bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ventilator-Associated Events Cost in ICU Patients Receiving Mechanical Ventilation: A Multi-State Model
Authors: Kafazi Alkmena , Apostolopoulou Eleni , Benetou Vasiliki , Kourlaba Georgia , Stylianou Christos , Pavlopoulou Ioanna D 
Published: June 2024

Abstract

Introduction
Cost analysis is complicated by the fact that patients acquire infections during their hospital stay, having already spent time at risk without having an infection. Multi-state models (MSM) accounts for this time at risk treating infections as time-dependent exposures from ICU admission.

Aim of the study
To estimate ventilator-associated events (VAEs) direct additional cost in ICU patients.

Material and Methods
This was a prospective, observational study carried out for a two-year period in four medical-surgical ICUs of Athens, Greece. The sample consisted of adult patients who received mechanical ventilation for ≥4 days and were followed until discharge from the ICU or until death. CDC standard definitions were used to diagnose VAEs. To estimate VAEs additional length of stay (LOS), we used a four-state model that accounted for the time of VAEs. The direct hospital cost was calculated, consisting of the fixed and variable cost. The direct additional cost per VAEs episode was calculated by multiplying VAEs extra LOS by cost per day of ICU hospitalization.

Results
In the final analysis were included 378 patients with 9,369 patient-days. The majority of patients were male (58.7%) with a median age of 60 years. Of 378 patients 143 (37.8%) developed 143 episodes of VAEs. VAEs crude additional LOS was 17 days, while VAE mean additional LOS after applying MSM was 6.55±1.78 days. The direct cost per day of ICU hospitalization was € 492.80. The direct additional cost per VAEs episode was € 3,227.84, € 885.56 the fixed and € 2,342.28 the variable cost. Antibiotic cost was € 1,570.95 per VAEs episode. The total direct additional cost for the two-year period was € 461,581.12.

Conclusions
These results confirm the importance of estimating VAEs real cost using micro-costing for analytical cost allocation, and MSM to avoid additional LOS and cost overestimation.
Extracorporeal Membrane Oxygenation as Circulatory Support in Adult Patients with Septic Shock: A Systematic Review
Authors: Khan Muhammad Faisal , Nazir Mohsin , Khan Muhammad Khuzzaim , Rajendram Raj Kumar , Shamim Faisal 
Published: June 2024

Abstract

Introduction
The utilization of extracorporeal membrane oxygenation (ECMO) in adult patients experiencing septic shock is a subject of ongoing debate within the medical community. This study aims to comprehensively address this issue through a systematic review conducted in accordance with the PRISMA guidelines.

Aim of Study
The primary objective of this study is to assess the outcomes of ECMO utilization in adult patients diagnosed with septic shock, thereby providing insights into the potential benefits and uncertainties associated with this treatment modality.

Materials and Methods
Our research encompassed a thorough search across electronic databases for relevant English-language articles published up until April 2023. The inclusion criteria were based on studies reporting on ECMO usage in adult patients with septic shock. Among the eligible studies meeting these criteria, a total of eleven were included in our analysis, involving a cohort of 512 patients. The mean age of the participants was 53.4 years, with 67.38% being male.

Results
In the pooled analysis, the mean survival rate following ECMO treatment was found to vary significantly across different ECMO modalities. Patients receiving venovenous-ECMO (VV-ECMO) and veno-venous-arterial ECMO (VVA-ECMO) demonstrated higher survival rates (44.5% and 44.4%, respectively) compared to those receiving venoarterial-ECMO (VA-ECMO) at 25% (p<0.05). A chi-square test of independence indicated that the type of ECMO was a significant predictor of survival (χ2(2) = 6.63, p=0.036). Additionally, patients with septic shock stemming from respiratory failure demonstrated survival rates ranging from 39% to 70%. Predictors of mortality were identified as older age and the necessity for cardiopulmonary resuscitation (CPR).

Conclusions
In septic shock patients, ECMO outcomes align with established indications like respiratory and cardiogenic shock. VV-ECMO and VVA-ECMO suggest better prognoses, though the optimal mode remains uncertain. Patient selection should weigh age and CPR need. Further research is vital to determine ECMO's best approach for this population.
Characteristics of the Cerebrospinal Fluid in Septic Patients with Critical Illness Polyneuropathy - A Retrospective Cohort Study
Authors: Zhang Yanyang , Ma Jinfu , Zhao Qing , Liu Hui 
Published: June 2024

Abstract

Background
Critical illness polyneuropathy (CIP) is a complex disease commonly occurring in septic patients which indicates a worse prognosis. Herein, we investigated the characteristics of cerebrospinal fluid (CSF) in septic patients with CIP.

Methods
This retrospective study was conducted between Match 1, 2018, and July 1, 2022. Patients with sepsis who underwent a CSF examination and nerve electrophysiology were included. The levels of protein, glucose, lipopolysaccharide, white blood cell (WBC), interleukin (IL)-1, IL-6, IL-8, and tumor necrosis factor (TNF) α in CSF were measured. The fungi and bacteria in CSF were also assessed.

Results
Among the 175 septic patients, 116 (66.3%) patients were diagnosed with CIP. 28-day Mortality in CIP patients was higher than that in non-CIP patients (25.0% vs. 10.2%, P = 0.02) which was confirmed by survival analysis. The results of propensity score matching analysis (PSMA) indicated a significant difference in the level of protein, WBC, IL-1, IL-6, IL-8, and TNFα present in the CSF between CIP patients and non-CIP patients. The results of the receiver operating characteristic (ROC) analysis showed that IL-1, WBC, TNFα, and their combined indicator had a good diagnostic value with an AUC > 0.8.

Conclusion
The increase in the levels of WBC, IL-1, and TNFα in CSF might be an indicator of CIP in septic patients.
A Randomised Control Study Comparing Ultrasonography with Standard Clinical Methods in Assessing Endotracheal Tube Tip Positioning
Authors: Sreedevi Jayalekshmi , Neethu George , Anjali George , Cherish Paul 
Published: June 2024

Abstract

Introduction
Airway ultrasound has been increasingly used in correct positioning of endotracheal tube. We hypothesize that a safe distance between endotracheal tube tip and carina can be achieved with the aid of ultrasound.

Aim of the study
Our primary objective was to determine whether ultrasound guided visualisation of proximal end of endotracheal tube cuff is better when compared to conventional method in optimal positioning of tube tip. The secondary objective was to find the optimal endotracheal tube position at the level of incisors in adult Indian population.

Materials and Methods
There were 25 patients each in the conventional group and the ultrasound group. Conventional method includes auscultation and end tidal capnography. In the ultrasound group the upper end of the endotracheal tube cuff was positioned with an intent to provide 4 cm distance from the tube tip to the carina. X ray was used in both groups for confirmation of tip position and comparison between the two groups. Further repositioning of the tube was done if indicated and the mean length of the tube at incisors was then measured.

Results
After x ray confirmation, endotracheal tube repositioning was required in 24% of patients in the USG group and 40 % of patients in the conventional group. However, this result was not found to be statistically significant (p = 0.364). The endotracheal tube length at the level of teeth was 19.4 ± 1.35 cm among females and 20.95 ± 1.37 cm among males.

Conclusions
Ultrasonography is a reliable method to determine ETT position in the trachea. There was no statistically significant difference when compared to the conventional method. The average length of ETT at the level of incisors was 19.5 cm for females and 21 cm for males.
Cefiderocol and Intraventricular Colistin for Ventriculitis due to an Extensively Drug-Resistant Pseudomonas Aeruginosa
Authors: Melo e Silva João , Oliveira Diogo , Louro João A. , Monteiro Elisabete 
Published: June 2024

Abstract
Rheumatoid arthritis, an inflammatory rheumatic disease predominantly affecting small limb joints, frequently compromises the cervical spine, resulting in spinal instability and the potential surgical necessity. This may result in severe complications, such as ventriculitis, often associated with a high mortality rate and multidrug-resistant organisms. A major challenge lies in achieving therapeutic antimicrobial concentrations in the central nervous system.
The authors present a case of a 65-year-old female, with cervical myelopathy due to severe rheumatoid arthritis. Following surgery, the patient developed ventriculitis caused by an extensively drug-resistant Pseudomonas Aeruginosa. Early diagnosis and prompt treatment played a crucial role in facilitating neurological and cognitive recovery.
Smart City Conceptual Framework in the Context of Achieving Sustainable Development Goals
Authors: Kuzior Aleksandra 
Published: June 2024

Abstract
The article presents the conceptual assumptions of the Smart City in its different phases of development - Smart City 1.0, Smart City 2.0, Smart City 3.0, Smart City 4.0, Smart City 5.0 and Smart Sustainable City. With reference to „Transforming our world: the 2030 Agenda for Sustainable Development” containing 17 Sustainable Development Goals, the article specifically presents the assumptions and practical solutions for SDG Goal 11. A critical analysis of the literature on the subject and a content analysis of the SDG reports revealed a juxtaposition of the diverse capabilities of smart technologies and their insufficient implementation to meet the Sustainable Development Goals in Smart Cities. The reality is not encouraging. The population of people living in slums is growing rapidly, social inequalities are widening, and there is a lack of access to convenient urban transport. There is chaotic urban sprawl, air pollution and insufficient public open spaces. Solutions to urban problems are often interventionist rather than preventive. The rational and sustainable use of modern technology can change this.
Integrated Subsystems of Materials and Information Flow for Continuous Manufacturing of Coal and Steel
Authors: Danel Roman , Gajdzik Bożena 
Published: June 2024

Abstract
With the concept of Industry 4.0 production processes are moving towards autonomy and intelligence. Technologies equipped with artificial intelligence (AI) are involved into processes that are more and more digitized. Collaborative technologies are a feature of discrete processes. The automotive industry has achieved many successes in the process innovation towards smart factories. Other plants, such as smelters or coal mining are also striving to develop smart manufacturing with integrated computer systems to support processes. A continuous production is different from a discrete or batch production. Industry 4.0 concept is focused on discrete production (with high level of automation and robotization of manufacturing) meanwhile there is a gap in implementation of these approach in the continuous production. The objective of the publication is to prepare and design the integrated computer management system based on processes realized in coal and steel manufacturing. Coal and steel production are key elements in a chain of any industrial manufacturing e.g. automotive or machinery engineering. These processes are crucial in building of smart value chain. In our paper we present the structure of processes for the continuous production. Based the processes model we proposed the next steps to build the smart manufacturing for continuous production.
Development and Improvement of a Production Company (and their Product) Based on the Value Stream Mapping of Business Processes
Authors: Klimecka-Tatar Dorota , Obrecht Matevž 
Published: June 2024

Abstract
Value stream mapping is one of the basic tools used in the processes improvement or design – in accordance with the Lean concept. This paper presents a model of designing production processes and introducing new products to the market based on the analysis of the value streams flow in the production process. Particular attention was paid to the importance of input data necessary to plan a properly functioning production process, which results in a high-value product (from the customer’s point of view). In the paper also the list of all the most important tools supporting all stages of designing new production processes or improving existing processes has been presented. Also the advantages of big pictures analysis using was highlighted. In this case value stream mapping and big picture analysis were oriented on quality in the product development process and contribute to: creating value (based on customer requirements) while maintaining timely deliveries and constant costs (Value Stream Mapping), sustainable use of tangible and intangible resources (removing waste at the design stage). However, from the company point of view, and particular in the cost level, the product can gain value because a lower input is required for its production. After improvement, the process lead time has been shortened in an area where value was not added, but the consequence of implementing the change is an increase in the production volume while maintaining the process transition time – therefore, unit costs of production will change.
Optimization of Financial Management for Enhancing the Electric Vehicle Market in Medan, Indonesia
Authors: Munthe Kornel , Simanihuruk Peran , Sitinjak Charli , Ober Józef , Kochmańska Anna 
Published: June 2024

Abstract
The global shift towards sustainable transportation, exemplified by the increasing adoption of Electric Vehicles (EVs), represents a vital response to contemporary environmental and energy challenges. This study investigates the determinants of consumers’ Desire to Purchase EVs within the unique context of the Medan market, where consumer preferences and market dynamics differ from more globally examined settings. Additionally, it explores the mediating roles of Consumer Awareness Campaigns and Local Industry Partnerships in shaping purchase intent. Through a comprehensive survey of 832 respondents in Medan, Indonesia, the study reveals crucial insights. Government incentives, including tax breaks and rebates, emerge as influential factors, significantly increasing consumers’ inclination to adopt EVs. Equally vital is the accessibility and availability of charging infrastructure, which is pivotal in bolstering consumer confidence in EVs. Consumer perceptions and attitudes have a significant bearing on purchase intent, with positive perceptions regarding environmental benefits, cost savings, and driving experiences contributing to the heightened desire for EV ownership. Effective financial management strategies also play a positive role, emphasizing the significance of sound financial planning and resource allocation. Further-more, this research emphasizes the instrumental role of Consumer Awareness Campaigns in shaping purchase intent. These campaigns are a powerful tool for elucidating the multifaceted advantages of EV ownership, encompassing environmental consciousness, economic feasibility, and enhanced driving experiences. Local Industry Partnerships within the Medan EV market equally contribute to heightened purchase intent, reflecting the synergistic effects of collaborative initiatives.
Assessing the Quality of Life of Regional Centres in Poland in the Context of Smart and Sustainable Cities
Authors: Tutak Magdalena 
Published: June 2024

Abstract
The article addresses the issue of quality of life in cities based on developed methodology. A multidimensional approach was adopted, namely 28 subindices characterizing seven dimensions affecting the quality of life in 18 provincial cities in Poland. The developed methodology consisted of two stages. In the first stage, using the indicators, the values of quality-of-life indices for the studied dimensions were determined. In the second stage, using these results, the values of the total quality-of-life indices in the studied cities were measured. Then, rankings for the cities in question were created. In addition, based on the values of the dimension indices and total indices, the levels of quality of life were determined. Relationships between parameters characterizing the sizes of studied cities and their wealth and the determined quality of life were also measured. The Gray Rational Analysis method was used for ranking, and three objective analytical methods were used to determine index weights: Equal weight, Entropy and CRITIC, and the Laplace’s criterion. The results indicate that living standards in the studied cities vary widely, both in terms of the value of the total index and the indices of individual dimensions. The best living conditions were found in Warsaw (the capital of Poland), Białystok and Olsztyn, and the worst in Kielce and Szczecin.
Analysis of Information Security Under the Conditions of Hybrid War in Ukraine: Social Aspects
Authors: Krawczyk Dariusz , Babenko Vitalina , Yemchuk Liudmyla , Lienkov Serhii , Dzhulii Volodymyr , Dzhulii Larysa , Muliar Ihor 
Published: June 2024

Abstract
The development of the post-industrial society requires the acceleration of the integration of the national economy into the globalized economic space. This stage is characterized by active informatization of all spheres of life in society, which requires information security and cyber protection for high-quality information provision of the country’s population, intellectualization of economic processes and prevention of destructive informational influence on the social status of the individual. It is also necessary to consider that for Ukraine the specified stage is complicated by the hybrid war with Russia, which requires strengthening the protection of information from cyber-attacks and the formation of new approaches in preserving the quality of information on social networks. Therefore, the purpose of this article is the development of scientific and methodological approaches in information security management, strengthening its social significance. This requires solving a certain range of tasks of identifying and preventing socially dangerous information based on the use of economic and mathematical methods and models. The article highlights the main directions of socialization of modern technological development and theoretically substantiates its significant impact on human consciousness and behavior, puts a person in front of serious challenges and, under conditions of hybrid warfare, requires strengthening of information security in social networks. In the work, the components of information security are supplemented, its impact on social aspects of society’s life is highlighted. As a result of the research, the authors proposed a scientific and methodical approach to the construction of a system for countering the spread of socially dangerous information in social networks. Besides, its functional elements are highlighted. A method of combating the spread of harmful information in social networks has been developed, which solves the problem of information support of the decision-making process and includes providing the chosen and alternative options to the person making the decision, with the justification of the choice. This creates prerequisites for information support for making a well-founded management decision.
Analysis Effect of Parameters of Genetic Algorithm on a Model for Optimization Design of Sustainable Supply Chain Network Under Disruption Risks
Authors: Al-Zuheri Atiya , Ketan Hussein S. , Alwan Layla L. 
Published: June 2024

Abstract
Over the last decade, our world exposed to many types of unpredictable disasters (recently Coronavirus). These disasters have clearly shown the uncertainty and vulnerability of supply chain systems. Also, it confirmed that adopting Just-in-Time (JIT) strategy to reduce the logistic chain cost may lead to inbuilt complexity and risks. Efficient tools are therefore needed to make complexity optimized supply chain decisions. Evolutionary algorithms, including genetic algorithms (GA), have proven effective in identifying optimal solutions that address the trade-offs between total supply chain cost and carbon emissions regulatory policy represented by carbon tax charges. These solutions pertain to the design challenges of supply networks exposed to potential disruption risks. However, GA have a set of parameters must be chosen for effective and robust performance of the algorithms. This paper aims to set the most suitable values of these parameters that used via GA – ased optimization cost and risk reduction model in firms using a JIT as a delivery system. The model has been conceptualized for addressing the design complexities of the supply chain, referred to as SCRRJITS (Simultaneous Cost and Risk Reduction in a Just-in-Time System). A complete analysis of the different parameters and operators of the algorithm is carried out using design of experiments approach. The algorithm performance measure used in this study is convergence of solutions. The results show the extent to which the quality of solution can be changed depending on selection of these parameters.
Restoration of the Impact Crusher Rotor Using FCAW with High-Manganese Steel Reinforced by Complex Carbides
Authors: Prysyazhnyuk Pavlo , Bembenek Michał , Drach Ilona , Korzhov Andrii , Romanyshyn Liubomyr , Ropyak Liubomyr 
Published: June 2024

Abstract
A new hardfacing alloy within the Fe-Ti-Nb-Mo-V-C alloying system was utilized to restore the working surfaces of cone crusher rotors using Flux-Cored Arc Welding (FCAW). TiC, NbC, Mo2C, VC, Mn, and ferromanganese powders were selected as the base materials for manufacturing the welding wire. The resulting hardfaced layer exhibits a composite structure, with manganese austenite as the matrix and complex solid solution reinforcements with a NaCl structure, closely resembling the formula (Ti0.3Nb0.3Mo0.3)C. The primary advantages of this hardfacing alloy include its capacity for intensive deformation hardening along with high abrasion resistance. The hardness of the hardfaced layer is approximately 47 HRC in the as-deposited state and increases to around 57 HRC after work hardening, surpassing typical hardfacing alloys derived from high manganese steel by about 10 HRC. The efficacy of the alloy was tested in restoring rotors made of Hadfield steel in a PULVOMATIC series crusher model 1145, during the milling of sand-gravel mixtures ranging from 25 to 150 mm into spalls measuring 5 to 20 mm. With an average productivity of approximately 60 tons per hour and a production volume of 300 tons, the utilization of this hardfacing alloy enabled multiple restorations of the rotor while maintaining productivity at a level of 15 thousand tons of spalls.