bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of surgical drain output monitoring on patient outcomes in hepatopancreaticobiliary surgery: A systematic review
Authors: Kowal Mikolaj , Bolton William , Van Duren Bernard , Burke Joshua , Jayne David 
Published: November 2021

Background and objective: Surgical drains are widely utilized in hepatopancreaticobiliary surgery to prevent intra-abdominal collections and identify postoperative complications. Surgical drain monitoring ranges from simple-output measurements to specific analysis for constituents such as amylase. This systematic review aimed to determine whether surgical drain monitoring can detect postoperative complications and impact on patient outcomes. Methods: A systematic review was performed, and the following databases searched between 02/03/20 and 26/04/20: MEDLINE, EMBASE, The Cochrane Library, and Clinicaltrials.gov. All studies describing surgical drain monitoring of output and content in adult patients undergoing hepatopancreaticobiliary surgery were considered. Other invasive methods of intra-abdominal sampling were excluded. Results: The search returned 403 articles. Following abstract review, 390 were excluded and 13 articles were included for full review. The studies were classified according to speciality and featured 11 pancreatic surgery and 2 hepatobiliary surgery studies with a total sample of 3262 patients. Postoperative monitoring of drain amylase detected pancreatic fistula formation and drain bilirubin testing facilitated bile leak detection. Both methods enabled early drain removal. Improved patient outcomes were observed through decreased incidence of postoperative complications (pancreatic fistulas, intra-abdominal infections, and surgical-site infections), length of stay, and mortality rate. Isolated monitoring of drain output did not confer any clinical benefits. Conclusions: Surgical drain monitoring has advantages in the postoperative care for selected patients undergoing hepatopancreaticobiliary surgery. Enhanced surgical drain monitoring involving the testing of drain amylase and bilirubin improves the detection of complications in the immediate postoperative period.
Exploring the perceptions of dignity among patients and nurses in hospital and community settings: an integrative review
Authors: Stephen Ekpenyong Mandu , Nyashanu Mathew , Ossey-Nweze Chioma , Serrant Laura 
Published: November 2021

Background Patients have a right to be treated with dignity. However, reports have continually identified concerns regarding the quality of care and dignity in hospitals. Undignified care can have unfavourable impact on the patient’s recovery such as leading to depression and loss of will to live. The aim of this study was to explore dignity as perceived by patients and nurses within hospital and community environments. Methods An integrative review methodological approach was adopted. Nine databases including Medline, CINAHL plus with full text, Web of Science, Embase, Pubmed, Psycinfo, Scopus, Nursing and Allied Health Source, and Science Direct were systematically searched for relevant articles using a predetermined set of inclusion criteria. Articles were included if they were primary empirical studies, peer reviewed, published between 2008–2019, assessing patients’ or nurses’ perception of dignity outside the end-of-life context, conducted in one of the European countries and written in English. Included papers were analysed using constant comparative analysis. The preferred reporting system for systematic review and meta-analysis (Prisma) flow diagram was used for quality appraisal and review. Results Fourteen relevant articles were included in this review. Four overarching themes and 10 subthemes were identified as impacting on patient dignity. Overarching themes include autonomy, healthcare delivery factors, organisational factors and the meaning of dignity, whilst subthemes include dependence/independence, choice, staff attitudes, communication, privacy, structure of services, staff shortages, physical environment, respect and person-centred care. Conclusion There are a wide range of factors impacting on patient dignity. Adopting evidence-based interventions supported by adequate theoretical backing can help to enhance patient dignity in hospital and community settings.
Prioritizing the influencing factors of utaut-2 model toward mobile network service providers
Authors: Patharia Ishani , Pandey Anjana , Gupta Sanjay 
Published: November 2021

Technological developments have a major impact on user behavior. The rapidly evolving communication system and technology have provided numerous choices for people. The ever-shifting changes in the generation of communication networks have posed challenges for mobile network service providers to attract and retain customers. This study aims to prioritize the determinants of the adoption of mobile network service providers using the unified theory of acceptance and use of technology (UTAUT-2). In this study, data were collected from 660 mobile phone users in Haryana, India. A fuzzy analytical hierarchy process (F-AHP) was applied to arrange the priority or rank the factors based on the significance of the factors in explaining the adoption of mobile network service providers. Results of the study reveal that efforts expectancy is the highest-ranked and prioritized factor for the adoption of mobile network service providers followed by performance expectancy and facilitating conditions. However, social influence emerged as the least important factor. The present study provides theoretical implications for future researchers by synthesizing and prioritizing the important factors affecting technology acceptance. The practical implications offer a clearer insight to marketers for developing focused pragmatic strategies to retain customer loyalty. The study has considered only UTAUT-2 model constructs and used the F-AHP technique. Other factors may be considered in future studies. Other priority analysis techniques can also be used such as ISM and MICMAC analysis for further study. The research has been conducted in Haryana, India, and therefore, it needs to be tested in other areas/countries for generalizability. JEL Classification: O1, O2, O4
Differences in Lower Extremity Kinematics Between Collegiate and Youth Softball Pitchers
Authors: Downs Talmage Jessica , Gilliam Jessica , Chardhari Ajit , Oliver Gretchen D. 
Published: November 2021

Background: Softball pitching is a whole-body motion that utilizes the kinetic chain to transfer the large amounts of force generated by the lower extremity to the ball. Although the lower extremity is responsible for generating most of the force in softball pitching, limited research has investigated how lower extremity kinematics vary with age. Purpose/Hypothesis: The purpose of this study was to compare lower extremity kinematics between collegiate and youth softball pitchers. It was hypothesized that there would be significant lower extremity kinematic differences between age groups. Study Design: Descriptive laboratory study. Methods: Overall, 83 softball pitchers participated in the study: 40 youth and 43 collegiate players. Kinematic data were collected using an electromagnetic motion capture system. All participants threw 3 fastballs to a catcher for a strike at regulation distance. Owing to nonnormally distributed data, Mann-Whitney U tests were used to determine group differences at 5 events during the pitching motion. The alpha level was set a priori at .006. Results: Collegiate pitchers had significantly higher drive-knee extension angular velocity at the 3-o’clock position than youth pitchers (182.30 ± 145.44 vs –34.66 ± 219.66 rad/s; P < .001). Collegiate pitchers also had greater peak drive-knee flexion angle than youth pitchers at the top of the arm circle (37.98° ± 18.09° vs 25.38° ± 17.58°; P = .004), while youth pitchers had a significantly more anteriorly shifted center of mass than collegiate pitchers at the top of the arm circle (49.93% ± 5.09% vs 46.47% ± 6.44%; P = .003). Conclusion: The authors found increased drive-knee flexion angle and angular extension velocity in collegiate compared with youth pitchers, although it is unknown if these differences were due to lack of experience or strength. Athletes should work on improving drive-leg mechanics to develop optimal push-off performance. Clinical Relevance: This information can be applied to develop strength and conditioning programs for softball pitchers. Player performance may be improved through performing exercises to strengthen knee and hip extension musculature and learning to eccentrically load the drive leg to activate the stretch shortening cycle.
Nursing Development in Indonesia: Colonialism, After Independence and Nursing act
Authors: Gede Juanamasta I , Iblasi Abdulkareem S. , Aungsuroch Yupin , Yunibhand Jintana 
Published: November 2021

Introduction Stereotyping of nurses still occurs nowadays in Indonesia. Society and healthcare think nursing is a doctor helper service. The public image of a nurse as a doctor's helper is hard to erase. Thus, the nursing development in Indonesia needs to be explored in describing the stereotyping and the nursing conditions in the current situation. Methods The study used a narrative review with 45 sources analyzed and extracted. Results Nursing education has been developed since colonialism. The first time the Netherland Indies built the hospital and they used Babu or a helper as a nurse. The result showed it had a negative impact, which showed as they started to train nurses. They trained male nurses to be Mantri nurses as hulpgeneesheeren (ancillary doctors). After independence, the project HOPE influenced the development of nursing in Indonesia. Indonesian nurses focused on technical aspects and added the nursing process to the education curricula in 1986. However, nurses’ practice culture did not change for a long time because of a lack of research and literature being evaluated during 1990–2010. Indonesia nursing started to increase the education, practice, and research afterward, with specifically the declaration of the Indonesian Nursing Act. It brought nurses into the professionalism of healthcare which the Indonesian government recognized. Then, nurses have faced new problems, including practice and education gaps. Conclusion The development of nurses will increase autonomy and dignity. Increasing education curricula, practice competency, and research impact will change the perspective of society with the support of recognition and education from the nursing organization. In addition, the nursing organization has an essential role in nursing development in each country.
The similarity of class II HLA genotypes defines patterns of autoreactivity in idiopathic bone marrow failure disorders
Authors: Pagliuca Simona , Gurnari Carmelo , Awada Hassan , Kishtagari Ashwin , Kongkiatkamon Sunisa , Terkawi Laila , Zawit Misam , Guan Yihong , LaFramboise Thomas , Jha Babal K. , Patel Bhumika J. , Hamilton Betty K. , Majhail Navneet S. , Lundgren Sofie , Mustjoki Satu , Saunthararajah Yogen , Visconte Valeria , Chan Timothy A. , Yang Chao-Yie , Lenz Tobias L. , Maciejewski Jaroslaw P. 
Published: November 2021

AbstractIdiopathic aplastic anemia (IAA) is a rare autoimmune bone marrow failure (BMF) disorder initiated by a human leukocyte antigen (HLA)-restricted T-cell response to unknown antigens. As in other autoimmune disorders, the predilection for certain HLA profiles seems to represent an etiologic factor; however, the structure-function patterns involved in the self-presentation in this disease remain unclear. Herein, we analyzed the molecular landscape of HLA complexes of a cohort of 300 IAA patients and almost 3000 healthy and disease controls by deeply dissecting their genotypic configurations, functional divergence, self-antigen binding capabilities, and T-cell receptor (TCR) repertoire specificities. Specifically, analysis of the evolutionary divergence of HLA genotypes (HED) showed that IAA patients carried class II HLA molecules whose antigen-binding sites were characterized by a high level of structural homology, only partially explained by specific risk allele profiles. This pattern implies reduced HLA binding capabilities, confirmed by binding analysis of hematopoietic stem cell (HSC)-derived self-peptides. IAA phenotype was associated with the enrichment in a few amino acids at specific positions within the peptide-binding groove of DRB1 molecules, affecting the interface HLA-antigen-TCR β and potentially constituting the basis of T-cell dysfunction and autoreactivity. When analyzing associations with clinical outcomes, low HED was associated with risk of malignant progression and worse survival, underlying reduced tumor surveillance in clearing potential neoantigens derived from mechanisms of clonal hematopoiesis. Our data shed light on the immunogenetic risk associated with IAA etiology and clonal evolution and on general pathophysiological mechanisms potentially involved in other autoimmune disorders.
Pain sensitivity in men who have never experienced a headache: an observer blinded case control study
Authors: Olofsson Isa Amalie , Hvedstrup Jeppe , Falkenberg Katrine , Chalmer Mona Ameri , Schytz Henrik Winther , Pedersen Miguel Benjamin , Ullum Henrik , Pedersen Ole Birger , Olesen Jes , Hansen Thomas Folkmann 
Published: November 2021

Abstract
Background
Headache affects 90–99% of the population. Based on the question “Do you think that you never ever in your whole life have had a headache?” 4% of the population say that they have never experienced a headache. The rarity of never having had a headache suggests that distinct biological and environmental factors may be at play. We hypothesized that people who have never experienced a headache had a lower general pain sensitivity than controls.

Methods
We included 99 male participants, 47 headache free participants and 52 controls, in an observer blinded nested case-control study. We investigated cold pain threshold and heat pain threshold using a standardized quantitative sensory testing protocol, pericranial tenderness with total tenderness score and pain tolerance with the cold pressor test. Differences between the two groups were assessed with the unpaired Student’s t-test or Mann-Whitney U test as appropriate.

Results
There was no difference in age, weight or mean arterial pressure between headache free participants and controls. We found no difference in pain detection threshold, pericranial tenderness or pain tolerance between headache free participants and controls.

Conclusion
Our study clearly shows that freedom from headache is not caused by a lower general pain sensitivity. The results support the hypothesis that headache is caused by specific mechanisms, which are present in the primary headache disorders, rather than by a decreased general sensitivity to painful stimuli.

Trial registration
Registered at ClinicalTrials.gov (NCT04217616), 3rd January 2020, retrospectively registered.
Application of artificial intelligence ensemble learning model in early prediction of atrial fibrillation
Authors: Wu Cai , Hwang Maxwell , Huang Tian-Hsiang , Chen Yen-Ming J. , Chang Yiu-Jen , Ho Tsung-Han , Huang Jian , Hwang Kao-Shing , Ho Wen-Hsien 
Published: November 2021

AbstractBackgroundAtrial fibrillation is a paroxysmal heart disease without any obvious symptoms for most people during the onset. The electrocardiogram (ECG) at the time other than the onset of this disease is not significantly different from that of normal people, which makes it difficult to detect and diagnose. However, if atrial fibrillation is not detected and treated early, it tends to worsen the condition and increase the possibility of stroke. In this paper, P-wave morphology parameters and heart rate variability feature parameters were simultaneously extracted from the ECG. A total of 31 parameters were used as input variables to perform the modeling of artificial intelligence ensemble learning model.ResultsThis paper applied three artificial intelligence ensemble learning methods, namely Bagging ensemble learning method, AdaBoost ensemble learning method, and Stacking ensemble learning method. The prediction results of these three artificial intelligence ensemble learning methods were compared. As a result of the comparison, the Stacking ensemble learning method combined with various models finally obtained the best prediction effect with the accuracy of 92%, sensitivity of 88%, specificity of 96%, positive predictive value of 95.7%, negative predictive value of 88.9%, F1 score of 0.9231 and area under receiver operating characteristic curve value of 0.911.ConclusionIn feature extraction, this paper combined P-wave morphology parameters and heart rate variability parameters as input parameters for model training, and validated the value of the proposed parameters combination for the improvement of the model’s predicting effect. In the calculation of the P-wave morphology parameters, the hybrid Taguchi-genetic algorithm was used to obtain more accurate Gaussian function fitting parameters. The prediction model was trained using the Stacking ensemble learning method, so that the model accuracy had better results, which can further improve the early prediction of atrial fibrillation.
Artificial intelligence classification model for macular degeneration images: a robust optimization framework for residual neural networks
Authors: Ho Wen-Hsien , Huang Tian-Hsiang , Yang Po-Yuan , Chou Jyh-Horng , Huang Hong-Siang , Chi Li-Chung , Chou Fu-I , Tsai Jinn-Tsong 
Published: November 2021

Abstract
Background
The prevalence of chronic disease is growing in aging societies, and artificial-intelligence–assisted interpretation of macular degeneration images is a topic that merits research. This study proposes a residual neural network (ResNet) model constructed using uniform design. The ResNet model is an artificial intelligence model that classifies macular degeneration images and can assist medical professionals in related tests and classification tasks, enhance confidence in making diagnoses, and reassure patients. However, the various hyperparameters in a ResNet lead to the problem of hyperparameter optimization in the model. This study employed uniform design—a systematic, scientific experimental design—to optimize the hyperparameters of the ResNet and establish a ResNet with optimal robustness.

Results
An open dataset of macular degeneration images (https://data.mendeley.com/datasets/rscbjbr9sj/3) was divided into training, validation, and test datasets. According to accuracy, false negative rate, and signal-to-noise ratio, this study used uniform design to determine the optimal combination of ResNet hyperparameters. The ResNet model was tested and the results compared with results obtained in a previous study using the same dataset. The ResNet model achieved higher optimal accuracy (0.9907), higher mean accuracy (0.9848), and a lower mean false negative rate (0.015) than did the model previously reported. The optimal ResNet hyperparameter combination identified using the uniform design method exhibited excellent performance.

Conclusion
The high stability of the ResNet model established using uniform design is attributable to the study’s strict focus on achieving both high accuracy and low standard deviation. This study optimized the hyperparameters of the ResNet model by using uniform design because the design features uniform distribution of experimental points and facilitates effective determination of the representative parameter combination, reducing the time required for parameter design and fulfilling the requirements of a systematic parameter design process.
Metaproteomics reveals insights into microbial structure, interactions, and dynamic regulation in defined communities as they respond to environmental disturbance
Authors: Shrestha Him K. , Appidi Manasa R. , Villalobos Solis Manuel I. , Wang Jia , Carper Dana L. , Burdick Leah , Pelletier Dale A. , Doktycz Mitchel J. , Hettich Robert L. , Abraham Paul E. 
Published: November 2021

Abstract
Background
Microbe-microbe interactions between members of the plant rhizosphere are important but remain poorly understood. A more comprehensive understanding of the molecular mechanisms used by microbes to cooperate, compete, and persist has been challenging because of the complexity of natural ecosystems and the limited control over environmental factors. One strategy to address this challenge relies on studying complexity in a progressive manner, by first building a detailed understanding of relatively simple subsets of the community and then achieving high predictive power through combining different building blocks (e.g., hosts, community members) for different environments. Herein, we coupled this reductionist approach with high-resolution mass spectrometry-based metaproteomics to study molecular mechanisms driving community assembly, adaptation, and functionality for a defined community of ten taxonomically diverse bacterial members of Populus deltoides rhizosphere co-cultured either in a complex or defined medium.

Results
Metaproteomics showed this defined community assembled into distinct microbiomes based on growth media that eventually exhibit composition and functional stability over time. The community grown in two different media showed variation in composition, yet both were dominated by only a few microbial strains. Proteome-wide interrogation provided detailed insights into the functional behavior of each dominant member as they adjust to changing community compositions and environments. The emergence and persistence of select microbes in these communities were driven by specialization in strategies including motility, antibiotic production, altered metabolism, and dormancy. Protein-level interrogation identified post-translational modifications that provided additional insights into regulatory mechanisms influencing microbial adaptation in the changing environments.

Conclusions
This study provides high-resolution proteome-level insights into our understanding of microbe-microbe interactions and highlights specialized biological processes carried out by specific members of assembled microbiomes to compete and persist in changing environmental conditions. Emergent properties observed in these lower complexity communities can then be re-evaluated as more complex systems are studied and, when a particular property becomes less relevant, higher-order interactions can be identified.