A Clinical Decision Support System for Increasing Compliance with Protocols in Chemotherapy of Children with Acute Lymphoblastic Leukemia.

Objective: In this survey, a protocol-based Chemotherapy Prescription Decision Support System (CPDSS) was designed and evaluated to reduce medication errors in the chemotherapy process of children with ALL. Methods: The CPDSS algorithm was extracted by the software development team based on the protocol used by doctors to treat children with ALL. The ASP.Net MVC and SQL Server 2016 programming languages were used to develop the system. A 3-step evaluation (technical, retrospective, and user satisfaction) was performed on CPDSS designed at 2 children's hospitals in Tehran. The data were analyzed using descriptive statistics. At the technical evaluation step, users provided recommendations included in the system. Results: In the retrospective CPDSS evaluation step, 1281 prescribed doses of the drugs related to 30 patients were entered into the system. CPDSS detected 735 cases of protocol deviations and 57 (95%, CI = 1.25-2.55) errors in prescribed chemotherapy for children with ALL. In the user satisfaction evaluation, the users approved two dimensions of the user interface and functionality of the system. Conclusions: With the provision of alerts, the CPDSS can help increase compliance with chemotherapy protocols and decrease the chemotherapy prescribing errors that can improve patient safety.

First-principles studies on two-dimensional B3O3 adsorbent as a potential drug delivery platform for TEPA anticancer drug.

The remarkable properties of pristine B3O3 nanosheet as a nanocarrier for adsorption and desorption of TEPA anticancer drug for designing potential drug delivery platform were investigated using periodic DFT calculations. We studied the adsorption energy of all stable complexes formed between the drug molecule and B3O3 in gas and aqueous phases along with electronic structure analysis of complexes. Different adsorption configurations were studied for drug/B3O3 complexes, including the interaction of the C atom of the triangular ring, O atom in the TEPA drug with the B atom in B3O3, and indirect drug interaction the middle of the R1 ring cavity of the B3O3 nanosheet. The take-up of TEPA prompts a substantial change of 68.13% in the band gap (Eg) of the B3O3 nanosheet in the most stable complex. The present study results affirmed the application of B3O3 nanosheet as a potential vehicle for TEPA drugs in the treatment of cancerous tissues.

Investigating the effective factors of using mHealth apps for monitoring COVID-19 symptoms and contact tracing: A survey among Iranian citizens.

BACKGROUND AND OBJECTIVES: The use of mHealth applications depends on cognitive and social factors of individuals in different nations. This study aimed to identify the factors influencing the use of mHealth applications for both "contact-tracing" and "symptom-monitoring" of COVID-19 among Iranian citizens. METHODS: A cross-sectional study with an online survey was conducted among Iranian citizens. Correlation calculation and multiple linear regression analysis were performed on the studied variables to find the effective factors. RESULTS: A total of 1031 Iranian citizens over the age of 18 participated in this survey. A large percentage of the participants wanted to use the mHealth app to trace contacts of COVID-19 (74.5%) and the mHealth app to identify and monitor COVID-19 symptoms (74.0%). Gender, age, level of education, attitude towards technology, and fear of COVID-19 were among the factors that influenced the intention to use these two apps. The top reasons for using these apps were: "to keep myself and my family safe", "to control the spread of the coronavirus in general", and "to cooperate with healthcare professionals". The reasons given for not using these two apps were related to the issues of "security and privacy" and "doubt in efficiency and usefulness" of them. CONCLUSIONS: The study showed that many participants in this survey were interested in using the COVID-19 apps. Policies, regulations and procedures are needed to protect the privacy of individuals by ensuring data governance. Further investigation with a larger sample is suggested to generalize these results.

Toxic volatile organic compounds sensing by Al2C monolayer: A first-principles outlook.

Adsorption and detection performance of two-dimensional Al2C monolayer for four toxic volatile organic compounds (VOCs) viz. acetaldehyde, ethylene oxide, vinyl chloride, and benzene are investigated using first-principles calculations based on the periodic density functional theory. The band gap of Al2C nanosheet is changed substantially from 0.9 eV to 0.52, 1.41, 1.57, and 0.42 eV upon interaction with acetaldehyde, ethylene oxide, vinyl chloride, and benzene molecules respectively. The Al2C nanosheet maintains its semiconductor properties even after the adsorption of the four VOCs. The adsorption energy of four typical toxic volatile organic compounds (VOCs) viz. acetaldehyde, ethylene oxide, vinyl chloride, and benzene on the Al2C monolayer is in a range of -1.972 eV to -2.244 eV, which is higher than the adsorption energies obtained for several other VOCs adsorbed on different materials. Larger VOCs adsorption energies on Al2C monolayer obtained here may lead to adsorption of more VOC molecules on the material and consequently enhanced sensitivity. The results of ab initio molecular dynamics (AIMD) calculations for the studied complexes confirm their stability under the considered conditions of the simulation. Pristine Al2C monolayer might be a superior adsorbent and a promising sensing medium for toxic VOCs in real applications.

The potential application of borazine (B3N3)-doped nanographene decorated with halides as anode materials for Li-ion batteries: a first-principles study.

In this research, borazine-doped nanographene (BNG) decorated with halides as the anode material for Li-ion batteries (LIBs) has been investigated by means of first-principles calculations. The calculated adsorption energies of Li+/BNG and Li/BNG complexes are - 47.9 kcal/mol and - 25.2 kcal/mol, respectively, that gives electrochemical cell voltage (Vcell) of 0.99 V. To increase Vcell, different halide anions such as F-, Cl-, and Br- are added to BNG. This strategy increases Vcell from 0.99 V to 3.98, 1.54, and 1.62 V for BNG/F-, BNG/Cl-, and BNG/Br- complexes, respectively. The calculated Vcell value of 3.98 V for BNG/F- is remarkable compared with previous reports in the literature. The results presented in this study may be useful for the widespread usage of BNG/F- as a promising anode material for LIBs. Graphical abstract Note : This data is mandatory. Please provide.

Effects of chemotherapy prescription clinical decision-support systems on the chemotherapy process: A systematic review.

OBJECTIVE: To carry out a systematic review of studies assessing the effects of chemotherapy prescription clinical decision-support systems (CDSSs) on the chemotherapy process. METHODS: Articles published in English before May 1, 2017 and indexed in the PubMed and Embase databases were reviewed systematically. Studies that focused on the effects of chemotherapy prescription CDSSs on the chemotherapy process were included in this research and reviewed. RESULTS: 2283 articles were retrieved, of which 37 met the inclusion criteria. Twenty-seven of the included studies reported the effect of chemotherapy prescription CDSSs on medication errors, 18 studies focused on user satisfaction and system acceptance, 10 articles studied the effect of CDSSs on costs and care time and only 3 studies examined the impact on compliance with chemotherapy protocols. DISCUSSION AND CONCLUSION: In most of the studies, the use of CDSSs in chemotherapy prescription has reduced medication errors, especially dosage errors and has also reduced the time of chemotherapy process takes. However, in a few studies, the system has not been effective in reducing medication errors, has increased certain type of errors or has introduced new errors. Most of the software used has been specifically designed for the chemotherapy process and is intended to increase user satisfaction and system acceptance. There was not sufficient evidence on the effects of these systems on compliance with protocols and chemotherapy costs to draw firm conclusion. Higher quality studies are required to provide more evidence on the effects of CDSSs on medication errors, user satisfaction and system acceptance, costs, care time and compliance with protocols.

Specifications of Computerized Provider Order Entry and Clinical Decision Support Systems for Cancer Patients Undergoing Chemotherapy: A Systematic Review.

OBJECTIVE: Chemotherapy medication errors are catastrophic. The prescription phase in the chemotherapy process plays a key role in the creation of medication errors, and therefore the use of computerized physician order entry (CPOE) and clinical decision support system (CDS) systems is recommended to reduce chemotherapy medication errors. The purpose of this study was to carry out a systematic review on the specifications of the CPOE and CDS systems for chemotherapy prescription. MATERIALS AND METHODS: A systematic review on articles published in English up to September 22, 2017, using the 3 databases PubMed, Embase, and Medline was conducted. Those articles that focused on the specifications of CPOE and CDSS in chemotherapy prescription were included in this review. FINDINGS: Of the 2,471 articles identified, 58 articles met the inclusion criteria and were included in this study. Specifications related to chemotherapy CPOE systems were categorized into the following 6 groups: automation and facilitation of the chemotherapy prescription phase, hospital workflow support, documentation and reporting, drug safety, information security, and system communications. The specifications of chemotherapy CDSS were also divided into 4 categories: embedding chemotherapy protocols, automated dose calculations and adjustment, providing alerts/reminders at the time of prescribing, and guiding or asking the user to complete the important prescription parameters. In 12 articles, the chemotherapy prescription CDSS were designed and evaluated independently of the CPOE; 45 articles provided prescription chemotherapy CDSS as part of the CPOE system, and in 1 article CPOE was introduced with no CDSS. CONCLUSION: In complicated settings such as chemotherapy, simplification of the processes is more imperative. The use of chemotherapy CPOE, which includes specifications for helping the medical staff with their workload, encourages the professionals to use such systems and increases the likelihood for success of these systems.