bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of Transversus Thoracis Muscle Plane Plus Rectus Sheath Block in the Perioperative Pain Management of Cardiac Surgery：Study Protocol of a Randomized Double-blind Controlled Trial
Authors: Luo Jierong , Lu Chengxiang , Zhou Haitao , Ou Guokun , Xu Lixin , Zheng Bin 
Published: June 2021

Abstract
BackgroundTraditional cardiac surgical anesthesia is characterized by the use of large doses of opioids, accompanied by side effects such as oversedation, respiratory depression, long ventilator duration, prolonged ICU stay, opioid tolerance, addiction, and postoperative delirium. Fast track cardiac anesthesia under the Enhanced Recovery After Surgery (ERAS) concept requires quick recovery, rapid extubation, reduced perioperative opioid dosage and shorter ICU stay. An emerging regional block technique, transverse thoracic muscle plane block (TTPB) covers the Thoracic 2-6 (T2-T6) intercostal nerves and recluse sheath block (RSB), which can effectively relieve perioperative pain during median sternotomy. Bilateral TTPB plus RSB is expected to be a new analgesic mode in perioperative thoracotomy.MethodsThis is a single-center, randomized, double-blind, parallel controlled clinical trial. Eighty patients planning to undergo coronary artery bypass grafting or heart valve surgery via median sternotomy were randomly assigned 1:1 to the experimental group or control group. After general anesthesia, all subjects were injected with 0.3% ropivacaine (experimental group) or 0.9% normal saline (control group) 15ml (TTPB)and 10ml (RSB) on each side after insertion guided by B-ultrasound by anesthesiologist. The main outcomes were the threshold of incision pain and the total amount of analgesics used during the operation and 48h after the operation. Secondary outcomes were as follows: postoperative VAS score, duration of mechanical ventilation, length of stay in ICU, and hospitalization cost. In addition, random assignment is a computer program that generates random results. Patients, operators, and evaluators were grouped in a blind manner.DiscussionThe TTPB plus RSB on transthoracic median incision heart surgery is just a ramification of nerve block anesthesia. Thanks to the visualization development of ultrasound, the safety factor of TTPB and RSB is greatly improved and the block effect is more accurate, which provides a guarantee for the application. This study will provide evidence-based medical evidence and clinical data support for the application of TTPB and RSB in cardiac surgery.Trial registrationClinicalTrials.gov, NCT04838132. Registered 8 April 2021.Verson1.2. https://clinicaltrials.gov/ct2/show/NCT04838132?term=NCT04838132&draw=2&rank=1
Evaluating the Implementation of a National COVID-19 Hospital Guideline in Wales
Authors: Jefferies Rhys , Ponsford Mark J , Barry Simon 
Published: June 2021

Abstract
BackgroundThe COVID-19 pandemic created a unique situation where a national clinical guideline would address uncertainty, and provide a trusted source for up-to-date information and advice. We developed a dynamic online infrastructure together with a dedicated implementation team to deliver this at scale and pace. The guideline was implemented through a digital implementation framework (SIMPSI framework) deploying facilitators to maximise guideline adoption, particularly targeting senior clinical decision makers (consultants) involved with the care of COVID-infected patients across six Health Boards (HB) in Wales. Methods We evaluated guideline implementation using the Taxonomy of Implementation Outcomes Model. The primary outcome was consultant engagement, with a target of 193 registrations. We assessed wider impact through analysis of guideline platform activity and a user survey, with additional sensitivity analysis to derive penetration ratios, catchment population, clinical staff, acute beds, and COVID-19 admissions. ResultsThe guideline platform had 4521 total registrants, with over 170,000 page views during the first wave. We exceeded the target nearly six-fold (1159 consultant registrants). This represented 45% of all medical consultants in Wales, and made up the highest proportion of guideline registrants of all professional groups (23%, 1159/4521). We observed significant variation in guideline penetration across the six HBs, ranging from 31% to 74% of consultants registered. The HB with highest penetration had the most active guideline facilitator. The HB with the lowest penetration was the region first impacted and most affected by COVID-19 at the time of guideline publication (37% inpatients of peak, versus 10% or less for the other HBs). ConclusionWe utilised a digital implementation framework to construct a system that could be rapidly applied throughout all hospitals in Wales. Whilst we exceeded the intended target demonstrating full implementation, we identified two key factors to account for differences in the penetration rates across the different HBs. First, an experienced and active facilitator with the capacity to undertake the role was associated with significantly better penetration. Second, timeliness of implementation was crucial as evidenced by lower penetrance is the one HB that was impacted earliest by COVID-19 at the time of guideline dissemination. Nevertheless, the rapid implementation of the guideline has coincided with Wales demonstrating more favourable intensive care survival rates and maintaining one of the lowest mortality rates when compared to the UK as a whole for the first wave of the COVID-19 pandemic.
Clinical Impact of Pharmaceutical Consultations in Patients Treated for Chronic Obstructive Pulmonary Disease: Study Protocol for a Randomized Controlled Trial (BPCObs study).
Authors: Hachemi Djamila , Leguelinel-Blache Géraldine , Bouvet Sophie , Roux-Marson Clarisse , Ray Patrice , Plouvier Nathalie , Kinowski Jean-Marie , Dubois Florent 
Published: June 2021

Abstract
BackgroundChronic obstructive pulmonary disease (COPD) is an irreversible chronic respiratory disease whose evolution depends on the patient’s adherence to inhaler devices. Pharmacists may play a role in adherence to medication therapy in hospital and in primary care interacting with patients to provide advice on proper use. This paper presents the protocol for a randomized controlled trial conducted at a university hospital to assess the clinical impact of pharmaceutical consultations on COPD exacerbations, medical care, adherence to inhaler devices and quality of life. MethodsThis trial will include 226 COPD patients treated with inhaler devices: 94 in a control group with the usual hospital care, 66 receiving a pharmaceutical consultation at the hospital and 66 receiving several pharmaceutical consultations at their community pharmacy. The aim of these interventions is to inform patients about COPD and medication therapy, train them in the proper use of inhaler devices and make them aware of good therapeutic adherence. Patients will be randomized to either the control group or the experimental hospital group by the clinical pharmacist at the hospital. Community pharmacists will include patients in the experimental community group. All patients will be monitored for 12 months by their community pharmacists (CPs). The primary outcome is the mean number of COPD exacerbations. Secondary outcomes include the number of medical consultations, emergency visits and hospitalizations; patients’ adherence to inhaler devices and ability to use them and quality of life. DiscussionOur study is the first randomized controlled trial in France to assess the effect of pharmaceutical interventions on COPD exacerbations. Study limitations include patient recruitment and the CPs’ adherence to follow-up. Indeed, the success of this trial depends on the willingness of CPs to collect the data. However, we envisage this work as the first step towards building a network of CPs trained for clinical research. Trial registrationClinicaltrials.gov, NCT03704545. Registered on October 12th, 2018. https://clinicaltrials.gov/ct2/show/NCT03704545?cond=COPD&cntry=FR&city=nimes&draw=2&rank=1
Abnormal Ship Behavior Detection after the Closure of AIS Based on Radar Data
Authors: Zhang Tao , Liu Chuanchang , Wen Bodong 
Published: June 2021

Abstract
In marine transportation, most ships are equipped with AIS devices. The AIS data sent by these devices can help maritime authorities to manage ships in relevant sea areas. However, AIS is a self-reporting system, when a ship is engaged in illegal activities, the AIS device may be turned off. Therefore, after the AIS is closed, if the ship's behavior during a certain period of time is different from the ship's behavior before the closure of AIS, the different behavior is likely to represent that the ship is conducting illegal activities. This behavior is considered abnormal and needs to be detected in time. Based on radar trajectory data, the detection of abnormal ship behavior is studied from two aspects: speed and direction. In order to improve the intelligent level of abnormal ship behavior detection, the abnormal speed behavior detection algorithm combined with rules and clustering (ASBD-RC) and the abnormal direction behavior detection algorithm combined with partition and the earth mover's distance (ADBD-PE) are proposed. The ASBD-RC algorithm can reduce the influence of noise and sea clutter on abnormal speed behavior detection. The ADBD-PE algorithm can effectively partition and identify trajectory segments with abnormal direction. In the experiment, based on the real and simulated radar trajectories, the abnormal behaviors of ships under different scenarios are generated. The experimental results show that in most scenarios, the ASBD-RC algorithm and the ADBD-PE algorithm can effectively detect abnormal ship behavior. And compared with other algorithms, the proposed two algorithms have better and more stable detection results.
A Homomorphic Encryption Based Location Privacy Preservation Scheme for Crowdsensing Tasks Allocation
Authors: Zheng Xiaodong , Yuan Qi , Wang Bo , Zhang Lei 
Published: June 2021

Abstract
In the process of crowdsensing, tasks allocation is an important part for the precise as well as the quality of feedback results. However, during this process, the applicants, the publisher and the authorized agency may aware the location of each other, and then threaten the privacy of them. Thus, in order to cope with the problem of privacy violation during the process of tasks allocation, in this paper, based on the basic idea of homomorphic encryption, an encrypted grids matching scheme is proposed (short for EGMS) to provide privacy preservation service for each entity that participates in the process of crowdsensing. In this scheme, the grids used for tasks allocation are encrypted firstly, so the task matching with applicants and publisher also in an encrypted environment. Next, locations used for allocation as well as locations that applicants can provide services are secrets for each other, so that the location privacy of applicants and publisher can be preserved. At last, applicants of task feedback results of each grid that they located in, and the publisher gets these results, and the whole process of crowdsensing is finished. At the last part of this paper, two types of security analysis are given to prove the security between applicants and the publisher. Then several groups of experimental verification that simulates the task allocation are used to test the security and efficiency of EGMS, and the results are compared with other similar schemes, so as to further demonstrate the superiority of proposed scheme.
Low Energy Routing Protocol for Oil and Gas Pipeline Internet of Things
Authors: Liu Miao , Huo Zhuo-Miao , Zhang Jie , Yao Rong , Sun Zhen-Xing 
Published: June 2021

Abstract
Nodes in the Internet of Things of oil and gas pipelines are linearly distributed according to the direction of pipelines, so it is difficult to realize timely and large-scale battery replacement. Therefore, effective energy management has always been a key factor restricting the performance of the IoT of oil and gas pipelines.In addition, the end-to-end delay determines the response time of pipeline safety accidents and is also a key parameter to improve the real-time performance of the network. Considering energy effciency and delay comprehensively, this paper proposes PIOT-LPRP (Pipeline Internet of Things - Low Power Routing Protocol) protocol. The remaining energy of nodes and the distance between nodes and sink nodes are used as indicators to select candidate forwarding nodes in opportunistic routing to achieve energy balance in the network. The use of energy collection technology to extend the service life of the network. By choosing the node which is far away from the transmission as the forwarding node, the number of hops of data transmission can be effectively reduced, so as to reduce the end-to-end delay of the network. The simulation results show that PIOT-LPRP can effectively take into account the network life and network latency, and improve the network performance, by comparing with the classical opportunistic routing protocol EXOR, the same type of protocol RE-OR, and the HER protocol using energy harvesting technology.
Analgesic Effect of a 5% Lidocaine Patch in Patients With Opioid Treatment-Resistant Neuropathic Cancer Pain
Authors: Tsai Jui-hung , Liu I-Ting , Su Pei-Fang , Huang Ying-Tzu , Chiu Ge-Lin , Chen Yu-Yeh , Lai Wei-Shu , Lin Peng-Chan 
Published: June 2021

Abstract
PurposeLimited efficacy has been observed when using morphine to treat neuropathic pain. Lidocaine patches reduce neuropathic pain in post-herpetic neuralgia, but their benefits for cancer-related neuropathic pain remain unclear. This study aimed to demonstrate a useful treatment for cancer-related neuropathic pain. The primary endpoint was pain intensity evaluated by the visual analog scale (VAS). The secondary endpoints were the pain relief score and the quality of analgesic treatment. MethodsWe assessed the efficacy and safety of lidocaine patches in patients experiencing neuropathic cancer pain. Terminal cancer patients with opioid treatment resistance participated in the 3-day study. ResultsThe results showed a statistically significant difference in the median VAS over three days (Kruskal-Wallis test, P<0.0001). The median VAS pain intensity from Day 1 to Day 3 was 4.0 with 95% C.I. (3.3, 5.0), 3.0 (2.5, 3.5) and 2.5 (2.0, 3.0), respectively. The difference between the median VAS pain intensities of any two days was statistically significant (Wilcoxon signed-rank test, P < 0.0001). There was no statistically significant difference in the pain relief score or the quality of analgesic treatment. Conclusion﻿In this study, the 5% lidocaine transdermal patch reduced the VAS pain intensity in neuropathic cancer patients with morphine resistance. The transdermal patch is generally useful and well-tolerated.
Caffeine as a Pollution Marker for Shallow Groundwaters in a Peri-Urban Area of Campinas / São Paulo – Brazil
Authors: Rupias Osvaldo Jorge Brito , Pereira Sueli Yoshinaga , de Abreu Ana Elisa Silva , Marques Adriana , de Alencar Joana Miranda 
Published: June 2021

Abstract
The presence of emerging contaminants, including caffeine, in groundwater can represent an anthropogenic contamination that can impact human health. The present research aims to use caffeine as a wastewater pollution marker of shallow groundwaters in the peri-urban area of Campinas/SP. For a better evaluation of caffeine as an anthropogenic marker, more conventional markers were also analyzed, such as Cl-, NO3-, K+, B, NH4+, NO2- and DOC, and physicochemical parameters such as pH, Eh and EC. Two samplings campaign were done, the first in April (wet season) and the second in August 2019 (dry season), where 18 domestic wells, one sample from the river and one sample from an abandoned meander were selected points to collect water for physicochemical analysis. Nine wells and an abandoned meander waters were selected for the analysis of caffeine. Results show correlations between NO3- and Cl- indicating apport of domestic septic tanks sewage in groundwater. Caffeine, however, was detected in three samples and quantified in one during the wet season and was detected in two samples and quantified in one during the dry season. In the area, caffeine and nitrate have opposite behavior due to reducing conditions of the environment. The study area is rich in dissolved organic carbon, so the conditions for caffeine conservation are not ideal, because it degrades rapidly in groundwaters rich in bacteria and organic matter. Even in this scenario, caffeine was detected in groundwater in the study area, providing unambiguous evidence of anthropogenic pollution of the phreatic aquifer.
Concomitant Bilateral Intravitreal Injection of Anti-Vascular Endothelial Growth Factor: Experience in Covid-19 Pandemic
Authors: ÖZEN SERKAN , Koc Hakan , Kaptı Hasan Burhanettin , Ozer Murat Atabey 
Published: June 2021

Abstract
Purpose: To report the concomitant bilateral intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection preference rates of patients before and after the Covid-19 outbreak and to evaluate whether this practice is safe when compared to unilateral injection. Materials and Methods: This is a single-center, retrospective study including consecutive series of 198 eyes of 112 patients received bilateral same-day (concomitant) or unilateral anti-VEGF injections of bevacizumab, ranibizumab, and aflibercept in the operating-room between January 2020 and January 2021. One-year medical record data including preference of bilateral over unilateral injection and adverse events were reviewed with 3-month intervals as before and after Covid-19 pandemic due to the labile Covid-19 outbreak course.Results: A total of 504 injections with 234 concomitant bilateral (%46) were administered to 112 patients. The study group consisted of 58 neovascular age-related macular degeneration (nAMD- 63.7% had bilateral nAMD), 46 diabetic macular edema (DME- 67.3% had bilateral DME) and 8 macular edema complicating retinal vein occlusion (RVO- 25% had bilateral RVO) patients. Of the injections, 156 (31%) were bevacizumab, 144 (29%) were aflibercept, and 204 (40%) were ranibizumab. The mean follow-up time per patient was 7.4 ± 4.3 months (range 4-11 months) and the mean number of injections was 3.6 ± 2.1 (range 2-10). None of the patients experienced serious vision-threatening complications or non-ocular adverse events. 85% of patients whose both eyes involved strongly preferred concomitant bilateral injection during Covid-19 pandemic while it was %35 before Covid-19 (P<0.001). The ratio of the number of concomitant bilateral injections to a total of injections increased from 30% to 57% after Covid-19 (P=0.03). Only 3 patients (2.6%) requested alternating unilateral injections after receiving the second concomitant bilateral injections.Conclusion: Concomitant bilateral injection approach was preferred by the majority of patients and did not increase the adverse event rate when applied under meticulous precautions; This intravitreal injection option may be preferred during still ongoing pandemic to reduce the clinical visits of patients at risk of Covid-19 related mortality due to their comorbidities and age.
System Lifetime and Performance Improvement in Wireless Sensor Networks by having Improved Energy Distributed Unequal Clustering Protocol
Authors: T Ashok , R Prabakaran 
Published: June 2021

Abstract
Wireless Sensor Network (WSN) is becoming a very important area of research in today’s world and contributes a lot in the field of technology. Reducing energy consumption and improving the network lifetime is the key factor to be considered.Clustering provides an effective way for prolonging the lifetime of a wireless sensor network. Current clustering algorithms usually utilize two techniques, selecting cluster heads with more residual energy and rotating cluster heads periodically, to distribute the energy consumption among nodes in each cluster and extend the network lifetime. Also, it comprises various sensor nodes to detect different parameters. Among those non-replaceable batteries plays a greater part. Hence the system with such networks is essential that the sensor nodes consume as little energy as possible.To address the problem, we propose anovel model namely enhanced energy distributed unequal clustering which is mainly utilized for tackling energy consumption issues in multi-hop remote sensor systems. In the proposed method with an area of base station and energy are given significance as clustering parameters. Because of these parameters, diverse nodes are assigned. Here, another methodology has been proposed to enhance the working of EDUC, by electing cluster heads considering several nodes in the neighborhood. The incorporation of the area data for calculation of the opposition radii gives better adjusting of energy in correlation with the current methodology. The technique utilized is of holding similar bunches for a couple of rounds and is successful in decreasing the clustering overhead. The execution of the proposed convention has been assessed under three distinct scenarios and contrasted and existing conventions through reenactments. The outcomes demonstrate that the proposed plan beats the current conventions regarding system lifetime and performances in all the scenarios in terms of delay, energy consumption, packet loss ratio, and packet received ratio.
Design of Two-Stage Differential Amplifier with Stacked Transistors for Biomedical Applications
Authors: Jain Prateek , Sharma Shambhu Dayal , Joshi Amit M. 
Published: June 2021

Abstract
In this paper, CMOS based optimized two stage differential amplifier circuit for convenient biomedical signal conditioning system is presented. A low-power, low noise & high CMRR differential amplifier is designed for portable ECG signal conditioning using MOS based low pass filter with stacked transistors. The stack transistors with MOS which is connected at output terminal optimize the design for ECG signal conditioning and other biomedical device signal conditioning. The presented amplifier is designed with standard 45nm CMOS process technology at a 0.85 V supply voltage. The simulation results are derived using Cadence Analog Virtuoso Spectre Simulator. The simulation results show that the presented differential amplifier has a common-mode rejection ratio (CMRR) of 178dB at 100Hz, power supply rejection ratio (PSRR) of 68 dB and power dissipation of 1.5μW. The input referred (IR) noise is 3.83μV/√f and slew rate is 11volt/μsec. These obtained performance parameters is better and efficient compared to conventional differential amplifier. The noise performance is improved using proposed design compared to previous designed differential amplifier.