bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacist Avoidance or Reductions in Medical Costs in Critically and Emergently Ill Pediatrics: PHARM-PEDS Study
Authors: Kiskaddon Amy L. , Smith Michelle M. , Gilliland Frankie , Rech Megan A. ,   Pharmacist Avoidance or Reductions in Medical Costs in Critically and Emergently Ill Pediatrics (PHARM-PEDS) Investigators
Published: October 2023

OBJECTIVES:
To comprehensively classify interventions performed by pediatric critical care clinical pharmacists and quantify cost avoidance (CA) generated through their accepted interventions.

DESIGN:
A multicenter, prospective, observational study performed between August 2018 and January 2019.

SETTING:
Academic and community hospitals in the United States with pediatric critical care units.

SUBJECTS:
Pediatric clinical pharmacists.

INTERVENTIONS:
Pharmacist recommendations were classified into one of 38 total intervention categories associated with CA.

MEASUREMENTS AND MAIN RESULTS:
Nineteen pediatric pharmacists at five centers documented 1,458 accepted interventions during 112 shifts on 861 critically ill pediatric patients. This calculated to an associated CA of $450,590. The accepted interventions and associated CA in the six established categories included as follows: adverse drug event prevention (155 interventions, $118,901 CA), resource utilization (267 interventions; $59,020), individualization of patient care (898 interventions, $217,949 CA), prophylaxis (8 interventions, $453 CA), hands-on care (30 interventions, $35,509 CA), and administrative/supportive tasks (108 interventions, $18,758 CA). The average associated CA was $309 per accepted intervention, $523 per patient day, and $4,023.13 per pediatric clinical pharmacist shift. The calculated potential annualized CA of accepted interventions from a pediatric pharmacist was $965,550, resulting in a potential monetary-associated CA-to-pharmacist salary ratio between $1.5:1 and $5.2:1.

CONCLUSIONS:
There is potential for significant avoidance of healthcare costs when pediatric pharmacists are involved in the care of critically and emergently ill pediatric patients, with a monetary potential CA-to-pediatric pharmacist salary ratio to be between $1.5:1 and $5.2:1.
Relationship of blood pressure measured in the calf with arm blood pressure and arterial stiffness: a general population study
Authors: Marques Edmilson R. , Bernardino Alana C. , Alvim Rafael O. , Schreiber Roberto , Krieger José Eduardo , Matos-Souza José R. , Sposito Andrei C. , Pereira Alexandre C. , Nadruz Wilson 
Published: October 2023

Aim:
Leg blood pressure (BP) measurement is needed when arm BP evaluation is not feasible, and calf BP, especially when measured in standing position, may have greater association with cardiovascular remodeling than arm BP. This study evaluated the relationship between calf and arm BP, and investigated whether calf BP would be superior to arm BP in predicting increased arterial stiffness [pulse wave velocity (PWV) > 10 m/s].

Methods:
We evaluated clinical and laboratory characteristics, BP measurements, and PWV in 1397 individuals resident in Baependi, Brazil, between 2017 and 2019. Arm BP was measured in the seated and supine positions while calf BP was measured in supine and standing positions using digital oscillometric devices. Carotid–femoral PWV was measured using a noninvasive mechanotransducer.

Results:
The sample had 62.7% females, age = 48.1 ± 15.4 years and 8.4% with PWV >10 m/s. Results of linear regression analysis showed that BP values of 140/90 mmHg measured in the arm in supine and seated position were equivalent to calf supine BP values of 164/81 mmHg and 166/78 mmHg and calf standing BP values of 217/137 mmHg and 221/137 mmHg, respectively. Calf-arm BP differences were associated with age, glomerular filtration rate, body mass index, smoking, low-density lipoprotein-cholesterol, diabetes and height. Furthermore, stepwise logistic regression analysis revealed that arm supine systolic BP, but not calf BP measurements, was independently associated with increased arterial stiffness.

Conclusion:
Thresholds of ≈165/80 mmHg and ≈220/135 mmHg could be used for diagnosing hypertension when only calf measurements in supine and standing positions, respectively, are available. Conversely, calf BP was not superior to arm BP in predicting increased arterial stiffness.
Vascular Reconstruction After Cannulation for Support With Extracorporeal Membrane Oxygenation: Literature Review of Data in the Pediatric Population*
Authors: Zens Tiffany , Eldredge R. Scott , Gill Manrit , Mathew Steven , Molitor Mark 
Published: October 2023

OBJECTIVES:
Extracorporeal membrane oxygenation (ECMO) is an invaluable life-support resource in the treatment of critically ill children. Traditionally, neck vascular cannulation requires ligation of the carotid artery and jugular vein. In this literature review, we identify rates of postoperative vessel patency, complications, and neurologic outcomes after vascular reconstruction following decannulation.

DATA SOURCES:
Embase, PubMed, and Cochrane Review.

STUDY SELECTION:
No publication date limits. Inclusion criteria comprised of studies addressing repair of the carotid artery and jugular vein after ECMO decannulation and outcomes from this procedure.

DATA EXTRACTION:
Authors identified publications on vascular reconstruction after ECMO decannulation, including possible technical considerations, complications, and outcomes.

DATA SYNTHESIS:
We identified 18 articles: 13 studies were limited to the neonatal population. The largest series included 51 patients after vascular reconstruction. The rate of postoperative arterial occlusion ranged from 11.8% to 17.8%, and overall patency rate postoperatively was 78.6%. No major thromboembolic events were reported. One study demonstrated an increase in neuroimaging abnormalities for patients undergoing ligation compared with vascular reconstruction. No studies demonstrated differences in functional neurodevelopmental testing.

CONCLUSIONS:
Vascular reconstruction after ECMO decannulation has been reported since 1990. Although reconstruction does not appear to carry significant short-term morbidity, there are no large prospective studies or randomized controlled trials demonstrating its efficacy in improving neurologic outcomes in ECMO patients. There is also a paucity of data regarding outcomes in older children or long-term ramifications of vascular reconstruction.
Evolution of Response-Based Radiotherapy for Hepatocellular Cancer
Authors: Elaimy Ameer L. , Cao Yue , Lawrence Theodore S. 
Published: October 2023

Abstract
Stereotactic body radiation therapy has emerged as a safe and effective treatment modality for properly selected hepatocellular cancer (HCC) patients with normal liver function. However, many HCC patients have reduced baseline liver function due to underlying cirrhosis or prior liver-directed therapies. Therefore, because of the increased risk of hepatotoxicity, the use of stereotactic body radiation therapy for patients with reduced liver function has been approached with caution. Individualized, response-based radiotherapy incorporates models, imaging tools, and biomarkers that determine the dose-response relationship of the liver before, during, and after treatment and has been useful in reducing the likelihood of liver damage without sacrificing tumor control. This review discusses the evolution of response-based radiotherapy for HCC and highlights areas for further investigation.
Acute Appendicitis Complicated by Septic Thrombophlebitis of the Portal Vein Shown by 18F-FDG and 68Ga-FAPI-46 PET/CT
Authors: Cai Jiayu , Xu Weizhi , Meng Tinghua , Pang YiZhen , Chen Haojun 
Published: October 2023

Abstract
Septic thrombophlebitis of the portal vein is a serious infectious disorder and is difficult to be diagnosed at an early stage. In this case, we presented 18F-FDG and 68Ga-FAPI-46 PET/CT findings in a 45-year-old man with acute appendicitis complicated by septic thrombophlebitis of the portal vein. 68Ga-FAPI-46 PET/CT showed intense radiotracer uptake in the thrombosis of the portal vein, with higher SUVmax and larger disease extent than 18F-FDG PET/CT. This case demonstrated that 68Ga-FAPI PET/CT may be a useful imaging modality for the diagnosis of this infectious condition.
Small Bowel Metastases From Malignant Phyllodes Breast Tumor Detected by 18F-FDG PET/CT
Authors: Yuan Meng , Han Bing , Zhang Nan , Lu Lu , Liu Shuai 
Published: October 2023

Abstract
The most common sites of distant metastases are lung, bone, pleura, and mediastinum in malignant phyllodes breast tumors. However, small bowel metastasis from malignant phyllodes breast tumors is rare. We reported that using CT and FDG PET/CT imaging we identified a case with small bowel metastasis from breast cancer. PET/CT scan showed that high 18F-FDG uptake occurred in the duodenum and jejunum. Histopathology and immunohistochemistry analyses further confirmed that malignant phyllodes tumors are derived from the breast.
A False-Positive Bone Oligometastatic Prostate Cancer in 18F-Choline PET/CT
Authors: Pretet Valentin , Moreau Aurélie , Larrouquere Louis , Mognetti Thomas , Kryza David 
Published: October 2023

Abstract
We report the case of a 71-year-old man undergoing initial assessment for a high-risk group prostate adenocarcinoma. His medical history includes gastric carcinoma treated with surgery and chemotherapy. 18F-choline PET/CT was performed for initial staging and displayed several intense foci uptake of sternum and thoracic vertebrae, suggestive of bone metastasis. Because of a chronic right jugulosubclavian confluent thrombosis related to his implantable chamber, a control was performed 3 weeks later. It showed spontaneous disappearance of those uptakes, consistent with pitfalls related to the collateral circulation induced by the chronic right subclavian vein thrombosis, despite the chronic anticoagulation.
A Novel Approach to Brain Tumor Classification Using Deep Neural Networks
Authors: Tummala Rohan 
Published: October 2023

AbstractThe American Cancer Society estimates that in 2023 about 24,810 malignant brain and spinal cord tumors will be diagnosed in the United States and about 18,990 people will die from these tumors. Early detection of malignant brain tumors is crucial in improving survival. Currently, MRI is the standard radiological method used to identify brain tumors. However, these tests are prone for human error, inefficiencies, and often require invasive tissue diagnosis for confirmation. Advancement in machine learning algorithms has shown to improve accuracy in detection of brain tumors. In this study, a novel deep learning approach, called Inception Resnet, a type of pretrained Convolutional Neural Network(CNN), was used to identify and classify three common brain tumors. These classes were pituitary, meningioma, and glioma. Pituitary tumors are the most harmless of the three as they are noncancerous. This contrasts with both glioma and high grade meningioma tumors which are life-threatening. It should be noted, however, that high grade meningioma tumors are very rare. Along with these three classes, a separate control class with no brain tumors was also used. This dataset contained 5,952 MRI images that included 1621 glioma images, 574 meningioma images, 1751 pituitary images and 2000 images with no tumor. Based on this data, a model was created that was able to diagnose brain tumors with an accuracy of 96.7%.
The MAGMA pipeline for comprehensive genomic analyses of clinicalMycobacterium tuberculosissamples
Authors: Heupink Tim H. , Verboven Lennert , Sharma Abhinav , Rennie Vincent , de Diego Fuertes Miguel , Warren Robin M. , Rie Annelies Van 
Published: October 2023

AbstractBackgroundWhole genome sequencing (WGS) holds great potential for the management and control of tuberculosis. Accurate analysis of samples with low mycobacterial burden, which are characterized by low (<20x) coverage and high (>40%) levels of contamination, is challenging. We created the MAGMA (Maximum Accessible Genome forMtbAnalysis) bioinformatics pipeline for analysis of clinicalMtbsamples.Methods and resultsHigh accuracy variant calling is achieved by using a long seedlength during read mapping to filter out contaminants, variant quality score recalibration with machine learning to identify genuine genomic variants, and joint variant calling for lowMtbcoverage genomes. MAGMA automatically generates a standardized and comprehensive output of drug resistance information and resistance classification based on the WHO catalogue ofMtbmutations. MAGMA automatically generates phylogenetic trees with drug resistance annotations and trees that visualize the presence of clusters. Drug resistance and phylogeny outputs from sequencing data of 79 primary liquid cultures were compared between the MAGMA and MTBseq pipelines. The MTBseq pipeline reported only a proportion of the variants in candidate drug resistance genes that were reported by MAGMA. Notable differences were in structural variants, variants in highly conservedrrsandrrlgenes, and variants in candidate resistance genes for bedaquiline, clofazmine, and delamanid. Phylogeny results were similar between pipelines but only MAGMA visualized clusters.ConclusionThe MAGMA pipeline could facilitate the integration of WGS into clinical care as it generates clinically relevant data on drug resistance and phylogeny in an automated, standardized, and reproducible manner.Key points-Accurate analysis of clinical samples is challenging when samples have high levels of contamination and lowMycobacterium tuberculosisgenome coverage-When analyzing primary liquid (MGIT) cultures, the MAGMA pipeline generates clinically relevant drug resistance information (including major, minor and structural variants) and phylogeny in an automated, standardized and reproducible way.-MAGMA-generated phylogenetic trees are annotated with drug resistance information and updated with every run so that they can be used to make clinical or public health decisions-MAGMA reports drug resistance variants for all tier 1 and tier 2 candidate drug resistance conferring genes, with interpretation of their relevance to drug resistance (associated with drug resistance, not associated with drug resistance or unknown significance) based on the WHO catalogue of mutations inMycobacterium tuberculosis.
Automatic sleep stage classification using physiological signals acquired by Dreem headband
Authors: Dogaheh Shahla Bakian , Moradi Mohammad Hassan 
Published: October 2023

ABSTRACTIn this paper, we aim to propose a model for automatic sleep stage classification based on physiological signals acquired by Dreem Headband and extreme gradient boosting (XGBoost) method. The dataset used in this study belongs to a challenge competition, namely as “Challenge Data”, held in 2017-2018, and is publicly available on their website. Recordings, includes 4 EEG channels (FpZ-O1, FpZ-O2, FpZ-F7, F8-F7), 2 Pulse oximeter (RED & infra-red), and 3 accelerometer channels (X, Y, Z). In this work, sleep stages have been scored according to the AASM standard. Different features were extracted from the physiological signals after applying a preprocessing step. Each of the elicited features from EEG and PPG signals is falling into one of the three categories: time-domain, frequency domain, or non-linear features. Moreover, ancillary features including body movement, frequency features, breathing frequency, and respiration rate variability were also extracted from the accelerometer signal. Significance of the extracted features was examined through the Kruskal Wallis test, and features with P-value>0.01 were discarded from features set. Finally, significant features were classified by using support vector machine (SVM), K-nearest neighbors (KNN), random forest (RF), and XGBoost classifiers. Due to the class imbalance problem, repeated stratified 5-fold cross-validation was performed in order to tune systems parameters. Results show that among the four above-mentioned models, XGBoost has the best performance for the 5-class classification problem with accuracy: 81.34%±0.76% and Kappa 0.7388±0.0101. The proposed model shows promising results, therefore the model can be implemented in Dreem headband to differentiate between sleep states efficiently and be applicable in clinical trial.
Multi-stage skewed grey cloud clustering model and its application
Authors: Yang Jie , Zhang Manman , Shangguan Linjian , Shi Jinfa 
Published: October 2023

PurposeThe possibility function-based grey clustering model has evolved into a complete approach for dealing with uncertainty evaluation problems. Existing models still have problems with the choice dilemma of the maximum criteria and instances when the possibility function may not accurately capture the data's randomness. This study aims to propose a multi-stage skewed grey cloud clustering model that blends grey and randomness to overcome these problems.Design/methodology/approachFirst, the skewed grey cloud possibility (SGCP) function is defined, and its digital characteristics demonstrate that a normal cloud is a particular instance of a skewed cloud. Second, the border of the decision paradox of the maximum criterion is established. Third, using the skewed grey cloud kernel weight (SGCKW) transformation as a tool, the multi-stage skewed grey cloud clustering coefficient (SGCCC) vector is calculated and research items are clustered according to this multi-stage SGCCC vector with overall features. Finally, the multi-stage skewed grey cloud clustering model's solution steps are then provided.FindingsThe results of applying the model to the assessment of college students' capacity for innovation and entrepreneurship revealed that, in comparison to the traditional grey clustering model and the two-stage grey cloud clustering evaluation model, the proposed model's clustering results have higher identification and stability, which partially resolves the decision paradox of the maximum criterion.Originality/valueCompared with current models, the proposed model in this study can dynamically depict the clustering process through multi-stage clustering, ensuring the stability and integrity of the clustering results and advancing grey system theory.
The relationship between service quality of banking kiosk and customer satisfaction: the moderating role of technology readiness
Authors: Nguyen Hong Quan , Nguyen Quynh Huong , Tran Phuong Thao , Trinh Ngoc Linh , Nguyen Quynh Trang 
Published: October 2023

Purpose
The aim of this empirical study is to investigate an integrated model that captures the way service quality of banking kiosks (BK-SQ) exerts its impacts on customer perceived value and customer satisfaction and the moderating mechanism of technology readiness (TR) in the quality–satisfaction relationship in the banking sector in Vietnam.

Design/methodology/approach
An offline survey was conducted to obtain responses from 604 users of banking kiosks in Vietnam. Exploratory factor analysis, confirmatory factor analysis and structural equation modeling were used for data analysis. The moderating effect of TR was examined following the product indicator method.

Findings
The results validate significant positive correlations between BK-SQ, customer perceived value and customer satisfaction. Among six service quality dimensions, convenience is the most significant factor in predicting perceived service quality. The study also delineates how TR can moderate the link between service quality and customer satisfaction.

Research limitations/implications
Future studies may make further attempts to incorporate other human and demographic factors as a moderator into the research model.

Practical implications
Bank managers should strive to improve the operations of banking kiosks based on six aspects and increase TR levels of customers to boost customer satisfaction with banking kiosks.

Originality/value
The study contributes to the literature on service quality and self-service technologies (SSTs) by offering critical insights into how banks can make use of influence mechanisms in the model to enhance service quality and customer satisfaction.
Examining the role of heritage-destination attributes on travel constraints and revisit intention using multilevel analysis
Authors: Dabphet Siripen 
Published: October 2023

PurposeThis study aimed to explore how the attributes of heritage destinations become constraints on tourists' intention to revisit these destinations and to provide stakeholders with strategies to mitigate travel constraints, thereby increasing tourists' revisit intention.Design/methodology/approachA quantitative research approach was used, and data collection utilised a convenience sampling method. A total of 1,250 tourists completed self-administered, on-site surveys. To analyse the collected data effectively and to test hypotheses, multilevel analysis models were created.FindingsHeritage-destination attributes are found to mediate the impact of perceived constraints on tourists' intention to revisit heritage destinations. Positive perceptions of heritage and cultural attractions among tourists can mitigate the adverse effects of constraints on their intentions.Research limitations/implicationsThis study only focused on examining the downward cross-level impact, i.e. from the macro level to the individual level. This could be beneficial for exploring an upward cross-level impact.Practical implicationsThe findings provide strategic guidance for marketing programs to enhance the reputation of heritage destinations. By identifying and establishing attributes specific to heritage destinations that visitors perceive as the most appealing, program designers can effectively target their efforts. Additionally, the findings help stakeholders of heritage destinations develop and provide suitable heritage and cultural attractions and tourism infrastructure in line with tourists' preferences.Originality/valueThis study employed a multilevel approach to examine how heritage-destination attributes and related constraints on travelling on impact individuals' intentions to revisit destinations. The study considered a macro-based perspective to analyse these effects.
Value network partners' perception of co-creation and its impact on their satisfaction
Authors: Sambyal Rachita , Rishi Bikramjit , Mavi Anupreet Kaur , Marwaha Amandeep Singh 
Published: October 2023

PurposeCo-creating with value network partners (VNPs) in the tourism industry has become essential for delivering improved service quality and enhancing consumer experience. This research examines the impact of value co-creation on the satisfaction of VNPs. Further, the study examines the moderating effects of socio-demographic factors on the relation between co-creation and VNP satisfaction.Design/methodology/approachThe study collected data from VNPs engaged in tourism-related activities (N = 392). It analysed the data through structural equation modelling using SPSS 20 and AMOS 21. The study used the stimulus-organism-response framework to understand VNP's perceptions regarding co-creation.FindingsThe results indicate a significant relationship between the value processes and networks, service offerings, conversations and dialogues and value proposition in relation to co-creation. Additionally, the study identifies the significance of age, education level, job experience and job nature. The findings of the study can enable tourism managers to formulate effective co-creation strategies.Practical implicationsThe insights from the study enable tourism managers to devise co-creation strategies that nurture collaboration with VNPs. Managers can gain insights into the antecedents of the co-creation and the role of demographic factors in shaping strategies.Originality/valueThe study's findings have the potential to shape co-creation policies in the tourism and hospitality industry. Network partners and tourism companies can leverage insights from the study to develop and refine their co-creation policies. By bridging the gaps in the existing literature on value co-creation with network partners, the study contributes significantly to tourism and hospitality literature.