bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimising Outpatient Registration System Implementation Using Critical Path Method: A Case Study
Authors: Hong Dan 
Published: December 2024

ABSTRACTBackgroundToday, hospital information systems (HISs) play an irreplaceable role in hospital management. At present, HIS construction projects in many hospitals have faced the setback of ‘project quagmire’ to varying degrees. The critical path method (CPM) mainly aims to find the critical path, thus managing project progress.ObjectivesTo explore the importance and practical application of the CPM to the management of HIS project schedules.MethodsThis study used the construction project of a hospital's outpatient registration subsystem as an example. CPM was used to determine the critical path. The time and workload required for the project were calculated using the forward and backward extrapolation methods. The earliest start time and earliest completion time as well as the latest start time and latest completion time of each task could be calculated using the forward and backward extrapolation methods. The path with the longest construction period was determined to be the critical path, and the unit speed rate of each activity was calculated on this basis. Then, the time schedule of the outpatient registration subsystem was compressed and the project schedule optimised.ResultsPath 3 [outpatient registration demand analysis (A)—basic data preparation (C)—subsystem test (F)—simulation test (G)] was determined to be the critical path according to the construction period, and the task time was compressed on this basis. Considering many factors, the time of the subsystem test task (F) was reduced from 7 weeks to 4 weeks. The total cost was saved by 1000 yuan, which not only ensured the progress ahead but also saved the overall cost.ConclusionThe CPM could effectively measure the completion and deviation of each stage of the registration system project, which provided an effective guarantee for the subsequent schedule compression to ensure that the project was completed as scheduled and was of sufficient quality. However, all conditions had to be considered comprehensively; doing otherwise would lead to increased risks and costs.
Vertical Versus Horizontal Finishing Lines for Dental Preparations: A Systematic Review With Meta‐Analysis
Authors: Bonfanti‐Gris Monica , Pradies Guillermo , Moron‐Conejo Belen , Gil Alfonso , Martinez‐Rus Francisco 
Published: December 2024

ABSTRACTObjectivesTo evaluate the influence of horizontal and vertical dental preparation techniques on tooth‐supported fixed restorations, with specific focus on survival and success rates, periodontal‐related variables, and patient‐reported outcome (PROs) measures.MethodsA comprehensive literature search of relevant randomized and controlled clinical trials (RCTs/CCTs), prospective/retrospective cohort studies, and case series with a minimum follow‐up period of 3 years was performed across electronic databases (Medline, Embase, and Cochrane) up to January 2024. Primary outcomes included success and survival rates, and secondary outcomes included periodontal variables, both mechanical and biological complications, and PROs. Two reviewers independently conducted study selection, data extraction, and quality assessment. Of the 837 articles initially identified, 19 were included in the final analysis. A meta‐analysis was conducted to compare the preparation techniques using survival and success rates as the main outcomes. Additionally, periodontal variables were analyzed.ResultsThe included studies varied in design, follow‐up duration, restoration type, and materials used. Survival rates showed no significant differences between vertical and horizontal techniques (risk ratio (RR) 0.96–1.04, p = 0.95). Additionally, success rates (RR 0.93–1.14, p = 0.53) and periodontal variables also showed varied results with no clear preference for either technique.ConclusionsBoth the horizontal and vertical preparation techniques exhibited comparable survival and success rates for dental restorations. Given that there was no significant difference in outcomes between the two, the choice of technique may depend on the clinician's preference and specific clinical scenarios.
Rates and predictors of opioid deprescribing after fracture: A retrospective study of Medicare fee‐for‐service claims
Authors: Pritchard Kevin T. , Yang Chun‐Ting , Chen Qiaoxi , Zhang Yichi , Wilkins James M. , Kim Dae Hyun , Lin Kueiyu Joshua 
Published: December 2024

AbstractBackgroundAdults with Alzheimer's disease and Alzheimer's disease related dementias (ADRD) or frailty are susceptible to fractures. Opioid analgesics are frequently prescribed after fractures. Documenting post‐fracture opioid discontinuation rates and predictors of discontinuation among adults with ADRD or frailty can inform clinical practice, identify potential disparities, and improve pain management guidelines. The objective of this paper was to investigate opioid discontinuation in opioid‐naïve older adults who used opioids after an acute fracture.MethodsThis retrospective cohort study included opioid‐naïve Medicare fee‐for‐service beneficiaries (N = 33,027) ≥65 years of age who filled an opioid prescription within 30 days of a vertebral, lower extremity, or upper extremity fracture from 2013 to 2018. Beneficiaries were classified according to ADRD (yes/no) and frailty (yes/no) status using validated claims‐based algorithms. The primary outcome was opioid discontinuation, defined as a 30‐day supply gap. We estimated discontinuation rates with the Kaplan–Meier method and identified predictors of opioid discontinuation using Cox proportional hazards regression.ResultsThe 30‐day opioid discontinuation rate was similar among non‐frail beneficiaries without ADRD (81% [95% CI, 80%–81%]) and those who were non‐frail with ADRD (83% [81%–84%]). Comparatively, 30‐day discontinuation rates were lower among those with frailty and ADRD (76% [75%–77%]) and those with frailty alone (77% [75%–78%]). After adjusting for sociodemographic characteristics, health status, healthcare utilization, and calendar year, beneficiaries with both ADRD and frailty (HR, 0.90 [0.87–0.93]) and those with frailty alone (HR, 0.85 [0.82–0.89]), but not those with ADRD alone (HR, 1.06 [1.01–1.10]), were less likely to discontinue opioids compared with those without ADRD or frailty.Conclusions and RelevanceOur findings suggest that frailty, but not ADRD, was associated with a lower likelihood of opioid discontinuation among older adults who initiated opioids after an acute fracture. Further research is needed to understand how opioid deprescribing practices depend on patient and provider preferences.
Perceptions of rural Australian adults with chronic kidney disease stages 3 and 4 about the role of dietary intervention in their health and access to dietetic care
Authors: Shelley Annette , Duncanson Kerith , Lambert Kelly 
Published: December 2024

AbstractBackgroundDietary modification is an important component of chronic kidney disease (CKD) management. The aim of this study was to explore the perceptions of people with earlier‐stage CKD living in rural Australia about the role of dietary intervention in their health and access to dietetic care.MethodsSemi‐structured interviews were conducted with 14 people with stage 3–4 CKD living in a rural Australian health district. Interview questions were guided by the principles of the appreciative inquiry study methodology. The thematic analysis involved inductive coding of data, discussions of emerging themes between co‐researchers as coding proceeded and thematic memoing to finalise the transformation of data into distinct themes.ResultsThree predominant themes were evident from the data. First, people with CKD expressed that ‘Dietary change empowers’ them in self‐management. Second, ‘Dietetics is valued’ in achieving dietary change. Third, it was clear that nephrologists had a key role in determining service access through ‘Awareness and advocacy’ of renal dietetic services.ConclusionsPeople with CKD living in rural Australia desire early, specialised renal dietetic care. The unexpectedly high acceptability of less resource‐intensive technology for dietetic intervention suggests that there is an opportunity for service reorientation. Access to dietetic care could be enhanced by building on the key role of nephrologists in dietetic referral, service awareness and perception of value.
Quantitative Research Designs, Hierarchy of Evidence and Validity
Authors: Slater Paul , Hasson Felicity 
Published: December 2024

ABSTRACTThis paper provides a summary of the main quantitative research designs. Quantitative research designs occur in a hierarchy of evidence, ranging from descriptive research designs such as cross‐sectional studies, and cohort designs, to more carefully constructed experimental designs like randomised control trials (RCT's). The quality of a study's findings is determined by factors affecting its internal validity and its application to other settings is gauged by its external validity.
Clinical Outcome of Intravenous Alteplase Treatment in Patients With Acute Mild Cerebral Infarction
Authors: Deguchi Ichiro , Takahashi Shinichi , Nakagami Toru , Arai Noriko , Kimura Ryutaro , Oryu Kiichiro , Kido Syunsuke , Kato Yuji , Hayashi Takeshi , Suda Satoshi 
Published: December 2024

ABSTRACTBackgroundThe efficacy of intravenous alteplase therapy for acute cerebral infarction is well established, regardless of the ischemic stroke subtype. However, its effectiveness in patients with mild cerebral infarction remains controversial, raising concerns about the significance of the treatment.AimTo retrospectively evaluate the efficacy of intravenous alteplase in patients with mild cerebral infarction and other factors affecting the outcome.MethodsA total of 527 patients received intravenous alteplase (0.6 mg/kg) at our hospital between October 2012 and March 2023. Of these, 118 patients with mild cerebral infarction (National Institutes of Health Stroke Scale [NIHSS] ≤ 5) who were treated with intravenous alteplase without mechanical thrombectomy were retrospectively evaluated for treatment efficacy and the factors affecting the efficacy.ResultsThe modified Rankin scale (mRS) outcome at 90 days was good (mRS: 0–1) in 85 (72%) patients and poor (mRS: 2–5) in 33 (28%) patients. Branch atheromatous disease (BAD) and proximal anterior circulation large vessel occlusion (proximal LVO: internal carotid artery and M1 segment of middle cerebral artery) were observed more frequently in the poor outcome group than in the good outcome group. Multivariate analysis, adjusted for age and sex, identified BAD and proximal LVO as factors associated with poor outcomes after intravenous alteplase treatment for mild cerebral infarction. Symptomatic intracranial hemorrhage was observed in one patient with BAD.ConclusionMost patients with mild cerebral infarction who were treated with intravenous alteplase alone had good outcomes. BAD and proximal LVO were other factors influencing poor outcomes.
Transgressive Acts: Michel Foucault's Lessons on Resistance for Nurses
Authors: Moreno‐Mulet Cristina , Valdivielso‐Navarro Joaquín , Miró‐Bonet Margalida , Carrero‐Planells Alba , Gastaldo Denise 
Published: December 2024

ABSTRACTIn this paper, we bring together Foucault's biography and oeuvre to explore key concepts that support the analysis of nurses' acts of resistance. Foucault reflected on the power relations taking place in health services, making his contribution especially useful for the analysis of resistance in this context. Over three decades, he proposed a nonnormative philosophy while concomitantly engaging in transgressive practices guided by values such as human rights and social justice. Hence, Foucault's philosophy and public activism are an apparent contradiction, but we argue that when analysed together they allow for a different understanding of his work. We describe the evolution of the concept of resistance in Foucault's work, supported by the approaches of Brent Picket (1996) and Miguel Morey (2013). Foucault started his work considering the idea of transgressiveness as it connects to being at the margins of society. He then spent considerable time elaborating the concept of power and identifying resistance strategies as forms of power exercise. In doing so, he considered that people engage with social change from multiple positions, including limited desire for change, fomenting reforms, or engaging in everyday revolutionary acts. As he further elaborated on power relations and defined resistance, Foucault asserted that resistance involves both repressive and productive dimensions of power, governance of biological life, state governance, and deliberate practices of illegalisms. Finally, Foucault shifted his attention to the freedom of ethical subjects, proposing the use of counter‐conduct and counter‐discourses to speak truth against oppression. Such framework offers a comprehensive lens for analysing nurses' acts of resistance within the complexities of the healthcare system and in society. In summary, Foucault's conceptual framework on resistance expands the role of nurses, to understand them not only as caregivers, but also as political agents capable of confronting and transforming oppressive institutional practices.
‘One school, two systems’: Navigating the geographies of alternative education in an elite primary school in China
Authors: Yuan Zhenjie , Xie Huiyu , Zhu Hong 
Published: December 2024

AbstractDespite the global rise of alternative education as a response to the limitations of standardised methods, little attention has been given to how these systems coexist with mainstream education, particularly in non‐Anglophone contexts. This article addresses this gap by examining a distinctive primary school in Guangzhou, China, where alternative and mainstream education coexist on the same campus. Utilising the framework of spaces of prescription and negotiation, the study explores how alternative educational spaces navigate the constraints of China's centralised educational system while maintaining their distinctiveness. The findings reveal that T School strategically adapts mainstream educational spatial forms to support its elite education philosophy, thereby underscoring the fluid boundaries and dynamic interplay between alternative and mainstream education. This research advances the understanding of the spatial and temporal strategies that alternative education employs within standardised systems, offering insights into the adaptability of educational boundaries. Furthermore, the study illuminates the flexibility of spaces of prescription and negotiation within overlapping and interconnected power geometries. By adopting a critical and poststructuralist approach, the framework could enrich the understanding of the fluidity and negotiation of educational boundaries globally. The study's findings carry significant implications for policymakers and educators, guiding the development of more inclusive and responsive educational policies worldwide.
Boundary Strichartz estimates and pointwise convergence for orthonormal systems
Authors: Bez Neal , Kinoshita Shinya , Shiraki Shobu 
Published: December 2024

AbstractWe consider maximal estimates associated with fermionic systems. Firstly, we establish maximal estimates with respect to the spatial variable. These estimates are certain boundary cases of the many‐body Strichartz estimates pioneered by Frank, Lewin, Lieb and Seiringer. We also prove new maximal‐in‐time estimates, thereby significantly extending work of Lee, Nakamura and the first author on Carleson's pointwise convergence problem for fermionic systems.
The Effects of Fuel Cetane Number on Diesel Engines of Different Scale
Authors: Cowart Jim , Dickerson Terrence , Luning Prak Dianne 
Published: December 2024

Abstract
In this study, various cetane number fuels from 34 to 54 were operated in four instrumented (in-cylinder indicated metrics) diesel engines with bores ranging from 86 mm to 230 mm. The various cetane fuels were created from blends of renewable low cetane Alcohol-To-Jet (ATJ) Synthetic Paraffinic Kerosene with conventional jet and diesel fuels. The engines (CAT, EMD, MTU and Yanmar) had a range of fuel injection technologies which include pump-line-injector, unit injectors and high-pressure common rail. The engines were operated over a range of conditions specific to the given engine each with 8 different cetane number fuels. The high speed in-cylinder pressure data was analyzed using a single zone heat release model to determine conventional combustion metrics. These metrics were then normalized to the baseline operating fuel (diesel) for an indication of combustion sensitivity to fuel cetane number. It is seen that the smaller the engine’s bore, the greater the impact of reducing cetane number on the engine’s combustion (e.g. lengthening ignition delay). These results compare favorably with modeling work that shows smaller bore engines have a higher cylinder surface area to volume and thus greater heat losses of the in-cylinder charge. Cooler charge temperatures lead to longer ignition delays, especially with the lower cetane number fuels. These results are further compared to alternative fuels acceptance metrics. The smallest of the diesel engines tested was found to be the most sensitive to reduced cetane fuels. The largest engine tested was relatively insensitive to the fuels cetane number.
About the Use of Oxyfuel Combustion Engines to Assess the Heat and Power Flexibility Needs of Decarbonised E-Fuel Synthesis Plants While Keeping the Circularity of O2 and CO2 in the Process
Authors: Serrano José R. , Arnau Francisco J. , Piqueras Pedro , Contreras-Jimenez Diego , Ariztegui Javier , Oliva Fermín 
Published: December 2024

Abstract
This study investigates oxy-fuel combustion (OFC) applied to reciprocating internal combustion engines for a flexible Combined Heat and Power (CHP) plant with carbon capture. Utilizing one-dimensional (1-D) modelling software, the engine and associated components are modelled to generate operating maps based on control strategies.
Three control loops are employed: a lambda regulator maintaining a constant O2/fuel ratio, variable Inlet Valve Closing (IVC) adjusting exhaust temperature by varying trapped mass, and a valve regulating intake pressure through exhaust back-pressure, pressurizing the Exhaust Gas Recirculation (EGR) line to control EGR flow.
Analysis reveals a correlation between brake efficiency, mechanical power, and Start of Combustion (SoC), while heat production associates more closely with fuel injection. OFC consistently exhibits lower brake efficiency than conventional configurations but yields increased heat at the exhaust.
Toward the 50% Brake Thermal Efficiency: A 1D/3D Numerical Analysis of an Active Pre-Chamber for a SI Heavy-Duty Gas Engine
Authors: Di Maio Dario , Napolitano Pierpaolo , Guido Chiara , Sforza Lorenzo , Lucchini Tommaso , Golini Stefano , Rapetto Nicola 
Published: December 2024

Abstract
Innovative spark ignition heavy-duty engines with active pre-chamber combustion systems represent a promising and viable technology towards a marked reduction in pollutant emissions, with increased performance and reduced fuel consumption.
Through a parallel and combined 1D/3D simulation methodology, cruise point and rated torque operating conditions were analyzed to assess the increase of brake thermal efficiency (BTE) under two ultra-lean conditions: air-to-fuel ratio equal to 1.7 and 1.9.
The boundary conditions for the 3D-RANS numerical activity are provided by a 1D model of a single cylinder engine, properly calibrated according to experimental data detected by a large bore heavy-duty engine fueled by compressed natural gas (CNG). To evaluate the alignment between the two simulation platforms, the combustion process evolution, together with the turbulent flame propagation profiles obtained from 3D-CFD simulations, are used again iteratively in the 1D engine model to assess the in-cylinder pressures and heat release rate.
A sensitivity analysis to the change in fuel percentage between pre-chamber and main-chamber was performed due to the deployment of a specific injection control logic.
The characterization was then extended by performing an increasing compression ratio (CR) parameterization. Further insights to the variation of spark advance and the intake and exhaust pressure drop are proposed, for the evaluation of the most favorable conditions.
The present analysis methodology revealed a detectable decrease in NOx emissions in view of the introduction of EURO VII regulations, and a comprehensive evaluation of the pre-chamber potential to reach 50% BTE target.
Isolated Low Temperature Heat Release From Binary Blends of Iso-Octane, N-Heptane and Ethanol in a Spark Ignition Engine
Authors: White Samuel P. , Leach Felix C. P. 
Published: December 2024

Abstract
The potential of using low temperature heat release (LTHR) to improve engine efficiency is of particular interest because of its effect on autoignition chemistry in spark ignition (SI) and advanced compression ignition engines (ACI). A recently developed method has been shown to isolate LTHR in SI engine conditions, paving the way for more detailed and sophisticated analyses of LTHR characteristics and chemistry under realistic engine conditions. Previous LTHR modelling work has suggested that residuals and residual chemistry have a significant impact on LTHR characteristics. Until now, studies on isolated LTHR have focused on single-component surrogates.
In this work, the effect of primary reference fuels (PRFs), binary blends of n-heptane and iso-octane (2,2,4-trimethylpentane), alongside blends with ethanol on LTHR characteristics was studied. Tests were conducted on a single-cylinder engine with SI geometry, motored (with the ignition system disabled) but with fuels injected. PRFs containing 50 and 75% isooctane by volume (i.e. PRF50 and PRF75) were tested, as well as pure n-heptane and iso-octane. In addition, blends of n-heptane and ethanol containing 10, 20 and 50% ethanol by volume were also tested. The blends were tested with inlet temperatures of 40°C to 140°C at an inlet pressure of 0.9 bar (absolute).
To simulate the effect of high temperature combustion residuals, a skip spark duty cycle was employed for ignition of a PRF80 blend. A Fourier-Transform Infra-Red (FTIR) exhaust gas measurement system was employed to analyse the change in mixture composition as a result of experiencing LTHR. Ignition delay and homogeneous charge compression ignition (HCCI) simulations were performed with a gasoline surrogate chemical kinetic mechanism on CHEMKIN to assist with analysing the experimental data. At the conditions tested, the presence of iso-octane in the blend strongly reduced the intensity of LTHR whilst neat iso-octane exhibited no signs of LTHR due to its relatively lower reactivity at the conditions tested. Ignition delay contours were used to explain the results observed at the conditions tested and the HCCI modelling showed that as well as the n-heptane portion of the blends being almost entirely consumed during LTHR, significant fractions of iso-octane and ethanol were also consumed alongside it — as opposed to pro-rated consumption or single component consumption of n-heptane. Substituting ethanol into the blend reduced the LTHR intensity more dramatically because of ethanol’s interaction with n-heptane’s low temperature oxidation reactions. Skip firing was shown to have a small impact on the LTHR characteristics in cycles immediately after high temperature SI combustion cycles.