bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Digitalization on Nursing Practices using the Lean Approach
Authors: UZUN Lütfiye Nur , CERİT Birgül 
Published: August 2023

Objective: This study aimed to examine the effect of digitalization on nursing practices using the lean approach.
Method: This is a descriptive observational study. The data were collected using an activity chart to record nurses’ direct and indirect care practices and personal work and the Value Stream Map to compare and analyze work processes and determine both waste and value areas in the clinics. The study included a total of 15 nurses from two different internal medicine units of a hospital, including one digital clinic that uses digital applications for nurse work processes, and one partial digital clinic that has limited digital applications. The data were analyzed using current state value stream mapping, lean seven waste areas, and future state value stream mapping.
Results: In the digital clinic, 748.5 minutes were allocated for direct care, 129.1 minutes for indirect care, and 562.1 minutes for personal work. Total value-added time and non-value-added time was calculated as 1137.1 and 302.9 minutes, respectively. In the partial digital clinic, 623.9 minutes were allocated for direct care, 404.4 minutes for indirect care, and 411.1 minutes for personal work. Total value-added time and non-value-added time was calculated as 1006 and 433.4 minutes, respectively. According to the future state value stream map prepared in line with the improvement suggestions to eliminate unnecessary production, process, movement, transportation, waiting, and error waste in the current state of both clinics, it is predicted that 1354.3 minutes of value-added time will be obtained and non-value-added time will decrease to 85.7 minutes, by spending 910.9 minutes less on direct care, 190.2 minutes less on indirect care, and 259.2 minutes less on personal work.
Conclusion: The lean approach creates a repeated opportunity to review and improve processes. Analyzing nursing processes using the lean approach before and after digitalization and reviewing sources of both waste and value will contribute to implementing higher quality nursing care practices more effectively and safely and to using time and staff more efficiently.
Analyzing Common Market Options in the Scope of OIC
Authors: GULENAY Cemaleddin , YUMUŞAK İbrahim Güran 
Published: August 2023

This paper initially employs the gravity model in order to analyze the trade data of selected 23 OIC countries and its 4 different subgroups. Then it applies stochastic frontier analysis to the model to gain efficiency scores and uncapped trade potential among countries in order to determine whether the group would have trade creation effect once they go for a Common Market structure. According to the statistical results, the 23 country group gives statistically significant results while deriving a %62 uncapped trade potential among group countries. Additionally, the 13-country subgroup also gives statistically significant results while deriving a %59 uncapped trade potential among them.
While there are a number of studies which applies stochastic frontier analysis to the gravity model and gains efficiency scores, this study is the first to employ the method for OIC countries in order to determine the best possible country group for a Common Market without having trade diversion affect. The purpose of this study is to determine the Common Market options for Turkiye in the scope OIC in order to be a reference point for future Common Market initiatives.
The synthesis of copper-modified biochar from Elsholtzia Harchowensis and its electrochemical activity towards the reduction of carbon dioxide
Authors: Chen Shiqi , Liu Wei , Mei Ziwei , Li Haifu , Zhao Wenyu , Zhao Junkai , Tao Hong 
Published: August 2023

Phytoremediation techniques have been widely used in the treatment of heavy metal contaminated soils in recent years, but there is no effective post-treatment method for plant tissues containing heavy metals after remediation. Elsholtzia Harchowensis is a copper hyperaccumulator, commonly distributed in copper mining areas and often used for soil remediation of mine tailings. Moreover, copper-based catalysts are widely used in electrocatalytic reduction of carbon dioxide, which aims to convert carbon dioxide into useful fuels or chemicals. In this study, copper-modified biochar was prepared from Elsholtzia Harchowensis. Its specific surface area can reach as high as 1202.9 m2/g, with a certain porous structure and even distribution of copper on the amorphous carbon. Various products (such as carbon monoxide, methane, ethanol, and formic acid) could be obtained from the electrolytic reduction of carbon dioxide by using the as-prepared catalyst. Instantaneous current density of up to 15.3 mA/cm2 were achieved in 1.0 M KHCO3 solution at a potential of −0.82 V (vs. RHE). Electrolysis at a potential of −0.32 V (vs. RHE) for 8 h resulted in a stable current of about 0.25 mA/cm2, and the Faraday efficiency (FE) of carbon monoxide can reach as high as 74.6%. In addition, electrolysis at a potential of −0.52 V (vs. RHE) for 8 h led to a stable current of about 2.2 mA/cm2 and a FE of 8.7% for the C2 product. The rich variety of elements in plants leads to catalysts with complex structural and elemental characteristics as well, which facilitates the electrolytic reduction of carbon dioxide with a variety of useful products.
Tunable optical and semiconducting properties of eco-friendly-prepared reduced graphene oxide
Authors: Tene Talia , Jiménez-Gaona Yuliana , Campoverde-Santos Diana Katherine , Cevallos Yesenia , La Pietra Matteo , Vacacela Gomez Cristian , Scarcello Andrea , Straface Salvatore , Caputi Lorenzo S. , Bellucci Stefano 
Published: August 2023

Wide bandgap oxidized graphenes have garnered particular interest among the materials explored for these applications because of their exceptional semiconducting and optical properties. This study aims to investigate the tunability of the related properties in reduced graphene oxide (rGO) for potential use in energy conversion, storage, and optoelectronic devices. To accomplish this, we scrutinized crucial parameters of the synthesis process such as reduction time and temperature. Our findings demonstrate that controlling these parameters makes it possible to customize the optical bandgap of reduced graphene oxide within a range of roughly 2.2 eV–1.6 eV. Additionally, we observed that reduced graphene oxide has strong and superior absorption in the visible region, which is attributable to the existence of OFGs and defects. Notably, our results indicate that the absorption coefficients of reduced graphene oxide are up to almost three times higher (7426 ml mg−1 m−1) than those observed in dispersions of exfoliated graphene and graphene oxide (GO). To complement our findings, we employed several spectroscopic and morphological characterizations, including scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), X-ray diffraction (XRD), and electrical measurements. The implications of our results are significant for the development and design of future semiconductors for energy conversion and optoelectronic applications.
COVID-19 in congenital heart disease patients: what did we learn?!
Authors: Zareef Rana , Salameh Elio , Hammoud Rawan , Tannouri Theresia , Bitar Fadi , Arabi Mariam 
Published: August 2023

AimCOVID-19 pandemic has spread widely at unpreceded pace. Cardiovascular comorbidities are significantly correlated with severe and critical illness. Nevertheless, studies examining the impact of congenital heart disease on COVID-19 severity are scarce and restricted to hospitalized patients. This study aims to explore the course of COVID-19 illness, severity and complications in patients with concomitant congenital heart disease.MethodologyThis study is a cross sectional survey that includes patients with congenital heart disease who are registered at the Children Heart Center at the American University of Beirut Medical Center. The survey was conducted in the pediatric cardiology outpatient clinics or remotely via phone calls.ResultsA total of 238 patients participated in the study, of which 47.9% had suspected or confirmed diagnosis of SARS-CoV-2 infection. The majority of patients had mild illness. The symptoms ranged between rhinorrhea (15.6%), cough (15.6%), low-grade fever (11.2%), anosmia (2.7%), ageusia (2.5%), headache (9.8%), high-grade fever (8.5%), gastrointestinal symptoms (7.6%), lethargy (6.3%), muscle aches (5.6%), difficulty breathing (5.4%), joint pain (4.7%), and chills (4.7%). 20% of the surveyed patients required treatment at home. Hospitalization and oxygen therapy was required in 3.5% of cases, while only 1.5% demanded intensive care admission. Only one fatality was encountered.ConclusionCOVID-19 infection in pateints with congenital heart disease exhibits a mild to moderate course, and doesn't necessarily increase risk of complicated disease. No correlation could be found between specific congenital heart lesion and disease severity.
Energy efficiency optimization and carbon emission reduction targets of resource-based cities based on BiLSTM-CNN-GAN model
Authors: Wan Qunyan , Liu Jing 
Published: August 2023

IntroductionEnergy consumption and carbon emissions are major global concerns, and cities are responsible for a significant portion of these emissions. To address this problem, deep learning techniques have been applied to predict trends and influencing factors of urban energy consumption and carbon emissions, and to help formulate optimization programs and policies.MethodsIn this paper, we propose a method based on the BiLSTM-CNN-GAN model to predict urban energy consumption and carbon emissions in resource-based cities. The BiLSTMCNN-GAN model is a combination of three deep learning techniques: Bidirectional Long Short-Term Memory (BiLSTM), Convolutional Neural Networks (CNN), and Generative Adversarial Networks (GAN). The BiLSTM component is used to process historical data and extract time series information, while the CNN component removes spatial features and local structural information in urban energy consumption and carbon emissions data. The GAN component generates simulated data of urban energy consumption and carbon emissions and optimizes the generator and discriminator models to improve the quality of generation and the accuracy of discrimination.Results and discussionThe proposed method can more accurately predict future energy consumption and carbon emission trends of resource-based cities and help formulate optimization plans and policies. By addressing the problem of urban energy efficiency and carbon emission reduction, proposed method contributes to sustainable urban development and environmental protection.
Variable clinical expression of a Belgian TGFB3 founder variant suggests the presence of a genetic modifier
Authors: Perik Melanie H. A. M. , Govaerts Emmanuela , Laga Steven , Goovaerts Inge , Saenen Johan , Van Craenenbroeck Emeline , Meester Josephina A. N. , Luyckx Ilse , Rodrigus Inez , Verstraeten Aline , Van Laer Lut , Loeys Bart L. 
Published: August 2023

Background:TGFB3 variants cause Loeys–Dietz syndrome type 5, a syndromic form of thoracic aortic aneurysm and dissection. The exact disease phenotype is hard to delineate because of few identified cases and highly variable clinical representation.Methodology: We provide the results of a haplotype analysis and a medical record review of clinical features of 27 individuals from 5 different families, originating from the Campine region in Flanders, carrying the NM_003239.5(TGFB3):c.787G&gt;C p.(Asp263His) likely pathogenic variant, dbSNP:rs796051886, ClinVar:203492. The Asp263 residue is essential for integrin binding to the Arg-Gly-Asp (RGD) motif of the TGFβ3-cytokine.Results: The haplotype analysis revealed a shared haplotype of minimum 1.92 Mb and maximum 4.14 Mb, suggesting a common founder originating &gt;400 years ago. Variable clinical features included connective tissue manifestations, non-aneurysmal cardiovascular problems such as hypertrophic cardiomyopathy, bicuspid aortic valve, mitral valve disease, and septal defects. Remarkably, only in 4 out of the 27 variant-harboring individuals, significant aortic involvement was observed. In one family, a 31-year-old male presented with type A dissection. In another family, the male proband (65 years) underwent a Bentall procedure because of bicuspid aortic valve insufficiency combined with sinus of Valsalva of 50 mm, while an 80-year-old male relative had an aortic diameter of 43 mm. In a third family, the father of the proband (75 years) presented with ascending aortic aneurysm (44 mm).Conclusion: The low penetrance (15%) of aortic aneurysm/dissection suggests that haploinsufficiency alone by the TGFB3 variant may not result in aneurysm development but that additional factors are required to provoke the aneurysm phenotype.
Positive effects of dietary Clostridium butyricum supplementation on growth performance, antioxidant capacity, immunity and viability against hypoxic stress in largemouth bass
Authors: Li Peijia , Chen Xiaoying , Hou Dongqiang , Chen Bing , Peng Kai , Huang Wen , Cao Junming , Zhao Hongxia 
Published: August 2023

The effects of dietary supplementation of Clostridium butyricum (CB) on growth performance, serum biochemistry, antioxidant activity, mRNA levels of immune-related genes and resistance to hypoxia stress were studied in largemouth bass. Feed with CB0 (control, 0 CFU/kg), CB1 (4.3×108 CFU/kg), CB2 (7.5×108 CFU/kg), CB3 (1.5×109 CFU/kg) and CB4 (3.2×109 CFU/kg) CB for 56 days, and then a 3 h hypoxic stress experiment was performed. The results showed that dietary CB significantly increased the WGR (weight gain rate), SGR (specific growth rate), PDR (protein deposition rate) and ISI (Intestosomatic index) of largemouth bass (P&lt;0.05). Hepatic GH (growth hormone)/IGF-1 (insulin-like growth factor-1) gene expression was significantly upregulated in the CB3 and CB4 groups compared with the CB0 group (P&lt;0.05), while the FC (feed conversion) was significantly decreased (P&lt;0.05). Serum TP (total protein) and GLU (glucose) levels were significantly higher in the CB4 group than in the CB0 group (P&lt;0.05), while the contents of serum AST (aspartate transaminase), ALT (alanine transaminase), AKP (alkline phosphatase) and UN (urea nitrogen) in CB4 were significantly lower than those in CB0 (P&lt;0.05). T-AOC (total antioxidant capacity), SOD (superoxide dismutase), CAT (catalase), POD (peroxidase) and GSH-Px (glutathione peroxidase) activities were significantly higher in CB3 and CB4 groups than in CB0 group (P&lt;0. 05). The liver MDA (malondialdehyde) content of CB1, CB2, CB3 and CB4 groups was significantly higher than that of CB0 group (P&lt;0. 05). The relative expressions of IL-1β (interleukin 1β), TNF-α (tumor necrosis factor α) and TLR22 (toll-like receptor-22) genes in CB2, CB3 and CB4 groups were significantly lower than those in CB0 group (P&lt;0.05). The relative expression of IL-8 (malondialdehyde) and MyD88 (Myeloid differentiation factor 88) genes in the CB4 group was significantly lower than that in the CB0 group (P&lt;0.05). The liver LZM (lysozyme) content of CB2, CB3 and CB4 groups was significantly higher than that of CB0 group (P&lt;0. 05). The relative expression of IL-10 (interleukin 10) and TGF-β (transforming growth factor β) genes in the CB4 group was significantly higher than that in the CB0 group (P&lt;0.05). Under hypoxic stress for 3 h, the CMR of CB0 group was significantly higher than that of CB1, CB2, CB3 and CB4 groups (P&lt;0.05). Dietary CB can improve the growth performance and resistance to hypoxic stress of largemouth bass by regulating the expression of GH/IGF-1 gene and inflammatory factors and inhibiting TLR22/MyD88 signaling pathway.
Urine L-selectin reflects clinical and histological renal disease activity and treatment response in lupus nephritis across multi-ethnicity
Authors: Shen Yiwei , Vanarsa Kamala , Yin Zhihua , Zhang Ting , Castillo Jessica , Dai Min , Zou Linghua , Qin Ling , Wang Jieying , Guo Qiang , Saxena Ramesh , Petri Michelle , Shen Nan , Ye Zhizhong , Mohan Chandra , Ding Huihua 
Published: August 2023

ObjectiveThere is an urgent need for novel biomarkers in lupus nephritis (LN). We report a non-invasive urinary biomarker, L-selectin, in two independent multi-ethnic cohorts.MethodsuL-selectin was tested cross-sectionally in a Chinese cohort (n=255) and a US cohort (n=219) of SLE patients and controls using ELISA. A longitudinal cohort includes 20 active Chinese LN patients.ResultsuL-selectin was significantly increased in active LN patients compared to active non-renal SLE, inactive LN, inactive non-renal SLE, chronic kidney disease patients, and healthy controls. uL-selectin positively correlated with global and renal disease activities and was significantly associated with histological activity index and chronicity index (CI). Low uL-selectin was an independent predictor for high CI. During follow-up, uL-selectin levels decreased significantly in the complete renal remission group.ConclusionuL-selectin is a novel biomarker of disease activity and renal histopathology in LN across multiple ethnicities. It also reflects treatment response in LN patients during follow up.
The impact of EMA recommendations on the real-life use of Janus kinases inhibitors for rheumatoid arthritis: the Expanded Risk Score in RA as a tool to quantify the risk of cardiovascular events
Authors: Favalli Ennio Giulio , Cincinelli Gilberto , Germinario Sabino , Di Taranto Raffaele , Orsini Francesco , Maioli Gabriella , Biggioggero Martina , Ferrito Matteo , Caporali Roberto 
Published: August 2023

ObjectiveTo evaluate in patients with rheumatoid arthritis (RA) the impact of EMA recommendations on the real-life prescription of JAK inhibitors (JAKis) and the use of the Expanded Risk Score in RA (ERS-RA) to quantify the risk of major adverse cardiac events (MACE).MethodsWe conducted a retrospective analysis of real-life RA patients treated with JAKis. Patients were classified as ineligible for JAKis if they fulfilled EMA criteria (&gt;65 years-old, history of malignancy, or increased risk of venous thromboembolic events [VTE] or MACE including smoking). Risk of MACE was defined according to ORAL Surveillance trial inclusion criteria (ORALSURV) or by using the ERS-RA.ResultsOf 194 patients enrolled, 57.9% were classified as ineligible according to EMA definition (ORALSURV criteria). The most frequent reason for ineligibility was increased MACE risk (70.2%), followed by age&gt;65 (34.2%), smoking (30.7%), and increased risk of VTE (20.2%) or malignancy (7%). The use of the ERS-RA reduced the rate of patients carrying an increased CV risk to 18.6% (p&lt;0.001 versus ORALSURV), leading to 46.4% overall ineligible patients. Over a drug-exposure of 337 patient/years, we observed 2 VTE, one MACE (non-fatal stroke), and one solid malignancy (all in the group of patients classified as ineligible according to both the definitions).ConclusionsRigorous application of EMA indications in clinical practice could result in the exclusion of a large proportion of RA patients from treatment with JAKis. A proper quantification of the risk for MACE by dedicated tools as ERS-RA is advocated to better tailor the management of RA.
Factor VIII antibody immune complexes modulate the humoral response to factor VIII in an epitope-dependent manner
Authors: Batsuli Glaivy , Ito Jasmine , York Elizabeth S. , Cox Courtney , Baldwin Wallace , Gill Surinder , Lollar Pete , Meeks Shannon L. 
Published: August 2023

IntroductionSoluble antigens complexed with immunoglobulin G (IgG) antibodies can induce robust adaptive immune responses in vitro and in animal models of disease. Factor VIII immune complexes (FVIII-ICs) have been detected in individuals with hemophilia A and severe von Willebrand disease following FVIII infusions. Yet, it is unclear if and how FVIII-ICs affect antibody development over time.MethodsIn this study, we analyzed internalization of FVIII complexed with epitope-mapped FVIII-specific IgG monoclonal antibodies (MAbs) by murine bone marrow-derived dendritic cells (BMDCs) in vitro and antibody development in hemophilia A (FVIII-/-) mice injected with FVIII-IC over time.ResultsFVIII complexed with 2-116 (A1 domain MAb), 2-113 (A3 domain MAb), and I55 (C2 domain MAb) significantly increased FVIII uptake by BMDC but only FVIII/2-116 enhanced antibody titers in FVIII-/- mice compared to FVIII alone. FVIII/4A4 (A2 domain MAb) showed similar FVIII uptake by BMDC to that of isolated FVIII yet significantly increased antibody titers when injected in FVIII-/- mice. Enhanced antibody responses observed with FVIII/2-116 and FVIII/4A4 complexes in vivo were abrogated in the absence of the FVIII carrier protein von Willebrand factor.ConclusionThese findings suggest that a subset of FVIII-IC modulates the humoral response to FVIII in an epitope-dependent manner, which may provide insight into the antibody response observed in some patients with hemophilia A.
TCM “medicine and food homology” in the management of post-COVID disorders
Authors: Ng Chester Yan Jie , Bun Hung Hung , Zhao Yan , Zhong Linda L. D. 
Published: August 2023

BackgroundThe World Health Organization declared that COVID-19 is no longer a public health emergency of global concern on May 5, 2023. Post-COVID disorders are, however, becoming more common. Hence, there lies a growing need to develop safe and effective treatment measures to manage post-COVID disorders. Investigating the use of TCM medicinal foods in the long-term therapy of post-COVID illnesses may be beneficial given contemporary research’s emphasis on the development of medicinal foods.Scope and approachThe use of medicinal foods for the long-term treatment of post-COVID disorders is highlighted in this review. Following a discussion of the history of the TCM “Medicine and Food Homology” theory, the pathophysiological effects of post-COVID disorders will be briefly reviewed. An analysis of TCM medicinal foods and their functions in treating post-COVID disorders will then be provided before offering some insight into potential directions for future research and application.Key findings and discussionTCM medicinal foods can manage different aspects of post-COVID disorders. The use of medicinal foods in the long-term management of post-COVID illnesses may be a safe and efficient therapy choice because they are typically milder in nature than chronic drug use. These findings may also be applied in the long-term post-disease treatment of similar respiratory disorders.