bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Web-based Clinical Decision Support Systems on Adherence to Venous Thromboembolism Prophylaxis guideline among ICU Nonsurgical Patients: A Prospective Before and After Study
Authors: Karajizadeh Mehrdad , Zand Farid , Sharifian Roxana , Vazin Afsaneh , Bayati Najmeh 
Published: September 2021

Abstract
Background and objective: There is a gap between expert recommendations and clinical practice in (Venous Thromboembolism) VTE prophylaxis among nonsurgical patients worldwide. Rate of adherence to evidence-based practice is inadequate in the nonsurgical population. Therefore, this study aimed to determine The effect of Clinical Decision Support Systems(CDSS) on the use of the appropriate VTE Prophylaxis in Nonsurgical Patients in the Intensive Care Unit (ICU).Method: We conducted a cross-sectional study (pre and post-implementation CDSS for recommendation VTE prophylaxis order set) to analyze the effect of the CDSS within CPOE on the appropriate VTE prophylaxis in three ICUs of the Nemazee hospital (before intervention from 20 April 2020, to 21 November 2020 and post-intervention duration form 7 April 2021, to 9 July 2021). The pre-intervention and post-intervention phase samples comprised 175 and 27 patients, respectively. P-value is less than 0.05 was considered a significant level. All statistical analysis was performed by SPSS version 24.Results: Adherence to VTE prophylaxis guidelines after introduced CDSS for recommendation VTE prophylaxis within CPOE system in nonsurgical patients in ICUs increase from 48.6% to 77.8% (p-value<01). However, mortality rate (pre-intervention 13.80% vs post-intervention 14.80%(p-value=0.88)) and means of length of stay (pre-intervention 13.66 vs post intervention13.63(p-value=0.49)) in ICU have not significantly change after introduced CDSS for recommendation VTE prophylaxis order sets.Conclusion: The results indicate that the CDSS for recommendation VTE prophylaxis within CPOE improves adherence to VTE prophylaxis in nonsurgical patients at ICUs, which assist provider to select the most tailored VTE prophylaxis. Further study needs to evaluate implemented CDSS for recommendation VTE prophylaxis in nonsurgical patients at a province and national level.
Early Palliative Referral Reduces the Odds of Receiving Chemotherapy During the Last 30 Days of Life, a Single Center Experience From Windsor Essex, Ontario, Canada.
Authors: Woldie Indryas , Elfiki Tarek , Kulkarni Swati , Springer Colvin , McArthur Eric , Freeman Nicole 
Published: September 2021

Abstract
Background: Chemotherapy use closer to the end of life is becoming an important issue in cancer care. There are now multiple studies and local reviews addressing this issue. Understanding the practice locally will give valuable insight and opportunity for improvement.Methods: The study is a retrospective chart review of patients on chemotherapy at the Windsor Regional Cancer Center who died between April 1st, 2016 to December 31st, 2018. Information on demographics, type of cancer, type, intent and route of chemotherapy, line of chemotherapy, referral to hospice and palliative care services was collected.Results: A total of 681 patients on chemotherapy died between April 1st, 2016 to Dec 13th, 2018. Of these, 119 (17.4 %) passed away within 30 days following chemotherapy. Chemotherapy was parenteral (Intravenous and Subcutaneous) for the majority (75.2%) of the patients. Most (66.4%) of the patients died of disease progression. Intent for chemotherapy was palliative in 85% of patients, adjuvant/neoadjuvant in 6.6% and curative in 8.4% of the patients. Chemotherapy was 1st, 2nd, 3rd line or more in 67.4%, 21.3% and 11.3% of the patients respectively. The type of chemotherapy was conventional in 74.3% of patients and targeted/immunotherapy in 25.7% of patients.Of the variables studied, lack of palliative referral and having lung cancer or melanoma were significantly associated with higher risk of getting chemotherapy within the last four weeks of life. The odds of getting chemotherapy in within the last four weeks of life is 0.35, 95% CI (0.24-0.53), P <0.001 for those who were referred to palliative care. On the other hand, the odds of getting chemotherapy was 4.18, 95% CI (1.17-13.71), P = 0.037 and 2.21, 95% CI (1.24-4.01), P = 0.037 for those with melanoma and lung cancer respectively.Conclusion: Administration of chemotherapy within the last 30 days of life could cause unnecessary suffering to patients and cost to society. Early referral to palliative care was significantly associated with reduced risk of getting chemotherapy within the last 30 days of life in this study. Prospective study is recommended to further investigate the role of early palliative referral on use of chemotherapy during the last 30 days of life.
A Multi-Objective Mathematical Model for Real-Time Employee Assignment in the Service Industry
Authors: Budak Gercek , Chen Xin 
Published: September 2021

Abstract
The American economy has shifted toward services since the 1980s. The service industry is an important part of economy and is growing quickly in the last three decades. It is more human-capital intensive than the manufacturing sector and there is a shortage of highly-skilled workforce. One solution to this problem is to improve the efficiency through optimization. Because demand in the service industry changes constantly, it is a great challenge to determine the number of employees and their tasks to improve customer service while reducing cost. This article develops a multi-objective mixed-integer linear programming model to dynamically assign employees to different workstations in real time. A case study of the model is solved in less than one second and its pareto optimal solutions determine the number of employees who are assigned to each workstation and the expected customer service times. The mathematical model is robust and provides optimal employee assignment and service rates for workstations in many situations.
β-Hydroxy-β-Methylbutrate (HMB) Supplementation and Functional Outcomes in Multi-trauma Patients: A Study Protocol for a Pilot Randomised Clinical Trial (BOOST trial)
Authors: Wittholz Kym , Fetterplace Kate , Abdelhamid Yasmine Ali , Presneill Jeffery J , Beach Lisa , Thomson Benjamin , Read David , Koopman René , Deane Adam M 
Published: September 2021

Abstract
BackgroundThere are no therapies proven to diminish the muscle wasting that occurs in patients after major trauma who are admitted to the Intensive Care Unit (ICU). β-Hydroxy-β-Methylbutrate (HMB) is a nutrition intervention that may attenuate muscle loss and, thereby, improve recovery. The primary aim of this study is to determine the feasibility of a blinded randomised clinical trial of HMB supplementation to patients after major trauma who are admitted to the ICU. Secondary aims are to establish estimates for the impact of HMB when compared to placebo on muscle mass and nutrition-related patient outcomes.MethodsThis prospective, single centre, blinded, randomised, placebo controlled, parallel group, feasibility trial with allocation concealment will recruit 50 participants over 18 months. After informed consent, participants will be randomised [1:1] to receive either the intervention (three grams of HMB dissolved in either 150ml of orange juice for those allowed oral intake or 150ml of water for those being enterally fed) or placebo (150ml of orange juice for those allowed oral intake or 150ml of water for those being enterally fed). The intervention will be commenced in ICU, continued after ICU discharge and ceased at hospital discharge or day 28 post randomization, whichever occurs first. The primary outcome is the feasibility of administering the intervention. Secondary outcomes include change in muscle thickness using ultrasound, and other nutritional and patient-centred outcomes. DiscussionThis study aims to determine the feasibility of administering HMB to critically ill multi-trauma patients throughout ICU admission until hospital discharge. Results will inform design of a larger randomised clinical trial. Trial registrationThe protocol is registered with Australian New Zealand Clinical Trials Registry (ANZCTR) ANZCTR: 12620001305910, registered 02/12/2020 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380744&isReview=true. UTN: U1111-1259-5534
Exploring the Genetic Diversity of Some Squash (Cucurbita Maxima L.) Germplasm Using Morphological and Molecular Markers in Erzincan
Authors: OZTURK HALIL IBRAHIM , Dönderalp Veysel , Bulut Hüseyin , Korkut Recep , HOSSEINPOUR Arash , DURSUN Atilla 
Published: September 2021

Abstract
Background Plant genetic resources constitute the most valuable assets of countries. It is of great importance to determine the genetic variation among these resources and to use the data in breeding studies. Cucurbita maxima species in the cucurbitaceae family have high genetic diversity, but its genetic diversity at the molecular level is inadequately characterized. Methods and Results To determine the genetic diversity among genotypes of Cucurbita maxima species of squash, which is widely grown in Erzincan, 14 different squash genotypes collected were examined based on the morphological parameters and molecular characteristics. SSR (Simple sequence repeat) markers were used to determine genetic diversity at the molecular level. The analysis of morphological characterization within genotypes showed a wide variability in morphological traits of plant, flower, fruit, and leaf. Seven SSR markers yielded a total of 23 polymorphic bands, the number of alleles per marker ranged from 2 to 5, and the mean number of alleles was 3.286. Polymorphic information content (PIC) ranged from 0.00 (GMT-M61) to 0.202 (GMT-P25), and the mean PIC value per marker was 0.130. Cluster analysis using Nei's genetic distance determined that 14 genotypes were divided into 3 major groups. Conclusions The SSR markers used were effective in distinguish among similar winter squash or pumpkin and therefore can be beneficial for consideration of Cucurbita maxima species diversity, screening of genetic resources and their selection.
Comparison Analysis Between Simulation and Experiment of Cutting Force and Cutting Stress as Well as Chip Morphology During the Macro and Nano Cutting of Single Crystal Copper
Authors: Chen Dongju , Wu Shuiyuan , He Yazhong , Li Shupei , Luo Yuchi , Wang Xiang 
Published: September 2021

Abstract
In this paper, the simulation and experiment comparison of cutting force, cutting stress and chip morphology during the macro and nano cutting of single crystal copper are carried out. Firstly, a finite element method based on Johnson-Cook metal strength and failure model were used to establish a macro cutting model, and the cutting force, cutting stress, cutting displacement and chip morphology were obtained. Then a molecular dynamics simulation was used to establish a nano cutting model, and the cutting force, von mises stress and chip morphology were obtained. Afterwards, a comparative analysis of the two was carried out. Finally, the external turning experiment was used to verify the simulation results of the macro cutting model. The results show that: 1. The change trend of the cutting force in x and y directions are different,but the corresponding ratios of cutting forces in x and y directions in macro and nano cutting process are very close, and the corresponding ratios of the average macro and nano cutting forces in x and y directions are also very close. 2. The cutting stress in nano cutting process was about 100 times of macro cutting stress. 3. The chip length in macro cutting process is larger than the chip length in nano cutting process, and the shape is more regular. 4. The experimental cutting force change trend is very similar to the simulation cutting force change trend, but there exits difference in the value between the experiment cutting forces and simulated cutting forces.
Globalization And Capital Flows: Cases of Nigeria And Ghana
Authors: Danladi. Jonathan D. , Tunbosun Ogundipe Adebayo , Falaye Motunrayo Helen , James Barka Rejoice 
Published: September 2021

Abstract
This study aimed at examining the effect of globalization on capital flows (capital inflows and capital outflows) in Nigeria and Ghana for the period 1981 to 2019. Secondary data obtained from the World Bank Development Indicators was used to examine this effect. The ADF unit root test was used to test for stationarity of the variables and the result indicated that all variables are stationary at first difference in both countries. The Johansen co-integration test revealed that co-integration exists among the variables in all models used in this study. In Nigeria, the result of the error correction model indicated that globalization has a negative relationship with capital inflows in the current period while the relationship is positive and significant in the first lag. In Ghana, the result of the error correction model indicated that globalization has a positive and significant relationship with capital inflows in both the current period and the first lag. For the effect of globalisation on capital outflows, the error correction result showed that globalization has a positive and significant relationship with capital outflows in Nigeria in both the first lag and the current year. In Ghana however, globalization has a positive relationship with capital outflows in the current period but in the first lag, the relationship is negative and significant. It was then recommended that the issue of insecurity and policy inconsistency so as to allow the free flow of capital into both countries should be looked into. Also, the Nigerian and Ghanaian government should undertake policy measures and reforms that will help in providing sound macroeconomic policies which will create a more stable and conducive environment for investment. Finally, there should be an intensification of government efforts in its anti-corruption campaign as this will improve the country’s image and attract inflow of funds from abroad for investment purposes in both countries.
The trajectory of a photon emitted by an accelerating light source. The apparent motion of a light source
Authors: Deligiannis John 
Published: September 2021

Abstract
In this article the concept of ``tachy-photons'' is introduced. The tachy-photons are photons emitted by an accelerating light source. The tachy-photons can travel faster than the speed of light, but their average speed is equal to the speed of light.
Using the trajectories of tachy-photons, the apparent motion of an accelerating light source is calculated. This apparent motion of the light source is dramatically different from its actual motion.
The diagnostic accuracy and era for improvement for frameless stereotactic brain biopsy: a series of 109 procedures and a systemic review
Authors: He Zhexi , Zhu Xian Lun , Chan Tat Ming Danny , Cheung Chi Yan Tom , Ng Ho-Keung , Mok Chung Tong Vincent , Poon Wai Sang 
Published: September 2021

Abstract
PurposeTo evaluate the diagnostic accuracy of frameless stereotactic brain biopsy and review the era for improvement.MethodsThis is a prospectively collected cohort study from 2007 to 2020. We reviewed patients who received frameless stereotactic brain biopsy in Prince of Wales Hospital and evaluated the diagnostic accuracy of the frameless stereotactic brain biopsy procedures. The biopsy result was classified into conclusive, inconclusive or negative, based on the pathological, radiological and clinical diagnosis concordance. For inconclusive or negative results, we further evaluated the pre-operative planning and post-operative imaging to review if further improvement could be made. The complication rate of symptomatic hemorrhage and mortality rate was also analyzed.ResultsThere were 106 patients with 109 biopsy procedures performed from 2007 to 2020. The conclusive diagnosis was reached in 103 (94.5%) procedures. The inconclusive diagnosis was noted in four (3.7%) procedures and negative diagnosis was yielded in two (1.9%) procedures. Symptomatic hemorrhage was noted in one patient (0.9%). There was no mortality case (0.0%) in our case series. The registration errors occurred in three cases (2.8%), sampling of the non-representative part of the lesion occurred in two cases (1.8%), and one biopsy (0.9%) for lymphoma was negative after the commencement of steroids. Systemic review showed that the diagnostic accuracy under the structurally defined diagnosis criteria was comparable with published literatures in recent ten years.ConclusionThe stereotactic biopsy is a safe procedure with high diagnostic accuracy only if meticulous pre-operative planning and careful intra-operative registration is performed. The common pitfalls precluding a conclusive diagnosis are errors during registration and non-representative biopsy sites.
Effects of Complex Heavy Metal Stress on the Hydrodynamic Parameters, Stem Anatomy and Photosynthetic Properties of Three Desert Species in the Jinchang Mining Area
Authors: Gao Tian Peng , Wang Hao Ming , Li Changming , Zuo Mingbo , Wang Xueying , Liu Yuan , Yang Yingli , Liu Yubing , Yao Guangqian , Chang Guohua , Xu Danghui , Fang Xiangwen 
Published: September 2021

Abstract
PurposeThe physiological mechanism and phytoremediation effects of heavy metal pollution by local desert plants, namely, Kochia scoparia, Chenopodium glaucum and Atriplex centralasiatica, around tailings were investigated. MethodsTwo different types of local soils (native soil and native soil + tailings, which are labeled CK and T, respectively) were used for potting experiments in the open, and the photosynthesis performance, chlorophyll content, hydraulics and stem anatomy of the potted plants were analyzed. The collection of soil samples has been approved by the soil resources management department of the local government.ResultsIt was found that the chlorophyll content, photosynthetic rate and transpiration rate decreased but the chlorophyll a and b (Chl a/b) and intercellular CO2 concentration (Ci) values increased in Kochia scoparia under complex heavy metal stress. Nonstomatal restriction led to a decrease in the net photosynthetic rate (Pn) and damage to the chloroplasts. Additionally, four hydrodynamic parameters were elevated under heavy metal stress along with a decrease in duct density and diameter and a significant thickening of the duct wall. Under heavy metal stress, the changes in the chlorophyll parameters of Chenopodium glaucum, Atriplex centralasiatica and Kochia scoparia exhibited the same pattern, with stomatal restriction causing a decrease in Pn and Ci and a significant increase in the leaf specific conductance, hydraulic conductivity, and duct diameter. ConclusionsAtriplex centralasiatica is the dominant desert plant in the region and demonstrates good adaptability and heavy metal accumulation under the stress of heavy metal tailings; therefore, it is a good candidate for tailings remediation in the Jinchang desert mining area.
Predictive Factors of Acute Complicated Appendicitis: A Retrospective Study
Authors: Hiroi Sawako , Hamaoka Michinori , Miguchi Masashi , Misumi Toshihiro , Yamamoto Yuji , Ikeda Satoshi , Matsugu Yasuhiro , Nakahara Hideki , Itamoto Toshiyuki 
Published: September 2021

Abstract
Background: Complicated appendicitis is an indication for emergency surgery. Therefore, the predictive factors for appendicitis based on the patient background needs identification. Previously, factors predicting non-complicated and complicated appendicitis were reported. However, most of those reports were deemed unsuitable as a standard for emergency use, since those comprised too many items as predictors. We previously reported three items that preoperatively predicted complicated appendicitis (body temperature, C-reactive protein, and fluid retention around the appendix). In this study, we re-evaluated different cases to confirm the usefulness of these three items can for accurately predicting complicated appendicitis preoperatively. In addition, we compared the effectiveness of these predictor items with those reported by other researchers.Methods: We retrospectively evaluated 417 adult patients who underwent surgery for acute appendicitis between January 2013 and December 2019, and compared our predictor items with those used in previous reports on the preoperative prediction of complicated appendicitis (criteria A consisting of eight predictor items and criteria B consisting of seven predictor items). Results: The area under the receiver operating characteristic curve (AUC) for the sensitivity to diagnose complicated appendicitis according to our criteria, criteria A, and criteria B were 0.823, 0.839, and 0.856, respectively. The AUC of our criteria and criteria A were similar (P = 0.356); those of criteria A and B were also similar (P = 0.352). However, the AUC of criteria B was statistically higher than that of our criteria (P < 0.05).Conclusion: Diagnostic criteria B were statistically the best predictor items for characterizing complicated and uncomplicated appendicitis. However, like criteria A and B, the AUC of our criteria exceeded 0.8, and only involved three predictor items; therefore, they can be considered useful predictors.
Phosphohistone H3 Immunohistochemical Labeling: a Potentially Useful Tool for Risk Stratification and Prognostic Analysis in Gastrointestinal Stromal Tumors.
Authors: Li Xiaohong , Zhang Yutao , Li Feng , Tang Yun , Zhou Hongyuan 
Published: September 2021

Abstract
BackgroundIt is well recognized that risk stratification of gastrointestinal stromal tumors (GISTs) is closely related to tumor size, mitotic index (MI), and primary location. Among these three parameters, tumor size and primary location are easily established, while MI is subjective and its repeatability is poor. It is thus necessary to identify a biomarker to represent the true MI. Expression status and biological or prognostic significance of mitotic marker phosphohistone H3 (PHH3) and cell proliferation marker Ki67 in GIST have not been clearly understood until now. MethodsAn immunohistochemistry experiment was performed to detect the expression status of PHH3 and Ki67 in 125 paraffin-embedded GIST samples. All of the patients were followed up until September 30, 2019. ResultsThe MI determined using stained hematoxylin and eosin (H&E) sections (MI-H&E) and immunohistochemically positive PHH3 index (PHH3-IHC) was compared among groups of different genders, ages, primary locations, and histological subtypes, showing that the difference was not statistically significant (P>0.05). MI-H&E and the immunohistochemically positive Ki67 index were positively correlated (r=0.273, P=0.001), but the correlation was lower than that with the PHH3-positive index (r=0.705, P=0.000). The PHH3-positive index was also positively correlated with the Ki67 index (r=0.224, P=0.006). MI-H&E were positively correlated with MI quantified using immunohistochemically stained PHH3 sections (MI-PHH3) (P<0.05). After using PHH3 to perform MI quantification, the risk stratification of five GIST cases was changed, where two cases were given a higher risk grade and three cases were given a lower risk grade. Follow-up data were obtained from 98 cases (98/125, 78.4%), including two cases of metastasis and one death. Both metastatic and death cases had high MI-H&E. One metastatic case and one death case had high PHH3-positive indexes, while the remaining metastatic case had a low PHH3-positive index. ConclusionImmunohistochemical PHH3 labeling is a potentially useful tool for risk stratification and prognostic analysis in GIST. Using immunohistochemical PHH3 labeling makes it more convenient for pathologists to determine the MI for GIST. MI quantification with immunohistochemical PHH3 sections can be used as an adjunct tool for risk stratification and prognostic analysis of GIST, but cannot completely replace MI quantification using stained H&E sections. The Ki67 index is positively correlated with MI-H&E, although the efficiency of tumor risk stratification is lower than that of PHH3.