bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of a kidney‐specific disease‐specific care certification program on the institutional performance indicators of hospitals caring for patients with chronic kidney disease: A national data analysis
Authors: Chao Chia‐Ter , Chang Ching‐I , Wang Pa‐Chun , Chiang Ching‐Feng , Chen Chia‐Pei , Hsu Hui‐Shu , Hung Kuan‐Yu
Published: May 2021

Aim

The prevalence of chronic kidney disease (CKD) is on the rise due to population aging and multimorbidity. Taiwan is particularly afflicted by this prevailing ailment. Although multidisciplinary pre‐dialysis care has been implemented to halt CKD progression and reduce health‐care utilization in Taiwan, more is needed to reduce the local burden of CKD.

Methods

The Taiwan Joint Commission initiated a kidney‐care disease‐specific care (DSC) certification program since 2017, aiming to improve participating hospitals' quality of care for kidney disease and to synchronize the quality of kidney care across Taiwan. We analysed the trend of changes over time among the kidney DSC certification program participating institutes during the period before, during, and after DSC certification program implementation, using the Generalized Estimating Equation methods.

Results

A total of 20 institutes participated in the DSC certification program focusing on kidney diseases between January 2018 and March 2020, among which 70% were medical centres. DSC certification program was shown to significantly reduce the annual incidence of arteriovenous fistula reconstruction while increase the levels of serum albumin and haemoglobin among patients with end‐stage renal disease (ESRD) under haemodialysis over time. For parameters related to peritoneal dialysis (PD), participating in the kidney‐care DSC certification program significantly increased serum albumin levels among these patients with ESRD over time.

Conclusion

In this study, we discovered that a kidney‐care DSC certification program significantly improved multiple performance indicators of participating institutes including patients' haemoglobin, albumin, and shunt re‐creation probability among patients with end‐stage renal disease.
Auricular vagal nerve stimulation enhances gastrointestinal motility and improves interstitial cells of Cajal in rats treated with loperamide
Authors: Zhang Yiling , Lu Tao , Dong Yan , Chen Yan , Chen Jiande D. Z.
Published: May 2021

Background

Gastrointestinal (GI) motility disorders affect a large proportion of the population with limited treatment options. The aims of this study were to investigate the potential of a non‐invasive method of auricular vagal nerve stimulation (aVNS) for treating GI dysmotility and to explore possible mechanisms involving slow waves and interstitial cells of Cajal (ICC).

Methods

Normal rats were treated daily with loperamide for 1 week and then treated, while still on daily loperamide, with aVNS/Sham‐aVNS for another 1 week. Gastric emptying (GE), small intestine transit (SIT), and GI slow waves were measured. The plasma level of pancreatic polypeptide (PP) and noradrenaline (NE) was assessed by ELISA. ICC in the gastric antrum were detected by immunohistochemistry.

Key results

(a) aVNS significantly increased the percentage of normal GI slow waves (p < 0.05 for both fasting and postprandial states, vs. Sham‐aVNS) and accelerated GE (p < 0.05, vs. Sham‐aVNS) and SIT (p < 0.05, vs. Sham‐aVNS) impaired by loperamide. (b) aVNS increased plasma PP (p < 0.01) and decreased plasma NE (p < 0.01), compared with Sham‐aVNS. (c) Gastric ICC was decreased by loperamide (p < 0.01) but increased after aVNS (p < 0.01, vs. Sham aVNS).

Conclusions & Inferences

Loperamide induces upper GI dysmotility. aVNS accelerates upper GI transit and improving pace‐making activity mediated via the ICC. Non‐invasive aVNS may have a therapeutic potential for upper GI dysmotility.
Management of laryngeal chondroradionecrosis with pentoxifylline and vitamin E: A case report and review of the literature
Authors: Grossman Sanford , Simo Ricard , Patel Vinod
Published: May 2021

Laryngeal chondroradionecrosis (LCRN) is a rare complication characterised by radiation‐induced fibro‐atrophy and necrosis of the laryngeal cartilage. There is a mixed consensus on treatment strategy with limited cases reported in the literature. A 60‐year‐old female patient with a history of a poorly differentiated T3N0M0 glottic laryngeal squamous cell carcinoma treated via chemo‐radiotherapy presented 18 months following treatment with discomfort of her throat and difficulty swallowing. Imaging showed fracture of the right lamina of the thyroid cartilage with accompanying soft tissue swelling representative of LCRN. A combination of pentoxifylline and tocopherol (vitamin E) (PENTO) was prescribed on the principle of managing radiation induced fibrosis. At the 1‐month review, the patient's throat pain had resolved and her swallowing had improved. A further 2 months later a nasoendoscopy showed no evidence of LCRN. The PENTO protocol has been a successful management strategy in this case in the medium term.
Debunking the “Big Lie”: Election Administration in the 2020 Presidential Election
Authors: Canon David T. , Sherman Owen
Published: May 2021

The democratic process in the United States was sorely tested in the aftermath of the 2020 presidential election. Our electoral institutions survived that test, but the fragility of our democracy was exposed by a concerted effort to overturn the results of the presidential election, first in the courts and then with an insurrection at the nation's Capitol on January 6, 2021. We examine how this happened. Specifically, we will attempt to answer the following questions: How did the big lie evolve and what were its claims? How did the COVID pandemic and foreign interference complicate the voting process and contribute to the claims of fraud? How did the courts adjudicate the claims of fraud? Finally, how do we restore trust in the voting process?
Virtual reality expands the toolkit for conducting health psychology research
Authors: Martingano Alison Jane , Persky Susan
Published: May 2021

Virtual reality (VR) has become a readily available consumer technology, strengthening its promise as a research tool for health psychology. We identify five key strengths of VR‐based research: data collection, realism, experimental control, adaptability, and mobility (DREAM). We review how these advantages allow researchers to investigate behavioral, psychological, and social processes related to health and well‐being in novel ways, by using VR as both a stimulus and a measurement tool. We also describe challenges facing VR research and potential strategies researchers can use to mitigate them. In addition to reviewing existing research, we hope to inspire researchers to consider ways in which VR might be used in future to augment their own research programs or answer currently impracticable research questions in health psychology.
Ratings, rankings and managing numbers: Professionals' perspectives on user surveys in Swedish nursing home care
Authors: Carlstedt Elisabeth
Published: May 2021

Public sector services are audited, measured and ranked in order to improve quality and transparency and to prompt organizations to conform to normative definitions of quality. In Swedish eldercare, a nationwide user survey distributed by the public authorities to all eldercare users, designed to gauge user satisfaction, is a prominent example of this form of soft governance. The aim of the present study is to investigate nursing home representatives' meaning making of the user survey and its function. The findings from 24 qualitative interviews suggest that despite professional scepticism about flawed measurement procedures and tools and thus the validity of the survey results, organizations adjust the care they offer in order to improve low scores. External pressure and the risk of shame and a bad reputation may explain their willingness to let survey results guide their organizational improvements. The article concludes that practitioners may rely on their professional knowledge to dismiss the validity of normative external demands on one level but still manage such demands by making organizational changes on another level for the sake of good reviews. Moving between these levels makes it possible for respondents to be simultaneously critical and compliant. As an organization will need to appeal to external assessors of quality if it is to manage its reputation by achieving high scores, the audience's perceptions risk overriding care users' voices—the very voices the survey is intended to listen to.
Popular Attitudes Toward the Distribution of Vaccines Against COVID‐19: The Swiss Case
Authors: Knotz Carlo M. , Gandenberger Mia K. , Fossati Flavia , Bonoli Giuliano
Published: May 2021

With the arrival of vaccines against the novel coronavirus in late 2020, the issue of how vaccines should be distributed and which groups should be prioritized has become salient. We study popular attitudes toward the distribution of COVID‐19 vaccines and how these have changed over the course of the pandemic in Switzerland, drawing on data from two rounds of an original public opinion survey conducted in the spring and winter of 2020. We find that the public supports prioritizing vulnerable groups such as health care workers or the elderly. We also find a notable degree of cross‐generational solidarity: younger age cohorts prioritize the elderly, while older groups prioritize (typically younger) health care workers. We then examine whether this finding is not in fact driven by vaccine hesitancy. This is not the case for older age groups, whose solidarity thus seems to be genuine. Vaccine hesitancy is an issue among younger groups, however.
A national level estimation of population need for blood in India
Authors: Mammen Joy John , Asirvatham Edwin Sam , Lakshmanan Jeyaseelan , Sarman Charishma Jones , Mani Thenmozhi , Charles Bimal , Upadhyaya Sunita , Rajan Shobini
Published: May 2021

Background

The population need for blood is the total volume required to transfuse all the individuals who need transfusion in a defined population over a defined period. The clinical demand will arise when people with a disease or condition who require transfusion, access healthcare services, and subsequently the clinicians request blood. Essentially, the conversion of need to demand must be maximum to avoid preventable mortality and morbidity. The study estimated the population need for blood in India.

Methods

The methodology included a comprehensive literature review to determine the diseases and conditions requiring transfusion, the population at risk, and prevalence or incidence; and Delphi method to estimate the percentage of people requiring transfusion, and the quantum.

Results

The estimated annual population need was 26.2 million units (95% CI; 17.9–38.0) of whole blood to address the need for red cells and other components after the separation process. The need for medical conditions was 11.0 million units (95% CI:8.7–14.7), followed by surgery 6.6 million (95% CI:3.8–10.0), pediatrics 5.0 million (95% CI:3.5–7.0), and obstetrics and gynecology 3.6 million units (95% CI:1.9–6.2). The gap between need and demand which depends upon the access and efficiency of healthcare service provision was estimated at 13 million units.

Conclusion

The study brings evidence to highlight the gap between need and demand and the importance of addressing it. It cannot be just the responsibility of blood transfusion or health systems, it requires a multi‐sectoral approach to address the barriers affecting the conversion of need to clinical demand for blood.
Examining interindividual differences in select muscle and whole‐body adaptations to continuous endurance training
Authors: Bonafiglia Jacob T. , Islam Hashim , Preobrazenski Nicholas , Ma Andrew , Deschenes Madeleine , Erlich Avigail T. , Quadrilatero Joe , Hood David A. , Gurd Brendon J.
Published: May 2021

New Findings

What is the central question of the study?

Do interindividual differences in trainability exist for morphological and molecular skeletal muscle responses to aerobic exercise training?

What is the main finding and its importance?

Interindividual differences in trainability were present for some, but not all, morphological and molecular outcomes included in our study.

Our findings suggest that it is inappropriate, and perhaps erroneous, to assume that variability in observed responses reflects interindividual differences in trainability in skeletal muscle responses to aerobic exercise training.

Studies have interpreted a wide range of morphological and molecular changes in human skeletal muscle as evidence of interindividual differences in trainability. However, these interpretations fail to account for the influence of random measurement error and within‐subject variability. The purpose of the present study was to use the standard deviation of individual response (SDIR) statistic to test the hypothesis that interindividual differences in trainability are present for some but not all skeletal muscle outcomes. Twenty‐nine recreationally active males (age: 21 ± 2 years; BMI: 24 ± 3 kg/m2; ; 45 ± 7 ml/kg/min) completed 4 weeks of continuous training (REL; n = 14) or control (n = 15). Maximal enzyme activities (citrate synthase and β‐hydroxyacyl‐CoA dehydrogenase), capillary density, fibre type composition, fibre‐specific succinate dehydrogenase activity and substrate storage (intramuscular triglycerides and glycogen), and markers of mitophagy (BCL2‐interacting protein 3 (BNIP3), BNIP3‐like protein, parkin and PTEN‐induced kinase 1) were measured in vastus lateralis samples collected before and after the intervention. We also calculated SDIR values for , peak work rate and the onset of blood lactate accumulation for the REL group and a separate group that exercised at the negative talk test stage. Although positive SDIR values – indicating interindividual differences in trainability – were obtained for aerobic capacity outcomes, maximal enzyme activities, capillary density, all fibre‐specific outcomes and BNIP3 protein content, the remaining outcomes produced negative SDIR values indicating a large degree of random measurement error and/or within‐subject variability. Our findings question the interpretation of heterogeneity in observed responses as evidence of interindividual differences in trainability and highlight the importance of including control groups when analysing individual skeletal muscle response to exercise training.
A Multiscale Method for Coupled Steady-State Heat Conduction and Radiative Transfer Equations in Composite Materials
Authors: Tong Zi-Xiang , Li Ming-Jia , Yu Yi-Si , Guo Jing-Yu
Published: May 2021

Predictions of coupled conduction-radiation heat transfer processes in periodic composite materials are important for applications of the materials in high-temperature environments. The homogenization method is widely used for the heat conduction equation, but the coupled radiative transfer equation is seldom studied. In this work, the homogenization method is extended to the coupled conduction-radiation heat transfer in composite materials with periodic microscopic structures, in which both the heat conduction equation and the radiative transfer equation are analyzed. Homogenized equations are obtained for the macroscopic heat transfer. Unit cell problems are also derived, which provide the effective coefficients for the homogenized equations and the local temperature and radiation corrections. A second-order asymptotic expansion of the temperature field and a first-order asymptotic expansion of the radiative intensity field are established. A multiscale numerical algorithm is proposed to simulate the coupled conduction-radiation heat transfer in composite materials. According to the numerical examples in this work, compared with the fully resolved simulations, the relative errors of the multiscale model are less than 13% for the temperature and less than 8% for the radiation. The computational time can be reduced from more than 300 h to less than 30 min. Therefore, the proposed multiscale method maintains the accuracy of the simulation and significantly improves the computational efficiency. It can provide both the average temperature and radiation fields for engineering applications and the local information in microstructures of composite materials.
Resilience Assessment and Importance Measure for Interdependent Critical Infrastructures
Authors: Liu Xing , Fang Yi-Ping , Ferrario Elisa , Zio Enrico
Published: May 2021

Based upon a novel control-based dynamic modeling framework, this paper proposes two new indicators, i.e., resilience by mitigation and resilience by recovery, for the resilience analysis of interdependent critical infrastructures (ICIs) under disruptions. The former is built from the protection activities before and during the mitigation phase of a disruptive event, and the latter is the result of the restoration efforts, which take place at the recovery phase. The total resilience of ICIs combines both of these two aspects by taking into account the preferences of the decision makers. We demonstrate the applicability of the proposed modeling framework and metrics in a case study involving ICIs made of a power grid and a gas distribution system. Owing to the new resilience indicators, the priorities of subsystems and links within ICIs at different phases can be ranked; therefore, different resilience strategies at different phases of disruptive events are compared. The results show that proposed metrics can be used by stakeholders of ICIs on improving the effectiveness of system protection measurements.
Molybdenum and silver photoemission survey spectra from hard x-rays
Authors: Flanagan T. M. , Brumbach M. T. , Chow R. , Casalnuovo D. , Rubio-Zuazo J. , Castro G. R.
Published: May 2021

Electron emission from thick polished samples of polycrystalline molybdenum (Mo) and single crystalline 〈111〉 silver (Ag) was measured with hard x-ray photoemission spectroscopy. Six different excitation x-ray energies were used, nominally 8.0, 11.0, 13.0, 15.0, 18.0, and 21.5 keV. Survey spectra were recorded with each excitation to a kinetic energy of at most 15 keV, often capturing the entire emission range. The Mo 1s core peak was measured. Detailed LMM Auger spectra of Mo show marked increases in intensity and altered shape when x-ray energy exceeds the Mo 1s binding energy. The Mo and Ag L-shell photoelectron peaks are measured at four x-ray energies up to 18 keV showing the transition from 2p3/2 to 2s photoionization dominance.
The Marek's Disease Virus Unique Gene MDV082 Is Dispensable for Virus Replication but Contributes to a Rapid Disease Onset
Authors: You Yu , Conradie Andelé M. , Kheimar Ahmed , Bertzbach Luca D. , Kaufer Benedikt B.
Published: May 2021

MDV is a highly oncogenic alphaherpesvirus that causes Marek’s disease in chickens. The virus causes immense economic losses in the poultry industry due to the high morbidity and mortality, but also the cost of the vaccination.
Supplemental Material: Jurassic–Cenozoic tectonics of the Pequop Mountains, NE Nevada, in the North American Cordillera hinterland
Authors: Zuza A.V. , al. et
Published: May 2021

Supplemental Text: Supplemental figures (i.e., structural data and topographic profile across Pleistocene fault) and argon domain diffusion (MDD) modeling methods and data table. Tables S1 and S2: Argon data. Table S3: Apatite fission-track (AFT) data. Table S4: Zircon data.
Supplemental Material: Mafic-ultramafic intrusion formed by multi-stage evolution of hydrous basaltic melts
Authors: Li Qiwei , Zhao Jun-Hong , al. et
Published: May 2021

Table S1: Electron microprobe analyses of spinel; Table S2: Electron microprobe analyses of olivine; Table S3: Electron microprobe analyses of clinopyroxene; Table S4: Electron microprobe analyses of orthopyroxene; Table S5: Electron microprobe analyses of plagioclase; Table S6: Electron microprobe analyses of amphibole; Table S7: EC-AFC modeling results for the contamination of average lower crust.
Neutron Star Mergers and Gamma-Ray Bursts: Stripping Model
Authors: Blinnikov S. I. , Nadyozhin D. K. , Kramarev N. I. , Yudin A. V.
Published: May 2021

This paper provides an overview of the current state of the stripping model for short gamma-ray bursts. After the historical joint detection of the gravitational wave event GW170817 and the accompanying gamma-ray burst GRB170817A, the relation between short gamma-ray bursts and neutron star mergers has been reliably confirmed. We show that many properties of GRB170817A, which turned out to be peculiar in comparison with other short gamma-ray bursts, are naturally explained in the context of the stripping model, specifically, the time (1.7 s) between the peak of the gravitational wave signal and the detection of the gamma-ray burst, its total isotropic energy, and the parameters of the red and blue components of the accompanying kilonova.
Intravitreal conbercept for diabetic macular oedema: 2-year results from a randomised controlled trial and open-label extension study
Authors: Liu Kun , Wang Hanying , He Wei , Ye Jian , Song Yanping , Wang Yusheng , Liu Xiaoling , Wu Zhifeng , Chen Shaojun , Fan Ke , Liu Yuling , Zhang Feng , Li Zhiqing , Liu Lin , Zhang Junjun , Zhang Xuedong , Ye Junjie , Liang Xiaoling , Li Xiaoxin , Ke Xiao , Wu Quan , Li Jie , Tao Shanshan , Wang Xinguo , Rosenfeld Philip , Heier Jeffrey S , Kaiser Peter , Xu Xun
Published: May 2021

Background

To demonstrate the efficacy and safety of intravitreal injections of conbercept versus laser photocoagulation in the treatment of diabetic macular oedema (DME).

Methods

A 12-month multicentre, randomised, double-masked, double-sham, parallel controlled, phase III trial (Sailing Study), followed by a 12-month open-label extension study. Patients with centre-involved DME were randomly assigned to receive either laser photocoagulation followed by pro re nata (PRN) sham intravitreal injections (laser/sham) or sham laser photocoagulation followed by PRN 0.5 mg conbercept intravitreal injections (sham/conbercept). Patients who entered the extension study received PRN conbercept treatment. The primary endpoint was the changes in best-corrected visual acuity (BCVA) from baseline.

Results

A total of 248 eyes were included in the full analysis set and 157 eyes continued in the extension study. Significant improvement in mean change in BCVA from baseline to month 12 was observed in the sham/conbercept group (8.2±9.5 letters), whereas no improvement was observed in the laser/sham group (0.3±12.0 letters). Patients in the laser/sham group showed a marked improvement in BCVA after the switch to conbercept in the extension study, and there was no difference in BCVA between the two groups at the end of the extension study.

Conclusion

The use of a conbercept PRN intravitreal injection regimen improved the BCVA of patients with DME, and its efficacy was better than that of laser photocoagulations, and the same efficacy was observed when the eyes treated with laser alone were switched to conbercept.

Trial registration number

NCT02194634.
Do exercise-based prevention programmes reduce non-contact musculoskeletal injuries in football (soccer)? A systematic review and meta-analysis with 13 355 athletes and more than 1 million exposure hours
Authors: Lemes Italo Ribeiro , Pinto Rafael Zambelli , Lage Vitor N , Roch Bárbara A B , Verhagen Evert , Bolling Caroline , Aquino Cecilia Ferreira , Fonseca Sérgio T , Souza Thales R
Published: May 2021

Objective

The aim of this systematic review was to investigate the effect of exercise-based programmes in the prevention of non-contact musculoskeletal injuries among football players in comparison to a control group.

Design

Systematic review and meta-analysis of randomised controlled trials.

Data sources

MEDLINE, EMBASE, CENTRAL, CINAHL, PEDro and SPORTDiscus databases were searched from the earliest record to January 2021.

Eligibility criteria

Studies were eligible if they (1) included football players aged 13 years or older, (2) used exercise-based programmes as intervention, (3) presented the number of non-contact musculoskeletal injuries (ie, defined as any acute sudden onset musculoskeletal injury that occurred without physical contact) and exposure hours for each group, and (4) had a control group (eg, usual training, minimal intervention, education). All types of exercise-based prevention programmes were eligible for inclusion. Risk of bias for each included study and overall quality of evidence for the meta-analysis were assessed.

Results

Ten original randomised controlled trials with 13 355 football players and 1 062 711 hours of exposure were selected. Pooled injury risk ratio showed very low-quality evidence that exercise-based prevention programmes reduced the risk of non-contact musculoskeletal injuries by 23% (0.77 (95% CI 0.61 to 0.97)) compared with a control group.

Conclusion

Exercise-based prevention programmes may reduce the risk of non-contact musculoskeletal injuries by 23% among football players. Future high-quality trials are still needed to clarify the role of exercise-based programmes in preventing non-contact musculoskeletal injuries among football players.

PROSPERO registration number

CRD42020173017.
Why have so many African leaders died of COVID-19?
Authors: Falisse Jean-Benoît , Macdonald Robert , Molony Thomas , Nugent Paul
Published: May 2021

This paper provides evidence that the COVID-19-related mortality rate of national government ministers and heads of state has been substantially higher than that of people with a similar sex and age profile in the general population, a trend that is driven by African cases (17 out of 24 reported deaths worldwide, as of 6 February 2021). Ministers’ work frequently puts them in close contact with diverse groups, and therefore at higher risk of contracting SARS-CoV-2, but this is not specific to Africa. This paper discusses five non-mutually exclusive hypotheses for the Africa-specific trend, involving comorbidity, poorly resourced healthcare and possible restrictions in accessing out-of-country health facilities, the underreporting of cases, and, later, the disproportionate impact of the so-called ‘South African’ variant (501Y.V2). The paper then turns its attention to the public health and political implications of the trend. While governments have measures in place to cope with the sudden loss of top officials, the COVID-19-related deaths have been associated with substantial changes in public health policy in cases where the response to the pandemic had initially been contested or minimal. Ministerial deaths may also result in a reconfiguration of political leadership, but we do not expect a wave of younger and more gender representative replacements. Rather, we speculate that a disconnect may emerge between the top leadership and the public, with junior ministers filling the void and in so doing putting themselves more at risk of infection. Opposition politicians may also be at significant risk of contracting SARS-CoV-2.
Completeness and quality of low back pain prevalence data in the Global Burden of Disease Study 2017
Authors: Tamrakar Mamata , Kharel Priti , Traeger Adrian , Maher Chris , O'Keeffe Mary , Ferreira Giovanni
Published: May 2021

Introduction

Completeness of Global Burden of Disease (GBD) Study data is acknowledged as a limitation. To date, no study has evaluated this issue for low back pain, a leading contributor to disease burden globally.

Methods

We retrieved reports, in any language, based on citation details from the GBD 2017 study website. Pairs of raters independently extracted the following data: number of prevalence reports tallied across countries, age groups, gender and years from 1987 to 2017. We also considered if studies enrolled a representative sample and/or used an acceptable measure of low back pain.

Results

We retrieved 488 country-level reports that provide prevalence data for 103 of 204 countries (50.5%), with most prevalence reports (61%) being for high-income countries. Only 16 countries (7.8%) have prevalence reports for each of the three decades of the GBD. Most of the reports (79%) did not use an acceptable measure of low back pain when estimating prevalence.

Conclusion

We found incomplete coverage across countries and time, and limitations in the primary prevalence studies included in the GBD 2017 study. This means there is considerable uncertainty about GBD estimates of low back pain prevalence and the disease burden metrics derived from prevalence.
End-of-life care in illicit drug users: mapping medication use
Authors: Ulrick Phoebe , Panozzo Stacey , Marco David , Collins Anna , Philip Jennifer
Published: May 2021

Background

While clinical wisdom has long provided suggested guidance around caring for people who use illicit drugs (referred to as PWUD) at the end of life, there is striking paucity of empirical evidence underpinning these practices. Understanding medications and doses required to manage symptoms at the end of life is essential to provide effective end-of-life care for these patients. This study aimed to examine the type and dose of medications prescribed to hospitalised patients who use illicit drugs at the end of life, compared with patients without previous or current illicit drug use.

Method

A retrospective medical record review was conducted on consecutive patient deaths between 2012 and 2017 at a metropolitan hospital. PWUD were identified using the International Classification of Diseases 10th Revision codes for illicit drug use. Daily dosage of opioids, benzodiazepines and antipsychotics was documented for the last 3 days of life and compared with a matched comparator group.

Results

PWUD patients (n=55) received higher doses of opioids, midazolam and antipsychotics than comparator patients (n=55) for each day, significant for opioids in the last 24 hours (p=0.01). PWUD patients received a significantly higher total opioid dose (median=480.0 mg vs 255.0 mg) and midazolam (median=15.0 mg vs 5.0 mg) (both p<0.05). Rates of dose escalation did not differ.

Conclusions

Results suggest that PWUD require greater doses of symptom-controlling medications, particularly opioids and midazolam, at the end of life but that rates of dose escalation do not differ greatly. This study provides a foundation for future research to inform clinical guidelines for this cohort of palliative care patients.
Mimetic matter in LRS Bianchi type-I model
Authors: Güdekli E. , Demir E.
Published: May 2021

This paper deals with the locally rotationally symmetric (LRS) Bianchi type-I universe model in Mimetic Gravity Theory assuming it is an extended form of General Relativity Theory. It was developed as a conformal transformation of the Einstein–Hilbert action from the Einstein frame to the Jordon frame. First, we have proposed a potential function to clarify the expansion of our universe by considering the general solutions of the field equations that originate from the action of the theory, including the Lagrange multipliers. Lastly, after having achieved the general equation of the state parameter ω, we discussed whether the result corresponds to some fluids illuminating the expansion of the Universe or not.
General features of Nash equilibria in combinations of elementary interactions in symmetric two-person games
Authors: Szabó György , Király Balázs
Published: May 2021

Two-person games are used in many multi-agent mathematical models to describe pair interactions. The type (pure or mixed) and the number of Nash equilibria affect fundamentally the macroscopic behavior of these systems. In this paper, the general features of Nash equilibria are investigated systematically within the framework of matrix decomposition for n strategies. This approach distinguishes four types of elementary interactions that each possess fundamentally different characteristics. The possible Nash equilibria are discussed separately for different types of interactions and also for their combinations. A relation is established between the existence of infinitely many mixed Nash equilibria and the zero-eigenvalue eigenvectors of the payoff matrix.
Convenient and accurate formulas for stress intensity factor distribution of semi-elliptical surface crack
Authors: Takase Yasushi , Noda Nao-Aki
Published: May 2021

In this paper, the stress intensity factor (SIF) formula [Formula: see text] along the crack front of a semi-elliptical surface crack is studied. The exact SIF solution [Formula: see text] is used by solving the hypersingular integral equation of the body force method discussed in the previous paper. To obtain the accurate formula, the SIF ratio [Formula: see text]/[Formula: see text] is focused considering the exact solution [Formula: see text] of an elliptical crack. By applying the least squares method to the ratio [Formula: see text]/[Formula: see text], accurate and convenient formula is proposed. The proposed formulas may provide the accurate SIF distributions for the aspect ratio [Formula: see text]–4 better than 0.2% accuracy.
Surface defect detection of cylindrical lithium-ion battery by multiscale image augmentation and classification
Authors: Dandage Harshad K. , Lin Keh-Moh , Lin Horng-Horng , Chen Yeou-Jiunn , Tseng Kun-San
Published: May 2021

While deep convolutional neural networks (CNNs) have recently made large advances in AI, the need of large datasets for deep CNN learning is still a barrier to many industrial applications where only limited data samples can be offered for system developments due to confidential issues. We thus propose an approach of multi-scale image augmentation and classification for training deep CNNs from a small dataset for surface defect detection on cylindrical lithium-ion batteries. In the proposed Lithium-ion battery Surface Defect Detection (LSDD) system, an augmented dataset of multi-scale patch samples generated from a small number of lithium-ion battery images is used in the learning process of a two-stage classification scheme that aims to differentiate defect image patches of lithium-ion batteries in the first stage and to identify specific defect types in the second stage. The LSDD approach is an efficient prototyping method of defect detection from limited training images for quick system evaluation and deployment. The experiments show that, based on only 26 source images, the proposed LSDD (i) constructs two augmented multi-scale datasets of 19,309 and 6889 image patches for training and test, respectively, (ii) achieves 93.67% accuracy for discriminating defect image patches in the first stage, and (iii) reaches 90.78% mean precision rate and 93.89% mean recall rate for defect type identification in the second stage. Our two-stage classification scheme has higher defect detection sensitivity than an intuitive one-stage classification scheme by 0.69%, and outperforms the one-stage scheme in identifying specific defect types. For comparing with YOLOv3 detector, less defect misdetections are observed in our approach as well.
Stress due to interfacial slip causing sleeve fracture in shrink-fitted work roll
Authors: Noda Nao-Aki , Rafar Rahimah Abdul , Sano Yoshikazu
Published: May 2021

The rolls are classified into two types; one is a single-solid type, and the other is a shrink-fitted construction type consisting of a sleeve and a shaft. The bimetallic work rolls are widely used in the roughing stands of hot rolling stand mills. Regarding a shrink-fitted construction type, the interfacial slip sometimes appears between the shaft and the shrink-fitted sleeve. This interfacial slip can be regarded as the relative displacement between the sleeve and the shaft. In this paper, the stress due to the interfacial slip is studied because the stress may cause the sleeve fracture. It is found that the stress in the shrink-fitted surface is slightly decreased with increasing number of rotations [Formula: see text]. Therefore, the stress obtained by the simulation at [Formula: see text] can be used to estimate the fatigue strength.
Mechanical properties of large-scale composite structures according to process conditions
Authors: Park Chang Wook , Yoon Sung Won
Published: May 2021

The purpose of this study is to determine the correct estimation of the concept design and laminating pattern for composites. In this study, the effect of carbon tow prepreg on the composite structure has been investigated. Also, this work evaluated the structural safety according to the laminating pattern and process technique by computer simulation. The laminating pattern of three kinds was designed through the normal shape. Also, process technique of two kinds were carried out in dry and wet method to produce composites structure. The result of FEA showed that the structural safety of carbon tow prepreg is not significantly superior to that of the structure with wet method material. However, considering the benefits of working environment and the reduction of the number of process, the possibility of replacing materials and process technique will be sufficient for composite structure.
How to estimate fatigue strength of wood material
Authors: Saitou Kinjirou , Noda Nao-Aki
Published: May 2021

When wood materials are used for a mechanical structure, the fatigue strength should be estimated due to repeated loads they receive. This paper reveals that the methods to calculate allowable stresses along with American Society for Testing and Materials (ASTM) and Architectural Institute of Japan (AIJ) can take the strength reduction due to fatigue into account because the ASTM/AIJ allowable stresses against the static strength closely resemble the fatigue limit against the wood static strength.
Piecewise modeling and dynamic analysis of hydro-turbine governing system in the process of shutdown transient
Authors: Chen Yuansheng , Tong Fei
Published: May 2021

This paper pays attention to the piecewise continuous time modeling of a hydro-turbine governing system in the process of shutdown transient. As a pioneering work, the piecewise nonlinear dynamic transfer coefficients are introduced into the system. Moreover, for different hydrographs of shutdown transient process, the effect of different shutdown laws on the quality of shutdown transient process has been analyzed by numerical simulations. The nonlinear dynamic behaviors of the hydro-turbine governing system are illustrated by bifurcation diagrams, Poincaré maps, time waveforms and phase orbits. More importantly, these methods and analytic results are useful for the safe and stable operation of a hydropower station in the process of shutdown transient.
Efficient Deep Learning Models for Categorizing Chenopodiaceae in the Wild
Authors: Heidary-Sharifabad Ahmad , Zarchi Mohsen Sardari , Emadi Sima , Zarei Gholamreza
Published: May 2021

The Chenopodiaceae species are ecologically and financially important, and play a significant role in biodiversity around the world. Biodiversity protection is critical for the survival and sustainability of each ecosystem and since plant species recognition in their natural habitats is the first process in plant diversity protection, an automatic species classification in the wild would greatly help the species analysis and consequently biodiversity protection on earth. Computer vision approaches can be used for automatic species analysis. Modern computer vision approaches are based on deep learning techniques. A standard dataset is essential in order to perform a deep learning algorithm. Hence, the main goal of this research is to provide a standard dataset of Chenopodiaceae images. This dataset is called ACHENY and contains 27030 images of 30 Chenopodiaceae species in their natural habitats. The other goal of this study is to investigate the applicability of ACHENY dataset by using deep learning models. Therefore, two novel deep learning models based on ACHENY dataset are introduced: First, a lightweight deep model which is trained from scratch and is designed innovatively to be agile and fast. Second, a model based on the EfficientNet-B1 architecture, which is pre-trained on ImageNet and is fine-tuned on ACHENY.

The experimental results show that the two proposed models can do Chenopodiaceae fine-grained species recognition with promising accuracy. To evaluate our models, their performance was compared with the well-known VGG-16 model after fine-tuning it on ACHENY. Both VGG-16 and our first model achieved about 80% accuracy while the size of VGG-16 is about 16[Formula: see text] larger than the first model. Our second model has an accuracy of about 90% and outperforms the other models where its number of parameters is 5[Formula: see text] than the first model but it is still about one-third of the VGG-16 parameters.
Inductive Feedback Technique for Design of High Gain 0.18μm CMOS LNA for 5G Applications
Authors: Banu Anjana Jyothi , Kavya G. , Jahnavi D.
Published: May 2021

A 26[Formula: see text]GHz low-noise amplifier (LNA) designed for 5G applications using 0.18[Formula: see text][Formula: see text]m CMOS technology is proposed in this paper. The circuit includes a common-source in the first stage to suppress the noise in the amplifier. The successive stage has a Cascode topology along with an inductive feedback to improve the power gain. The input matching network is designed to achieve the input reflection coefficient less than [Formula: see text]7dB at the intended frequency. The matching network at the output is designed using inductor–capacitor (LC) components connected in parallel to attain the output reflection coefficient of [Formula: see text]10[Formula: see text]dB. Due to the inductor added in feedback at the second stage. The [Formula: see text] obtained is 18.208[Formula: see text]dB at 26[Formula: see text]GHz with a noise figure (NF) of 2.8[Formula: see text]dB. The power supply given to the LNA is 1.8[Formula: see text]V. The simulation and layout of the presented circuit are performed using Cadence Virtuoso software.
ECCENTRIC DISTANCE SUM OF SUBSTITUTION TREE NETWORKS
Authors: KIM JINMYONG , KIM MYONGJIN
Published: May 2021

In this paper, we study the eccentric distance sum of substitution tree networks. Calculation of eccentric distance sum naturally involves calculation of average geodesic distance and it is much more complicated. We obtain the asymptotic formulas of average geodesic distance and eccentric distance sum of both symmetric and asymmetric substitution tree networks. Our result on average geodesic distance generalizes the result of [T. Li, K. Jiang and L. Xi, Average distance of self-similar fractal trees, Fractals 26(1) (2018) 1850016.] from symmetric case to asymmetric case. To derive formulas, we investigate the corresponding integrals on self-similar measure and use the self-similarity of distance and measure. For simplicity, we introduce some systematic symbolic assignments and make some assumptions on the graph. We verify that our formulas are correct using the numerical calculation results.
ON FRACTIONAL ORDER MAPS AND THEIR SYNCHRONIZATION
Authors: GADE PRASHANT M. , BHALEKAR SACHIN
Published: May 2021

We study the stability of linear fractional order maps. We show that in the stable region, the evolution is described by Mittag-Leffler functions and a well-defined effective Lyapunov exponent can be obtained in these cases. For one-dimensional systems, this exponent can be related to the corresponding fractional differential equation. A fractional equivalent of map [Formula: see text] is stable for [Formula: see text] where [Formula: see text] is a fractional order parameter and [Formula: see text]. For coupled linear fractional maps, we can obtain ‘normal modes’ and reduce the evolution to an effective one-dimensional system. If the coefficient matrix has real eigenvalues, the stability of the coupled system is dictated by the stability of effective one-dimensional normal modes. If the coefficient matrix has complex eigenvalues, we obtain a much richer picture. However, in the stable region, evolution is dictated by a complex effective Lyapunov exponent. For larger [Formula: see text], the effective Lyapunov exponent is determined by modulus of eigenvalues. We extend these studies to fixed points of fractional nonlinear maps.
BIFURCATION BEHAVIORS OF A FRACTIONAL-ORDER PREDATOR–PREY NETWORK WITH TWO DELAYS
Authors: HUANG CHENGDAI
Published: May 2021

This paper highlights the stability and bifurcation of a fractional-order predator–prey model involving two delays. The critical values of delays with respect to Hopf bifurcation are exactly calculated for the developed model by taking two different delays as bifurcation parameters, respectively. Moreover, the effects of fractional order and additional delay on the bifurcation point are carefully explored. It detects that the stability performance is extremely strengthened by taking an appropriate fractional order and another delay. This hints that the onset of Hopf bifurcation can be advanced (lagged) with variations of their values. Numerical simulations are ultimately employed to check the correctness of the derived theoretical analysis.
MILD SOLUTIONS OF COUPLED HYBRID FRACTIONAL ORDER SYSTEM WITH CAPUTO–HADAMARD DERIVATIVES
Authors: BEDI PALLAVI , KUMAR ANOOP , ABDELJAWAD THABET , KHAN AZIZ , GÓMEZ-AGUILAR J. F.
Published: May 2021

This paper is devoted to prove the existence of mild solutions of coupled hybrid fractional order system with Caputo–Hadamard derivatives using Dhage fixed point theorem in Banach algebras. In order to confirm the applicability of obtained result an example is also presented.
MEAN DISTANCE ON STRETCHED CANTOR PRODUCT
Authors: JIA QI , FAN JIAQI , XI LIFENG
Published: May 2021

The stretched Cantor product is not self-similar but rectifiable. Using the method of finite pattern, we study the mean geodesic distance on the stretched Cantor product.
MULTIFRACTAL TEMPORALLY WEIGHTED DETRENDED CROSS-CORRELATION ANALYSIS OF PM10, NOX AND METEOROLOGICAL FACTORS IN URBAN AND RURAL AREAS OF HONG KONG
Authors: JIANG SHAN , YU ZU-GUO , ANH VO V. , ZHOU YU
Published: May 2021

Understanding of its correlation to some relevant factors is of paramount importance for modeling and predication of the air pollution process. Compared with the traditional cross-correlation analysis, multifractal detrended cross-correlation analysis (MFDCCA) was argued to be a more suitable method to analyze air pollutant time series due to their non-stationarity nature. Multifractal temporally weighted detrended cross-correlation analysis (MF-TWXDFA) was proposed to improve the shortcomings of MFDCCA. In this study, we apply MF-TWXDFA to investigate the cross-correlation between pollutants ([Formula: see text] and [Formula: see text]) and meteorological factors (temperature, pressure, wind speed (WS) and relative humidity (RH)). The results on the dataset from 1 January 2005 to 31 December 2014 in urban and rural areas of Hong Kong show the existence of multifractal cross-correlation between all pairs of pollutants and meteorological factors in both urban and rural areas. Different from the previous MFDCCA results, we found that the multifractal degree of cross-correlation between [Formula: see text] and (temperature, pressure) is more obvious in urban area. The multifractal strength of cross-correlation between [Formula: see text] and WS is very weak in either urban or rural area. Furthermore, the MF-TWXDFA cross-correlation coefficient [Formula: see text] can capture negative correlation between pollutants and meteorological factors. For [Formula: see text], [Formula: see text] in urban area is less than or close to that in rural area with respect to these four meteorological factors. The [Formula: see text] of [Formula: see text] in urban and rural areas shows more complex patterns for varied meteorological factors. Compared with MFDCCA, MF-TWXDFA can provide much richer information about the relationships between pollutants and meteorological factors, which is beneficial to further modeling and prediction of the air pollution process.