bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flow rate accuracy of infusion devices within healthcare settings: a systematic review
Authors: Atanda Opeyemi , West Jonathan , Stables Tom , Johnson Chris , Merrifield Robert , Kinross James 
Published: July 2023

Background: One in five patients admitted to the hospital treated with intravenous (IV) fluid therapy suffer complications due to inappropriate administration. Errors have been reported in 13–84% of the preparation and administration of IV medications. The safe delivery of IV fluids requires precise rate administration. Objectives: This systematic review aims to determine the accuracy of infusion sets and devices and examine the factors that affect the flow rate accuracy of devices. Data Sources and Methods: Six databases (CINAHL, MEDLINE PubMed, EMBASE, Web of Science and Cochrane Database of systematic reviews) were systematically searched. Search terms included infusion pumps, infusion devices, flow rate accuracy, fluid administration rate, gravity-led infusion set and fluid balance. Studies were included if they examined infusion devices’ flow rate accuracy and drop rates for fluids or non-oncological drugs. Findings were tabulated and synthesised qualitatively. The quality of the studies was examined based on the design of the studies due to their heterogeneity. Results: Eight studies were included: Four studies were conducted on human subjects in the hospital environment; studies recruited 182 participants between the ages of 18 and 94 years. Two studies examined flow rate accuracy in recruited patients across 509 observations and 2387 drip hours. No trials prospectively assessed the accuracy of infusion pumps in the clinical domain, and no studies were reported on patient safety outcomes. Four studies examined the impact of mechanical and physiological factors on the flow rate accuracies of infusion devices. Height and back pressure simulated vibrating conditions, the viscosity of IV fluid and the positions of patients were reported to have a significant impact on infusion volume and flow rates of infusion devices. Additionally, giving sets that vary from the manufacturer’s specifications are reported to increase error percent by 10–20%. Conclusion: Infusion devices are an important source of error in administering IV fluids. Yet, there needs to be more prospective trial data to support their clinical accuracy and the impact on patient outcomes. Future flow variability and accuracy studies should capture their impact on patient safety and clinical outcomes.
Snake envenomation in three cats in South Korea
Authors: Lee Jeong-Min , Park Mi-Kyung , Lee Gi-Ppeum , Song Joong-Hyun , Song Kun-Ho 
Published: July 2023

Case series summary Three cats in South Korea were diagnosed with snake envenomation based on the appearance and location of bite wounds. Two cats were envenomed by the Gloydius species and one by an unidentified species. Clinical signs were detected, including local bite-site swelling, haemorrhagic discharge and necrosis. All three cats were given supportive treatment. An antivenom was administered to one cat, and the cat showed no adverse reactions. All cats survived, but skin necrosis remained a complication of the snake envenomation. This was observed during the 1-year follow-up period. Relevance and novel information Cats with snake envenomation are extremely rare in South Korea, and information regarding clinical details are limited. This study is the first to describe the clinical details and prognosis of feline snake envenomation in South Korea.
Status and associated factors of gerontological nurse specialists’ core competency: a national cross-sectional study
Authors: Chen Hongxiu , Pu Lihui , He Shengyuan , Hu Xiuying , Chen Qian , Huang Zhaojing , Cheng Linan 
Published: July 2023

Abstract
Background
Nurses’ core competency directly affects patients’ safety and health outcomes. Gerontological nurse specialists play an essential role in improving older adults’ health status. However, little is known about their core competency level and the factors influencing core competency. Therefore, this study aimed to investigate the status of core competency and factors influencing the core competency of gerontological nurse specialists in China.

Methods
A multicenter cross-sectional study was conducted on gerontological nurse specialists certified by province-level or above organizations across China between March 2019 and January 2020. The Revised Core Competency Evaluation Instrument for Gerontological Nurse Specialists was used to measure participants’ core competency. The median, frequencies, and percentages were used to describe participants’ characteristics and level of core competency. Multivariate stepwise regression analysis was applied to analyze the factors influencing core competency.

Results
The median score of gerontological nurse specialists’ core competency was 3.84, and professional development skills and research and analysis decision-making skills had the lowest scores among the dimensions. The multivariate stepwise regression analysis showed that individual-level factors (i.e., working experience length of geriatric nursing and attitudes toward caring for older adults), employer-level factors (i.e., departments, job responsibilities, the degree of satisfaction toward the attention and support and the promotion rules provided by the hospital or department), and training-associated factors (i.e., economic zone where training organizations are located and the degree to which the training content met clinical needs) are independently associated with gerontological nurse specialists’ core competency level (P < 0.05).

Conclusions
This study showed that gerontological nurse specialists’ core competency needs further improvements, especially regarding professional development skills and research and analysis decision-making skills. Additionally, individual-, training-, and employer-level factors could influence their core competency level, indicating that interventions targeting these factors could be applied to improve the core competency of gerontological nurse specialists.
Barriers and needs in mental healthcare of adults with autism spectrum disorder in Germany: a qualitative study in autistic adults, relatives, and healthcare providers
Authors: Dückert Sophia , Gewohn Petia , König Hannah , Schöttle Daniel , Konnopka Alexander , Rahlff Pascal , Erik Frank- , Vogeley Kai , Schulz Holger , David Nicole , Peth Judith 
Published: July 2023

Abstract
Background
Autism refers to a neurodevelopmental condition with characteristic impairments in social interaction and communication, restrictive and repetitive behaviors, as well as difficulties in sensory information processing and daily living skills. Even though symptoms persist from early childhood throughout the lifespan and often require long-term support, there is a lack of mental health services that sufficiently meet the needs of autistic adults. Previous evidence suggested individual, professional and structural barriers to healthcare for autistic adults. Here, using a peer research approach, we sought to systematically investigate barriers and needs in mental healthcare of autistic adults in Germany at the three relevant levels (individual, professional, structural) and from three relevant perspectives (autistic adults, relatives and healthcare providers), in order to obtain specific recommendations for optimized healthcare.

Methods
Maximum variation sampling was used to account for the complexity of the research field. Semi-structured, open-ended interviews were conducted with autistic adults (n = 15) and focus groups with relatives/partners (n = 12), and healthcare providers of several professions (n = 15). Data analysis was performed using the codebook approach of thematic analysis.

Results
Poor mental healthcare of autistic adults in Germany was characterized by six central and overarching themes: (i) lack of knowledge about autism, (ii) a need for increased participation/involvement, (iii) consideration of autism-specific needs in treatment, (iv) lack of services, (v) limited access to services, and (vi) improvement of stakeholder collaboration. Themes were similarly reported across participants, emphasizing dissatisfaction in all stakeholders.

Conclusions
We identified major barriers to mental healthcare for autistic adults in Germany that affect autistic adults, but are also of concern to relatives and healthcare providers. Our results point to specific and generic areas for improvement, independent of stakeholder perspectives, which could guide future development of needs- and evidence-based services, recommendations and guidelines of mental healthcare for people with autism across the lifespan.

Trial registration
This study protocol was preregistered at the Open Science Framework (https://osf.io/5x8pg).
Developing an integrated model of care for vulnerable populations living with non-communicable diseases in Lebanon: an online theory of change workshop
Authors: Truppa Claudia , Ansbro Éimhín , Willis Ruth , Zmeter Carla , El Khatib Aya , Roberts Bayard , Aebischer Perone Sigiriya , Perel Pablo 
Published: July 2023

AbstractIntroductionThe Syrian crisis, followed by a financial crisis, port explosion, and COVID-19, have put enormous strain on Lebanon’s health system. Syrian refugees and the vulnerable host population have a high burden of Non-communicable Diseases (NCD) morbidity and unmet mental health, psychosocial and rehabilitation needs. The International Committee of the Red Cross (ICRC) recently introduced integrated NCD services within its package of primary care in Lebanon, which includes NCD primary health care, rehabilitation, and mental health and psychosocial support services. We aimed to identify relevant outcomes for people living with NCDs from refugee and host communities in northern Lebanon, as well as to define the processes needed to achieve them through an integrated model of care. Given the complexity of the health system in which the interventions are delivered, and the limited practical guidance on integration, we considered systems thinking to be the most appropriate methodological approach.MethodsA Theory of Change (ToC) workshop and follow-up meetings were held online by the ICRC, the London School of Hygiene and Tropical Medicine and the American University of Beirut in 2021. ToC is a participatory and iterative planning process involving key stakeholders, and seeks to understand a process of change by mapping out intermediate and long-term outcomes along hypothesised causal pathways. Participants included academics, and ICRC regional, coordination, and headquarters staff.ResultsWe identified two distinct pathways to integrated NCD primary care: a multidisciplinary service pathway and a patient and family support pathway. These were interdependent and linked via an essential social worker role and a robust information system. We also defined a list of key assumptions and interventions to achieve integration, and developed a list of monitoring indicators.DiscussionToC is a useful tool to deconstruct the complexity of integrating NCD services. We highlight that integrated care rests on multidisciplinary and patient-centred approaches, which depend on a well-trained and resourced team, strong leadership, and adequate information systems. This paper provides the first theory-driven road map of implementation pathways, to help support the integration of NCD care for crises-affected populations in Lebanon and globally.
Implementation of a web-based partnership support program for improving the quality of life of male patients undergoing infertility treatment: a pilot feasibility study
Authors: Asazawa Kyoko , Jitsuzaki Mina , Mori Akiko , Ichikawa Tomohiko , Kawanami Masami , Yoshida Atsumi 
Published: July 2023

AbstractObjectivesIn this study, we aimed to implement and evaluate a Web-based partnership support program to enhance the QoL of male patients undergoing infertility treatment. We conducted a pilot study involving 41 infertile couples from September to October of 2021. We used a quasi-experimental design (pre-test and post-test with comparison) involving purposive sampling. A subgroup analysis was conducted to determine which demographics of the participants would benefit from the program.ResultsThirty-four participants (mean age 37.3 years; duration of infertility treatment 14.5 months) were included in the final analysis (follow-up rate 82.9%). Although there was no significant increase in the participants’ QoL under the Web-based partnership support program, the assisted reproductive technology group (P = 0.03), the no medical history group (P = 0.032), and the with experience of changing hospital group (P = 0.027) showed a significant increase in the relational subscale scores of the QoL before and after the program. The majority of the participants (n = 29; 85.3%) expressed satisfaction with the support program. Participation in the Web-based partnership support program may improve the QoL of some men undergoing infertility treatment.Trial registrationRetrospectively registered at the University Hospital Medical Information Network on 26 January 2023 (ID: UMIN0000 000050153).
Alzheimer’s pathology is associated with altered cognition, brain volume, and plasma biomarker patterns in traumatic encephalopathy syndrome
Authors: Asken Breton M. , Tanner Jeremy A. , Gaynor Leslie S. , VandeVrede Lawren , Mantyh William G. , Casaletto Kaitlin B. , Staffaroni Adam M. , Fonseca Corrina , Shankar Ranjani , Grant Harli , Smith Karen , Lago Argentina Lario , Xu Haiyan , La Joie Renaud , Cobigo Yann , Rosen Howie , Perry David C. , Rojas Julio C. , Miller Bruce L. , Gardner Raquel C. , Wang Kevin K. W. , Kramer Joel H. , Rabinovici Gil D. 
Published: July 2023

Abstract
Background
Traumatic encephalopathy syndrome (TES) is a clinical phenotype sensitive but non-specific to underlying chronic traumatic encephalopathy (CTE) neuropathology. However, cognitive symptoms of TES overlap with Alzheimer’s disease (AD), and features of AD pathology like beta-amyloid (Aβ) plaques often co-occur with CTE, making clinical-to-pathological conclusions of TES diagnoses challenging. We investigated how Alzheimer’s neuropathological changes associated with cognition, brain volume, and plasma biomarkers in patients with repetitive head impacts (RHI)/TES, clinical AD, or typically aging controls.

Methods
We studied 154 participants including 33 with RHI/TES (age 61.5 ± 11.5, 100% male, 11/33 Aβ[ +]), 62 with AD and no known prior RHI (age 67.1 ± 10.2, 48% male, 62/62 Aβ[ +]), and 59 healthy controls without RHI (HC; age 73.0 ± 6.2, 40% male, 0/59 Aβ[ +]). Patients completed neuropsychological testing (memory, executive functioning, language, visuospatial) and structural MRI (voxel-based morphometry analysis), and provided plasma samples analyzed for GFAP, NfL, IL-6, IFN-γ, and YKL-40. For cognition and plasma biomarkers, patients with RHI/TES were stratified as Aβ[ +] or Aβ[ −] and compared to each other plus the AD and HC groups (ANCOVA adjusting for age and sex). Differences with at least a medium effect size (Cohen’s d > 0.50) were interpreted as potentially meaningful.

Results
Cognitively, within the TES group, Aβ[ +] RHI/TES performed worse than Aβ[-] RHI/TES on visuospatial (p = .04, d = 0.86) and memory testing (p = .07, d = 0.74). Comparing voxel-wise brain volume, both Aβ[ +] and Aβ[ −] RHI/TES had lower medial and anterior temporal lobe volume than HC and did not significantly differ from AD. Comparing plasma biomarkers, Aβ[ +] RHI/TES had higher plasma GFAP than HC (p = .01, d = 0.88) and did not significantly differ from AD. Conversely, Aβ[ −] RHI/TES had higher NfL than HC (p = .004, d = 0.93) and higher IL-6 than all other groups (p’s ≤ .004, d’s > 1.0).

Conclusions
Presence of Alzheimer’s pathology in patients with RHI/TES is associated with altered cognitive and biomarker profiles. Patients with RHI/TES and positive Aβ-PET have cognitive and plasma biomarker changes that are more like patients with AD than patients with Aβ[ −] RHI/TES. Measuring well-validated Alzheimer’s biomarkers in patients with RHI/TES could improve interpretation of research findings and heighten precision in clinical management.
Design of PFC converter with stand-alone inverter for microgrid applications
Authors: Boddu Sujith , Ghosh Arnab 
Published: July 2023

AbstractThe proposed topology is used to connect a single-phase and a three-phase renewable energy resources to the grid. The single-phase source is coupled to a single-phase PFC boost converter, which enhances the input PF utilizing two feedback loops: outer voltage loop control and inner current loop control. The basic hightlight is to study the PFC converter in microgrid application where renewables are integrated with the systems. The basic aim is to observe the overall performance of the converters with various disturbances such as load variations, etc. Here, the single-phase and three-phase stand-alone inverter is used to get the the output of the PFC boost converters. A symmetrical sinusoidal output voltage waveform should be produced and maintained by the inverter. The three-phase source is also coupled to a PFC buck converter, which enhances the input PF utilizing two feedback loops: outer voltage loop control and inner current loop control. The single-phase stand-alone inverter receives the output of the PFC buck converter. The transformer receives the outputs of both the inverters as it is a multi-winding high-frequency transformer and offers isolation between the grid and the source. The pulses for the switches in the single-phase inverter coupled stand-alone system were generated using a sinusoidal pulse width modulation approach. Both the PI controllers are implemented to maintain the regulations. The simulation results are achieved by varying the load, maintaining a constant voltage, and observing whether the current varies as the load changes. It also provides the efficacy of the study.
The Impact of Input and Output Farm Subsidies on Farmer Welfare, Income Disparity, and Consumer Surplus
Authors: Tang Christopher S. , Wang Yulan , Zhao Ming 
Published: July 2023

Because of a growing population and shrinking arable land, the world is facing a global food crisis. One important solution could be to subsidize farmers to sustain their production so that they can produce more food for consumers and earn more money for themselves. An efficient subsidy program should also aim to reduce income inequality among farmers, as measured by the Gini coefficient of farmers’ income. In this paper, we examine and compare the effects of input and output farm subsidy programs. The input subsidy reduces the farmers’ input purchasing costs, whereas the output subsidy reduces the farmers’ output processing costs. By considering a continuum of infinitesimal price-taking farmers who are heterogeneous in their average yield rates, our equilibrium analysis of a game-theoretical model yields three results. First, both subsidy schemes reduce the aggregate income inequality measured by the Gini coefficient. However, they create the following “opposite” effects: the input subsidy decreases the income gap among farmers (under mild conditions), whereas the output subsidy increases it. Second, farmers with low yield rates prefer the input subsidy, whereas farmers with high yield rates prefer the output subsidy. Third, the output subsidy scheme is more effective in improving the total farmer income than the input subsidy scheme, whereas the input subsidy scheme is more effective in reducing income disparities and improving consumer surplus than the output subsidy scheme. Our results provide new insights for policymakers who are crafting subsidy schemes. This paper was accepted by Jayashankar Swaminathan, operations management. Funding: This work was supported by the National Natural Science Foundation of China [Grants 71971184, 71972025, and 72032001], the Departmental General Research Fund of the Hong Kong Polytechnic University [Grant P0008761], and the Research Grants Council of Hong Kong [Grants 15504615 and 15500820]. Supplemental Material: The online appendix and data are available at https://doi.org/10.1287/mnsc.2023.4850 .
Providing strategic information during a public health emergency: lessons learned during the COVID-19 pandemic in Germany
Authors: Bahr Thurid , Klein Nina , Fehr Angela , Fischer Hanna-Tina , Hanefeld Johanna , Iskandarani Dounia , Pozo Martin Francisco , Weishaar Heide , El Bcheraoui Charbel 
Published: July 2023

Background:Timely strategic information is essential for decision makers to mount an effective public health response to infectious disease outbreaks, and public health actors must find an effective way to supply it. The Centre for International Health Protection at the Robert Koch Institute (Germany’s national public health institute) developed a three-pronged approach to processing and supplying strategic information on the international state of the COVID-19 pandemic to the German Federal Ministry of Health: monitoring and analysis of international public health and social measures (PHSM); screening, validating, analysing and reporting the global epidemiological situation; and in-depth analyses and syntheses of COVID-19 evidence.
Aims and objectives:We discuss the approach taken by the Centre to provide strategic information and challenges and adaptations during the information provision process. We then distil lessons that will be critical to improve strategic information provision for evidence-informed decision making in future public health emergencies.
Key conclusions:Several lessons can be derived from the Centre’s experience. Timeliness of evidence is essential for enabling decision makers to tailor a public health response to an outbreak, and requires sufficient and skilled staff to process evidence. Evidence formats should be adapted to decision makers’ information needs; this requires open channels of communication to understand needs. Access to high-quality international data hinges on data sharing across countries and the capacity to collect and process such data in many countries. Heeding the lessons will strengthen pandemic response.
Addressing Balance of Payment Disequilibrium Through Non-Oil Export and Exchange Rate Stability in Nigeria: An Empirical Investigation
Authors: Agu Christian , Obodoechi Divine Ndubuisi , Nebo Ifeanyi Kennedy 
Published: July 2023

Abstract
This study investigates the impact of non-oil export on the Nigeria balance of payment between 1981 and 2020. To achieve the broad objective, two specific objectives were set out, viz: investigate the impact of non-oil export on the Nigeria balance of payment; and examine the level of impact of exchange rate volatility on balance of payment in Nigeria. Using the Autoregressive Distributed Lagged (ARDL) and Error Correction Model (ECM), the findings of the study show that non-oil exports have had a strong positive impact on Nigeria’s balance of payment within the period under study both in the short and long-run. It shows that a percentage increase in non-oil export increases the balance of payment (surplus) by 31.47 % in the long-run. However, exchange rate was shown to have had a negative blow on Nigeria’s balance of payment, though not statistically significant. The study therefore recommend among others that, for Nigeria to enjoy a surplus balance of payment, which is one of her major macroeconomic goals, there is the need to shift attention to the non-oil sector which has always been the main source of her foreign exchange earnings prior to the discovery of crude oil.
Estimates for certain class of rough generalized Marcinkiewicz functions along submanifolds
Authors: Ali Mohammed , Al-Qassem Hussain 
Published: July 2023

Abstract
We establish certain delicate

L

p

{L}^{p}

bounds for a class of generalized Marcinkiewicz integral operators along submanifolds with rough kernels. These bounds allow us to use Yano’s extrapolation method to prove the

L

p

{L}^{p}

boundedness of the aforementioned integral operators under very weak assumptions on the kernels. Our results in this article improve and generalize many previously known results.