bluuebunny/crossref_metadata_2025_split huggingface dataset:
Economic evaluation of a collaborative model of pharmaceutical care in an Irish hospital: cost-utility analysis
Authors: Kirwan Gráinne , O'Leary Aisling , Walsh Cathal , Grimes Tamasine 
Published: March 2023

Background: A complex, collaborative pharmaceutical care intervention including medication review and reconciliation demonstrated a statistically significant reduction in the prevalence of discharge medication error and improved quality of prescribing for hospitalised adults. This study sought to assess the cost-effectiveness of this intervention. Methods: A cost-utility analysis was undertaken using a decision-analytic framework. The evaluation was undertaken from the Health Service Executive’s perspective, the payer for primary and secondary care settings. Direct costs associated with managing hypothetical harm consequent to intercepted discharge medication error and consequences in terms of quality-adjusted life years loss were key input parameters. Analysis was structured within a decision tree model in Microsoft Excel® populated with consequences as utilities, estimated costs using macro- and micro-costing approaches, and event probabilities generated from the original study. Incremental analysis, one-way and probabilistic sensitivity analyses were performed. Results: The results of analysis for the base-care demonstrated that the intervention dominated standard care with an incremental cost-effectiveness ratio of -€36,537.24/quality-adjusted life year, indicating that the intervention is less costly and more effective. The one-way and probabilistic sensitivity analyses both demonstrated that the intervention dominated standard care. The model was relatively robust to variation in input parameters through one-way sensitivity analysis. The cost of discharge medication error and effect parameters relating to standard care were most sensitive to change. Discussion: The analysis demonstrated the cost-effectiveness of a complex pharmaceutical intervention which will support decision-making regarding implementation. This is the first cost-utility analysis of a complex, collaborative pharmaceutical care intervention, adding to the scant evidence-base in the field.
Factors affecting women's sexual life after oncological treatment of breast cancer
Authors: Kamińska Barbara , Białczyk Aleksandra , Kunicka Aleksandra 
Published: March 2023

Introduction and purpose: Breast cancer is the most common malignant tumor among Polish women. However, with the development of medicine, new methods of treating and detecting breast cancer are accessible. In consequence, there is a significant decrease in mortality and an increase in the number of detected cases. Therefore, the needs and difficulties faced by women with breast cancer, including those related to their sexuality, require a different approach. This paper aims to present the impact of breast cancer treatment on women's sexuality based on a review of the available literature.
Description of the state of knowledge: There are many methods of treating breast cancer, but mastectomy, one of the most radical therapies, is performed in almost half of the patients. There is a high percentage of psychological complications associated with this procedure, among others, since female breasts are perceived as attributes of femininity. Women diagnosed with breast cancer face concerns about self-esteem and body image. Breast cancer has a notable impact on sexuality, and cancer diagnosis and oncological cancer treatment are associated with several physical and psychosocial uncertainties. The lack of a native breast can cause a sense of imperfection, shame, and fear of rejection by the partner.
Summary: Health professionals should concentrate on the sexual health of women with breast cancer because it is frequently overlooked and assigned less priority. The return of sexual satisfaction and acceptance of the new body appearance should be a component of successful breast cancer treatment.
The effectiveness of negative pressure wound therapy compared to the traditional method in the treatment of diabetic foot
Authors: Bogucka Julia , Brzyska Anna , Bojarska Małgorzata , Burda Bartosz 
Published: March 2023

Introduction and objective: Diabetes is one of the most common metabolic diseases in the world. Diabetic foot ulcers, which are often the result of the disease, are undoubtedly a nursing challenge. Negative pressure wound therapy (NPWT) is a new therapeutic method supporting wound healing, which has been useful in patients with diabetic foot. The purpose of this study is to compare the effectiveness of negative pressure therapy in comparison to the standard method in the treatment of diabetic foot.
Review methods: In February 2023, articles found in the Medline (Pubmed) and Google Scholar databases were selected by using the following keywords: negative pressure wound therapy; VAC therapy; traditional dressing; standard moist wound care; diabetic foot.
Brief description of the state of knowledge: NPWT has been proven to be associated with reduced healing time and faster appearance of granulation tissue, which is a sign of wound healing. Patients using this method require fewer dressing changes and surgical cleanings. Negative pressure therapy reduces the time to rehospitalisation and the risk of amputation or resection of the diabetic foot.
Summary: Negative pressure wound therapy is more effective in the treatment of diabetic foot ulcers than traditional therapy. Despite the costs associated with NPWT being higher, the method proves to be more profitable. It is important to remember about good therapy technique and proper selection of patients.
The quantity, quality, and daily distribution of protein supplementation in maximizing muscle hypertrophy induced by resistance training
Authors: Pawlina Mateusz , Ziętara Karolina , Orzechowska Aleksandra , Oskroba Aleksander , Pawełczak Natalia , Raksa Karolina , Zielonka Bartłomiej , Kowalczyk Ilona , Pawłowski Piotr , Stawikowski Cezary 
Published: March 2023

Introduction and purpose: Resistance training (RT) combined with sufficient protein intake (PI) stimulates muscle hypertrophy. There are many factors determining the influence of PI on muscle hypertrophy. The aim of the study is to analyze the current state of knowledge on protein supplementation in the context of optimizing the effects of RT-induced muscles hypertrophy.
Description of the state of knowledge: The quality of protein supplements is a factor that has a significant impact on the degree to which they increase MPS. Protein meals containing all EAAs will stimulate MPS most potently. The most important factor determining the effectiveness of protein supplementation is the amount of protein intake per day in relation to body weight. PI in amounts greater than ~1.6 g/kg b.w./day does not further increase the rate of fat free mass gains induced by RE. Supplementing more protein at breakfast than at dinner is more effective in increasing muscle mass gain in response to RT.
Summary: The quantity, quality and source of protien supplements, that are daily administered, are important factors contributing to the efectiveness of the supplementation. Distributing the doses of protein supplement throughout the day and consuming greater amount of protein for breakfast rather than dinner may also be beneficial in terms of augmenting muscle protein synthesis (MPS). Optimizing these conditions is conducive to achieving a positive net protein balance, which result in improving RT-induced muscle mass gain.
Awareness of pregnant women about proper nutrition habits and rational diet
Authors: Mandryk Izabela , Węgrzyn Izabella 
Published: March 2023

IntroductionProper nutrition of a woman before conception and during pregnancy determines the proper course of pregnancy, fetal development and the health of the mother and child in the future. A properly balanced diet must cover the increased demand for energy and provide the right amount and quality of nutrients.
AimThe aim of the study was to verification the nutritional knowledge of pregnant womendepending on age, place of residence and number of pregnancies.
ResultsThe survey involved 66 women between 19 and 40 years old (average age 30.50±4.30 years). 40.9% of the women were under 30 (N=27), and 59.1% of the respondents were 30 or older (N=39). 54.5% of women lived in cities (N=36), and 45.5% of the respondents lived in rural areas (N=30). Women who were pregnant for the first time accounted for 48.5% of the respondents (N=32). According to their own opinion, the majority of women (62.1%) stated that their knowledge of nutrition during pregnancy was good, and 28.8% assessed their knowledge as very good. The change in diet after pregnancy was confirmed by 81.8% of the surveyed women, in particular the changes concerned eating more vegetables and fruits (79.6%), avoiding highly processed products (61.1%) and avoiding sweets (50.0%). Most of the respondents (97.0%) indicated that they had eliminated products from their diet, i.e. alcohol (100.0%), Fast Food (57.8%) or sushi (60.9%). Snacks were eaten by 92.4% of the respondents, most often fruits (83.6%) and vegetables (63.9%).
ConclusionNutritional awareness of pregnant women is at a good level. Appropriate changes in their diet are declared by the majority of the surveyed women. It would be advisable to educate women planning pregnancy and pregnant women about the specific effects of essential nutrients and the risk of their deficiencies.
Rationalized Timetabling Using a Simulation Tool: A Paradigm Shift in Indian Railways
Authors: Anoop K. P. , Reddy A. Madhukumar , Bhatia Mandeep Singh , Jain Amit Kumar , Gopalakrishnan R. , Salekin Merajus , Singh Samay Pritam , Satwik R. V. , Pulapadi Sudarshan , Bobade Chandrashekhar , Kumar I. Sidhartha , Gopalakrishnan Shivasubramanian , Appaiah Kumar , Rangaraj Narayan , Belur Madhu N. 
Published: March 2023

During the year 2020, Indian Railways undertook an extensive timetabling exercise for its entire network. The timetable for its six principal routes known as the golden quadrilateral + diagonals (GQD) was generated using a rail traffic simulation tool. The simulation tool and the methodology had to be customized to handle the complex technical requirements of the GQD network, which spans more than 9,000 km. Challenges related to using and integrating data into the simulator also had to be addressed. This was the first time that a simulation software tool of this kind was used for timetabling in Indian Railways, and hence, there were uncertainties regarding the timely delivery, which gave rise to additional challenges to the overall effort. This paper focuses on these challenges and the managerial and human aspects of this massive timetabling exercise. It also explains how this project leverages the benefits of combining top-down and bottom-up approaches in timetabling and how it sets a new paradigm for network-wide timetabling in Indian Railways. History: This paper was refereed. Funding: This work was supported financially through the Indian Railways–sponsored project titled “Implementing Zero Based Timetabling for Major IR Routes by IIT Bombay through Simulation Model of Mixed Rail Traffic” [Grant RD/0120-WRAIL00-002].
Dynamic adjustable metalens based on a stretchable substrate with a double-layer metal microstructure
Authors: Li Xiangjun , Zhao Yang , Yan Dexian , Hou Xiaomei , Yang Ji , Liu Huadong 
Published: March 2023

Based on the impedance-matching theory, a double-layer metal structure
dynamical focusing cylindrical metalens with a stretchable substrate
was designed at the operation frequency of 0.1 THz. The
diameter, initial focal length, and NA of the metalens were
80 mm, 40 mm, and 0.7, respectively. The transmission
phase of the unit cell structures could cover 0−2π by changing the size of the metal
bars, and then the different unit cells were spatially arranged as the
designed phase profile for the metalens. When the stretching range of
the substrate was about 100%–140%, the focal length changed from
39.3 mm to 85.5 mm, the dynamic focusing range was about
117.6% of the minimum focal length, and the focusing efficiency
decreases from 49.2% to 27.9%. Then, by rearranging the unit cell
structures, a dynamically adjustable bifocal metalens was numerically
realized. Using the same stretching ratio, compared to a single focus
metalens, the bifocal metalens can provide a larger focal length
control range.
Time-aware deterministic bandwidth allocation scheme in TDM-PON for time-sensitive industrial flows
Authors: Su Chen , Zhang Jiawei , Ji Yuefeng 
Published: March 2023

A programmable logic controller deployed in the cloud or edge cloud (cloud PLC) contributes to flexible and scalable industrial manufacturing processes. For the industrial Internet, a time-division multiplexing passive optical network is a promising access technology for connecting cloud PLC and industrial devices. Time-sensitive (TS) industrial applications such as motion control and mobile robotics impose strict delay and jitter requirements, pursuing deterministic transmission capability, that is, guaranteeing that the upper bounds on delay and jitter of the TS industrial flow meet its requirements. However, traditional bandwidth allocation schemes aim to leverage statistical multiplexing to improve bandwidth resource utilization efficiency, so it guarantees only the “average delay/jitter” of the service and cannot meet the deterministic requirements of the TS industrial flow. This paper presents a time-aware deterministic bandwidth allocation (TA-DetBA) scheme to satisfy the deterministic transmission of TS industrial flows. To this purpose, first, we constrain the position of the transmission window (i.e., bandwidth) allocated by optical line termination to the optical network unit according to the arrival characteristics (i.e., flow arrival time and flow cycle) and requirements (i.e., delay and jitter) of the flow. Subsequently, we propose an integer linear programming scheduling model and a greedy-based time slot equalization heuristic scheduling algorithm to improve schedulability and reduce the average delay of best-effort flows. Simulation results show that our proposed TA-DetBA scheme guarantees the deterministic delay and jitter of TS industrial flow. Compared with the fixed bandwidth allocation (FBA) scheme, the average resource utilization efficiency of the TA-DetBA scheme is improved by up to 20.6% higher than FBA.
Impact of He+N2 concentration on self-modulated laser wakefield acceleration driven by pulses of a few TW
Authors: Maldonado Edison Puig , Samad Ricardo Elgul , Zuffi Armando Valter Felicio , dos Santos Jhonatha Ricardo , Dias Vieira Nilson 
Published: March 2023

Laser wakefield electron acceleration with ionization injection has rarely been studied in the low-power, self-modulated case. We performed simulations of such regimes using a mixture of He and N2 gases and driven by laser pulses with peak powers around 1 TW. Analyses show the generation of electron bunches with an average energy of up to 70 MeV, an energy spread as low as 18%, and an emittance as good as a fraction of a mm mrad. The obtained electron beam parameters lead to several trade-offs as a function of N2 concentration, allowing for many different designs.
Raman based on-chip photonic quantizers for ADCs
Authors: Pradhan Akash Kumar , Sen Mrinal , Datta Tanmoy 
Published: March 2023

In this work, a model for an on-chip all-photonic analog to digital converter is proposed. Here, the underlying quantization technique is based on slicing the supercontinuum generated inside the highly nonlinear nanocrystal embedded slotted photonic crystal waveguide at specifically chosen wavelengths. It is shown that although both the broadening and splitting of the spectrum can be used for four level quantization, only broadening can be used for designing eight (or more) level quantization. The highly nonlinear device system makes the eight level quantization scheme incremental within a footprint of 50×20µm2, which can convert 0–11 mW analog optical power to respective quantization levels. Although both Kerr and stimulated Raman scattering (SRS) contribute to the generation of the supercontinuum, the giant SRS gain of the silicon nanocrystal essentially outweighs that of the Kerr, with, consequently, unprecedented miniaturization in both operating power and footprint.
A co-designed website (FindWays) to improve mental health literacy of parents of children with mental health problems: Protocol for a pilot randomised controlled trial
Authors: Peyton Daniel , Wadley Greg , Hackworth Naomi , Grobler Anneke , Hiscock Harriet 
Published: March 2023

Background
Mental health problems, such as behavioural and emotional problems, are prevalent in children. These problems can have long lasting, detrimental effects on the child, their parents and society. Most children with a mental health problem do not receive professional help. Those that do get help can face long wait times. While waiting, parents want to learn how they can help their child. To address this need, we co-designed a new website to help parents find ways of helping their child’s mental health problem while waiting to get specialist help.

Objectives
To assess the acceptability and feasibility of a new co-designed website, FindWays, through a pilot randomised controlled trial. The protocol is registered with ISRCTN (ISRCTN64605513).

Methods
This study will recruit up to 60 parents of children aged two-twelve years old referred to a paediatrician for behavioural and/or emotional problems. Participants will be randomly allocated by computer generated number sequence to either the intervention or control group. Intervention group participants will receive access to the FindWays website to help them manage their child’s mental health problem while they wait to see the paediatrician. Acceptability and feasibility will be assessed over the 4-month intervention through mixed methods including: recruitment, adherence, retention, net promoter score (quantitative measures) and semi-structured interviews to gain an in-depth understanding of parents’ experience and potential adverse effects (qualitative measure). Secondary outcomes measured by parent survey at 4-months post randomisation include child mental health, parent mental health, impact of the child’s mental health problem on their functioning and family, and health service use and associated costs.

Results
Recruitment commenced June 2022 with publication expected in October 2023.

Conclusion
This study will provide novel data on the acceptability and feasibility of a new website co-designed with parents to help them find ways of managing their child’s behaviour and emotions.
Coaching doctors to improve ethical decision-making in adult hospitalised patients potentially receiving excessive treatment: Study protocol for a stepped wedge cluster randomised controlled trial
Authors: Benoit Dominique D. , Vanheule Stijn , Manesse Frank , Anseel Frederik , De Soete Geert , Goethals Katrijn , Lievrouw An , Vansteelandt Stijn , De Haan Erik , Piers Ruth ,   on behalf of the CODE study group
Published: March 2023

Background
Fast medical progress poses a significant challenge to doctors, who are asked to find the right balance between life-prolonging and palliative care. Literature indicates room for enhancing openness to discuss ethical sensitive issues within and between teams, and improving decision-making for benefit of the patient at end-of-life.

Methods
Stepped wedge cluster randomized trial design, run across 10 different departments of the Ghent University Hospital between January 2022 and January 2023. Dutch speaking adult patients and one of their relatives will be included for data collection. All 10 departments were randomly assigned to start a 4-month coaching period. Junior and senior doctors will be coached through observation and debrief by a first coach of the interdisciplinary meetings and individual coaching by the second coach to enhance self-reflection and empowering leadership and managing group dynamics with regard to ethical decision-making. Nurses, junior doctors and senior doctors anonymously report perceptions of excessive treatment via the electronic patient file. Once a patient is identified by two or more different clinicians, an email is sent to the second coach and the doctor in charge of the patient. All nurses, junior and senior doctors will be invited to fill out the ethical decision making climate questionnaire at the start and end of the 12-months study period. Primary endpoints are (1) incidence of written do-not-intubate and resuscitate orders in patients potentially receiving excessive treatment and (2) quality of ethical decision-making climate. Secondary endpoints are patient and family well-being and reports on quality of care and communication; and clinician well-being. Tertiairy endpoints are quantitative and qualitative data of doctor leadership quality.

Discussion
This is the first randomized control trial exploring the effects of coaching doctors in self-reflection and empowering leadership, and in the management of team dynamics, with regard to ethical decision-making about patients potentially receiving excessive treatment.
Denial of legal abortion in Nepal
Authors: Puri Mahesh C. , Raifman Sarah , Daniel Sara , Karki Sunita , Maharjan Dev Chandra , Ahlbach Chris , Diamond-Smith Nadia , Foster Diana Greene 
Published: March 2023

Introduction
In Nepal, abortion is legal on request through 12 weeks of pregnancy and up to 28 weeks for health and other reasons. Abortion is available at public facilities at no cost and by trained private providers. Yet, over half of abortions are provided outside this legal system. We sought to investigate the extent to which patients are denied an abortion at clinics legally able to provide services and factors associated with presenting late for care, being denied, and receiving an abortion after being denied.

Methods
We used data from a prospective longitudinal study with 1835 women aged 15–45. Between April 2019 and December 2020, we recruited 1,835 women seeking abortions at 22 sites across Nepal, including those seeking care at any gestational age (n = 537) and then only those seeking care at or after 10 weeks of gestation or do not know their gestational age (n = 1,298). We conducted interviewer-led surveys with these women at the time they were seeking abortion service (n = 1,835), at six weeks after abortion-seeking (n = 1523) and six-month intervals for three years. Using descriptive and multivariable logistic regression models, we examined factors associated with presenting for abortion before versus after 10 weeks gestation, with receiving versus being denied an abortion, and with continuing the pregnancy after being denied care. We also described reasons for the denial of care and how and where participants sought abortion care subsequent to being denied. Mixed-effects models was used to accounting clustering effect at the facility level.

Results
Among those recruited when eligibility included seeking abortion at any gestational age, four in ten women sought abortion care beyond 10 weeks or did not know their gestation and just over one in ten was denied care. Of the full sample, 73% were at or beyond 10 weeks gestation, 44% were denied care, and 60% of those denied continued to seek care after denial. Nearly three-quarters of those denied care were legally eligible for abortion, based on their gestation and pre-existing conditions. Women with lower socioeconomic status, including those who were younger, less educated, and less wealthy, were more likely to present later for abortion, more likely to be turned away, and more likely to continue the pregnancy after denial of care.

Conclusion
Denial of legal abortion care in Nepal is common, particularly among those with fewer resources. The majority of those denied in the sample should have been able to obtain care according to Nepal’s abortion law. Abortion denial could have significant potential implications for the health and well-being of women and their families in Nepal.