bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medication Safety Amid Technological Change: Usability Evaluation to Inform Inpatient Nurses’ Electronic Health Record System Transition
Authors: Reale Carrie , Ariosto Deborah A. , Weinger Matthew B. , Anders Shilo 
Published: October 2023

Abstract
Background
Electronic health record (EHR) system transitions are challenging for healthcare organizations. High-volume, safety–critical tasks like barcode medication administration (BCMA) should be evaluated, yet standards for ensuring safety during transition have not been established.

Objective
Identify risks in common and problem-prone medication tasks to inform safe transition between BCMA systems and establish benchmarks for future system changes.

Design
Staff nurses completed simulation-based usability testing in the legacy system (R1) and new system pre- (R2) and post-go-live (R3). Tasks included (1) Hold/Administer, (2) IV Fluids, (3) PRN Pain, (4) Insulin, (5) Downtime/PRN, and (6) Messaging. Audiovisual recordings of task performance were systematically analyzed for time, navigation, and errors. The System Usability Scale measured perceived usability and satisfaction. Post-simulation interviews captured nurses’ qualitative comments and perceptions of the systems.

Participants
Fifteen staff nurses completed 2–3-h simulation sessions. Eleven completed both R1 and R2, and seven completed all three rounds. Clinical experience ranged from novice (< 1 year) to experienced (> 10 years). Practice settings included adult and pediatric patient populations in ICU, stepdown, and acute care departments.

Main Measures
Task completion rates/times, safety and non-safety-related use errors (interaction difficulties), and user satisfaction.

Key Results
Overall success rates remained relatively stable in all tasks except two: IV Fluids task success increased substantially (R1: 17%, R2: 54%, R3: 100%) and Downtime/PRN task success decreased (R1: 92%, R2: 64%, R3: 22%). Among the seven nurses who completed all rounds, overall safety-related errors decreased 53% from R1 to R3 and 50% from R2 to R3, and average task times for successfully completed tasks decreased 22% from R1 to R3 and 38% from R2 to R3.

Conclusions
Usability testing is a reasonable approach to compare different BCMA tasks to anticipate transition problems and establish benchmarks with which to monitor and evaluate system changes going forward.
Practices Supporting Electronic Health Record Transitions: Lessons from Four US Healthcare Systems
Authors: Rinne Seppo T. , Brunner Julian , Mohr David C. , Bearak Adena-Cohen , Anderson Ekaterina 
Published: October 2023

Abstract
Background
Electronic health record (EHR) transitions are common and complex organizational changes, yet limited published literature is available to guide health systems that are changing from one EHR to another. Clinicians and staff end users at sites that have undergone EHR transitions may have critical insights that could inform future transitions.

Objective
To assess end user perspectives on organizational practices that support successful EHR transitions.

Design
Multi-site qualitative study of end users at healthcare systems that transitioned to a new EHR (either Epic or Cerner) within the prior 3 years.

Participants
Forty-two participants, including providers, clinical leaders, and informaticists at four geographically and organizationally diverse US healthcare systems.

Approach
We conducted semi-structured telephone interviews, which were audio-recorded and transcribed. We used content analysis to identify key practices that influenced EHR transition success.

Key Results
Participants described specific organizational practices that they found most helpful in supporting EHR transitions, and these practices transcended individual sites and EHR systems. We categorized practices based on how they were described relative to the stage of implementation. During pre-go-live, recommended practices included communicate rationale and anticipated outcomes of the EHR change; understand baseline workflows; and plan for appropriate customization. During go-live, recommended practices included personalize training and support; invest in robust internal support; reduce workload expectations; and proactively address challenges. The recommended post-go-live practice was to continue to invest in the change.

Conclusions
Our findings may act as a roadmap for future EHR transitions by identifying specific and actionable organizational practices across stages of implementation. These recommendations highlight the role of health system leaders in preparing for the organizational change, working with and supporting end users, and addressing challenges that arise.
Cerner Millennium’s Care Pathways for Specialty Care Referrals: Provider and Nurse Experiences, Perceptions, and Recommendations for Improvements
Authors: Cordasco Kristina M. , Gable Alicia R. , Ganz David A. , Brunner Julian W. , Smith Anita J. , Hertz Brian , Post Edward P. , Fix Gemmae M. 
Published: October 2023

Abstract
Background
Using structured templates to guide providers in communicating key information in electronic referrals is an evidence-based practice for improving care quality. To facilitate referrals in Veterans Health Administration’s (VA) Cerner Millennium electronic health record, VA and Cerner have created “Care Pathways”—templated electronic forms, capturing needed information and prompting ordering of appropriate pre-referral tests.

Objective
To inform their iterative improvement, we sought to elicit experiences, perceptions, and recommendations regarding Care Pathways from frontline clinicians and staff in the first VA site to deploy Cerner Millennium.

Design
Qualitative interviews, conducted 12–20 months after Cerner Millennium deployment.

Participants
We conducted interviews with primary care providers, primary care registered nurses, and specialty providers requesting and/or receiving referrals.

Approach
We used rapid qualitative analysis. Two researchers independently summarized interview transcripts with bullet points; summaries were merged by consensus. Constant comparison was used to sort bullet points into themes. A matrix was used to view bullet points by theme and participant.

Results
Some interviewees liked aspects of the Care Pathways, expressing appreciation of their premise and logic. However, interviewees commonly expressed frustration with their poor usability across multiple attributes. Care Pathways were reported as being inefficient; lacking simplicity, naturalness, consistency, and effective use of language; imposing an unacceptable cognitive load; and not employing forgiveness and feedback for errors. Specialists reported not receiving the information needed for referral triaging.

Conclusions
Cerner Millennium’s Care Pathways, and their associated organizational policies and processes, need substantial revision across several usability attributes. Problems with design and technical limitations are compounding challenges in using standardized templates nationally, across VA sites having diverse organizational and contextual characteristics. VA is actively working to make improvements; however, significant additional investments are needed for Care Pathways to achieve their intended purpose of optimizing specialty care referrals for Veterans.
Using Research to Transform Electronic Health Record Modernization: Advancing a VA Partnered Research Agenda to Increase Research Impacts
Authors: Cogan Alison M. , Rinne Seppo T. , Weiner Michael , Simon Steven , Davila Jessica , Yano Elizabeth M. 
Published: October 2023

Abstract
Background
The U.S. Department of Veterans Affairs (VA) is undergoing an enterprise-wide transition from a homegrown electronic health record (EHR) system to a commercial off-the-shelf product. Because of the far-reaching effects of the EHR transformation through all aspects of the healthcare system, VA Health Services Research and Development identified a need to develop a research agenda that aligned with health system priorities so that work may inform evidence-based improvements in implementation processes and outcomes.

Objective
The purpose of this paper is to report on the development of a research agenda designed to optimize the EHR transition processes and implementation outcomes in a large, national integrated delivery system.

Design
We used a sequential mixed-methods approach (portfolio assessment, literature review) combined with multi-level stakeholder engagement approach that included research, informatics, and healthcare operations experts in EHR transitions in and outside the VA. Data from each stage were integrated iteratively to identify and prioritize key research areas within and across all stakeholder groups.

Participants
VA informatics researchers, regional VA health system leaders, national VA program office leaders, and external informatics experts with EHR transition experience.

Key Results
Through three rounds of stakeholder engagement, priority research topics were identified that focused on operations, user experience, patient safety, clinical outcomes, value realization, and informatics innovations.

Conclusions
The resulting EHR-focused research agenda was designed to guide development and conduct of rigorous research evidence aimed at providing actionable results to address the needs of operations partners, clinicians, clinical staff, patients, and other stakeholders. Continued investment in research and evaluation from both research and operations divisions of VA will be critical to executing the research agenda, ensuring its salience and value to the health system and its end users, and ultimately realizing the promise of this EHR transition.
Existence of solutions of nonlinear systems subject to arbitrary linear non-local boundary conditions
Authors: Cabada Alberto , López-Somoza Lucía , Yousfi Mouhcine 
Published: October 2023

AbstractIn this paper, we obtain an explicit expression for the Green’s function of a certain type of systems of differential equations subject to non-local linear boundary conditions. In such boundary conditions, the dependence on certain parameters is considered. The idea of the study is to transform the given system into another first-order differential linear system together with the two-point boundary value conditions. To obtain the explicit expression of the Green’s function of the considered linear system with non-local boundary conditions, it is assumed that the Green’s function of the homogeneous problem, that is, when all the parameters involved in the non-local boundary conditions take the value zero, exists and is unique. In such a case, the homogeneous problem has a unique solution that is characterized by the corresponding Green’s function g. The expression of the Green’s function of the given system is obtained as the sum of the function g and a part that depends on the parameters involved in the boundary conditions and the expression of function g. The novelty of our work is that in the system to be studied, the unknown functions do not appear separated neither in the equations nor in the boundary conditions. The existence of solutions of nonlinear systems with linear non-local boundary conditions is also studied. We illustrate the obtained results in this paper with examples.
Sharp and plain estimates for Schrödinger perturbation of Gaussian kernel
Authors: Jakubowski Tomasz , Szczypkowski Karol 
Published: October 2023

AbstractWe investigate whether a fundamental solution of the Schrödinger equation ∂tu = (Δ + V)u has local in time sharp Gaussian estimates. We compare that class with the class of V for which local in time plain Gaussian estimates hold. We concentrate on V that have fixed sign and we present certain conclusions for V in the Kato class.
Gender research in Japanese coastal fisheries
Authors: Matsubara Hana , Makino Mitsutaku 
Published: October 2023

AbstractFisheries have diverse gendered division of labor worldwide. It is essential to consider the activities and relations of all gender groups to fully understand the social-ecological systems of coastal resource use toward achieving sustainability. Gendered division of labor is also found in Japanese coastal fisheries. However, the number of studies focusing on the gender aspects of Japanese coastal fisheries is limited. This paper reviews previous studies on gender aspects of Japanese coastal fisheries and identified the features of the studies of Japan through comparison with studies in other countries. The results indicate that most previous studies in Japan were anthropological or socio-economic studies focusing on the activities of women. Following the result, three research topics with a gender lens are considered necessary in Japan: (1) studies on social-ecological systems of coastal fisheries with a gender lens, (2) studies on gender-differentiated impacts of fishery policies, and (3) studies on the gender-differentiated vulnerability and adaptive capacity in coastal areas. The future implementation of these studies will avoid the negative impacts on specific gender groups and provide critical insights for innovating sustainable and equitable coastal resource use by exploring gender-based knowledge, networks, and opportunities that have not been fully utilized.
Graphical Abstract
A 12-month study of dialectical behavioral therapy for bοrderline patients suffering from eating disorders
Authors: Liakopoulou Efi , Vassalou Georgia , Tzavara Chara , Gonidakis Fragiskos 
Published: October 2023

Abstract
Purpose
Individuals with eating disorders (ED) and comorbid borderline personality disorder (BPD) may benefit from therapies focusing on emotion regulation, such as dialectical behavioral therapy (DBT). The aim of the study was to evaluate the effectiveness of one-year standard DΒΤ enhanced with cognitive-behavioral therapy (CBT) strategies for patients suffering from ED and BPD.

Methods
Seventy-two BPD and ED (anorexia and bulimia nervosa) participants were recruited from the eating disorders unit of the 1st Psychiatric Department of National and Kapodistrian University of Athens. All participants completed one year of standard DBT. ED-related behaviors were added to the treatment plan according to the DBT targeting hierarchy. Individual therapy and skills training group sessions were adapted to incorporate CBT strategies for nutritional and weight restoration. BPD and ED symptomatology were measured at the beginning and at the end of one year of treatment.

Results
The major finding of the study was the significant improvement of patients in all the outcome measurements after one year of treatment. The study's second finding was that the severity of BPD symptomatology was significantly related to the severity of ED symptomatology. It was also shown that improvement of the patients coping skills was correlated with the reduction of ED and BPD symptomatology.

Conclusions
These results support previous studies on the effectiveness of DBT for comorbid BPD and EDs. Despite the promising results, randomized controlled trials are needed to establish the efficacy of DBT for BPD and ED patients.

Level of evidence
Level IV: Evidence obtained from multiple time series with or without the intervention, such as case studies. Dramatic results in uncontrolled trials might also be regarded as this type of evidence.
The finite and solvable genus of finitely generated free and surface groups
Authors: Jaikin-Zapirain Andrei 
Published: October 2023

AbstractLet $${\mathcal {C}}$$
C
be the pseudovariety $${\mathcal {F}}$$
F
of all finite groups or the pseudovariety $${\mathcal {S}}$$
S
of all finite solvable groups and let $$\Gamma $$
Γ
be either a finitely generated free group or a surface group. The $${\mathcal {C}}$$
C
-genus of $$\Gamma $$
Γ
, denoted by $${\mathcal {G}}_{{\mathcal {C}}}(\Gamma )$$

G
C

(
Γ
)

, consists of the isomorphism classes of finitely generated residually-$$\mathcal C$$
C
groups G having the same quotients in $${\mathcal {C}}$$
C
as $$\Gamma $$
Γ
. We show that the groups from $${\mathcal {G}}_{{\mathcal {C}}}(\Gamma )$$

G
C

(
Γ
)

are residually-p for all primes p. This answers a question of Gilbert Baumslag and shows that the groups in the genus are residually finite rationally solvable groups. This leads to a positive solution of particular case of a question of Alexander Grothendieck: if F is a free group, G is a finitely generated residually-$${\mathcal {C}}$$
C
group and $$u:F\rightarrow G$$

u
:
F
→
G

is a homomorphism such that the induced map of pro-$${\mathcal {C}}$$
C
completions $$u_{\widehat{{\mathcal {C}}}} : F_{\widehat{{\mathcal {C}}}}\rightarrow G_{\widehat{{\mathcal {C}}}}$$

u

C
^

:

F

C
^

→

G

C
^

is an isomorphism, then u is an isomorphism.
Influence of clearance between cradle and barrel on nonlinear dynamic response of the artillery system
Authors: Lu Shaojie , Gao Zhiying , Zhang Haifeng , Liao Maolin 
Published: October 2023

AbstractThe artillery weapon system,characterized as a complex nonlinear mechanical system, is influenced by various factors affecting its muzzle vibration response.In the article, the model of the artillery system with variable cross-section and multistep barrel is established on the basis of the bending deformation equation, and the fundamental frequency equation is obtained, and the auxiliary verification is completed through modal testing and finite element methods. Then, considering the clearance between the barrel and the cradle, the equivalent nonlinear dynamic model of the vertical vibration of the muzzle is established is established. Furthermore, the multi-scale analysis method obtains the amplitude-frequency curve of the equivalent model under sinusoidal excitation, and analyzes the influence of parameters on the response characteristics. Finally, the vibration research system of the model of the artillery system is constructed to study the vibration characteristics of the muzzle. The results show that the equivalent nonlinear dynamic model established in the paper has certain accuracy, which can provide a certain reference for the related research of the artillery system
Preservation of mean inactivity time ordering for coherent systems
Authors: Rao T. V. , Naqvi Sameen 
Published: October 2023

AbstractPreservation of stochastic orders through the system signature has captured the attention of researchers in recent years. Signature-based comparisons have been made for the usual stochastic order, hazard rate order, and likelihood ratio orders. However, for the mean residual life (MRL) order, it has recently been proved that the preservation result does not hold true in general, but rather holds for a particular class of distributions. In this paper, we study whether or not a similar preservation result holds for the mean inactivity time (MIT) order. We prove that the MIT order is not preserved from signatures to system lifetimes with independent and identically distributed (i.i.d.) components, but holds for special classes of distributions. The relationship between these classes and the order statistics is also highlighted. Furthermore, the distribution-free comparison of the performance of coherent systems with dependent and identically distributed (d.i.d.) components is studied under the MIT ordering, using diagonal-dependent copulas and distorted distributions.
Hensel minimality II: Mixed characteristic and a diophantine application
Authors: Cluckers Raf , Halupczok Immanuel , Rideau-Kikuchi Silvain , Vermeulen Floris 
Published: October 2023

Abstract
In this paper, together with the preceding Part I [10], we develop a framework for tame geometry on Henselian valued fields of characteristic zero, called Hensel minimality. It adds to [10] the treatment of the mixed characteristic case. Hensel minimality is inspired by o-minimality and its role in real geometry and diophantine applications. We develop geometric results and applications for Hensel minimal structures that were previously known only under stronger or less axiomatic assumptions, and which often have counterparts in o-minimal structures. We prove a Jacobian property, a strong form of Taylor approximations of definable functions, resplendency results and cell decomposition, all under Hensel minimality – more precisely,

$1$

-h-minimality. We obtain a diophantine application of counting rational points of bounded height on Hensel minimal curves.
Rethinking the Conceptual Space for Science in Society after the VFI
Authors: Branch T. Y. , Douglas Heather 
Published: October 2023

AbstractReplacing the value-free ideal (VFI) for science requires attention to the broader understanding of how science in society should function. In public spaces, science needed to project the VFI in norms for science advising, science education, and science communication. This resulted in the independent science advisor model and a focus on science literacy for science education and communication. Attending to these broader implications of the VFI that structure science and society relationships is crucial if we are to properly replace the VFI with a better ideal.
Overcoming Arbitrage Limits: Option Trading and Momentum Returns
Authors: Abhyankar Abhay , Filippou Ilias , Garcia-Ares Pedro A. 
Published: October 2023

AbstractMomentum profits depend mainly on the short leg and therefore on barriers to short sales. Our research indicates that the decline in momentum profitability in the past 2 decades is driven partly by a contemporaneous growth in stock options trading. Stock options offer an alternative to short selling, augmenting the stock lending market, and thereby contributing to improved pricing efficiency. The resulting reduction in barriers to short sales contributes to lower returns to momentum trading from the short leg. Our results persist after matching stocks with and without options based on different firm-level characteristics.
Foreign Trade Policy in the Argentine Automotive Industry: An Analysis of the Business Power of its Actors and their Influence over the State (2002–15)
Authors: Perez Almansi Bruno 
Published: October 2023

AbstractThe article aims to analyse how the business power of actors in the Argentine automotive industry influenced the foreign trade policies relevant to the sector between 2002 and 2015. The research methods employed combine documentary sources, interviews with key informants and descriptive statistics. The overall findings show how automakers achieved considerable power in the first stage of the period, obtaining clear benefits in terms of foreign trade policy. However, macroeconomic and political changes in Argentina after 2008 had a negative impact on their business power, leading to their enjoying a reduced number of trade policy concessions.
Dependence among order statistics for time-transformed exponential models
Authors: Kochar Subhash , Spizzichino Fabio L. 
Published: October 2023

AbstractLet $(X_{1},\ldots,X_{n})$ be a random vector distributed according to a time-transformed exponential model. This is a special class of exchangeable models, which, in particular, includes multivariate distributions with Schur-constant survival functions. Let for $1\leq i\leq n$, $X_{i:n}$ denote the corresponding ith-order statistic. We consider the problem of comparing the strength of dependence between any pair of Xi’s with that of the corresponding order statistics. It is in particular proved that for $m=2,\ldots,n$, the dependence of $X_{2:m}$ on $X_{1:m}$ is more than that of X2 on X1 according to more stochastic increasingness (positive monotone regression) order, which in turn implies that $(X_{1:m},X_{2:m})$ is more concordant than $(X_{1},X_{2})$. It will be interesting to examine whether these results can be extended to other exchangeable models.