bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving decision making, communication and documentation regarding advance resuscitation decisions in a tertiary care hospital in Sri Lanka
Authors: Appuhamy Shenal , Hewage Dinusha 
Published: August 2021

Abstract
BACKGROUND

Resuscitation decisions made in advance are especially important to prevent negative patient outcomes at end-of-life. We conducted a clinical audit to assess the current practice of these decisions in Sri Lanka and then introduced interventions to improve the same.
MATERIALS AND METHODS

An auditor-administered questionnaire developed through a focused group discussion among experts was used to analyze the medical records of deaths during a period of sixty days focusing on advance resuscitation decisions and factors affecting them. The junior doctors directly involved in the care of each patient were interviewed regarding their retrospective judgement about the most appropriate resuscitation decision, which was later compared with the decision of an expert panel, who decided on the most appropriate resuscitation decision based on the medical records of the patient. An educational session for doctors was then conducted to improve their knowledge about advance resuscitation decisions including the importance of meticulous documentation of such decisions. The outcome was assessed after sixty days following the introduction of the intervention using the same questionnaire.
RESULTS

There was a significant improvement in the number of documented advance resuscitation decisions from 4/40 (10%) to 17/38 (44.73%) (Z = 3.5, P = 0.0006), with a significant increase in DNACPR decisions from 4/40 (10%) to 14/38 (36.8%) (Z = 2.8, P = 0.005) following the intervention. Unsuccessful CPR attempts decreased significantly from 31/40 (77.5%) to 14/38 (36.8%) (Z = 3.6, P = 0.0003) in the post-intervention period. The resuscitation decisions suggested by junior doctors that matched with expert decision increased significantly for both interns ((from 11/40 (27.5%) to 22/38 (57.9%) (Z = 2.7, P = 0.0066)) and registrars ((18/40 (45%) to 27/38 (71.05%) (Z = 2.3, P = 0.0202)) in the post-intervention period.
CONCLUSION

Documentation and practice regarding advance resuscitation decisions is suboptimal in Sri Lanka. This can be improved by interventions targeting improving the knowledge about the concept and its proper documentation among health care professionals.
An Analytical Approximation to the Seismic Response of Light Linear Nonstructural Components in Resonance With Linear Structures
Authors: Miranda Julio Cesar 
Published: August 2021

Abstract
This paper considers the analytical calculation of the seismic response of light nonstructural components resonant with the buildings to which they are affixed. The mechanical systems thus conformed are presumed to be linearly elastic and classically damped, such that a traditional modal analysis can be carried out. Intended to estimate the upper limit of the response, the procedure developed is indicated for resonance with the fundamental mode, a condition which usually controls the response of the components. The correlation of the two closely spaced modes resulting from the dynamics of the component-building system, is accounted for through a spectral analysis. Comparison of the results predicted by the procedure described in this paper with limited numerical applications, corroborates that it is successful in predicting the response of the components when these are tuned to low order modes of the carrying structure. However, as also seen, the procedure is inappropriate to calculate the response of the components when their tuning involves higher modes of the supporting structure. Given the successful numerical forecasting of the response of the components, and given the compact form of the proposed equations, the feasibility of developing their codified form merits further investigation.
A Variable Neighborhood Search Algorithm with Constraint Relaxation for the Two-Echelon Vehicle Routing Problem with Simultaneous Delivery and Pickup Demands
Authors: Liu Ran , JIANG Shan 
Published: August 2021

Abstract
This paper considers a special vehicle routing problem, the two-echelon vehicle routing problem with simultaneous delivery and pickup demands (2E-VRPSDP). The 2E-VRPSDP differs from classic transportation and vehicle routing problems in two ways. First, freight delivery from the depot to the customers is managed by shipping the freight through intermediate satellites. Second, each customer in the 2E-VRPSDP may have simultaneous delivery and pickup demands. The 2E-VRPSDP is an extension of the two-echelon vehicle routing problem (2E-VRP) and the vehicle routing problem with simultaneous delivery and pickup (VRPSDP). A variable neighborhood search algorithm is designed to solve the 2E-VRPSDP in which both feasible and infeasible solutions can be explored. Numerical results show that the proposed algorithm is effective and that the algorithm can provide reasonable solutions within an acceptable computational time.
Genetic Diversity and Variety Identification of Panax Species Based on EST-SSR Markers
Authors: fan xin-yuan , Hui He-tong , Wang Tian-qi , Wang Ming-hui , Liu Mo-Yi , Su Feng-he , Wu Lun-peng , Liu Li-mei 
Published: August 2021

Abstract
Background: The roots of Panax species are widely used in the East because of their high medicinal and economic value. They are similar in plant morphology and chemical composition, but have quite differences in medicinal properties and efficacy, therefore, genetic diversity and variety identification of Panax species is particularly important. Methods: We screened 7 Simple Sequence Repeat (SSR) markers from expressed sequence tags (ESTs) database of Panax species in NCBI. Using these markers test SSR polymorphism in Panax species. Results: Seven SSR markers could successfully identify Panax ginseng, Panax quinquefolium, Panax notoginseng, and their commercial products. Among three ginseng varieties, garden ginseng, forest ginseng, and wild ginseng, the polymorphism of EST-SSR markers decreased gradually, which may be related to age and environment. Two pairs of EST-SSR primers can specifically identify three ginseng cultivars. The phylogenetic relationships analysis showed that Panax ginseng and Panax quinquefolium were closer than Panax notoginseng. Compared with wild ginseng, the relationship between the garden ginseng and the forest ginseng was closer. Conclusion: SSR molecular markers have high repeatability and can be used as reliable molecular markers for genetic diversity and variety identification of Panax species.
Nursing Professionals’ Perception of Health Care Quality Management
Authors: Ribeiro Danielle P. , Barbosa Maria A. , Fernandes Marcos R. , Silva Ludimila C. , Silva Júlio C. , Silva Edinamar A. , Prado Marinésia A. , Porto Celmo C. , Queiroz Maria C. , Filho Aroldo Vieira Moraes , Bezerra Ana Lúcia Q. 
Published: August 2021

Abstract
To understand the perception of nurses in quality management of nursing care at a public health institution in Brazil. Qualitative, participation of 18 nurses. Conducted with an interview, open questions with independent variables: characterization of professionals and outcome (perception of quality management, before - 1st phase - and after - 2nd phase - the intervention). Data organized with the help of ATLAS.ti software, Bardin analysis, with the theme “Delivery of value” in the first phase and the theme “Quality indicators focusing on delivering results” in the second phase. The third theme, “Management of care”, in 2 phases. Results showed that the perception of nursing managers about quality management varied between the first and second phases. Considering the revelations about scarce knowledge about quality management, we point out the need to carry out training with a health management approach focused on the management of the quality of care.
Dysfunction of CD27+IgD+B Cells Correlates With Aggravated Systemic Lupus Erythematosus
Authors: zhang wei , Wang YF , Hu Fanlei , Lu Fuai , Wu Tao , Li Ke 
Published: August 2021

Abstract
Objective：The apoptotic signaling pathway is obviously disordered in systemic lupus erythematosus (SLE). Natural IgM (nIgM) is important in clearing apoptotic cells and preventing them from triggering deleterious autoimmunity. B-1- and innate-like B- (ILBs) cells are the main nIgM producers. Human CD27+IgD+B cells (un-switched memory B cells) are considered ILBs. However, their functional properties in SLE remain undefined.Methods：Peripheral blood samples of 50 SLE patients and 50 healthy control were collected, and twelve SLE patients were assessed in a follow-up study. The amounts of CD27+IgD+ B cell was analyzed by flow cytometry. The IgM and IL-10 levels of CD27+IgD+ B cell were assessed by ELISPOT and qRT-PCR. SPSS 17.0 (SPSS, USA) was employed for data analysis. P<0.05 indicated statistical significance.Result：92.0% were females, 17-67 years. CD27+IgD+B cell amounts are significantly decreased in SLE patients than healthy control (p<0.01). CD27+IgD+B cell amounts were positively correlated with WBC(r=0.337, p=0.017), platelet count(r=0.396, p=0.004) and serum C3 levels(r=0.415, p=0.003), CD27+IgD+B cell amounts showed negative correlations with serum creatinine levels(r=-0.285, p=0.045), SLEDAI(r=-0.724, p=0.000), anti-dsDNA(r=-0.477, p=0.000) and CRP(r=-0.398,p=0.004). The IgM and IL-10 levels of CD27+IgD+B in SLE were decreased than healthy control (p<0.001), moreover CD27+IgD+B cells are increased in SLE cases after treatment in SLE patients than before treatment(p<0.001).Conclusion：CD27+IgD+B cell amounts are significantly decreased and it was correlated with clinical and immunological features in SLE patients. CD27+IgD+B cells had impaired function regarding IgM and IL-10 production in SLE, however, CD27+IgD+B cells amounts are recovered in SLE cases with treatment-related disease remission.
Research on Expansion and Classification of Imbalanced Data Based on SMOTE Algorithm
Authors: Wang Shujuan , Dai Yuntao , Shen Jihong , Xuan Jingxue 
Published: August 2021

Abstract
With the development of artificial intelligence, the research of medical auxiliary diagnosis based on big data classification is considered as a new technology that can be expected. Due to the different condition in the collection of different samples, medical big data often has imbalances. The class imbalance problems have been reported to severely hinder classification performance of many standard learning algorithms, and have attracted a great deal of attention from researchers of different fields. Focusing on this problem, an improved SMOTE algorithm based on Normal distribution is proposed in this paper. The principle of Normal random distribution is introduced to expand the minority sample, so that the new sample points are distributed closer to the center of the minority sample with a higher probability. In addition, the distribution of the generated data is controlled based on the characteristics of the Normal distribution. And the influence of the statistical characteristics of the original data on the parameter(variance) selection is analyzed based on the inter-class distance and sample variance. Experiments show that the proposed algorithm has better classification effect on the Pima, WDBC, WPBC, Ionosphere and Breast-cancer-wisconsin imbalanced datasets than the original SMOTE algorithm according to AUC, OOB, F-value, G-value.
Subaxial Lordosis Loss and Influence Factors After Posterior Atlantoaxial Fusion
Authors: Liu Shaoqiang , Liu Boling , Liang Guiqing , Chen Qiyong , Wang Huafeng , Lin Yuhan 
Published: August 2021

Abstract
Summary of Background Data: Cervical sagittal balance, an important evaluation index of cervical physiological function and surgical efficacy. Subaxial kyphosis after atlantoaxial fusion is negatively associated with worse clinical outcome and higher incidence of lower cervical disc degeneration. Objectives: This study aimed to confirm the factors that influence subaxial lordosis loss after posterior atlantoaxial fusion. Methods: We performed a retrospective review of all patients following posterior C1-C2 fusion for atlantoaxial dislocation between January 2015 and December 2017. All charts, records, and imaging studies were reviewed for each case, and preoperative, immediate postoperative, and final follow-up plain films were evaluated. Comparing final follow-up and preoprative C2-C7 angle, patients were divided into two groups for further comparison: subaxial lordosis loss group and subaxial lordosis increase group.Results: A total of 18 patients were included in the review, with an average radiographic follow-up of 8.4 ± 3.7 months (range, 6 to 17 months). Subaxial lordosis loss was observed in 5 cases (27.8%) at the final follow-up, whereas 13 cases had an increase of subaxial lordosis. The cervical sagittal parameters of preoperative and final follow-up between two groups were compared, the preoperative C2-C7 angle of the subaxial lordosis loss group was bigger than the subaxial lordosis increase group (27.6°±10.5° vs 10.5°±10.5°, P<0.05), but there was no statistical difference in other parameters. Univariate chi-square analysis showed that reduction of subaxial lordosis after posterior atlantoaxial fusion was associated with preoperative C2-C7 angle ≥20° (χ2=4.923, P=0.026). However, Logistic regression analysis showed that the preoperative C2-C7 angle ≥20° was not an independent risk factor (OR=0.147, P=0.225). Conclusion: Our study demonstrates that subaxial lordosis loss may occur after posterior atlantoaxial fusion, and preoperative C2-C7 angle ≥20° was a risk factor of postoperative loss of subaxial lordosis.
Beta-Lactam Dosing During Continuous Renal Replacement Therapy: A Survey of Practices in French Intensive Care Units
Authors: Matusik Elodie , Lemtiri Justine , Wabont Guillaume , Lambiotte Fabien 
Published: August 2021

Abstract
BackgroundLittle information is available on current practice in beta-lactam dosing during continuous renal replacement therapy (CRRT). Optimized dosing is essential for improving outcomes, and there is no consensus on the appropriate dose regimens. The objective of the present study was to describe current practice for beta-lactam dosing during CRRT in intensive care units (ICUs).MethodsWe conducted a nationwide survey by e-mailing an online questionnaire to physicians working in ICUs in France. The questionnaire included three sections: demographic characteristics, CRRT practices, and beta-lactam dosing regimens during CRRT.Results157 intensivists completed the questionnaire. Continuous venovenous hemofiltration was the most frequently used CRRT technique, and citrate was the most regularly used anticoagulant. The median prescribed dose at baseline was 30 mL/kg/h. The majority of prescribers (57%) did not reduce beta-lactam dosing during CRRT. The tools were used to adapt dosing regimens during CRRT included guidelines, therapeutic drug monitoring (TDM), and data from the literature. When TDM was used, 100% T > 4 time the MIC was the most common mentioned pharmacokinetic/pharmacodynamic target (53%). Pharmacokinetic software tools were rarely used. Prolonged or continuous infusions were widely used during CRRT (88%). Institutional guidelines on beta-lactam dosing during CRRT were rare. 41% of physicians sometimes consulted another specialist before adapting the dose of antibiotic during CRRT.ConclusionsOur present results highlight the wide range of beta-lactam dosing practices adopted during CRRT. Personalized TDM and the implementation of Bayesian software appear to be essential for optimizing beta-lactam dosing regimens and improving patient outcomes.
A Nomogram From The SEER Database For Predicting The Prognosis of Small Cell Lung Cancer With Different Patterns of Metastases
Authors: Ruan Hongli , Liu Yanmei , Sun Huali , Ding Yan , Ying Shenpeng , Lin Peipei 
Published: August 2021

Abstract
Backgroud: Distant metastases are one of the leading causes of high mortality in small cell lung cancer (SCLC). This research is aimed to investigate the different patterns of metastases in SCLC patients and their impact on prognosis based on the data from the Surveillance, Epidemiology, and End Results (SEER) database. Methods: The 2010-2015 SEER database of 15637 SCLC patients diagnosed from January to August were used as a training set for development of a nomogram. 7310 SCLC patients diagnosed from September to December were used as the validation set. Results: The overall survival (OS) of SCLC patients with no distant metastases, bone metastases, brain metastases, and liver metastases were 16.6, 9.1, 8.8 and 6.0 months, respectively. Patients with solitary liver metastases have the worst prognosis in the cases with single metastatic site. In the patients with multi-site metastases, the clinical outcomes of the cases combined with liver metastases were the worst. Our Cox model indicated that age, gender, American Joint Committee on Cancer (AJCC) stage, metastases, chemotherapy, radiation and surgery were independent predictors for OS in SCLC patients. The c-index value of nomogram was 7.52 in training set and 7.48 in of validation set for predicting OS in SCLC, indicating that the predictive ability of our nomogram model was of great superiority.Conclusion: The prognosis of SCLC patients with liver metastases alone or combined with other metastatic sites were worse than other metastatic models. Our nomogram model that integrated significant factors can aid as an individualized clinical predictive tool in SCLC patients.
Validating an Amharic Version of the 36-item Short Form Health Survey (SF-36) in Individuals With Leprosy in Ethiopia.
Authors: Lambert Saba Maria , Nigusse Shimelis D. , Alembo Digafe T. , Walker Stephen L. , Nicholls Peter G. , Lockwood Diana N.J. 
Published: August 2021

Abstract
Background: Health-related quality of life (HRQoL) has now become an indispensable outcome measure in many randomized clinical trials and other studies. It provides the patient’s voice in measuring health improvement or decline and assessing treatment effectiveness. A validated Amharic version of HRQoL assessment tool was needed for leprosy clinical trials in Ethiopia. The SF-36 was chosen but a validated Amharic version was not available. We describe how this was developed.Methods: The SF-36 was translated from English into Amharic and evaluated for content acceptability in a patient focus group. Back translation was performed. Validity and reliability of Amharic SF-36 in leprosy affected individuals was tested with 100 patients with leprosy attending the leprosy clinic at ALERT hospital and compared to the Amharic version of the WHOQOL-BREF.Results: Amharic translations of both the WHOQOL-BREF and the SF-36 had good reliability and validity amongst leprosy affected individuals. Internal consistency reliability estimates for each domain/scale exceeded 0.70. The Amharic SF-36 had better convergent and discriminant validity than WHOQOL-BREF in this group of patients. Good known-group validity was seen in both WHOQOL-BREF and SF-36 in leprosy affected patients. Amharic SF-36 had good inter-rater reliability with seven out of 8 domains scoring above 0.8 in intra-class correlation.Conclusion: This Amharic version of the SF-36 is a valid instrument to measure HRQoL in clinical trials involving leprosy affected individuals in Ethiopia.
Crystal Structure and Cellular Functions of uPAR Dimer
Authors: Yu Shujuan , Sui Yaqun , Wang Jiawei , Li Yongdong , Li Hanlin , Jiang Longguang , Yuan Cai , Huang Mingdong 
Published: August 2021

Abstract
Receptor dimerization of urokinase-type plasminogen activator receptor (uPAR) was previously identified at protein level and on the cell surface. Recently, a dimeric form of mouse uPAR isoform 2 was proposed, which induced kidney disease. Here, we report the crystal structure of human uPAR dimer at 2.96 Å. The structure reveals enormous conformational changes of the dimer compared to the monomeric structure: D1 of uPAR opens up into a large expanded loop that captures a β-hairpin loop of a neighboring uPAR to form an expanded β-sheet, leading to an elongated, highly intertwined dimeric uPAR. Based on the structure, we identify the E49P mutation promoting dimer formation. The mutation increases receptor binding to amino terminal fragment (ATF) of its primary ligand uPA, induces the receptor to distribute to the basal membrane, promotes cell proliferation, and alters cell morphology via the ERK activation of β1 integrin signaling. These results reveal the structural basis for uPAR dimerization, its effect on cell function, and provide new insight and tools to study this multifunctional receptor.
Experimental Studies on Frozen Soil
Authors: Gaur Kshitij , Sahu Anil Kumar 
Published: August 2021

Abstract
Various studies have been carried out for soils at normal room temperature but the studies on frozen soils are meagre. For every construction, soil investigation is the most important and the primary step for a site. For constructions at normal room temperature, there are plenty of experimentation and research data on soil is available. But lack of research data for colder regions, where the ambient temperature is below zero degree Celsius for most of the time. It is therefore the need to study soil under iced condition to get a better idea about the behaviour of frozen soils. There are few research on construction and mechanical behaviour of frozen soil but no study on the very basic parameters of like void ratio, bulk density, porosity, and the degree of freezing and how these parameters change as the soil temperature changes from normal room temperature to negative values. The main emphasis is on the study and experimentation on frozen soil and to formulate different relationships between individual soil parameters at various temperatures. The methodology used is to model the soil surface (open grounds in colder regions) by taking sand as the soil after sieving. The model samples are taken into beakers with different bulk densities to replicate real site condition in the freezer. Then by calculating factors like density, porosity, void ratio, etc at negative temperature (-5, -10, -15, -20 degree Celsius) and forming relationship with same parameters with that on room temperature. The experimental data obtained is used in “Eureqa software” that will utilize the input so provided and will find mathematical relation that exist in the soil parameters.