h after trauma. Patients who developed a coagulopathy had a worse clinical outcome than patients who did not develop a coagulopathy.
Commentary on Kate E. Lynch, Emily C. Parke, and Maureen A. O’Malley: ‘How Causal are Microbiomes? A Comparison with the Helicobacter pylori Explanation of Ulcers’
Authors: Gillies Donald 
Published: November 2019

AbstractThis commentary focuses on the authors’ treatment of Koch’s postulates. It argues in favour of a modification of Koch’s postulates and their analysis in terms of necessary and sufficient conditions. This leads to a criticism of the authors’ treatment of the C. difficile case, and to query the need for the criteria of specificity and proportionality.
Network structure and thermal properties of bioactive (SiO2–CaO–Na2O–P2O5) glasses
Authors: Fábián M. , Kovács Zs. , Lábár J. L. , Sulyok A. , Horváth Z. E. , Székács I. , Kovács Kis V. 
Published: November 2019

AbstractCa- and P-based bioactive glasses are excellent candidates for design and manufacture of biomaterials. Understanding the structure and physico-chemical–thermal behaviour of bioactive glasses is a fundamental step towards the design of a new generation of biocompatible materials. In this study, the structure of SiO2–CaO–Na2O glasses and its derivatives, obtained by substituting Na2O with P2O5 and prepared by melt–quench technique, was studied with neutron and electron diffraction techniques combined with thermal analysis, high-resolution electron microscopy and X-ray photoelectron spectroscopy. Neutron and electron diffraction data were analysed with reverse Monte Carlo simulation and pair distribution function analysis, respectively. Bioactivity of P2O5 substituted glasses was also investigated and proven in vitro using simulated body fluid. Based on the structural analysis, it was found that Si and P atoms are in well-defined tetrahedral units with a bond distance of 1.60 Å for both Si–O and P–O bonds, although P exhibits a higher average coordination number than Si. With increasing phosphate content, tendentious changes in the glass behaviour were observed. Linear increase in Tg, supported by the changes in the average coordination numbers of Si and P, indicates strengthening of network structure with increasing P content and formation of P–O–Ca atomic linkages, which lead to Ca–P-rich atomic environments in the silicate network. These Ca–P-rich environments trap volatile elements and thus decrease the total weight loss during heating at higher P concentrations. In the case of the highest investigated P2O5 content (5 mol%), nanoscale structural inhomogeneity and the formation of Ca–P-rich clusters were also revealed by electron diffraction and atomic resolution imaging. This type of Ca–(Na)–P clustering has a key role in the behaviour of phosphate-substituted silicate glasses under physiological conditions.
Novel transcutaneous sensor combining optical tcPO2 and electrochemical tcPCO2 monitoring with reflectance pulse oximetry
Authors: van Weteringen Willem , Goos Tom G. , van Essen Tanja , Ellenberger Christoph , Hayoz Josef , de Jonge Rogier C. J. , Reiss Irwin K. M. , Schumacher Peter M. 
Published: November 2019

AbstractThis study investigated the accuracy, drift, and clinical usefulness of a new optical transcutaneous oxygen tension (tcPO2) measuring technique, combined with a conventional electrochemical transcutaneous carbon dioxide (tcPCO2) measurement and reflectance pulse oximetry in the novel transcutaneous OxiVenT™ Sensor. In vitro gas studies were performed to measure accuracy and drift of tcPO2and tcPCO2. Clinical usefulness for tcPO2and tcPCO2monitoring was assessed in neonates. In healthy adult volunteers, measured oxygen saturation values (SpO2) were compared with arterially sampled oxygen saturation values (SaO2) during controlled hypoxemia. In vitro correlation and agreement with gas mixtures of tcPO2(r= 0.999, bias 3.0 mm Hg, limits of agreement − 6.6 to 4.9 mm Hg) and tcPCO2(r= 0.999, bias 0.8 mm Hg, limits of agreement − 0.7 to 2.2 mm Hg) were excellent. In vitro drift was negligible for tcPO2(0.30 (0.63 SD) mm Hg/24 h) and highly acceptable for tcPCO2(− 2.53 (1.04 SD) mm Hg/12 h). Clinical use in neonates showed good usability and feasibility. SpO2-SaO2correlation (r= 0.979) and agreement (bias 0.13%, limits of agreement − 3.95 to 4.21%) in healthy adult volunteers were excellent. The investigated combined tcPO2, tcPCO2, and SpO2sensor with a new oxygen fluorescence quenching technique is clinically usable and provides good overall accuracy and negligible tcPO2drift. Accurate and low-drift tcPO2monitoring offers improved measurement validity for long-term monitoring of blood and tissue oxygenation.
A preliminary study of heavy metals pollution risk in water
Authors: Abdeldayem Raafat 
Published: November 2019

Abstract
This study seeks to find out the risk of heavy metal pollution in domestic water on human health. The size of samples was 50 domestic water, 50 urine, and 50 blood samples taken from subjects chosen of the different four districts during 2017. Trace metal analysis was done using atomic absorption spectrophotometer. The results showed alarming levels of heavy metal contamination that exceed national and international thresholds in several observed sites. Therefore, stricter standards may be needed in order to reduce overall population exposure.
Simultaneous removal of selenite and selenate from drinking water using mesoporous activated alumina
Authors: Meher Alok Kumar , Jadhav Asmita , Labhsetwar Nitin , Bansiwal Amit 
Published: November 2019

AbstractThe present study reports detailed evaluation of mesoporous activated alumina (MAA) for simultaneous removal of two hazardous inorganic species of selenium, namely selenite and selanate, from drinking water. MAA was used after washing with deionized water followed by drying at 110 °C for 8 h. The material was characterized using pXRD, FTIR, zeta potential, SEM and BET surface area measurements. Batch adsorption studies were performed, and various adsorption isotherms and kinetic parameters were computed to delineate the mechanism of adsorption. It was observed that Freundlich adsorption isotherm was the best-fit model for both the species of selenium. The adsorption capacity obtained from Freundlich isotherm for selenite and selenate was found to be 9.02 µg g−1 and 5.38 µg g−1, respectively. Kinetics studies revealed that adsorption of selenite follows pseudo-second-order model, whereas selenate adsorption follows pseudo-first-order model. The efficiency of the material was also evaluated at different pH and in the presence of different competitive co-ions, which confirms efficacy of MAA at near-neutral pH and lower concentrations of competitive co-ions. Negligible changes in the pH were observed during the course of adsorption. Further, the saturated adsorbent was subjected to regeneration and reuse studies up to ten cycles, showing insignificant reduction in adsorption efficiency of the adsorbent during few initial cycles. The study infers the effectiveness of MAA as a potential adsorbent for drinking water treatment contaminated with selenium.
Coffee processing wastewater treatment: a critical review on current treatment technologies with a proposed alternative
Authors: Ijanu E. M. , Kamaruddin M. A. , Norashiddin F. A. 
Published: November 2019

AbstractCoffee is globally the second largest most traded commodity after petroleum, and this has facilitated many countries to grow and produce coffee in commercial quantity. The production processes uses large volume of water which comes out as contaminated water. The presence of toxic chemicals like tannins, phenolic and alkaloids inhibits biological degradation. Microbial processes break down the organic substances released into water bodies slowly, using up the oxygen from the water (COD). As demand for oxygen needed to break down organic waste in a wastewater begins to exceed supply, a decrease in oxygen needed to combine with chemicals (COD) slowly creates anaerobic condition. The review looks at few of the current methods (physicochemical and biological) used in coffee wastewater management, their advantages and disadvantages including, high cost implication, complex operation and more time consumption among others; furthermore, the review suggests ion exchange technique as a better alternative based on its capacity to act as both an ion exchanger and absorber.
Drinking water desalination using low-cost Tubular Solar Still
Authors: Karima Azrina , Shafiul Islam Kh. Md. 
Published: November 2019

Abstract
Growing freshwater scarcity in arid and remote areas usually is caused by the growth of population, urbanization and industrialization and the rather limited natural resources of potable water. In coastal belt of southwest region of Bangladesh, groundwater contains high salinity as well as excessive arsenic contamination. Though pond sand filter and rainwater harvesting system are usually used to meet the freshwater demand throughout the year in this area, along with these, household-based solar desalination could be a good source of drinking water in this region. In this study, a low-cost Tubular Solar Still (TSS) was designed using locally available materials to meet such demand. It was consisted of a tubular frame (0.00275 m thick helical GI wire, 1.0 m long and 0.2 m in diameter) and a rectangular tray (1.0 m × 0.16 m × 0.05 m ) covered with black polythene paper. The collection bottle was kept in an insulation box. The field experiment on the constructed TSS was carried out on the rooftop of Civil Engineering Department building from June 25, 2011, to June 20, 2012. Daily distilled output from the TSS was collected approximately 2 h after sunset. The maximum daily production rate was found as 3.83 l/m2 in May 2012. The production cost of distilled water is estimated as 0.39 BDT/L or 0.0046 USD/L. The application of this process can fulfill the demand of freshwater for drinking purpose for single household in coastal areas.