bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of digitalization of nursing forms in ICUs on time and cost
Authors: Yilmaztürk Nevin , Kose İlker , Cece Sinem 
Published: June 2023

Abstract
Objective
Intensive Care Units are one of the areas with the lowest digitization rate. This study aims to measure the effect of digitizing medical records kept in paper forms in ICUs on time-saving and paper consumption. In our study, care forms in ICUs were transferred to digital media. In our research, care forms in ICUs were transferred to digital media.

Methods
The time required to fill out the nursing care forms on paper and digital media was measured, the change in paper and printer costs was determined, and the results were compared. Two volunteer nurses working in the ICU of a university hospital in Istanbul measured the time it took to fill out the forms of patients on paper. Then, a future projection was made using digital form data of 5,420 care days of 428 patients hospitalized between October 2017 and September 2018. Only anonymous data of patients hospitalized in the general ICU were used, and other untempered were not included in the study.

Results
When the forms were filled in digitally by the nurses, one nurse per patient per day saved 56.82 min (3.95% per day).

Discussion
Health care services are provided in hospitals in Turkey with 28,353 adult intensive care beds and an occupancy rate of 68%. Based on the occupancy rate of 68%, the number of full beds is 19,280. When 56.82 min are saved per bed from the forms filled by the nurses, 760.71 care days are dedicated. Considering the salary of 1,428.67 US dollars per nurse, the savings to be achieved are estimated to be 13,040,804.8 US dollars per year.
The needs and experiences of critically ill patients and family members in intensive care unit of a tertiary hospital in Malaysia: a qualitative study
Authors: Leong E-Li , Chew Chii-Chii , Ang Ju-Ying , Lojikip Sharon-Linus , Devesahayam Philip-Rajan , Foong Kit-Weng 
Published: June 2023

Abstract
Background
Admission to an intensive care unit (ICU) is a stressful experience for patients and their family members. While the focus of management is primarily on medical care, there can be other areas which are overlooked. The purpose of this study was to investigate the needs and experiences of ICU patients and family members.

Method
This qualitative study involved four trained researchers conducting in-depth interviews (IDI) based on a semi-structured interview guide. The participants were ICU patients and family members. All IDIs were audio-recorded and transcribed verbatim. Four researchers independently analyzed the data via thematic analysis with the aid of QDA Miner Lite®. The themes and subthemes were generated and confirmed by literature and expert opinion.

Results
Six IDIs were conducted with three patients and three family members, whose ages ranged from 31 to 64 years old. One pair of participants consisted of a patient and his respective family member, while the other four participants did not have a familial relationship with each other. Three main themes emerged from the analysis: (I) critical care services; (II) physical spaces; and (III) monitoring technology. Medical, psychological, physical, and social needs for critical care services were expressed by both patients and family members. Patients’ needs in clinical spaces were highlighted as a conducive ICU environment with ambient temperature and controlled noise levels. In non-clinical spaces, family members expressed a need for more chairs in the waiting area. Participants expressed the need for call bells as well as patients’ negative perceptions of medical equipment alarms in the ICU when it pertained to monitoring technology.

Conclusion
This study provides an in-depth view at the needs and experiences of ICU patients and family members who have a variety of unmet needs. This understanding is critical for guiding ICU personnel and stakeholders in their efforts to humanize ICU care.
An equitable and sustainable community of practice framework to address the use of artificial intelligence for global health workforce training
Authors: Frehywot Seble , Vovides Yianna 
Published: June 2023

AbstractArtificial Intelligence (AI) technologies and data science models may hold potential for enabling an understanding of global health inequities and support decision-making related toward possible interventions. However, AI inputs should not perpetuate the biases and structural issues within our global societies that have created various health inequities. We need AI to be able to ‘see’ the full context of what it is meant to learn. AI trained with biased data produces biased outputs and providing health workforce training with such outputs further contributes to the buildup of biases and structural inequities. The accelerating and intricately evolving technology and digitalization will influence the education and practice of health care workers. Before we invest in utilizing AI in health workforce training globally, it is important to make sure that multiple stakeholders from the global arena are included in the conversation to address the need for training in ‘AI and the role of AI in training’. This is a daunting task for any one entity and a multi-sectorial interactions and solutions are needed. We believe that partnerships among various national, regional, and global stakeholders involved directly or indirectly with health workforce training ranging to name a few, from public health & clinical science training institutions, computer science, learning design, data science, technology companies, social scientists, law, and AI ethicists, need to be developed in ways that enable the formation of an equitable and sustainable Communities of Practice (CoP) to address the use of AI for global health workforce training. This paper has laid out a framework for such CoP.
System dynamics models of depression at the population level: a scoping review
Authors: Graham Eva , Gariépy Geneviève , Orpana Heather 
Published: June 2023

AbstractAimsDepression is a disease driven by dynamic processes both at the individual- and system-level. System dynamics (SD) models are a useful tool to capture this complexity, project the future prevalence of depression and understand the potential impact of interventions and policies. SD models have been used to model infectious and chronic disease, but rarely applied to mental health. This scoping review aimed to identify population-based SD models of depression and report on their modelling strategies and applications to policy and decision-making to inform research in this emergent field.MethodsWe searched articles in MEDLINE, Embase, PsychInfo, Scopus, MedXriv, and abstracts from the System Dynamics Society from inception to October 20, 2021 for studies of population-level SD models of depression. We extracted data on model purpose, elements of SD models, results, and interventions, and assessed the quality of reporting.ResultsWe identified 1899 records and found four studies that met the inclusion criteria. Studies used SD models to assess various system-level processes and interventions, including the impact of antidepressant use on population-level depression in Canada; the impact of recall error on lifetime estimates of depression in the USA; smoking-related outcomes among adults with and without depression in the USA; and the impact of increasing depression incidence and counselling rates on depression in Zimbabwe. Studies included diverse stocks and flows for depression severity, recurrence, and remittance, but all models included flows for incidence and recurrence of depression. Feedback loops were also present in all models. Three studies provided sufficient information for replicability.ConclusionsThe review highlights the usefulness of SD models to model the dynamics of population-level depression and inform policy and decision-making. These results can help guide future applications of SD models to depression at the population-level.
TNF-α activates RELA expression via TNFRSF1B to upregulate OPA1 expression and inhibit chondrogenic differentiation of human adipose stem cells
Authors: Guo Jiajia , Ye Wang , Wu Xinglin , Huang Haifeng , Li Bo , Sun Zeyu , Ren Zhijing , Yang Zhen 
Published: June 2023

Abstract
Background
Tumor necrosis factor-alpha (TNF-α), one of the pro-inflammatory cytokines mediating the local inflammatory process in joints, inhibits cartilage formation and has a detrimental effect on stem cell-based cartilage regeneration for the treatment of osteoarthritis (OA). However, the mechanisms behind this inhibitory effect are still poorly understood. Mitochondrial morphological changes mediated by mitochondrial fusion and fission are highly plastic, are quite sensitive to environmental stimuli and play a crucial role in maintaining cell structure and function. In our study, chondrogenic differentiated human adipose stem cells (hADSCs) were exposed to TNF-α and the effect of TNF-α on the ability of hADSCs to chondrogenic differentiate and on mitochondrial fusion and fission was observed and analyzed. The aim was to investigate the role and mechanisms of mitochondrial fusion and fission regulation in the chondrogenic differentiation of hADSCs under normal conditions and under exposure to TNF-α.

Methods
We used flow cytometry to identify hADSCs immunophenotypes CD29, CD44, CD34, CD45, and HLA-DR. Alcian blue staining and Sirius red staining were used to observe the formation of proteoglycans and collagen during the chondrogenic differentiation of hADSCs, respectively. The mRNA and protein expression levels of the cartilage formation marker SOX9, type II collagen (COL2A1), and Aggrecan were measured by real-time fluorescent quantitative PCR (RT-qPCR) and western blot, respectively. The fluorescent probes MitoTracker® Red CMXRos and JC-1 were used to visualize mitochondria morphology and detect mitochondrial membrane electricity (MMP). Affymetrix PrimeView™ chips were used for gene expression profiling.

Results
The results showed that the chondrogenic differentiation of hADSCs was inhibited in the presence of TNF-α that optic atrophy 1 (OPA1) expression was significantly upregulated and mitochondria were prolonged and interconnected during this process. Gene microarray and RT-qPCR data showed that the presence of TNF-α led to increased expression of TNFα receptor 2 (TNFRSF1B) and RELA during chondrogenic differentiation of hADSCs.

Conclusions
TNF-α inhibits chondrogenic differentiation of human adipose stem cells by activating RELA expression through TNFRSF1B upregulating OPA1 expression thereby increasing mitochondrial fusion.
Clinical pharmacist intervention to improve medication safety for hip fracture patients through secondary and primary care settings: a nonrandomised controlled trial
Authors: Henriksen Ben Tore , Krogseth Maria , Andersen Randi Dovland , Davies Maren Nordsveen , Nguyen Caroline Thy , Mathiesen Liv , Andersson Yvonne 
Published: June 2023

Abstract
Background
Hip fracture patients face a patient safety threat due to medication discrepancies and adverse drug reactions when they have a combination of high age, polypharmacy and several care transitions. Consequently, optimised pharmacotherapy through medication reviews and seamless communication of medication information between care settings is necessary. The primary aim of this study was to investigate the impact on medication management and pharmacotherapy. The secondary aim was to evaluate implementation of the novel Patient Pathway Pharmacist intervention for hip fracture patients.

Methods
Hip fracture patients were included in this nonrandomised controlled trial, comparing a prospective intervention group (n = 58) with pre-intervention controls who received standard care (n = 50). The Patient Pathway Pharmacist intervention consisted of the steps: (A) medication reconciliation at admission to hospital, (B) medication review during hospitalisation, (C) recommendation for the medication information in the hospital discharge summary, (D) medication reconciliation at admission to rehabilitation, and (E) medication reconciliation and (F) review after hospital discharge. The primary outcome measure was quality score of the medication information in the discharge summary (range 0–14). Secondary outcomes were potentially inappropriate medications (PIMs) at discharge, proportion receiving pharmacotherapy according to guidelines (e.g. prophylactic laxatives and osteoporosis pharmacotherapy), and all-cause readmission and mortality.

Results
The quality score of the discharge summaries was significantly higher for the intervention patients (12.3 vs. 7.2, p < 0.001). The intervention group had significantly less PIMs at discharge (− 0.44 (95% confidence interval − 0.72, − 0.15), p = 0.003), and a higher proportion received prophylactic laxative (72 vs. 35%, p < 0.001) and osteoporosis pharmacotherapy (96 vs. 16%, p < 0.001). There were no differences in readmission or mortality 30 and 90 days post-discharge. The intervention steps were delivered to all patients (step A, B, E, F = 100% of patients), except step (C) medication information at discharge (86% of patients) and step (D) medication reconciliation at admission to rehabilitation (98% of patients).

Conclusion
The intervention steps were successfully implemented for hip fracture patients and contributed to patient safety through a higher quality medication information in the discharge summary, fewer PIMs and optimised pharmacotherapy.
Trial registration: NCT03695081.
Loosely synchronized activation of anterior cingulate cortical neurons for scratching response during histamine-induced itch
Authors: Lee Chiwoo , Oh Jihae , Lee Jae-Hyung , Kaang Bong-Kiun , Ko Hyoung-Gon 
Published: June 2023

AbstractItch is a distinctive sensation that causes a specific affection and scratching reaction. The anterior cingulate cortex (ACC) has been linked to itch sensation in numerous studies; however, its precise function in processing pruritic inputs remains unknown. Distinguishing the precise role of the ACC in itch sensation can be challenging because of its capacity to conduct heterologous neurophysiological activities. Here, we used in vivo calcium imaging to examine how ACC neurons in free-moving mice react to pruritogenic histamine. In particular, we focused on how the activity of the ACC neurons varied before and after the scratching response. We discovered that although the change in neuronal activity was not synchronized with the scratching reaction, the overall activity of itch-responsive neurons promptly decreased after the scratching response. These findings suggest that the ACC does not directly elicit the feeling of itchiness.
Effect of post-extubation high-flow nasal cannula combined with respiratory training versus conventional oxygen therapy on postoperative pulmonary complications in patients after major abdominal surgery: protocol for a single-centre randomized controlled trial
Authors: Jin Biao , Yao Mengjing , Shen Wenjuan , Fu Le , Liu Ping , Zheng Xu , Zhan Tiexiang , Luo Liang 
Published: June 2023

Abstract

Background
Nearly 234 million patients undergo surgery each year, and 1.3 million among them develop complications. Patients undergoing major upper abdominal surgery (operation time > 2 h) have a really high incidence of postoperative pulmonary complications (PPCs). The occurrence of PPCs seriously affects the outcomes of patients. High-flow nasal cannula (HFNC) is as effective as noninvasive ventilation (NIV) in preventing postoperative hypoxaemia and respiratory failure. Respiratory training using positive expiratory pressure (PEP) Acapella (Choice) has been shown to help patients with rapid recovery from postoperative atelectasis. However, no relevant randomized controlled studies have been conducted to clarify the effect of HFNC combined with respiratory training in the prevention of PPCs. This study aims to investigate whether the use of HFNC combined with respiratory training could reduce the incidence of PPCs within 7 days after major upper abdominal surgery compared to that with conventional oxygen therapy (COT).

Methods
This is a randomized controlled single-centre trial. A total of 328 patients who undergo major abdominal surgery will be included. Subjects who fulfil the eligible criteria will be randomly assigned into the combination treatment group (Group A) or COT group (Group B) after extubation. The interventions will begin within 30 min of extubation. Patients in Group A will receive HFNC for at least 48 h and respiratory training three times a day for at least 72 h. Patients in Group B will receive oxygen therapy through a nasal catheter or mask for at least 48 h. Our primary endpoint is the incidence of PPCs within 7 days, and the secondary outcome measures include 28-day mortality, reintubation rate, length of hospital stay, and all-cause mortality within 1 year.

Discussion
This trial would help provide evidence on the effectivity of applying HFNC combined with respiratory training for the prevention of PPCs in patients undergoing major upper abdominal surgery. The objective of this study is to determine the optimal treatment approach to improve the prognosis of patients undergoing surgery.

Trial registration
ChiCTR2100047146. Registered on 8 June 2021. Retrospectively registered.
A comparative study on the effect of dopamine vs phenylephrine in improving the cutaneous analgesic effect of mexiletine in rats
Authors: Zheng Kesong , Han Mingming , Kang Fang , Yang Chengwei , Li Juan 
Published: June 2023

Abstract
Background
The present study aimed to compare the effects of the combined administration of two adjuvants, dopamine and phenylephrine, on the cutaneous analgesic effect and duration of mexiletine in rats.

Methods
Nociceptive blockage was evaluated by the inhibition of response to skin pinpricks in rats via the cutaneous trunci muscle reflex (CTMR). After subcutaneous injection, the analgesic activities of mexiletine in the absence and presence of either dopamine or phenylephrine were assessed. Each injection was standardized into 0.6 ml with a mixture of drugs and saline.

Results
Subcutaneous injections of mexiletine successfully induced dose-dependent cutaneous analgesia in rats. The results revealed that rats injected with 1.8 μmol mexiletine exhibited 43.75% blockage (%MPE), while rats injected with 6.0 μmol mexiletine showed 100% blockage. Co-application of mexiletine (1.8 or 6.0 μmol) with dopamine (0.06, 0.60, or 6.00 μmol) elicited full sensory block (%MPE). Sensory blockage ranged from 81.25% to 95.83% in rats injected with mexiletine (1.8 μmol) and phenylephrine (0.0059 or 0.0295 μmol), and complete subcutaneous analgesia was observed in rats injected with mexiletine (1.8 μmol) and a higher concentration of phenylephrine (0.1473 μmol). Furthermore, mexiletine at 6.0 μmol completely blocked nociception when combined with any concentration of phenylephrine, while 0.1473 μmol phenylephrine alone exhibited 35.417% subcutaneous analgesia. The combined application of dopamine (0.06/0.6/6 μmol) and mexiletine (1.8/6 μmol) resulted in increased %MPE, complete block time, full recovery time, and AUCs compared to the combined application of phenylephrine (0.0059 and 0.1473 μmol) and mexiletine (1.8/6 μmol) (p < 0.001).

Conclusion
Dopamine is superior to phenylephrine in improving sensory blockage and enhancing the duration of nociceptive blockage by mexiletine.
Food addiction and binge eating disorder are linked to shared and unique deficits in emotion regulation among female seeking bariatric surgery
Authors: Ahmadkaraji Shahrzad , Farahani Hojjatollah , Orfi Koosha , Fathali Lavasani Fahimeh 
Published: June 2023

Abstract
Background
Problematic eating behaviors can indicate obesity-related problems. Food addiction (FA) is not classified as an official diagnosis. However, given the many commonalities between FA and binge-eating disorder (BED) within the context of obesity, it is imperative to conduct a comparative investigation. The current study aimed to identify overlapping and distinctive features in emotion dysregulation as an underlying mechanism and emotional eating as a clinical feature among four groups of females with obesity seeking bariatric surgery.

Methods
Data on emotion dysregulation and emotional eating were derived from the total 128 Females with obesity seeking bariatric surgery (Mage = 38.91 ± 10.59, MBMI = 42.10 kg/m2 ± 4.43) divided into four groups: those with FA (n = 35), BED (n = 35), BED + FA (n = 31) and a control group of individuals with obesity only (OB; n = 27), using well-established measures.

Results
Regarding descriptive statistics, the BED + FA group showed the highest levels of emotional dysregulation (M = 111.09) and emotional eating (M = 46.80), while the OB group acquired the lowest scores (M = 70.44 and M = 27.29, respectively). Univariate analyses of variance revealed significant differences between the four groups in terms of emotion dysregulation F(3, 124) = 24.63, p < .01 and emotional eating F(3, 124) = 26.26, p < .01. All of the emotion dysregulation domains revealed significant differences too. Pairwise comparisons using Bonferroni post hoc tests did not reveal any significant differences between BED + FA and BED groups, while all of our other hypotheses regarding this matter were confirmed.

Conclusions
The study found that individuals with obesity and comorbid BED exhibit greater emotional dysregulation compared to those with OB or FA, indicating a need to assess BED in individuals with obesity. Emotion dysregulation may be linked to increased BED and FA, but those with BED seem more affected by limited access to emotion regulation strategies. These findings support the notion that PEBs are associated with emotion dysregulation and underscore the need for tailored interventions that target emotion regulation skills before and after bariatric surgery.
Fast, precise and cloning-free knock-in of reporter sequences in vivo with high efficiency
Authors: Zhang Yiran , Marshall-Phelps Katy , de Almeida Rafael Góis 
Published: June 2023

ABSTRACT
Targeted knock-in of fluorescent reporters enables powerful gene and protein analyses in a physiological context. However, precise integration of long sequences remains challenging in vivo. Here, we demonstrate cloning-free and precise reporter knock-in into zebrafish genes, using PCR-generated templates for homology-directed repair with short homology arms (PCR tagging). Our novel knock-in reporter lines of vesicle-associated membrane protein (vamp) zebrafish homologues reveal subcellular complexity in this protein family. Our approach enables fast and efficient reporter integration in the zebrafish genome (in 10-40% of injected embryos) and rapid generation of stable germline-transmitting lines.