bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and facilitators of the electronic medical record adoption among healthcare providers in Addis Ababa, Ethiopia
Authors: Bekele Tadesse Alemu , Gezie Lemma Derseh , Willems Herman , Metzger Jonathan , Abere Biruhtesfa , Seyoum Blen , Abraham Loko , Wendrad Naod , Meressa Selamawit , Desta Bethel , Bogale Tariku Nigatu 
Published: December 2024

Introduction An electronic medical record (EMR) can enhance the quality of care and patient outcomes. Ethiopia started the implementation of EMR in 2013. However, its adoption among healthcare providers has been low. Thus, this study explored the barriers and facilitators of EMR adoption among healthcare providers in Addis Ababa, Ethiopia. Methods A descriptive-phenomenological approach was used. Data were collected from one hospital and three health centers from 5–13 June, 2023, that implemented the EMR. A total of 25 EMR users (physicians, health officers, pharmacists, nurses, laboratory technologists, radiology technicians) were included in the key informant interviews. The interviews were audio-recorded, transcribed verbatim, translated to English, and exported to OpenCode 4.03 software for analysis. Thematic analysis was applied to analyze, summarize, and present the data. Results Healthcare providers reported barriers operating at three levels: individual, technological, and organizational. Individual barriers included lack of digital literacy, technical knowledge, skill; motivation; and favorable attitude. Technological barriers included lack of infrastructure including computers, networks, and reliable power supply; and software-related challenges such as system downtime, lack of interoperability, comprehensiveness, and decision support systems; and system security and privacy concerns. Organizational barriers included poor quality of training, lack of follow-up, supervision and technical support; poor leadership commitment; lack of incentives and motivation; and staff turnover and workload. Perceived benefits of the system, such as ease of access to quality data, improved quality of care and work efficiency; availability of onsite technical support; presence of information technology supplies; and feedback from supervisors, were identified as facilitators of EMR adoption. Conclusion The study identified different barriers and facilitators to the adoption of the EMR. The health system should prioritize strategies to address technological, individual, and organizational factors influencing the successful adoption of the EMR to support the delivery of quality care and improve patient outcomes.
Intravenous thrombolysis in young adults with ischemic stroke: A cohort study from the international TRISP collaboration
Authors: Nybondas Miranda , Martinez-Majander Nicolas , Ringleb Peter , Ungerer Matthias , Gumbinger Christoph , Trüssel Simon , Altersberger Valerian , Scheitz Jan F , von Rennenberg Regina , Riegler Christoph , Cordonnier Charlotte , Zini Andrea , Bigliardi Guido , Rosafio Francesca , Michel Patrik , Wali Nabila , Nederkoorn Paul J , Heldner Mirjam , Zedde Marialuisa , Pascarella Rosario , Padjen Visnja , Berisavac Ivana , Béjot Yannick , Putaala Jukka , Sibolt Gerli , Tiainen Marjaana , Mannismäki Laura , Mertsalmi Tuomas , Myller Elina , Pezzini Alessandro , Leker Ronen R , Kägi Georg , Wegener Susanne , Cereda Carlo W , Nordanstig Annika , Ntaios George , Nolte Christian H , Gensicke Henrik , Engelter Stefan T , Curtze Sami ,   EVATRISP Investigators
Published: December 2024

Background and aims: Previous observational data indicate that young adults treated with intravenous thrombolysis (IVT) for acute ischemic stroke have more favorable outcomes and less complications when compared to older adults. Given the limited data on this topic, we aimed to provide more evidence on clinical outcomes and safety in such patients, using a large international thrombolysis registry. Methods: In this prospective multicenter study, we used data from the Thrombolysis in Ischemic Stroke Patients (TRISP) registry from 1998 to 2020. Patients who received endovascular treatment (EVT), as only treatment or in addition to IVT, were not included in this cohort. Using multivariable regression models, we compared thrombolysed young patients aged 18–49 years with those aged ⩾50 years with regards to the following outcomes: favorable outcome in stroke survivors (modified Rankin Scale ⩽2), symptomatic intracranial hemorrhage (sICH) according to European Cooperative Acute Stroke Study II (ECASS II) criteria, and three-months all-cause death. Results: Of the 16,651 IVT treated patients, 1346 (8.1%) were 18–49 years. Young adults in TRISP were more often male (59.6% vs 54.0%), had a lower median NIHSS score on admission, 7 (4–13) versus 8 (5–15), and had less cardiovascular risk factors except for smoking (42.0% vs 19.0%) when compared to older patients. When compared to thrombolysed patients aged ⩾50 years, a favorable functional outcome was more likely in young adults: 81.9% versus 56.4%, aOR 2.30 (1.80–2.95), whilst sICH 1.6% versus 4.6%, aOR 0.45 (0.23–0.90) and death 2.3% versus 14.2%, aOR 0.21 (0.11–0.39) were less likely. Conclusions: Intravenous thrombolysis in young adults is independently associated with higher rates of favorable outcomes and lower rates of complications.
Prevalence and determinants of thrombocytopenia in newborn unit at Alexandria University Hospital: a three-year report including 1000 patients
Authors: Farag Marwa Mohamed , Goda Mohamed Hazem , Nazir Hanan Fawzy , Deghedy Ahmed Akram 
Published: December 2024

Abstract
Background
Thrombocytopenia might be the only clinical clue of diseases in neonates. Classification of thrombocytopenia according to severity, onset offset, nadir and duration might help in identification of the etiology.

Aim
This study aims to estimate the prevalence and, identify the determinants and patterns of thrombocytopenia among neonates.

Method
An observational retrospective cohort study was conducted and included records of neonates admitted to neonatal intensive care unit of Alexandria University Maternity Hospital. Data were collected using a checklist and analyzed by SPSS version 20.0. Chi square test and independent sample t- test were used to compare different variables between thrombocytopenic and non- thrombocytopenic patients. Logistic regression analysis was carried out in order to identify the independent contribution of various maternal and neonatal variables influencing thrombocytopenia and factors impacting mortality in thrombocytopenic patients.

Results
Four-thousands five hundred neonates, were randomized to have sample of 1011 neonates to be included in the analysis. Patients were divided into thrombocytopenic group (n = 375) and thrombocytopenic group (n = 636). Gestational age and birthweight were significantly lower in thrombocytopenic group with p values < .001 and .03, respectively. Necrotizing enterocolitis, early onset sepsis and late onset sepsis were the main determinants of neonatal thrombocytopenia with OR (95% CL), 2.25 (1.25–3.98), 4.8 (3.249–7.19) and 6.567(4.083–10.562). severe intraventricular hemorrhage, pulmonary hemorrhage and cardiovascular instability were main predictors of death in thrombocytopenic patients with OR (95% CL), 4 (1.9–8.34), 20.9 (6.7 -64.9), and 5.76 (2.1–15.8), respectively.

Conclusion
Identification of severity and patterns of thrombocytopenia can help the clinician to recognize the etiology and consequently optimize management of thrombocytopenic neonates.
Effect of COVID-19 Vaccination on Thyroid Disease in 7 Million Adult and 0.2 Million Adolescent Vaccine Recipients
Authors: Bea Sungho , Ahn Hwa Young , Woo Jieun , Shin Ju-Young , Cho Sun Wook 
Published: December 2024

Abstract

Context
Emerging reports have raised concerns regarding the potential association between COVID-19 vaccination and thyroid dysfunction, specifically thyroiditis.

Objective
This study aimed to investigate the potential association between COVID-19 vaccination and thyroid diseases using data from a nationwide cohort of South Korea.

Methods
This study included 7 579 210 adult and 241 063 adolescent vaccine recipients. A self-controlled case series design was applied to estimate the incidence rate ratio (IRR) of thyroid disease during the 55-day postvaccination period (first and second dose) compared to the baseline period (nonexposure period) using conditional Poisson regression.

Results
In the adult population, IRRs for hyperthyroidism, hypothyroidism, subacute thyroiditis, and thyroid eye disease were 0.98 (95% CI, 0.89–1.09), 0.88 (95% CI, 0.84-0.93), 1.27 (95% CI, 0.94-1.72), and 0.68 (95% CI, 0.50-0.93) after the first vaccine dose and 0.96 (95% CI, 0.87-1.06), 0.96 (95% CI, 0.92-1.02), 1.32 (95% CI, 0.96-1.80), and 1.06 (95% CI, 0.81-1.38) after the second vaccine dose. While the risk of hyperthyroidism recurrence did not increase after vaccination, we observed an increased risk of hypothyroidism exacerbation. Subgroup analyses based on age, sex, and vaccine type revealed no significant differences in the incidence of thyroid diseases. In adolescents aged 12 to 17 years, no increase in the risk of thyroid disease was observed after vaccination.

Conclusion
This extensive, national self-controlled case series analysis found an increased risk of exacerbation of hypothyroidism following COVID-19 vaccination. However, no association was observed between COVID-19 vaccination and an increased risk of most other thyroid diseases. These findings contribute to increasing evidence supporting the safety of COVID-19 vaccination in relation to thyroid health.
Optimal Multi-Agent Pickup and Delivery Using Branch-and-Cut-and-Price Algorithms
Authors: Lam Edward , Stuckey Peter J. , Harabor Daniel 
Published: December 2024

Given a set of agents and a set of pickup-delivery requests located on a two-dimensional grid map, the multi-agent pickup and delivery problem assigns the requests to the agents such that every agent moves from its start location to the locations of its assigned requests and finally, to its end location without colliding into other agents and that the sum of arrival times is minimized. This paper proposes two exact branch-and-cut-and-price algorithms for the problem. The first algorithm performs a three-level search. A high-level master problem selects an optimal sequence of requests and a path for every agent from a large collection. A mid-level sequencing problem and a low-level navigation problem are solved simultaneously to incrementally enlarge the collection of request sequences and paths. The second algorithm first solves the sequencing problem to find a set of request sequences and then solves the navigation problem to determine if paths compatible with the request sequences exist. Experimental results indicate that the integrated algorithm solves more instances with higher congestion, and the deferred algorithm solves more instances with lower congestion and could scale to 100 agents and 100 requests, significantly higher than a state-of-the-art suboptimal approach. Funding: This research was supported by the Australian Research Council [Discovery Early Career Researcher Award DE240100042 and Discovery Projects DP190100013 and DP200100025] and by Amazon. Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2023.0268 .
Implementing a hosting model in general practice for adult nursing
Authors: Brown Debbie , Cleaver Karen , Cork Alison , Crowther Hannah , Gallagher Molly J 
Published: December 2024

The demand for nurses working in general practice settings is rapidly outstripping supply. This article outlines an initiative aimed at hosting students in general practice. Workforce shortages in primary care are widely recognised and reported. Increasing student nurses in primary care is seen as a key strategy for encouraging nursing students to opt for a career in primary care. However the organisation of placements generally means that adult nursing students are hosted by secondary care in acute NHS Trusts. Consequently, the majority of placements occur within the acute Trust and while adult nursing students may undertake placements in primary care, these are usually one-off rotational, elective or spoke placements. As a consequence completing students are far more likely to take up a post in secondary care, usually within their host Trust. This paper reports on a project which aimed to introduce general practice as a host organisation and in so doing ‘flipping’ the placement pattern allowing students to spend the majority of their placement time in primary care placements.
Diagnostic Method for the Disease Severity of Powdery Mildew in Pepper Leaves Based on Feature Transfer Learning Model
Authors: Xu Jiang , Li JunRui , Yang XiaoLing , Ouyang JingYi , Yao MingYin , Wang Xiao , Liu MuHua 
Published: December 2024

HighlightsPowdery mildew diagnostic system has been established for identifying diseased leaves in the complex backgrounds.The degree of disease has been quantified to improve the computational efficiency of the recognition model.A diagnostic system for early powdery mildew was constructed by combining feature transfer learning algorithms.The recognition system of disease degree realizes the precise diagnosis of early powdery mildew in the field.Abstract. Combining image processing technology to achieve real-time and accurate diagnosis of the powdery mildew can effectively improve the treatment efficiency of pepper diseases. Due to the influence of weeds and soil, capturing pepper disease information analyzed by traditional image processing algorithms in the field is laborious. From this perspective, the diagnostic system of powdery mildew has been proposed to automatically identify the different disease degrees in the initial stage of powdery mildew. The image segmentation algorithm of four-dimensional adaptive clustering was used to detect pepper leaves in complex backgrounds. The impact of each disease region on the accuracy of the recognition model was evaluated based on energy, entropy, contrast, and correlation. Combined with a neural network pattern recognition system and a quantitative conjugate gradient training algorithm, the fusion algorithm was evaluated on a dataset of 35577 images taken in the field with different distinct time intervals, angles, and lighting conditions. The diagnosis model was used to diagnose the disease grade of two peppers with different disease degrees. The collected images of the whole pepper plants were scanned and measured by a linear array. The experimental results showed that 66.34% of the leaves of the early disease plants were classified as disease level 5, and 65.88% of the leaves of the late disease plants were classified as disease level 10. In conclusion, this method can realize the intelligent recognition of pepper disease degree efficiently and accurately. Keywords: Diagnosis model, Feature transfer learning, Fusion algorithm, Powdery mildew.
Knowledge among clinical personnel on the impact of hemolysis using blood gas analyzers
Authors: Nielsen Trine Muhs , Gils Charlotte , Nybo Mads 
Published: December 2024

Abstract

Objectives
In the light of a rapidly increasing use of POCT blood gas testing, where tests and interpretation are performed by non-laboratory personnel, the objective was to investigate the knowledge among personnel in the Nordic countries using blood gas analyzers with focus on the interference from hemolysis.

Methods
Information was obtained from a self-developed, pre-tested online questionnaire. The questions covered demographic information about the respondents and specific questions on handling of and knowledge about blood gas analyses and the impact of hemolysis. The questionnaire was distributed by e-mail to relevant colleagues on behalf of the Nordic preanalytical scientific working group under the Nordic Federation of Clinical Chemistry.

Results
A total of 117 respondents completed the questionnaire. 62.7 % respondents both used the analyzer and interpreted the results. 59.6 % respondents did not know to which degree the blood gas analyzer can identify hemolysis. 4.4 % answered that all levels or high levels of hemolysis can be detected. 3.9 % considered the result valid despite hemolysis if it is released from the instrument. 73.7 % of all respondents knew that hemolysis alters potassium measurements, while knowledge about the effect on PaO2 and bicarbonate measurements were more divergent.

Conclusions
The knowledge about blood gas analyzers with focus on the interference from hemolysis is sparse among non-laboratory personnel using the blood gas analyzers. This emphasizes the need for better education and competence management, which perhaps is even more important for these analyses than for other point-of-care tests.
Limiting dynamics for stochastic complex Ginzburg-Landau systems with time-varying delays on unbounded thin domains
Authors: Li Xintao , Pan Shiyao 
Published: December 2024

Abstract
This study deals with the limiting dynamics for stochastic complex Ginzburg-Landau systems with time-varying delays and multiplicative noise on unbounded thin domains. We first prove the existence and uniqueness of pullback tempered random attractors for the systems and then establish the upper semicontinuity of these attractors when the thin domains collapse onto

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Analysis of kallikrein-related peptidase 7 (KLK7) autolysis reveals novel protease and cytokine substrates
Authors: Ghodge Swapnil V. , Lazarus Robert A. 
Published: December 2024

Abstract
Kallikrein-related peptidase 7 (KLK7) is one of 15 members of the tissue kallikrein family and is primarily expressed in the skin epidermis. The activity of KLK7 is tightly regulated by multiple stages of maturation and reversible inhibition, similar to several other extracellular proteases. In this work, we used protease-specific inhibitors and active site variants to show that KLK7 undergoes autolysis at two separate sites in the 170 and 99 loops (chymotrypsinogen numbering), resulting in a loss of enzymatic activity. A protein BLAST search using the autolyzed KLK7 loop sequences identified mast cell chymase as a potential KLK7 substrate. Indeed, KLK7 cleaves chymase resulting in a concomitant loss of activity. We further demonstrate that KLK7 can hydrolyze other mast cell proteases as well as several cytokines. These cytokines belong mainly to the interferon and IL-10 families including IFN-α, IFN-β, IFN-γ, IL-28A/IFN-λ2, IL-20, IL-22, and IL-27. This is the first study to identify a possible molecular interaction link between KLK7 and mast cell proteases and cytokines. Although the precise biological implications of these findings are unclear, this study extends our understanding of the delicate balance of proteolytic regulation of enzyme activity that maintains physiological homeostasis, and facilitates further biological investigations.
Nutzen- und Kostenbestimmung von Technologien
Authors: Wilsky Philipp , Riedel Ralph , Götze Uwe 
Published: December 2024

Abstract
Die Nutzung von Technologien zur Digitalisierung und Erhöhung der Transparenz in der Produktion wird häufig als Potenzial zur Produktivitätssteigerung gesehen. Die Quantifizierung desselben ist für Unternehmen jedoch oft schwierig. In diesem Beitrag erfolgt eine Analyse der möglichen Nutzenszenarien sowie deren Quantifizierbarkeit. Darüberhinaus wird eine Methode zur Berechnung von Lebenszykluskosten vorgestellt. Die Kombination aus Nutzenquantifizierung und Lebenszykluskostenermittlung ermöglicht eine Wirtschaftlichkeitsbetrachtung des Technologieeinsatzes.
Modulares Simulationsmodell für das operative Supply-Chain-Management
Authors: Perau Martin , Brings Hanna , Berninger Stefanie , Artelt Tom , Schröer Tobias , Boos Wolfgang , Schmitt Robert H. 
Published: December 2024

Abstract
Komplexe Anforderungen an das operative Supply-Chain-Management führen zu komplexen Entscheidungssituationen innerhalb des betrieblichen Alltags. Ein konzeptioniertes, modulares Simulationsmodell für das operative Supply-Chain-Management kann die Entscheidungsfindung auf Grundlage von Analysen und Daten unterstützen. Die Modularisierung ermöglicht eine flexible, effiziente und unternehmensspezifische Anwendung des Simulationsmodells. Die Modularität ist durch die individuelle Kombination geeigneter Module und Funktionen sowie der Abbildung dazugehöriger Informationsflüsse realisiert. Informationsflüsse werden dabei durch definierte Informationsobjekte, wie z. B. einen Fertigungsauftrag oder eine Maschine, spezifiziert. Die Module und Funktionen bilden die unterschiedlichen Prozessschritte ab.
A national survey of physicians regarding active surveillance for low-risk thyroid cancer in Korea
Authors: Kim Min Joo , Moon Jae Hoon , Lee Eun Kyung , Song Young Shin , Jung Kyong Yeun , Lee Ji Ye , Kim Ji-hoon , Lim Woojin , Kim Kyungsik , Park Sue K. , Park Young Joo 
Published: December 2024

ObjectiveActive surveillance (AS) has emerged as a viable alternative to immediate surgery for low-risk thyroid cancer. However, several barriers still hinder its widespread adoption and implementation by physicians.MethodsIn 2024, an email survey was conducted among members of the Korea Thyroid Association to assess their perspectives on AS. The survey comprised questions about clinical case scenarios, perceptions of the benefits and risks associated with AS, factors influencing the consideration of AS and unmet needs for the implementation of AS.ResultsAmong the 287 physicians surveyed, 40.8% were endocrinologists, followed by general surgeons at 20.9% and otolaryngologists at 19.9%. The majority worked in tertiary hospitals and had over 10 years of experience. Regarding a 65-year-old man with a 0.7 cm low-risk thyroid cancer, 74.6% of the respondents considered AS. Endocrinologists and physicians with higher self-assessment and experience explaining AS to patients were more inclined to consider AS. Although the respondents recognized the benefits of AS, such as avoiding surgery and reducing surgical complications, they expressed concerns about potential risks, including the possibility of patient lawsuits due to disease progression and patient worry and anxiety about the disease. Challenges in screening candidates for AS were highlighted, especially in detecting recurrent laryngeal nerve involvement and lymph node metastases. Additionally, physicians noted unmet needs in AS implementation, specifically regarding psychological support for patients and reimbursement for long-term follow-up costs.ConclusionsThe survey underscored the need for further research and initiatives to overcome the barriers and implement AS for the management of low-risk thyroid cancer.