bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Lean Six Sigma to improve timeliness of clinical laboratory test results in a university hospital in Egypt
Authors: Ibrahim Islam , Sultan Magda , Yassine Omaima Gaber , Zaki Adel , Elamir Hossam , Guirguis Wafaa 
Published: February 2022

Purpose
Healthcare environments are highly complex and full of variation and inefficiency. However, variation and inefficiency can be measured and improved, providing better quality care at a lower cost. This study aims to report the application of Lean Six Sigma (LSS) in a haematology laboratory in a university hospital in Egypt.

Design/methodology/approach
The authors used case study research. Applying the define, measure, analyse, improve and control phases of the DMAIC methodology together with lean tools, the problem was identified, the process mapped, the causes analysed and improvements implemented.

Findings
Results show that LSS can be successfully implemented in challenging public sector healthcare settings. Management commitment, generating and implementing ideas from frontline staff, using a variety of quality tools and previous LSS training were all key to success. This is evidence that the LSS methodology is adaptable to any process, people or place.

Originality/value
There are no publications on LSS implementation in health care in Egypt. This study demonstrates the successful use of LSS in a university hospital (public sector) in a developing country, sharing insight into the facilitators and barriers in a real context with others in the healthcare field.
The impact of uncertainty-fear against COVID-19 on corporate social responsibility and labor practices issues
Authors: Kholaif Moustafa Mohamed Nazief Haggag Kotb , Ming Xiao 
Published: February 2022

PurposeThe research aims to profoundly investigate the correlation between uncertainty-fear against COVID-19, corporate social responsibility (CSR) and labor practices issues based on ISO 26000.Design/methodology/approachPartial least squares structural equation modeling (PLS-SEM) was adopted for data analysis and hypotheses testing on a sample of 304 managers and employees in the Egyptian small and medium enterprises (SMEs).FindingsPreliminary results indicate that the uncertainty-fear against COVID-19 positively affects CSR practices in SMEs. CSR positively impacts labor practices dimensions. However, CSR has an insignificant effect on the social protection and work condition dimension. Also, CSR has a significant mediating role in the association between uncertainty-fear toward the pandemic and labor practices. But, this relation is insignificant regarding social protection and work condition dimension.Practical implicationsManagers could develop a consistent strategy for applying CSR practices, providing clear information and focusing on their procedures to protect their workforce during COVID-19. Governments should impose policies to guarantee that all employees have the same opportunities and not discriminate directly or indirectly in any labor practice.Originality/valueBased on both the “stakeholder” and “social-cognitive” theories, this study shed light on the optimistic side of the COVID-19 pandemic, as it also brings the concepts of social responsibility, sustainability and green practices back into the light, which helps in solving labor issues.
Forging a new corporate engagement
Authors: Hirsch Peter Buell 
Published: February 2022

Purpose
This paper aims to highlight the need for corporations to engage politically to create a more functional capitalist system.

Design/methodology/approach
Selective review of relevant economic and sociopolitical developments is presented in this paper.

Findings
There is a growing movement among economists and commentators to hold corporations accountable for political engagement which they ignore at their peril.

Originality/value
While individual strands of this story have been discussed before, the subject has never been handled from the perspective of corporate reputation in a comprehensive manner.
Crystal structure optimization approach to problem solving in mechanical engineering design
Authors: Talatahari Babak , Azizi Mahdi , Talatahari Siamak , Tolouei Mohamad , Sareh Pooya 
Published: February 2022

PurposeIn this paper, the authors aim to examine and comparatively evaluate a recently-developed metaheuristic called crystal structure algorithm (CryStAl) – which is inspired by the symmetries in the internal structure of crystalline solids – in solving engineering mechanics and design problems.Design/methodology/approachA total number of 20 benchmark mathematical functions are employed as test functions to evaluate the overall performance of the proposed method in handling various functions. Moreover, different classical and modern metaheuristic algorithms are selected from the optimization literature for a comparative evaluation of the performance of the proposed approach. Furthermore, five well-known mechanical design examples are utilized to examine the capability of the proposed method in dealing with challenging optimization problems.FindingsThe results of this study indicated that, in most cases, CryStAl produced more accurate outputs when compared to the other metaheuristics examined as competitors.Research limitations/implicationsThis paper can provide motivation and justification for the application of CryStAl to solve more complex problems in engineering design and mechanics, as well as in other branches of engineering.Originality/valueCryStAl is one of the newest metaheuristic algorithms, the mathematical details of which were recently introduced and published. This is the first time that this algorithm is applied to solving engineering mechanics and design problems.
Plant foliar nutrient response to active layer and water table depth in warming permafrost soils
Authors: Jasinski Briana L. , Hewitt Rebecca E. , Mauritz Marguerite , Miller Samantha N. , Schuur Edward A. G. , Taylor Meghan A. , Walker Xanthe J. , Mack Michelle C. 
Published: February 2022

AbstractThawing permafrost in northern latitudes has led to deepening active soil layers and fluctuating water tables. This could increase plant access to permafrost‐derived nitrogen (N), phosphorus (P) and other nutrients such as calcium (Ca) and magnesium (Mg), and subsequently increase plant productivity and ecosystem carbon storage and nutrient cycling. We hypothesized that deepening permafrost thaw and water table fluctuations would alter species‐specific foliar N:P ratios. Since there is often more P, Ca and Mg available in the deeper mineral soil layers and more N available in the shallow organic layers, we expected that deeply rooted species would decrease foliar N:P ratios due to root proximity to thawing mineral soil, and plants with shallower rooting systems mostly in the organic layer would increase foliar N:P ratios.We assessed foliar and canopy nutrient responses of seven vascular plant species in moist acidic tussock tundra vegetation in the northern foothills of the Alaska Range to variable soil thaw depths and water table levels induced by either a natural thermokarst gradient or a winter warming snow fence experiment.In both the natural thermokarst gradient and the warming experiment, wet or deeply thawed areas generally led to an increase in foliar nutrient concentrations and greater canopy mass and canopy nutrients. For the majority of species, foliar N:P ratios remained proportional or decreased in deciduous species in wet sites, with the exception of one shallowly rooted species that increased foliar N:P ratio in deeply thawed sites. Overall, plant acquisition of P was more related to water table level than to thaw depth, and water table modulated the canopy biomass response of the species at the warming experiment.Synthesis. Foliar N:P ratios suggest that plant species in this tussock tundra ecosystem are either remaining or becoming more N‐limited as thaw depth deepens and water table level rises, indicating that P is not likely to become the primary limiting nutrient with the progression of permafrost thaw. However, the amount of deeply thawed, wet areas that develop on the landscape as permafrost thaws will be important contributors in the total movement of nutrients above‐ground.
3D‐3D facial registration method applied to personal identification: Does it work with limited portions of faces? An experiment in ideal conditions
Authors: Gibelli Daniele , Palamenghi Andrea , Poppa Pasquale , Sforza Chiarella , Cattaneo Cristina , De Angelis Danilo 
Published: February 2022

AbstractPersonal identification of faces represents a challenging issue, especially for what concerns the quantification of the comparison. The 3D‐3D superimposition approach proved to distinguish between matches and mismatches. However, the potential of this procedure applied to cases where only parts of faces are visible still has to be verified. This study aimed at verifying the applicability of a 3D‐3D procedure to faces divided into three thirds. 3D models of fifty male subjects acquired through stereophotogrammetry were used. The 3D facial models were divided into upper, middle, and lower thirds and registered onto other models belonging to the same and different individuals according to the least point‐to‐point distance. In total, 50 matches and 50 mismatches were analyzed. RMS value (root mean square) of point‐to‐point distance between the two facial surfaces was calculated through VAM® software. Statistically significant differences between matches and mismatches in each facial third were assessed through Mann–Whitney test (p < 0.05). On average, RMS value in matches was 0.32 ± 0.12 mm in upper third, 0.36 ± 0.15 mm in middle third, and 0.40 ± 0.20 mm in lower third, respectively; in mismatches, RMS value was 1.40 ± 0.32 mm in upper third, 1.96 ± 0.58 mm in middle third, and 2.39 ± 0.90 mm in lower third, respectively. Differences in RMS values between matches and mismatches were significantly different for all facial thirds, without superimpositions (p < 0.01). This study shows that the existing 3D‐3D superimposition methods may be useful also when only a limited portion of face is visible in ideal conditions. Their application to forensic cases of identification still needs to be verified.
A comprehensive look at explicit screening tools for potentially inappropriate medication: A systematic scoping review
Authors: Schiavo Geovana , Forgerini Marcela , Lucchetta Rosa Camila , Mastroianni Patrícia de Carvalho 
Published: February 2022

AbstractObjectiveTo map explicit screening tools to identify potentially inappropriate medication (PIMs), and the characteristics and limitations of these tools. Including PIMs–interactions, therapeutic alternatives and the clinical management of PIMs.MethodsA systematic scoping review was conducted in PubMed and Scopus (until May 2021). The number of PIMs listed as essential drugs was identified in Model List of Essential Medicines by the World Health Organization (WHO) and National List of Essential Medicines (Brazil). In addition to reporting the therapeutic alternatives and clinical management proposed by explicit screening tools to identify PIMs, we suggested our own alternatives for the PIMs most frequently reported.ResultsFifty‐eight tools reported 614 PIMs and 747 PIMs–interactions. Limited overlap between the tools was observed: 123 (69.1%) of 178 therapeutic alternatives proposed by the tools were considered inappropriate by other tools, and 222 (36.1%) of the 614 PIMs identified were named as being inappropriate only once. Only 21 tools were developed by a Delphi panel technique associated with systematic review. The PIMs listed as essential medication in Brazil and by the WHO were 30.6% and 23.3% of the total reported, respectively. For the most‐cited PIMs, such as non‐steroidal anti‐inflammatory drugs, tricyclic antidepressants and benzodiazepines, we suggested the use of non‐opioid and opioid analgesics; agomelatine, bupropion or moclobemide; and melatonin, respectively.ConclusionsThe next stages in the development of explicit screening tools to identify PIMs include achieving more consensus between them and improving their applicability across countries. Further, it is recommended that tools include PIMs risks and advice on therapeutic alternatives.
GIPR gene expression in testis is mouse specific and can impact male mouse fertility
Authors: Killion Elizabeth A. , Hussien Rajaa , Shkumatov Artem , Davies Rhian , Lloyd David J. , Véniant Murielle M. , Lebrec Herve , Fort Madeline M. 
Published: February 2022

AbstractBackgroundGlucose‐dependent insulinotropic polypeptide receptor (Gipr) gene expression has been reported in mouse spermatids and Gipr knockout male mice have previously been reported to have decreased in vitro fertilization, although the role of Gipr signaling in male mouse fertility is not well understood.ObjectivesThe purposes of these studies were to determine the role of glucose‐dependent insulinotropic polypeptide receptor in male fertility using Gipr knockout mice and anti‐glucose‐dependent insulinotropic polypeptide receptor antibody‐treated wild‐type mice and to determine if the expression of Gipr in mouse testes is similar in non‐human and human primates.Methods and materialsAdiponectin promoter‐driven Gipr knockout male mice (GiprAdipo–/–) were assessed for in vitro and in vivo fertility, sperm parameters, and testicular histology. CD1 male mice were administered an anti‐glucose‐dependent insulinotropic polypeptide receptor antibody (muGIPR‐Ab) prior to and during mating for assessment of in vivo fertility and sperm parameters. Expression of Gipr/GIPR mRNA in the mouse, cynomolgus monkey, and human testes was assessed by in situ hybridization methods using species‐specific probes.ResultsGiprAdipo–/– male mice are infertile in vitro and in vivo, despite normal testis morphology, sperm counts, and sperm motility. In contrast, administration of muGIPR‐Ab to CD1 male mice did not impact fertility. While Gipr mRNA expression is detectable in the mouse testes, GIPR mRNA expression is not detectable in monkey or human testes.DiscussionThe infertility of GiprAdipo–/– male mice correlated with the lack of Gipr expression in the testis and/or adipocyte tissue. However, as administration of muGIPR‐Ab did not impact the fertility of adult male mice, it is possible that the observations in genetically deficient male mice are related to Gipr deficiency during development.ConclusionOur data support a role for Gipr expression in the mouse testis during the development of sperm fertilization potential, but based on gene expression data, a similar role for glucose‐dependent insulinotropic polypeptide receptor in non‐human primate or human male fertility is unlikely.
Following targeted routine antenatal anti‐D prophylaxis, almost half of the pregnant women had undetectable anti‐D prophylaxis at delivery
Authors: Sørensen Kirsten , Stjern Helena Eriksson , Karlsen Bente Anita Grande , Tomter Geir , Ystad Inger , Herud Ida , Bævre Mette Silihagen , Llohn Abid Hussain , Akkök Çiğdem Akalın 
Published: February 2022

AbstractIntroductionIn September 2016, a nationwide targeted routine antenatal anti‐D prophylaxis program was implemented in Norway. The prophylaxis (anti‐D immunoglobulin) aims to cover the whole third trimester and is administered in gestational week 28 to RhD‐negative women who carry RhD‐positive fetuses. However, in many women, antibody screening at delivery does not detect anti‐D immunoglobulin. The goal of this study was to investigate the presumable role of dose and timing of antenatal anti‐D immunoglobulin administration in non‐detectable prophylaxis at the time of delivery.Material and methodsIn this retrospective observational study, RhD‐negative pregnant women who gave birth at Oslo University Hospital and Akershus University Hospital between January 2017 and December 2019 were analyzed. Women who received antenatal anti‐D immunoglobulin (1500 IU at Oslo University Hospital and 1250 IU at Akershus University Hospital) when fetal RHD genotyping at gestational week 24 predicted an RhD‐positive fetus were included if an antibody screen at delivery was available. Data from the blood bank, maternity information systems, and electronic patient records were used.ResultsAnalysis of the 984 RhD‐negative women at the two hospitals revealed that 45.4% had non‐detectable anti‐D at delivery. A significant difference between the two hospitals was observed: 40.5% at Oslo University Hospital (n = 509) and 50.7% at Akershus University Hospital (n = 475) (p = 0.001). The proportion with non‐detectable anti‐D increased to 56.0 and 75.3%, respectively (p = 0.008) in the group of women who gave birth 12 weeks after routine antenatal anti‐D prophylaxis. Significantly fewer women had detectable anti‐D at delivery when the lower anti‐D immunoglobulin dose (1250 IU) was administered antenatally. Multiple logistic regression indicated that the time interval between routine antenatal anti‐D prophylaxis and delivery, in addition to anti‐D dose, were significantly associated with detectable anti‐D at delivery (p < 0.001).ConclusionsWe do not know which RhD‐negative pregnant women, despite antenatal anti‐D prophylaxis, are at risk of RhD alloimmunization, when antibody screening is negative at delivery. Administration of antenatal prophylaxis should probably be moved closer to delivery, since the risk of fetomaternal hemorrhage is higher during the last weeks of the third trimester.
Diaphragm pacing in spinal cord injury can significantly decrease mechanical ventilation in multicenter prospective evaluation
Authors: Onders Raymond P. , Khansarinia Saeid , Ingvarsson Páll E. , Road Jeremy , Yee John , Dunkin Brian , Ignagni Anthony R. 
Published: February 2022

AbstractBackgroundCervical spinal cord injury (SCI) can lead to dependence on mechanical ventilation (MV) with significant morbidity and mortality. The diaphragm pacing system (DPS) was developed as an alternative to MV.MethodsWe conducted a prospective single‐arm study of DPS in MV‐dependent patients with high SCI and intact phrenic nerves. Following device acclimation, pacing effectiveness to provide ventilation was evaluated. The primary endpoint was the number who could use DPS to breathe for 4 continuous hours without MV. Secondary endpoints included the number of patients that could use DPS 24 h/day free of MV and the ability of DPS to maintain clinically acceptable tidal volume (Vt). In addition, we conducted a meta‐analysis that included the prospective study along with data from four recently published studies to evaluate DPS hourly use.ResultsFifty‐three patients were implanted in the prospective study. Most were male (77.4%) with a median time from injury to treatment of 28.3 (IQR: 12.1, 83.3) months. Four‐ and 24‐h use occurred in 96.2% (95% CI: 87.0%, 99.5%) and 58.5% (95% CI: 44.1%, 74.9%), respectively. Four and 24‐h results in the meta‐analysis cohort (n = 196) exhibited similar results 92.2% (95% CI: 82.6%, 96.7%) and 52.7% (95% CI: 36.2%, 68.6%) using DPS for 4 and 24 h, respectively. DPS use significantly exceeded the calculated basal tidal volume requirements by a mean of 48.4% (95% CI: 37.0, 59.9%; p < 0.001).ConclusionsThis study demonstrates that in most ventilator‐dependent patients, diaphragm pacing can effectively supplement or completely replace the need for MV and support basal metabolic requirements.
Review article: hepatitis B—current and emerging therapies
Authors: Yardeni David , Ghany Marc G. 
Published: February 2022

AbstractBackgroundThe hepatitis B virus (HBV) affects an estimated 290 million individuals worldwide and is responsible for approximately 900 000 deaths annually, mostly from complications of cirrhosis and hepatocellular carcinoma. Although current treatment is effective at preventing complications of chronic hepatitis B, it is not curative, and often must be administered long term. There is a need for safe, effective, finite duration curative therapy.AimOur aim was to provide a concise, up to date review of all currently available and emerging treatment options for chronic hepatitis B.MethodsWe conducted a search of PubMed, clinicaltrials.gov, major meeting abstracts and pharmaceutical websites for publications and communications on current and emerging therapies for HBV.ResultsCurrently approved treatment options for chronic hepatitis B include peginterferon alpha‐2a and nucleos(t)ide analogues. Both options do not offer a ‘complete cure’ (clearance of covalently closed circular DNA (cccDNA) and integrated HBV DNA) and rarely achieve a ‘functional cure’ (hepatitis B surface antigen (HBsAg) loss). An improved understanding of the viral lifecycle, immunopathogenesis and recent advances in drug delivery technologies have led to many novel therapeutic approaches that are currently being evaluated in clinical trials including targeting of viral entry, cccDNA, viral transcription, core protein, and release of HBsAg and HBV polymerase. Additionally, novel immunological approaches that include targeting the innate and adaptive immune system and therapeutic vaccination are being pursued.ConclusionThe breadth and scope of novel therapies in development hold promise for regimen/s that will achieve functional cure.
Model to predict on‐treatment restoration of functional HBV‐specific CD8+ cell response foresees off‐treatment HBV control in eAg‐negative chronic hepatitis B
Authors: Peña‐Asensio Julia , Calvo Henar , Miquel Joaquín , Sanz‐de‐Villalobos Eduardo , González‐Praetorius Alejandro , Torralba Miguel , Larrubia Juan‐Ramón 
Published: February 2022

SummaryBackgroundHepatitis B virus (HBV)‐specific CD8+ cell response restoration during nucleos(t)ide analogue (NUC) treatment could lead to off‐treatment HBV control in e‐antigen‐negative chronic hepatitis B (CHBe(−)).AimTo predict this response with variables involved in T‐cell exhaustion for use as a treatment stopping tool.MethodsIn NUC‐treated CHBe(−) patients, we considered a functional response in cases with HBV‐specific CD8+ cells against core and polymerase HBV epitopes able to proliferate and secrete type I cytokines after antigen encounter. We performed a logistic regression model (LRM) to predict the likelihood of developing this response, based on patient age (subrogate of infection length), HBsAg level, NUC therapy starting point and duration (antigenic pressure). We discontinued treatment and assessed HBV DNA dynamics, HBsAg decline and loss during off‐treatment follow‐up according to LRM likelihood.ResultsWe developed an LRM that predicted the presence of a proliferative type I cytokine‐secreting CD8+ cell response, which correlated positively with treatment duration and negatively with treatment initiation after the age of 40 years and with age adjusted by HBsAg level. We observed a positive correlation between LRM probability and intensity of proliferation, number of epitopes with the functional proliferating response and type I cytokine secretion level. Off‐treatment, HBsAg loss, HBsAg decline >50% and HBV control were more frequent in the group with >90% LRM probability.ConclusionsShort‐term low‐level antigen exposure and early long‐term NUC treatment influence the restoration of a functional HBV‐specific CD8+ cell response. Based on these predictors, a high likelihood of detecting this response at treatment withdrawal is associated with off‐treatment HBV control and HBsAg decline and loss.