bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Systemised Approach to Smart Pump Integration with an Electronic Medical Record System – An Australian Experience
Authors: Dixon Madonna , Rattle Amelia , Yeoh Yen Nie , Hamid Ubai , Ngo Julie , Khalil Viviane 
Published: May 2022

ABSTRACT

Background:
Smart pump integration with Electronic Medical Record (EMR) systems offers an opportunity to introduce a closed-loop medication management system in hospital settings. Closed-loop medication management systems minimise human errors, improve nursing workflow and efficiency, and optimise patient safety. In this descriptive observational study, we will outline some of the key steps required to successfully integrate a smart pump dataset with EMR computerised provider/physician order entry (CPOE) systems.

Methodology:
The triple C model of consultation, collaboration and consolidation was used for the development and implementation of a smart infusion pump and EMR integration at a 160-bed specialist Australian hospital. This systemised approach allowed a methodical implementation process and ensured sustainability of the intervention. Key stakeholders were identified and engaged to establish a working group to align medication orders in the EMR and the smart pump library to ensure readiness of pump-EMR integration phase. Validation testing was conducted for each EMR infusion order to check successful auto-programming to a corresponding medication on the smart pump. The steps discussed are applicable to all hospital settings with EMR systems and smart pumps.

Results:
The smart pump dataset contained a total of 217 unique medications and fluids that were tested for interoperability. A total of 87% (188/217) passed full record testing. The remaining 13 % (29/217) were excluded from interoperability. The 13% of medication and fluids that were excluded was due to the medication being prescribed on paper (i.e. medicines with desensitisation regimen), the medication unable to be prescribed as a medicine in the EMR (i.e. blood products), the smart pump limitations to build safety limits around only one medicine (i.e. multi-additive infusions) or excluded due to specialist hospital formulary.

Conclusion:
This study using a systemised approach, that described and identified key stages and phases required for integration of smart pump infusions with an EMR system, to create a closed-loop medication management system in an Australian hospital setting.

Highlights
The Effect of Psychoreligy Dzikir Intervention on Self Efficacy and Blood Pressure on Hypertension
Authors: Adivtian Ragayasa  , Sylvina Rahmawati  , Emdat Suprayitno  
Published: May 2022

Background: Hypertension is a chronic disease condition that causes impaired self-efficacy and increased blood pressure. One of the non-pharmacological therapies that can do is dzikir or dhikr therapy.
Purpose: This study aimed to determine the effect of remembrance therapy on self-efficacy and blood pressure in hypertension. The study was an experimental study using a Randomized Pre Test-Post Test Control Group Design in hypertensive patients receiving psycho religious therapy. The subjects in this study were all hypertensive patients in the working area of ??the Teja Pamekasan Health Center, as many as 20 people.
Methods: The selected sample in this study was some hypertensive patients taken by simple random sampling. Blood pressure measurements were carried out twice before psycho religious therapy and two weeks after psycho religious therapy. Psychoreligious therapy is a series of dhikr and prayer by saying the letter "Al-Fatihah" 7 times, then "Istighfar" 100 times, followed by solawat "Allahumma shall 'ala Muhammad wa Ali Muhammad" as much as 100 (Solawat "Ya sayyidi ya Rasulullah " as much as 1000 times) which does once every day. Mann Whitney U Test analyzed data.
Results: The results of calculations using the Mann Whitney U Test statistical test showed a difference in blood pressure at the time of pre and post. The significance values indicate this at pre and post are 0.002 and 0.005.
Conclusion: Psychoreligious therapy in remembrance can increase self-efficacy and reduce blood pressure in hypertensive patients in the elderly posyandu in the working area of ??the Teja Pamekasan Health Center.
Impact of Dysmenorrhea on Female Adolescents
Authors: Karmacharya Poonam , Bhattarai Anshu , Tiwari Indu , Singh Surjit 
Published: May 2022

IntroductionDysmenorrhea is a common condition that usually presents itself with cramps or a dull ache, mostly in the abdominal region. Alongside the cramps, it is also common to suffer from other symptoms such as nausea, diarrhoea, constipation, mood swings and headaches. Dysmenorrhea has been considered a leading cause of occupational and college absenteeism among women, yet little is known about its actual impact. The objective of this study is to understand the impact ofdysmenorrhea in the young female medical students.
MethodsA cross-sectional study was carried out in 100 undergraduate students of Manipal college of Medical Sciences, Pokhara, Nepal. Standardized Self-reporting questionnaires were used to obtain relevant data. Data entry and analysis were done in SPSS 20.
ResultsOut of 100 females, Majority of girls, 84 out of 100 reported different grades of dysmenorrhea. The study also showed strong association of dysmenorrhea with the family history and the severity of dysmenorrhea was highly associated with college absenteeism and regularity of the cycle. (p-value<=0.005). Other symptoms like stomach cramp, anxiety, irritability, difficult in concentration and insomnia were also significantly associated with dysmenorrhea (p<0.005) while stress was strongly associated with the dysmenorrhea. (p<0.000). However, Backaches, painful breast, nausea, skin disorders, appetite and forgetfulness were not associated with dysmenorrhea (p>0.005).
ConclusionsDysmenorrhea is found to be highly prevalent and has a negative impact on physical, social and academic activities of medical female students. The effect of dysmenorrhea is very wide, therefore managing the condition is very important.
Trend and Usage of Internet for Self Directed Learning in Phase I MBBS Students in an Urban Medical College: Observations and Challenges
Authors: Bhattacharyya Swati , Roy Suparna , Kar Kaushik , Dasgupta Anindya 
Published: May 2022

IntroductionGMR 2019 have suggested fixed hours of self-directed learning (SDL) for all subjects for helping the students to develop their learning skills and sense of responsibility for a better learning in future. Presently, the trend of SDL is becoming more e learning centric in comparison to use of text books with its consequent advantages and disadvantages. The present study aimed to analyze the challenges associated with this trend in the phase 1 MBBS students.
MethodsIn an interventional educative study 203 phase 1 students from an urban medical college were assessed for an SDL based project on clinical aspects of the urea cycle at the end of the topic ammonia metabolism in Department of Biochemistry. Output from students were analysed for their trend for using resource materials, selection of relevant materials and originality of their inputs during the SDL process. Data obtained were analysed for their percentage distribution anddifference of mean values as applicable.
Results Out of 197 students who submitted their SDL projects in completed form, 61% students used internet information only, 20% used books only while 19% used both their resource materials. 32% of them could not use right key words for search and produced irrelevant materials in their topic. About 58% adopted copy and paste process without any change. Interestingly, the marks obtained by text book users were significantly higher than those using e resource materials.
ConclusionsThe present study reveals that in spite of having a higher inclination to use e learning resources most of the students are yet to coordinate between their study topic & internet information. Moreover, the trend for copying without comprehension was found to be significantly higher among e learners. Hence, the investigators suggest that for proper use of SDL, guidance by expert faculties regarding how to search internet properly using appropriate keywords and how to comprehend the core information of the e-resources into their own language are necessary to make it a successful component of CBME.
Knowledge and Practice of Documentation Techniques among Staff Nurses
Authors: Gurung Nirmala 
Published: May 2022

IntroductionNurses are the backbone of health care systems. They are have to deal with documentation process regularly.There may be good knowledge and poor practice about documentation.The objective of the study is to find out knowledge and practice of documentation among staff nurses.
MethodsA descriptive cross-sectional study was conducted on staff nurses of a College of Medical Sciences- Teaching hospital between, after taking ethical approval from the Institutional Review Committee. A purposive sampling method was used and sample size was calculated to be 200. A structured questionnaire was used to collect the demographic details and knowledge and practice of documentation. Data was analyzed using statistical package for the social sciences version 20.Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data.
ResultsThe knowledge of documentation was seen adequate among 150(75%) staff nurses. The practice of documentation was seen poor 188(94%) among staff nurses.
ConclusionsThe prevalence of adequate knowledge and poor practice is more in our study which is similar to other studies done in similar settings. Therefore, there is need of inservice education among staff nurses, thereby reaching a better patient care and safeguarding them from legal issues.
Brazil&apos;s foreign trade from 1822 to the end of the XIX century: the search for identity
Authors: Shkunov Vladimir 
Published: May 2022

The article is devoted to the problems of the development of Brazil&apos;s foreign trade during the XIX century. The author proposes a periodization of the history of Brazil&apos;s foreign trade in the period under review. Special attention is paid to the evolution of foreign trade relations with leading trading partners in Europe, the USA, Latin America, and the peculiarities of coffee trade. The article reveals the importance of the slave trade as a specific sphere of Brazil&apos;s foreign trade, and provides examples of Russian-Brazilian trade. The author uses mostly little-known and rarely used pre-revolutionary sources in Russian, English, Spanish and Portuguese, from which valuable statistical materials characterizing the dynamics and volumes of Brazil&apos;s foreign trade during the XIX century are extracted.
Age Dependent Changes in Corneal Epithelial Cell Signaling
Authors: Segars Kristen L. , Azzari Nicholas A. , Gomez Stephanie , Machen Cody , Rich Celeste B. , Trinkaus-Randall Vickery 
Published: May 2022

The cornea is exposed daily to a number of mechanical stresses including shear stress from tear film and blinking. Over time, these stressors can lead to changes in the extracellular matrix that alter corneal stiffness, cell-substrate structures, and the integrity of cell-cell junctions. We hypothesized that changes in tissue stiffness of the cornea with age may alter calcium signaling between cells after injury, and the downstream effects of this signaling on cellular motility and wound healing. Nanoindentation studies revealed that there were significant differences in the stiffness of the corneal epithelium and stroma between corneas of 9- and 27-week mice. These changes corresponded to differences in the timeline of wound healing and in cell signaling. Corneas from 9-week mice were fully healed within 24 h. However, the wounds on corneas from 27-week mice remained incompletely healed. Furthermore, in the 27-week cohort there was no detectable calcium signaling at the wound in either apical or basal corneal epithelial cells. This is in contrast to the young cohort, where there was elevated basal cell activity relative to background levels. Cell culture experiments were performed to assess the roles of P2Y2, P2X7, and pannexin-1 in cellular motility during wound healing. Inhibition of P2Y2, P2X7, or pannexin-1 all significantly reduce wound closure. However, the inhibitors all have different effects on the trajectories of individual migrating cells. Together, these findings suggest that there are several significant differences in the stiffness and signaling that underlie the decreased wound healing efficacy of the cornea in older mice.
Discovery of Early Mesozoic Magmatism in the Northern Muglad Basin (Sudan): Assessment of Its Impacts on Basement Reservoir
Authors: Zhao Jian , Dou Lirong 
Published: May 2022

The crystalline basement in the Central African Rift System (CARS) has been confirmed as a good unconventional reservoir in the surrounding basins of the Muglad area, Sudan. This study has recognized at least five Early Mesozoic intrusions for the first time at the northern margin of the Muglad Basin. Field and petrographic investigations show that they are mainly granite, syenite, diorite, and monzonite, with dominant alkali feldspar, plagioclase, quartz, and minor hornblende, biotite, and magnetite. Zircon internal structures, Th/U ratios, and rare earth element (REE) patterns indicate their magmatic origin. A total of 210 zircons from five samples were analyzed using LA-ICP-MS and they yielded U-Pb ages from 195.0 ± 6 to 225.0 ± 3 Ma, belonging to the Late Triassic-Early Jurassic. These results suggest that the Muglad Basin basement is not universally Precambrian as previously considered. The older basement was intruded and modified by Early Mesozoic magmas as evidenced by field contacts and our dating results. These magmatic events produced diverse Mesozoic igneous rocks prior to the formation of the Muglad Basin (Early Cretaceous), becoming new members of the crystalline basement. This composite basement then experienced prolonged weathering and fracturing for 65–95 Ma, resulting in porous and permeable weathered layers or fractured zones, making the basement a good unconventional reservoir for oil and gas.
Climatic Impacts of Wind-Wave-Wake Interactions in Offshore Wind Farms
Authors: Fischereit Jana , Larsén Xiaoli Guo , Hahmann Andrea N. 
Published: May 2022

Accurate wind resource assessments are necessary for cost effective offshore wind energy developments. The wind field offshore depends on the sea state. In coastal areas, where wind farms are usually built today, wind and waves are often not in full balance. In addition, wind farms modify their surrounding wind and turbulence field, especially downwind. These wind farm wakes, in turn, interact with the wave field, creating a complex dynamical system. To fully capture the dynamics in such a system in a realistic way, a coupled atmosphere-wave modelling system equipped with a wind farm parameterization should be applied. However, most conventional resource assessment relies on standalone atmosphere model simulations. We compare the wind-wave-wake climate predicted from a coupled modelling system, to one predicted from a standalone atmosphere model. Using a measurement-driven statistical-dynamical downscaling method, we show that about 180 simulation days are enough to represent the wind- and wave-climate, as well as the relation between those two, for the German Bight. We simulate these representative days with the atmosphere-wave coupled and the uncoupled modelling system. We perform simulations both without wind farms as well as parameterizing the existing wind farms as of July 2020. On a climatic average, wind resources derived from the coupled modelling system are reduced by 1% in 100 m over the sea compared to the uncoupled modelling system. In the area surrounding the wind farm the resources are further reduced. While the climatic reduction is relatively small, wind speed differences between the coupled and uncoupled modelling systems differ by more than ±20% on a 10-min time-scale. The turbulent kinetic energy derived from the coupled system is higher, which contributes to a more efficient wake dissipation on average and thus slightly smaller wake-affected areas in the coupled system. Neighbouring wind farms reduce wind resources of surrounding farms by up to 10%. The wind farm wakes reduce significant wave height by up to 3.5%. The study shows the potential of statistical-dynamical downscaling and coupled atmosphere-wave-wake modelling for offshore wind resource assessment and physical environmental impact studies.
Association of Obesity and Luminal Subtypes in Prognosis and Adjuvant Endocrine Treatment Effectiveness Prediction in Chinese Breast Cancer Patients
Authors: Tong Yiwei , Zhu Siyi , Chen Weiguo , Chen Xiaosong , Shen Kunwei 
Published: May 2022

PurposeTo evaluate the influence of obesity on clinicopathological characteristics of breast cancer; to explore the effect of obesity on the prognosis and performance of endocrine therapy in breast cancer patients.MethodsPatients with luminal/HER2-negative early breast cancer were included and categorized into the non-obese (BMI&lt;28kg/m2) and obese (BMI≥28kg/m2) groups according to body mass index (BMI). Clinicopathological characteristics and treatment modalities were compared between groups. Interaction of adjuvant endocrine therapy with obesity was analyzed.ResultsA total of 2,875 patients were included: 2,598 non-obese and 277 obese. A higher rate of patients with comorbidities (OR: 2.83, 95%CI 2.13-3.74, P&lt;0.001) or PR-positive tumor (OR: 1.63, 95%CI 1.03-2.58, P=0.037) were identified in the obese group. Obesity was not associated with disease recurrence (P=0.839) or overall survival (P=0.140) in the whole population. Subgroup analysis did show an association with worse relapse-free survival (RFS, HR 3.48, 95%CI 1.31-9.22, P=0.012) and overall survival (OS, HR 4.67, 95%CI 1.28-16.95, P=0.019) in luminal A breast cancer. These results could not be reproduced in the luminal B subtype with a RFS (HR 0.78, 95%CI 0.41-1.49, P=0.454) or OS (HR 1.17, 95%CI 0.50-2.74, P=0.727). Furthermore, obesity did not impact endocrine therapy effectiveness in Tamoxifen or the aromatase inhibitor group (RFS: interact P=0.381; OS: interact P=0.888).ConclusionsThe impact of obesity on prognosis interacted with luminal subtype status in Chinese breast cancer patients which was not related with endocrine treatment modality.
Current Treatment Approaches and Global Consensus Guidelines for Brain Metastases in Melanoma
Authors: Tan Xiang-Lin , Le Amy , Lam Fred C. , Scherrer Emilie , Kerr Robert G. , Lau Anthony C. , Han Jiali , Jiang Ruixuan , Diede Scott J. , Shui Irene M. 
Published: May 2022

BackgroundUp to 60% of melanoma patients develop melanoma brain metastases (MBM), which traditionally have a poor diagnosis. Current treatment strategies include immunotherapies (IO), targeted therapies (TT), and stereotactic radiosurgery (SRS), but there is considerable heterogeneity across worldwide consensus guidelines.ObjectiveTo summarize current treatments and compare worldwide guidelines for the treatment of MBM.MethodsReview of global consensus treatment guidelines for MBM patients.ResultsSubstantial evidence supported that concurrent IO or TT plus SRS improves progression-free survival (PFS) and overall survival (OS). Guidelines are inconsistent with regards to recommendations for surgical resection of MBM, since surgical resection of symptomatic lesions alleviates neurological symptoms but does not improve OS. Whole-brain radiation therapy is not recommended by all guidelines due to negative effects on neurocognition but can be offered in rare palliative scenarios.ConclusionWorldwide consensus guidelines consistently recommend up-front combination IO or TT with or without SRS for the treatment of MBM.
Evidence and Characteristics of Traditional Chinese Medicine for Coronary Heart Disease Patients With Anxiety or Depression: A Meta-Analysis and Systematic Review
Authors: Wang Baofu , Teng Yu , Li Yang , Lai Sijia , Wu Yang , Chen Shiqi , Li Tong , Han Xiaowan , Zhou Hufang , Wang Yu , Lu Ziwen , Li Haiyan , Ding Yukun , Ma Liang , Zhao Mingjing , Wang Xian 
Published: May 2022

Aims: The objective of this study was to assess the efficacy and potential mechanisms of Chinese herbal medicine (CHM) for treating coronary heart disease (CHD) patients with anxiety or depression.Methods: A systematic literature search was performed. Screening studies, extracting data, and assessing article quality were carried out independently by two researchers. The active ingredients of CHM for the treatment of CHD with anxiety or depression were analyzed by the network pharmacology, and the main potential mechanisms were summarized by the database of Web of Science.Results: A total of 32 studies were included. The results showed that compared with the blank control groups, CHM was more beneficial in treating anxiety or depression in patients with CHD [anxiety: OR = 3.22, 95% CI (1.94, 5.35), p &lt; 0.00001, I2 = 0%; depression: OR = 3.27, 95% CI (1.67, 6.40), p = 0.0005, I2 = 0%], and the efficacy of CHM was not inferior to that of Western medicine (WM) [anxiety: OR = 1.58, 95%CI (0.39, 6.35), p = 0.52, I2 = 67%; depression: OR = 1.97, 95%CI (0.73, 5.28), p = 0.18, I2 = 33%,]. Additionally, CHM also showed a significant advantage in improving angina stability (AS) in CHD patients with anxiety or depression compared with blank groups [anxiety: SMD = 0.55, 95%CI (0.32, 0.79), p &lt; 0.00001, I2 = 0%; depression: p = 0.004] and WM groups [anxiety: SMD = 1.14, 95%CI (0.80, 1.47), p &lt; 0.00001, I2 = 0%; depression: SMD = 12.15, 95%CI (6.07, 18.23), p &lt; 0.0001, I2 = 0%]. Angina frequency (AF) and electrocardiogram (ECG) analysis after using CHM demonstrated similar trends. Based on the network pharmacology, quercetin, kaempferol, luteolin, beta-sitosterol, puerarin, stigmasterol, isorhamnetin, baicalein, tanshinone IIa, and nobiletin were most closely and simultaneously related to the pathological targets of CHD, anxiety, and depression. The main underlying mechanisms might involve anti-damage/apoptosis, anti-inflammation, antioxidative stress, and maintaining neurotransmitter homeostasis.Conclusion: CHM exhibited an obvious efficacy in treating CHD patients with anxiety or depression, especially for improving the symptom of angina pectoris. The most active compounds of CHM could simultaneously act on the pathological targets of CHD, anxiety, and depression. Multiple effective components and multiple targets were the advantages of CHM compared with WM.