bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinician Consensus on “Inappropriate” Presentations to the Emergency Department in the Better Data, Better Planning (BDBP) Census: A Cross- sectional Multi-centre Study of Emergency Department Utilisation in Ireland
Authors: Cummins Niamh M , Barry Louise A , Garavan Carrie , Devlin Collette , Corey Gillian , Cummins Fergal , Ryan Damien , Wallace Emma , Deasy Conor , Flynn Mary , McCarthy Gerard , Galvin Rose 
Published: September 2022

Abstract
Background
Utilisation of the Emergency Department (ED) for non-urgent care increases demand for services, therefore reducing inappropriate or avoidable attendances is an important area for intervention in prevention of ED crowding. This study aims to develop a consensus between clinicians across care settings about the “appropriateness” of attendances to the ED in Ireland.
Methods
The Better Data, Better Planning study was a multi-centre, cross-sectional study investigating factors influencing ED utilisation in Ireland. Data was compiled in patient summary files which were assessed for measures of appropriateness by an academic General Practitioner (GP) and academic Emergency Medicine Consultant (EMC) National Panel. In cases where consensus was not reached charts were assessed by an Independent Review Panel (IRP). At each site all files were autonomously assessed by local GP-EMC panels.
Results
The National Panel determined that 11% (GP) to 38% (EMC) of n = 306 lower acuity presentations could be treated by a GP within 24-48h (k = 0.259; p < 0.001) and that 18% (GP) to 35% (EMC) of attendances could be considered “inappropriate” (k = 0.341; p < 0.001). For attendances deemed “appropriate” the admission rate was 47% compared to 0% for “inappropriate” attendees. There was no consensus on 45% of charts (n = 136). Subset analysis by the IRP determined that consensus for appropriate attendances ranged from 0–59% and for inappropriate attendances ranged from 0–29%. For the Local Panel review (n = 306) consensus on appropriateness ranged from 40–76% across ED sites.
Conclusions
Multidisciplinary clinicians agree that “inappropriate” use of the ED in Ireland is an issue. However, obtaining consensus on appropriateness of attendance is challenging and there was a significant cohort of complex heterogenous presentations where agreement could not be reached by clinicians in this study. This research again demonstrates the complexity of ED crowding, the introduction of evidence-based care pathways targeting avoidable presentations may serve to alleviate the problem in our EDs.
Machine Learning Techniques for C-slot Loaded Minkowski Fractal Antenna
Authors: Vedipala Venkateshwar Reddy , tumma Sunil kumar , R Rama sanjeev B , Nelaturi Suman 
Published: September 2022

Abstract
For Wi-MAX wireless applications, a C-slot-loaded Minkowski fractal microstrip antenna is examined and its operating frequency is predicted using machine learning techniques. A Minkowski fractal antenna is first created by substituting Minkowski curves along the square patch's sides. A C-slot is inserted afterwards. For parametric analysis, the minkowski fractal curve’s indentation depth, the length of the C-slot arm, and the width are changed. The training data set for the proposed C-slot-loaded minkowski fractal antenna resonance frequency is developed by altering the indentation depth, C-slot length, and width. The training data set is then evaluated using machine learning methods such as multivariate regression, ANN, XGBoost, random forest, and decision tree. XGBoost machine learning outscored them all and had a very low mean square error.
Development of Silicalite-1-encapsulated Ni catalyst from Ni phyllosilicate for dry reforming of methane
Authors: Zhang Yusheng , Takahashi Ryota , Kimura Kentaro , Fujitsuka Hiroyasu , Tago Teruoki 
Published: September 2022

Abstract
CO2 (dry) reforming of methane (DRM) is a significant and useful reaction from the standpoint of effective utilization and conversion of two main greenhouse gases to value-added synthesis gas. To achieve highly efficient and stable DRM reaction, a Silicalite-1-encapsulated ultrafine Ni nanoparticle catalyst(Ni@S-1)by using Ni phyllosilicate (Ni-PS) as precursor was newly developed. This Ni@S-1 catalyst exhibited negligible coke deposition (0.5 wt.%) evaluated at 600°C for 5 h. Additionally, this Ni@S-1 catalyst presented high and stable catalytic performances and maintained the Ni nanoparticles with ultrafine size (< 7 nm) at 850°C for 24 h. Therefore, this Ni@S-1 catalyst showed good suppression of coke formation and high resistance to nickel sintering and thus was promising for DRM reaction.
Modified Double-Tract Reconstruction in Terms of postoperative quality of life of Patients with Early Adenocarcinoma of Esophagogastirc Junction after Proximal Gastrectomy
Authors: Chang Xusheng , Luo Tianhang , Li Xu , Cui Hangtian , ZHAN LU , Gong Xiao , Zhang Jinghui , Yin Kai 
Published: September 2022

Abstract
Background Increased reflux symptoms limited clinical application of proximal gastrectomy (PG) in the patients with early adenocarcinoma of esophagogastirc junction (AEG). The purpose of this study is to describe a method of modified double-tract reconstruction (DTR) after PG, and to evaluate the feasibility, safety, surgical outcomes, postoperative gut function and nutritional status post operation. Methods Prospective cohort data of 25 patients with early AEG who presented to a single tertiary hospital from Jan 2019 to Jun2019 and underwent DTR after PG were analyzed respectively. The data of this prospective cohort included: clinicopathologic characteristics, surgical outcomes, time to first flatus and defecation, Visick Score, degrees and extent of remnant gastritis, Los Angles Classification in 1-year follow-up. Another 25 early AEG patients performed TG by propensity score matching analysis from Jan 2018 to Dec 2018 were picked as control group. Results There was no significant difference in BMI, ASA score, tumor size, Siewert type, tumor Grade, proximal resection margin, the number of LN harvested and TNM Stage between two groups.The operation time and hospital stay was longer, and estimated blood loss was more in DTR group. The postoperative complication rate was 8% (n = 2), which were both treated by conservative management. The volume of postoperative daily intake could reach over 700ml on 6th POD, which was much more than TG group. The weight loss of patients in DTR group remained steadily from 3rd month after operation, which was also better than TG group. The rate of reflux symptoms was 12% (n = 3), which were classified as Visick grade II. The degree and extent of remnant gastritis in DTR group were acceptable. The incidence of residual food in remnant stomach reached 32%, but most of them were only evaluated as Grade 1.ConclusionThe short-term outcome of this modified DTR was satisfied, which could improve the nutrition status and quality of life post operation. We believe our modified technique is one of feasible, safe, and useful choice for early AEG patients.
Comparison of Surgical Smoke between Two Approaches for Endoscopic Thyroidectomy and Open Thyroidectomy
Authors: Zhang Zhe , Jin Gongsheng , Liu Xianfu 
Published: September 2022

Abstract
Background
Surgical smoke has been recognized as a potential health risk by an increasing number of researchers. Moreover, the counts of surgical smoke produced during different surgical approaches are different. This study aimed to measure and compare the particulate matter (PM) of surgical smoke generated during open thyroidectomy and two endoscopic approaches for thyroidectomy to provide guidance for safe clinical practices.
Methods
Forty-eight patients with thyroid cancer admitted to our hospital from June 2020 to December 2021 and treated with different surgical approaches were enrolled in this study. The total and peak counts of PM, dynamic changes, and other characteristics of surgical smoke produced during surgery were recorded. PM was classified as PM2.5 (size ≤ 2.5 µm) and PM10 (size ≤ 10 µm).
Results
In a single cut, both the peak and total counts of PM2.5 and PM10 of surgical smoke in the open thyroidectomy group (n = 15) were significantly higher than those in the breast approach endoscopic thyroidectomy with CO2 insufflation group (n = 15) and the gasless transaxillary endoscopic thyroidectomy group (n = 18) (p < 0.001). Moreover, the latter two groups showed no significant differences in the peak and total counts of PM2.5 and PM10 (p > 0.05).
Conclusion
In thyroid surgery, more surgical smoke is produced during open thyroidectomy than during endoscopic thyroidectomy, while different endoscopic approaches showed no significant difference in surgical smoke production. Thus, endoscopic approaches outperform the open thyroidectomy approach with regard to surgical smoke production.
Infrared Thermographic Changes after Decompression Surgery in Patients with Carpal Tunnel Syndrome
Authors: Park Yeo Eun , Lee Sang-Eok , Eom Yoon Sik , Cho Jae Man , Yang Joong Won , Kim Man Su , Kwon Heum Dai , Lee Jang Woo , Park Dougho 
Published: September 2022

Abstract
Background
Digital infrared thermal imaging (DITI) is a useful tool for assessing carpal tunnel syndrome (CTS). Notably, this can demonstrate autonomic vasomotor activity in the nerve-innervated area. In this study, we compared DITI findings before and after carpal tunnel release (CTR) surgery in patients with unilateral CTS to investigate the corresponding neurophysiological changes.
Methods
DITI parameters such as the temperature differences between the median and ulnar nerve territories and median nerve-innervated digital anisometry were measured. Subjective symptom duration, pain scale, and ultrasonographic findings were also compared before and after CTR. Patients were evaluated before and six weeks after CTR, respectively.
Results
A total of 27 patients aged 59.0 ± 11.2 years were finally included. After CTR, median nerve-innervated thermal anisometry was improved (2.55 ± 0.96 ℃ to 1.64 ± 1.34 ℃; p = 0.003). The temperature differences between the median and ulnar nerve territories were not significantly changed. Subjective pain, the Simovic Weinberg Clinical Scale, and palmar bowing of the flexor retinaculum were also significantly improved (p < 0.001 for all comparisons).
Conclusions
Our results demonstrated that DITI findings could reflect an improvement in autonomic function after CTR. Therefore, DITI can be an objective method to assess pre- and post-operative neurophysiologic changes in CTS.
Robotic-assisted versus laparoscopic incisional hernia repair: differences in direct costs from a Brazilian public institute perspective
Authors: Costa Thiago Nogueira , Tustumi Francisco , Ferros Lucas Sousa Maia , Colonno Bárbara Buccelli , Abdalla Ricardo Zugaib , Junior Ulysses Ribeiro , Cecconello Ivan 
Published: September 2022

Abstract
Background
This study aimed to compare the direct cost differences between robotic (RVIHR) and laparoscopic (LVIHR) hernia repair and determine each source of expenditure that may be related to the increased costs in a robotic program from the perspective of a Brazilian public institution.
Methods
The present study investigated the differences in direct costs from the data generated from a trial protocol (ReBEC: RBR-5s6mnrf). Patients with incisional hernia were randomly assigned to receive LVIHR or RVIHR. The direct medical costs of hernia treatment were described in the Brazilian currency (R$).
Results
Nineteen patients submitted to LVIHR were compared with eighteen submitted to RVIHR. The amount spent on operation room time (RVIHR: 2447,91 ± 644,79; LVIHR: 1989,67 ± 763,00; p = 0,030), inhaled medical gases in operating room (RVIHR: 270,57 ± 211,51; LVIHR: 84,55 ± 252,34; p = 0,023), human resources in operating room (RVIHR: 3164,43 ± 894,97; LVIHR: 2120,16 ± 663,78; p < 0,001), material resources (RVIHR: 3204,32 ± 351,55; LVIHR: 736,51 ± 972,32; p < 0,001), and medications (RVIHR: 823,40 ± 175,47; LVIHR: 288,50 ± 352,55; p < 0,001) for RVIHR was higher than LVIHR, implying a higher total cost to RVIHR (RVIHR: 14712,24 ± 3520,82; LVIHR: 10295,95 ± 3453,59; p < 0,001). No significant difference was noted in costs related to the hospital stay, human resources in ICU and ward, diagnostic tests, and meshes.
Conclusion
Robotic system adds a significant overall cost to traditional laparoscopic hernia repair. The cost of the medical and robotic devices plus longer operative times are the main factors driving the difference in costs.
The marine factor 3,5-dihydroxy-4-methoxybenzyl alcohol expresses the anti-inflammatory effects in mouse macrophages RAW264.7 cells in vitro
Authors: Yamaguchi Masayoshi , Yoshiike Kenji , Watanabe Hideaki , Watanabe Mitsugu 
Published: September 2022

Abstract
Background: Inflammation is implicated in the pathogenesis of many diseases. Inflammatory cytokines are produced in macrophages with stimulation of lipopolysaccharide (LPS) and are used as biomarkers participating in diverse disease conditions. The novel marine factor 3,5-dihydroxy-4-methoxybenzyl alcohol (DHMBA) was initially identified in the Pacific oyster Crassostrea Gigas. DHMBA has properties to reduce oxidative stress as radical scavenging and increase the production of antioxidant proteins. The pharmacologic role of DHMBA, however, has been poorly understood.Methods and Results: This study has been undertaken to investigate whether DHMBA attenuates growth, cytokine production, and osteoclastogenesis in inflammatory mouse macrophage RAW264.7 cells. Culturing with DHMBA (1-1000 µM) suppressed the growth and stimulated the death of RAW264.7 cells in vitro, leading to decrease in cell number. Mechanistically, DHMBA treatment decreased the levels of Ras, PI3K, Akt, MAPK, phospho-MAPK, and mTOR of signaling factors to promote the proliferation, and it raised the levels of p53, p21, Rb, and regucalcin, which are cell growth suppressors. The levels of caspase-3 and cleaved caspase-3 were increased by DHMBA treatment. Culturing with DHMBA suppressed productions of inflammatory cytokines, including tumor necrosis factor-α, interleukin-6, interleukin-1β, or prostaglandin E2, were enhanced by LPS stimulation. Notably, the levels of NF-κB p65 were increased by LPS treatment, and this increase was repressed by DHMBA treatment. LPS treatment stimulated osteoclastogenesis of RAW264.7 cells. This stimulation was blocked by DHMBA treatment.Conclusion: DHMBA was found to potentially suppress the activity of inflammatory macrophages in vitro, suggesting therapeutic usefulness in inflammatory conditions.
Food born pathogen contamination of some meat products in Damanhur City, Egypt
Authors: Saad Saber , El-Sayed Amal Mohamed , Abdelgawad Mohamed Hassan , Batiha Gaber El-Saber , Simal-Gandara Jesus 
Published: September 2022

Abstract

Purpose
The study assessed the chemical and microbial quality of some meat products (Liver, Luncheon, minced meat, and Sausage) in addition to detecting some virulence genes associated with some isolated strains.
Method
Two hundred random samples of meat products including 50 samples each of (minced meat, Liver, luncheon and sausage) were randomly collected from different butchers at Damanhur city, El Behera Governorate for some chemical (TVN and TBA) and microbiological evaluation (APC, Staph. aureus, E.coli, Salmonella, Bacillus cereus, and Clostridium perfringens), in addition, detection of virulence genes in some isolated strains.
Result
The obtained results revealed that mean values of TVB-N and TBA was higher in liver than other meat products. In regard to microbiological evaluation, results revealed that incidence of staph. aureus, E.coli, Salmonella, Bacillus cereus and clostridium perfringens were (40, 24, 20 and 30%), (36, 10, 8 and 30%), (2, 4, 0, 4%), (16, 20, 24 and 34%) and (28, 10, 18, and 36%), in the examined minced meat, liver, luncheon and sausage, respectively. Salmonella could not be detected in examined luncheon samples. Regarding virulence genes (Pvl and Sea) and (invA and Stn) were detected in 100% of isolated Staph. aureus and Salmonella strains, respectively. eaeA was detected in 100% of isolated E.coli strains while Stx2 was detected in only one strain. Isolated strains of Clostridium perfringens were positive for enterotoxin gene (cpe) and alpha-toxin (cpa) at percent 100%.
Conclusion
The presence of aerobic bacteria like Staphylococci aureus, E. coli, bacillus cereus, Salmonella, and Clostridium perfringens may be due to poor hygienic measures during processing and handling of meat products. So, consumption of these products could be associated with possible risk of infection, suggesting the need for the institution of strict hygienic measures during handling of meat products.
A sub-wavelength Si LED integrated in a CMOS platform
Authors: Li Zheng , Xue Jin , de Cea Marc , Kim Jaehwan , Nong Hao , Chong Daniel , Lim Khee Yong , Quek Elgin , Ram Rajeev 
Published: September 2022

Abstract
A nanoscale on-chip light source with high intensity is desired for various applications in integrated photonics systems. However, it is challenging to realize such an emitter using materials and fabrication processes compatible with the standard integrated circuit technology. In this letter, we report an electrically driven Si light-emitting diode (LED) with sub-wavelength emission area fabricated in an open-foundry microelectronics CMOS platform. The LED emission spectrum is centered around 1100 nm and the emission area is smaller than 0.14 μm<2>( ≈ 400 nm diameter). This LED has high spatial intensity of > 50 mW/cm<2> which is comparable with the state-of-the-art Si-based emitters with much larger emission areas. Due to sub-wavelength confinement, the emission exhibits a high degree of spatial coherence, which is demonstrated by incorporating the LED into a compact lensless in-line holographic microscope. This centimeter-scale, all-silicon microscope utilizes a single emitter to simultaneously illuminate ≈ 9.5 million pixels of a CMOS imager.
Change of serum lipoproteins and its potential use in stratifying patients with sepsis among neonates
Authors: Guo Junfei , Lai Weiming , Wu Yongbing , Li Huan , Fu Zhenhua , Mu Xiaoping 
Published: September 2022

Abstract
Background: Changes of serum lipoprotein concentration during bacteremia or sepsis is observed and lipoproteins concentration facilitate the evaluation severity of sepsis in adults, but its clinical usage is still unclear. Here, we analyzed the lipoprotein concentration in neonates with sepsis and discussed its use in stratifying patients. Methods: This is a retrospective study involved 88 culture-proven septic patients. Clinical and microbiology data of involved patients were collected via inquiring data bases of our institute. Patients were grouped according to blood culture results or procalcitonin level, the difference between groups were analyzed. Results: Compared with uninfected group, there is no change of triglyceride (TG) concentrations and significant decrease of Total cholesterol (TC) concentration in septic patients. There is no significant difference between Gram positive and Gram negative related septic patients in terms of serum TG and TC concentration. Other than group with procalcitonin level of 0.5-2 ng/ml, both serum TG and TC concentration were decreased while serum procalcitonin level increasing. Conclusions: Our results indicated that serum lipoprotein concentration may be recommended to help diagnosis of bacteria and to evaluate the severity of sepsis.
Riparian soil toxicity caused by sediment metal transport, seasonal changes and ecological risk assessments for the watershed
Authors: Çelebi Ahmet , Şengörür Bülent , Haghighi Ali Torabi 
Published: September 2022

Abstract
Accumulation of the pollutants in the sediment along the surface water may negatively affect on the riparian zones and ecological risk dimension. In order to reveal this problem, in the present study, detailed metal monitoring of sediments and riparian soils was performed seasonally with ICP-OES analysis. Pollution levels, changes, and potential sources were determined statistically. Ecological statuses are detailed. Contamination factor (CF), Enrichment factor (EF), Index of geo-accumulation (Igeo), pollution index (PI), and modified pollution index (MPI) potential and modified ecological risk indexes were analyzed. Although no significant seasonal differences were observed, almost all metals in the sediments and riparian soils spatially differed. Cr (11.4 to 136), Co (7.7 to 21.52), Cu (11.4 to 76.6), and Ni (14.06 to 128.2) as mg/kg from the upstream to the downstream increased significantly and gradually accumulated. The riskiest metals in the sediment and riparian soil in terms of basin river health are Cu, Co, Ni. Risk values were found heavily polluted (PI > 3 and MPI > 10), and the risk indexes (RI) are well above the "desired environment without the risk". RI was found to be more than 50, and modified risk indices exceeded 200 at many points. The transport of pollution in surface water has been revealed in the sediment and adverse effects on the riparian zone and ecological system. Considering sediment and riparian soil together, pollutant-based and holistic ecological risk assessments are necessary to determine river health.
Effects of Different concentration of Copper on Performance, Immunity, Blood biochemical and Carcass traits in Broiler Japanese Quails
Authors: Deo Chandra , Biswas Avishek , Sharma Divya , Tiwari A. K 
Published: September 2022

Abstract
The effects of dietary supplemental copper sources and concentrations on broiler Japanese quail growth performance, immunological response, blood biochemistry and carcass quality were investigated in this study. Two copper sources (copper sulphate - CuS, copper methionine - CuM) were used in this experiment, each at five different dietary dosages of 5, 10, 15, 100, and 150 mg/kg. 280 (10 x 4 x 7) day old quail chicks were randomly assigned to ten feed treatments for a period of up to five weeks. Each treatment had four replications, each with seven chicks. CuM (100 mg Cu/kg diet) supplemented diets had significantly (P < 0.01) higher body weight gain and a better feed conversion ratio (FCR) than CuS supplemented diets, according to the findings. At 150 mg CuM/kg diet, the cell mediated immune response (foot web index to PHAP) was significantly higher (P < 0.01) than at other dietary doses of Cu. With copper sulphate (CuS) supplemented diets, the humoral immunological response (HA titre to SRBC) was significantly (P < 0.01) lower than with copper methionine supplemented diets. At 5, 10, and 15mg Cu/kg diet the humoral immunological response (HA titre to SRBC) was significantly (P < 0.01) lower than at 100 and 150mg Cu/kg diet. Bursa weight was significantly higher (P < 0.01) in the 10 and 15mg Cu/kg meals with copper methionine source than in the 5, 10, 15, and 150 mg Cu/kg diets with copper sulphate supplementation. CuM source resulted in significantly (P < 0.01) larger bursa and spleen weight than CuS source. Serum cholesterol levels were significantly (P < 0.01) lower on the 100 and 150 mg CuM/kg diets compared on the 5,10, and 15mg Cu/kg diets. Various carcass quality parameters including as pre-slaughter live weight, shrinkage loss, blood loss, feather loss, dressed weight, and eviscerated weight were not substantially (P > 0.05) different due to either the main effect or the interaction between copper concentrations and sources. Similarly, the weight of organs such as giblets and liver percent did not alter significantly (P > 0.05) due to either the main effect or the interaction between copper concentrations and sources. At 5 mg Cu/kg diet, there was a significantly higher percent gizzard weight (P0.05) than at other dietary Cu doses. The percent of heart weight recorded at 5mg Cu/kg diet was significantly greater (P < 0.05) than those recorded at other dietary Cu concentrations. Thus it may be concluded that dietary supplementation of copper methionine as a source of Cu @ 100mg Cu/kg diet to broiler Japanese quails was more effective in improving growth performance, immunological response, carcass quality features, and serum cholesterol reduction.