bluuebunny/crossref_metadata_2025 huggingface dataset:
QED coherence in matter, syntropy and the coherent domains as storing “devices”
Authors: Caligiuri Luigi Maxmilian
Published: April 2022

Several macroscopic systems, like in particular living organisms, are characterized by stability and high level of order at mesoscopic / macroscopic scale. These peculiar features cannot be explained by considering just short-range interactions among their elementary constituents (atoms / molecules) and the entropic dynamics governing it. The theory of QED coherence predicts that in condensed matter, when suitable boundary conditions about temperature and density are satisfied (as generally happens in living systems), a quantum phase transition spontaneously occurs, driving the system towards a macroscopic coherent quantum state in which phase tuned oscillations between matter and electromagnetic field take place and ensure long-range correlation and order. In 1944, the italian mathematician Luigi Fantappie formulated the “Principi di una teoria unitaria del mondo fisico e biologico”, according to which living systems are governed by “syntropic” spontaneous phenomena, that are dual with respect the “entropic” ones, characterized by a reduction of entropy with time and whose causes are put in the future with respect the occurring events, able to ensure the organization and stability of living systems. In this paper we show how the results of QED coherence in matter are able to reproduce several of the main features of “syntropic” dynamics so giving it a support based on Quantum Field Theory. Finally, the role of water as a gatherer of quantum information, predicted by the QED coherence theory, is discussed as a possible practical realization of syntropic dynamics.
Macroscopic nonlocal correlations by new data of the Baikal Experiment
Authors: Korotaev S , Budnev N , Serdyuk V , Kiktenko E , Orekhova D , Gorohov J
Published: April 2022

The long-term Baikal experiment on study of macroscopic nonlocal correlations between random dissipative heliogeophysical processes and probe ones in the detectors have revealed prominent features of macroscopic entanglement predicted by action-at-a-distance electrodynamics. These correlations have both the retarded and advanced components with large time shifts. The correlations occur at extremely low frequencies and require long series of observations, so the Baikal experiment is continuing to study their unusual properties. In 2019-2021 new data were obtained on correlation of the signals of spaced detectors with each other and with to the natural processes: solar and hydrodynamic activity in Lake Baikal, as well as with the earthquake. The possibility of forecasting of solar and hydrodynamic activity on nonlocal correlations is demonstrated. Recently we paid attention to relatively short periods and discovered unexpected in-phase diurnal variation in the signals of both deep-sea detectors. This diurnal variation is not related to any hydrological processes. Moreover, this variation turned out in-phase with that one recorded by the remote lab detector (at the longitude difference 67°), that is it occurs in universal time, and cannot be associated with the meteorological or geomagnetic diurnal variations. The source of this signal in nonlocal correlation detectors is unknown yet.
Quantum phase effects for electrically charged particles and redefinition of the momentum operator
Authors: Kholmetskii A.L. , Yarman T. , Missevitch O.V.
Published: April 2022

We analyze the physical meaning of quantum phases for moving electric/magnetic dipoles through a superposition of quantum phases for point-like charges of the dipole, and in this way we disclose two new quantum phases for moving charges, next to the well-known magnetic and electric Aharonov-Bohm phases. We find that a consistent description of the full set of quantum phase effects for charged particles requires to modify the standard definition of the momentum operator via the canonical momentum of a particle towards a more inclusive definition, where this operator is associated with the vector sum of mechanical and interactional electromagnetic (EM) momenta for a charged particle in the EM field. Some principal implications of this result are discussed.
High-accuracy Machine Learning Models to Estimate above Ground Biomass over Tropical Closed Evergreen Forest Areas from Satellite Data
Authors: Tappayuthpijarn Ktawut , Vindevogel Bernd S
Published: April 2022

Quantifying the amount of biomass stored in forested areas has been traditionally done with manual field measurements, which is costly, time consuming and doesn’t scale well over large areas. This paper investigates the possibility to estimate the amount of Above Ground Biomass (AGB) using machine learning models with publicly available satellite data, where a large-scale training dataset has been created from a detailed biomass mapping project in the Democratic Republic of Congo (DRC). Several model architectures including the current state-of-the-art tree-based models were tested along with deep neural network (DNN) ones. It was found that DNN models provide slight improvement in accuracy, whilst can potentially be used for further fine-tuning with smaller local dataset for usage elsewhere outside of the DRC.
A Comparative Study of Geometric and Exponential Laws in Modelling the Distribution of Daily Precipitation Durations
Authors: Hafyani Mounia El , Himdi Khalid El
Published: April 2022

Wet and dry duration modelling is critical in engineering hydrology. The goal of this study is to model and analyze the wet and dry duration distributions. For this intent, daily rainfall data for Kenitra station were used on the period from 1967 to 2017. To represent the distribution of wet and dry durations, First-order Markov chain, Second-order Markov chain, and truncated negative binomial distribution are applied to represent the distribution of wet and dry durations. To assess the data adherence to the proposed models, the Chi-square and Kolmogorov-Smirnov tests have been used. The Akaike information criterion is applied to determine the most effective model distribution. We go further to investigate the distribution of the number of wet and dry days over a k-day period. This law is implemented using an algorithm based on conditional laws. This work is completed by comparing the calculated moments of the three estimated models to the observed moments of the number of wet/dry days over k consecutive days. The study demonstrates the effectiveness of our method for modelling wet and dry daily precipitation durations.
GIS Mapping of Salt Farms and Salt Supply Chain Actors in the Visayas and Mindanao, Philippines
Authors: Bartolome G J C , Magpantay J P , Delos Reyes J A , Lat A T , Reodica T J I , Manalo C J B
Published: April 2022

The 2010 survey of the Nutrition Council of the Philippines (NCP) revealed dramatic changes in the level of participation of the salt supply chain actors and their production, processing, and marketing activities. Among the industry’s biggest challenges are: salt remains excluded from the list of priority commodities of the government; the changes in weather patterns due to climate change which adversely impact the production cycle; prominence of traditional methods of production; and low productivity of local farms. While remote sensing technologies including geographic information system (GIS) mapping have been widely adopted for the improvement of agricultural productivity in the Philippines, use of such in research that focuses on salt production and supply chain is still very limited. GIS maps are perceived as effective information library and decision support tool that can help the supply chain of the neglected salt industry. This study focused on the mapping of salt farms and their supply chain actors from selected salt production sites in the Visayas and Mindanao islands. Eleven provinces were included in the surveys of market intermediaries and end-consumers who were traced from salt producers. Their geographic coordinates were recorded and satellite and Google Earth images of the supply chain actors were digitized in ArcGIS 10.5 software to generate the maps, physical characteristics of which were examined for possible patterns. Results show that in Mindanao, the market areas (or the salt traders) are concentrated in Zamboanga del Sur particularly in Aurora and Zamboanga City, but the producers are in Alubijid and El Salvador City, Misamis Oriental. In the Visayas, traders are more scattered and are greater in number than in Mindanao.
Evaluating the Effects of Environmental Stress on Leaf Chlorophyll Content as an Index for Tree Health
Authors: Talebzadeh F , Valeo C
Published: April 2022

Chlorophyll content plays a vital role in photosynthetic and biomass production in all plants. Because chlorophyll shows a greater sensitivity to changes in external conditions than do other pigments in foliage, such as carotenoids for example, chlorophyll content in leaves may be a good surrogate for environmental stress, changes in temperature and humidity, as well as in pollutant levels both in the air and in the soil. This paper reviews the potential for chlorophyll content in the leaves of trees as a measure of tree health, resistance to stress and environmental conditions. Because chlorophyll content is shown to decrease dramatically with increases in pollution, non-destructive methods for evaluating the amount of chlorophyll in leaves and its changes over a time may be a sufficient indicator for environmental pollutant levels in the air, in the soil and in the water used by a tree.
Safety of direct oral anticoagulants (DOACs) vs. warfarin for people aged ≥ 75 years with atrial fibrillation: a cohort study
Authors: Mitchell A , Snowball J , Welsh T J , Watson M C , McGrogan A
Published: April 2022

Introduction

Warfarin significantly reduces the risk of stroke in people with atrial fibrillation (AF), but historically has been underused in older people due to complicated dosage regimens. DOACs offer an attractive alternative to warfarin and were shown to be non-inferior in randomised controlled trials, however older people were underrepresented in these trials and there have been few studies investigating outcomes specifically in this high risk group (1).

Aim

To compare the risk of major, non-major, gastrointestinal, and intracranial bleeding between warfarin and DOACs in people aged ≥ 75 years with AF.

Methods

A cohort of patients aged ≥ 75 years with a diagnosis of AF was extracted from the Clinical Practice Research Datalink (CPRD). Patients could enter the study on the date of their first prescription for warfarin or a DOAC between 1/1/2013 and 27/12/2017. Patients were censored on the date of the outcome, death, or leaving the general practice. Switching between anticoagulants and unexposed periods were measured using prescription mapping. Crude and adjusted hazard rates of the risk of bleeding were calculated using a Cox proportional hazards model with oral anticoagulant prescribing as a time varying covariate.

Results

The cohort included 10,149 patients in the warfarin group and 10,237 in the DOAC group. The groups had similar characteristics and the average age was 81 in the warfarin group and 82 in the DOAC group. The table summarises the results. Whilst major and non-major bleeding was similar between all DOACs and warfarin, rivaroxaban was associated with higher risk and apixaban lower risk when analysed separately. Risk of gastrointestinal bleeding was higher with all DOACs and rivaroxaban than warfarin but apixaban was not significantly different. Few intracranial events occurred (n=131).

Conclusion

The results indicate that DOACs as a group are not significantly different to warfarin, however when analysed separately, apixaban may be safer. While the study relies on prescription data and hence it is not known if patients were taking the medications, the large cohort studied is representative of older people who are prescribed these medications in UK primary care.

Reference

(1) Mitchell A, Watson MC, Welsh T, McGrogan A. Effectiveness and safety of direct oral anticoagulants versus vitamin K antagonists for people aged 75 years and over with atrial fibrillation: A systematic review and meta-analyses of observational studies. Journal of Clinical Medicine. 2019; 8 (554).
Machine Learning and the Platformization of the Military: A Study of Google's Machine Learning Platform TensorFlow
Authors: Hoijtink Marijn , Planqué-van Hardeveld Anneroos
Published: April 2022

Against the background of the growing use of machine learning (ML) based technologies by the military, our article calls for an analytical perspective on ML platforms to understand how ML proliferates across the military and to what effects. Adopting a material–technical perspective on platforms as developed within new media studies, and bringing this literature to critical security studies, we suggest that a focus on platforms and the technical work they do is needed to understand how digital technologies are emerging and shaping security practices. Through a detailed study of Google's open-source ML platform TensorFlow and a discussion of the US Department of Defense Algorithmic Warfare Cross-Functional Team, or Project Maven, we make two broader contributions. First, we identify a broader “platformization” of the military, with which we refer to the growing involvement and permeation of the (technomaterial) ML platform as the infrastructure that enables new practices of decentralized and experimental algorithm development across the military. Second, we draw out how this platformization is accompanied by new entanglements between the military and actors in the corporate domain, especially Big Tech, which play a key role in this context, as well as the open-source community that is organized around these platforms.
Distinguishing gravitational and emission physics in black hole imaging: spherical symmetry
Authors: Kocherlakota Prashant , Rezzolla Luciano
Published: April 2022

Imaging a supermassive black hole and extracting physical information requires good knowledge of both the gravitational and the astrophysical conditions near the black hole. When the geometrical properties of the black hole are well understood, extracting information on the emission properties is possible. Similarly, when the emission properties are well understood, extracting information on the black hole geometry is possible. At present however, uncertainties are present both in the geometry and in the emission, and this inevitably leads to degeneracies in the interpretation of the observations. We explore here the impact of varying geometry and emission coefficient when modelling the imaging of a spherically accreting black hole. Adopting the Rezzolla–Zhidenko parametric metric to model arbitrary static black holes, we first demonstrate how shadow-size measurements leave degeneracies in the multidimensional space of metric-deviation parameters, even in the limit of infinite-precision measurements. Then, at finite precision, we show that these degenerate regions can be constrained when multiple pieces of information, such as the shadow-size and the peak image intensity contrast, are combined. Such degeneracies can potentially be eliminated with measurements at increased angular resolution and flux sensitivity. While our approach is restricted to spherical symmetry and hence idealized, we expect our results to hold also when more complex geometries and emission processes are considered.
Dollar beta and stock returns
Authors: Bruno Valentina , Shim Ilhyock , Shin Hyun Song
Published: April 2022

The financial channel of exchange rates operates through changes in risk-taking by investors and is reflected in the response of financial conditions to exchange rate movements. We show that stock returns also reflect the financial channel of exchange rates, with higher local currency stock returns associated with a weaker dollar. The broad dollar index emerges as a global factor, consistent with the financial channel operating through swings in risk-taking by global investors. We introduce the ‘dollar beta’ as the sensitivity of stock returns to swings in the broad dollar index and show that emerging market stock indices that have a higher dollar beta tend to have higher average returns, implying that the dollar beta is a cross-section risk factor that is priced.
Between Federal and Unitary States
Authors: Arretche Marta
Published: April 2022

This chapter considers the proposition that the binary distinction between constitutional forms is an expression of clusters of real-world political institutions must be demonstrated rather than assumed. If this proposition is not demonstrated, the binary distinction cannot be considered as a good predictor of different patterns of performance between the two blocs of countries. The chapter is organized into four sections. The first section explores arguments in favour of the analytical utility of employing the binary distinction between federal and unitary states as representative of clusters of political institutions. The second section demonstrates how empirical research has cast several doubts on this proposition. The third examines Latin American democracies with a population of over eight million and demonstrates how this binary distinction hides important institutional variations in the design of governance structures and political institutions. The fourth section discusses problems of endogeneity of the causal relation between political institutions and economic and social performance. The paper concludes that the theorizing of the relations between prescriptive theorization and positive theories of forms of state requires identifying subtypes of governance structures that do not coincide with the constitutional forms of state.
Constitutions and International Law
Authors: Chehtman Alejandro
Published: April 2022

This chapter examines the role of international law in the Constitutional systems of Latin America. The relationship between international law and municipal law is examined within the jurisprudential debate between monism and dualism. At issue in that debate is whether they consist of two separate systems of law, or whether they are both a single legal system. The chapter focuses on the extent to which international law can be validly invoked before domestic authorities, both as a legal and a political issue, and the role these authorities recognize it in their reasoning and decision-making. It considers three specific questions. First, it examines whether international norms can be validly invoked before local authorities, particularly courts. Second, it pays attention to the hierarchy conferred upon these norms under the domestic Constitutional system. Finally, it assesses the role of the case-law or decisions by supranational bodies is considered relevant to the application of these rules by domestic authorities.
Political Participation and Democratic Innovation
Authors: Avritzer Leonardo , Faria Cláudia Feres
Published: April 2022

Latin America democratized during the 1980s following a century of authoritarian breakdowns. In the ensuing thirty-five years, the new democracies were strengthened through different democratic processes such as constitution-making, accountability, and participation that have re-energized the regimes in the regions. This chapter shows how the new rights for political participation created many different ways of combining representation and participation in those countries, without promoting political instability. This breaks with a relatively well-established view of democratic theory which affirms that increased social participation generates political instability. The process of constitutional change impacted the relationship between the political system and civil society, allowing more political and social inclusion. Nonetheless, this process of including new actors in the countries’ social policies were not homogeneous. The democratic innovations that were created, as well as the state willingness to implement these innovations, are also important variables to explain these differences.
Judicial Independence in Latin America
Authors: Shankar Shylashri
Published: April 2022

This chapter addresses the question of how Asia perceives judicial independence in Latin America. A general definition of judicial independence is that courts can act in ways that are not dictated by the political and administrative organs of the state or by powerful non-governmental actors. Such independence can refer to the institutional autonomy of judges from other individuals and institutions. However, it is not enough for courts to possess structurally (constitutionally) assigned powers such as judicial review, and be insulated in its governance (appointments, promotion, transfers, and budget). Judicial independence also refers to behavioural autonomy of the judges. One has to separate the scope of judicial choices from questions about the direction of such choices.
Latin American Constitutionalism
Authors: Ginsburg Tom
Published: April 2022

For a North American looking at constitutions in Latin America, one recognizes certain broad similarities to the familiar image of constitutions and constitutionalism; thus, one can see the general shape of the phenomenon. But the particular features appear different, even distorted or inverted. On several dimensions, including stability, efficacy, and the relationship between written texts and constitutionalism in practice, the story in Latin America is in many ways the opposite of that in the United States. In Latin America, a colonial legacy of domination and exploitation of large indigenous populations has left the region today as the world’s most unequal with a good deal of violence. Even as both parts of the New World drew on the revolutionary ideas of the 18th century in their independence movements, these were instantiated in different environments and so developed differently. This chapter covers several different arenas in which constitutional norms or practices have diverged.
Xenogeneic Mesh Provides Safe and Durable Long-Term Outcomes in Abdominal Wall Reconstruction of High-Risk Centers for Disease Control and Prevention Class III and IV Defects
Authors: Hassan Abbas M. , Asaad Malke , Liu Jun , Offodile Anaeze C. , Butler Charles E.
Published: April 2022

Objective:

Evaluate long-term outcomes of abdominal wall reconstruction (AWR) using xenogeneic mesh in patients with Centers for Disease Control and Prevention (CDC) class III/IV defects. We hypothesized that AWR with xenogeneic mesh results in acceptable outcomes.

Background:

Optimal mesh selection in AWR of CDC class III/IV defects is controversial. Outcomes using xenogeneic mesh are lacking.

Methods:

We conducted a retrospective cohort study of patients who underwent AWR using xenogeneic mesh in CDC class III/IV defects from March 2005 to June 2019. Primary outcome was hernia recurrence (HR). Secondary outcomes were surgical site occurrence (SSO) and surgical site infection (SSI).

Results:

Of consecutive 725 AWRs, we identified 101 patients who met study criteria. Sixty-eight patients had class III defects, while 33 had class IV defects. Patients had a mean age of 61.3 ± 11.1 years, mean body mass index of 31.8 ± 7.3 kg/m2, and mean follow-up time of 41.9 ± 26.3 months. Patients had HR rate of 21%, SSO rate of 49%, and SSI rate of 24. Class IV defects were predictive of SSOs (odds ratio [OR], 2.88; 95% confidence interval [CI], 1.11–7.42; P = 0.029) but not HR (hazard ratio, 1.60; 95% CI, 0.59–4.34; P = 0.355) or SSIs (OR, 2.62; 95% CI, 0.85–8.10; P = 0.094).

Conclusions:

Patients with class IV defects have a higher risk of SSOs, but not HR or SSIs, compared with patients with class III defects. Despite the high level of defect contamination, AWR with xenogeneic mesh demonstrated acceptable HR, SSO, and SSI rates. Therefore, safe and durable long-term outcomes are achievable in single-stage AWR using xenogeneic mesh for CDC class III/IV defects.
Nurses' Experiences Implementing ePED
Authors: Klingbeil Carol G. , Gibson Cori , Johnson Norah L. , Polfuss Michele , Gralton Karen , Lerret Stacee M.
Published: April 2022

Quality discharge teaching prepares patients and families to transition safely from hospital to home. Technology can enhance and support quality discharge teaching by promoting patient family engagement during the transition. The purpose of this mixed methods study was to explore clinical nurses' experience with using Engaging Parents in Education for Discharge, an iPad application to guide quality discharge teaching. Twelve nurses at a large Midwestern Children's Hospital participated in small focus groups after use of the Engaging Parents in Education for Discharge application and completed a questionnaire on their perception of the acceptability and feasibility of the app. Findings revealed three themes: (1) development and deployment issues focused on the importance of training and support by the study team during implementation; (2) workflow integration centered on the importance of incorporating use of the app into current workflows and to preserve effective communication strategies with parents to optimize use in the healthcare setting; and (3) nurses perceived value in the use of the Engaging Parents in Education for Discharge app for beneficial scripting, questions on discharge topics often forgotten, and guidance for complex patients. Results of this study offer insight into key components for consideration when implementing and integrating technology to aid nursing practice.
An Integrated Review of Obstetric Admissions in the Intensive Care Unit
Authors: Luebcke Caitlin , Smith Beth E. , Abrahamson Kathleen
Published: April 2022

Background

Critically ill expectant mothers are regularly transferred from obstetrics units to an intensive care unit (ICU), placing one specialty population in an environment designed for another.

Objective

The purpose of this study is to examine the rates of admission, admitting diagnoses, and mortality of obstetric intensive care patients in the United States and peer nations, and discuss implications to the critical care nurse.

Methods

Relevant studies were identified in PubMed and Cumulative Index of Nursing and Allied Health Literature following strict eligibility criteria, including peer reviewed primary research, from 2010–2021, that examined rates of admissions, diagnoses, morbidity, and mortality of peripartum women requiring intensive care. Specialty ICU and countries with an overall performance score from the World Health Organization that placed them in the lower two-thirds deciles of all member countries were excluded. Fourteen articles, representing 9 countries, were reviewed by a single doctoral student.

Results

Few obstetrics patients required intensive care. The majority of admissions and deaths occurred within the postpartum period. The most common admitting diagnoses were hemorrhage, hypertensive disorders of pregnancy, and sepsis. Mean mortality ranged from 0.2% to 9.7%. The most common causes of death were cardiovascular diseases and postpartum hemorrhage.

Discussion

These women represent a truly specialized subset within the critical care population. Limitations include possible selection, confounding, and chronology biases; use of a single data extractor, and a relative dearth of relevant studies, originating in developed nations.

Conclusions

This review provided information on characteristics of the obstetric critical care population. Education and instituting early warning systems, formal debriefings, and standardization of protocols may assist in preparing critical care nurses in confidently caring for this population.
Development of a Comprehensive Extracorporeal Membrane Oxygenation Program in a Cardiac Transplant Intensive Care Unit
Authors: Galos Michelle
Published: April 2022

Background

A major academic medical center in the Midwest has expanded their extracorporeal membrane oxygenation (ECMO) program from 8 ECMO cases in 2014 to 97 ECMO cases in 2017. The Extracorporeal Life Support Organization states that standardized policies, procedures, and standards of care are necessary for an ECMO center to be successful.

Local Problem

With the rapid growth of the ECMO program, this medical center has chosen to transition nurses and respiratory therapists into the role of ECMO specialist to bridge the gap in care created by the influx in patients. Currently, no specific set of policies/procedures or standards of care exist for ECMO patients. The primary objective of this study is to improve the self-efficacy of ECMO specialists and bedside nurses through the development of a comprehensive ECMO program that includes standardized policies and procedures, order sets, and evidence-based patient management guidelines.

Methods/Implementation

The General Self-Efficacy Survey was used to assess the self-efficacy of both the ECMO specialists and the bedside nurses before implementation of the program. An ECMO manual was created that contained education on veno-arterial and veno-venous ECMO, policies and procedures, and patient management guidelines. An EPIC order set was created to ensure the correct protocols and management guidelines were ordered for all ECMO patients. Postimplementation self-efficacy surveys, direct observations, and chart audits occurred to assess program fidelity.

Results

The self-efficacy was assessed of the ECMO specialists and beside nurses 4 months after implementation of policies, procedures, patient management guidelines, and an ECMO order set. The ECMO specialists' self-efficacy survey responses increased by 25% and the bedside nurses' self-efficacy survey responses increased by 27% after 4 months. Direct observation of ECMO specialist handoff to ensure protocol fidelity also occurred. There was a 40% increase in ECMO specialist handoff taking place and a 72% increase in ECMO circuit examination.

Conclusions

With the significant growth of ECMO patients, policies, protocols, and management guidelines are essential to provide safe care to these patients. There was a statistically significant improvement in the self-efficacy of both the ECMO specialists and bedside nurses. This was shown to directly correlate to an improvement in professional practice behaviors and ultimately improve the quality of patient care provided to ECMO patients.
Refinement of the Intensive Care Unit Complexity Assessment and Monitoring to Ensure Optimal Outcomes III Acuity Tool
Authors: Connor Jean A. , LaGrasta Christine , Hickey Patricia A.
Published: April 2022

Background

The Intensive Care Unit (ICU) Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO) acuity tool quantifies patient acuity in terms of nursing cognitive workload complexity.

Objectives

The aim of this study was to refine the ICU CAMEO II acuity tool. An expert panel of nursing staff from 4 pediatric ICUs convened to refine the CAMEO II across a large, freestanding children’s hospital in the United States.

Method

This study used a modified Delphi technique.

Results

Through a series of 4 Delphi rounds, the expert panel identified Domains of Care and nursing care items that were suitable to be collapsed or bundled. The number of Domains of Care decreased from 18 to 10. Each of the expert panel members then completed the ICU CAMEO II tool and the newly revised tool, ICU CAMEO III, on 5 to 10 patients. Sixty completed ICU CAMEO II tools, and ICU CAMEO III tools were available for comparison. The average difference of the 2 tools' total scores was 5 points (minimum, 4; maximum, 7). The level of agreement between the 2 tools by CAMEO Complexity Classification level (I-V) was 90%.

Discussion

The ICU CAMEO III acuity tool is a streamlined measure to describe and quantify the acuity of pediatric critical care nursing. Use of this acuity measure will support projection of staffing models, staffing assignments, and benchmarking across pediatric ICUs. Further research is underway to validate the CAMEO III for multisite use.
Noninvasive and Minimally Invasive Cardiac Output Monitoring
Authors: Berndsen Michelle
Published: April 2022

For decades, nurses have monitored and titrated medications based on cardiac output. In the past, this was almost exclusively done through the use of an invasive pulmonary artery catheter. However, there are inherent patient risks to using a pulmonary artery catheter, and trends have shown a decreased use of this method. Advances in technology have brought about various noninvasive and minimally invasive methods to monitor cardiac output including pulse contour analysis, finger cuff technology, thoracic bioimpedance and bioreactance, and endotracheal electrical bioimpedance. A review of current noninvasive and minimally invasive methods to monitor cardiac output, and nursing considerations are discussed.
Impact of the COVID-19 Pandemic on the Diagnosis of Congenital Cytomegalovirus Infection in Spain
Authors: Villaverde Serena , Esquivel Estrella , Baquero-Artigao Fernando , Noguera-Julian Antoni , Frick Marie Antoinette , Rojo Pablo , Blázquez-Gamero Daniel ,   on behalf of the Spanish Registry of Children with Congenital CMV
Published: April 2022

We conducted an observational study performed within the Spanish Registry of Children with congenital cytomegalovirus (cCMV) to evaluate the impact of the COVID-19 pandemic on the diagnosis of new cases of cCMV. Our study suggest a significant decrease in the monthly rate of new cCMV diagnoses during the COVID-19 pandemic.
Reliability and Validity of a Turkish Version of Multi-Factor Attitude Toward Condoms Scale: A Methodological Study
Authors: Ozdemir Serpil , Oz Emine , Karasahin Kazım Emre , Bicer Burcu Kucuk
Published: April 2022

This study tested the validity and reliability of the Turkish translation of the Multi-Factor Attitude toward Condoms Scale in a sample of Turkish outpatient clients (N = 336). Internal consistency reliability was demonstrated by a Cronbach α of .82, and test–retest reliability was supported by a positive correlation between initial and retest scores (p < .05). Construct validity was supported by results of an exploratory factor analysis that yielded a three-factor solution, explaining 71.0% of the variance. The Turkish version of the scale was found to be valid and reliable.
Delayed diagnosis of multiple systemic disseminated tuberculosis
Authors: Li Huan , He Fang , Zhong Cejun , Qu Junyan
Published: April 2022

Rationale:

The clinical manifestations in patients with disseminated tuberculosis (TB) are nonspecific and may present challenges for early diagnosis.

Patient concerns and diagnoses:

We describe the case of a 44-year-old man who presented with abdominal pain and discomfort for more than a month. He had undergone surgery for a chest wall abscess 9 months ago. Computed tomography scans showed a miliary pattern in the lung and multiple abscesses in the liver, spleen, left psoas major muscle, skin, and soft tissue, with rim enhancement. Mycobacterium tuberculosis was detected in the drainage fluid of the abscesses and surgical slices, and disseminated TB was diagnosed.

Interventions and outcomes:

With anti-tuberculosis therapy, the abscesses were gradually absorbed and all cultures were negative.

Lessons:

The patient exemplifies the difficulty of the early diagnosis of disseminated TB. Disseminated TB should be considered first in patients with multisystem illness, and then evidence should be pursued relentlessly to establish a diagnosis.
The efficacy of traditional Chinese medicine exercise therapy for the prevention and treatment of mental health disorders in university students
Authors: Lu Tuoyu , Lu Zhenhui , Yu Yingzi
Published: April 2022

Background:

Mental health disorders are highly prevalent among university students. Mental health is important in the healthy growth and overall development of university students. Many studies have indicated that traditional Chinese medicine (TCM) exercise therapies can alleviate anxiety and depression symptoms in university students. However, their definite efficacy and the optimal choice of TCM exercise therapy remain controversial. In this study, we aim to assess and compare the effects of different TCM exercise therapies on anxiety and depression symptoms in university students by network meta-analysis.

Methods:

Randomized controlled trials (RCTs) examining TCM exercise therapies for the anxiety and depression in university students published before January 2022 will be searched in online databases, including the PubMed, Web of Science, Scopus, Cochrane Library, Embase, China Scientific Journal Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang Database. Two researchers will be independently responsible for literature screening, data extraction, and assessment of their quality. Standard pairwise and network meta-analysis will be performed to compare the efficacy of different TCM exercise therapies on anxiety and depression symptoms in university students using Stata14.0 and GeMTC0.14.3.

Results:

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:

This meta-analysis will provide the evidence for supporting the intervention strategies of TCM exercise therapy for improving negative emotions such as anxiety and depression among university students.

OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/VTGBE.
Primary fibroblastic osteosarcoma of sternum
Authors: Fu Shaozi , Zhou Yile , Xu Heyun
Published: April 2022

Rationale:

Osteosarcoma, a malignant bone tumor, rarely occurs in the sternum, especially the fibroblastic type, and is associated with poor survival. This case report describes a patient with a neoplasm of the sternum who underwent tumor resection 3 times and reconstruction twice because of the high risk of recurrence.

Patient Concerns:

A 60-year-old Chinese man presented with a 3-cm palpable bulging mass located in front of his sternum. Chest computed tomography (CT) revealed an anterior chest wall neoplasm with sternal destruction.

Diagnosis:

Pathological examination revealed that the mass was a low-grade malignant primary fibroblastic osteosarcoma.

Interventions:

Locking plates were used for chest wall reconstruction, demonstrating good structural stability and economic applicability. Regarding the ineffectiveness of current therapies, whole-exome sequencing was conducted, and no targets matched any of the currently available agents.

Outcomes:

No recurrence was found on regular reexamination.

Lessons:

Surgery is the first choice of treatment for patients with primary fibroblastic osteosarcoma of the sternum. The reconstruction-locking plate is a good alternative for chest wall reconstruction. Whole-exome sequencing can shed new light on this uncommon disease and help identify novel therapeutic targets.
Evaluation of efficacy and safety of aspirin combination treatment in treating patients with coronary heart disease
Authors: Wang Xueling , Han Lin , Yang Jiyuan
Published: April 2022

Background:

Coronary heart disease (CHD) has a high incidence rate as a cardiovascular condition, primarily affecting the elderly and middle-aged individuals. CHD has debilitating effects on the standard of life of the elderly, and affecting their physical and psychological health. Reportedly, using aspirin alone is less effective as a first line of treatment for CHD. Therefore, this systematic review and meta-analysis will synthesize evidence on the effectiveness and safeness of aspirin combination treatment in treating patients with CHD.

Methods:

A comprehensive meta-analysis is to be performed to evaluate the effectiveness and safety of aspirin combination treatment for CHD patients. A search will be performed on PubMed, EMBASE, Cochrane Central, WanFang, and Chinese National Knowledge Infrastructure till December 25, 2021 to identify randomized controlled trials, assess all related studies on the aspirin combination treatment in treating patients with CHD. In this systematic review, we will adopt the second version of Cochrane risk of bias assessment tool to assess the bias risk in all studies that fulfil the eligibility conditions. Two authors will separately conduct the study selection process, risk of bias assessment, and data extraction. Moreover, a random-effects meta-analysis will be conducted to synthesize evidence for all outcomes. Provided there is sufficient homogeneity among the studies, we will perform meta-analysis. I
2 test will be employed to assess the heterogeneity of the outcomes.

OSF registration number:

10.17605/OSF.IO/MDTCA
Anesthetic management of patients with carnitine deficiency or a defect of the fatty acid β-oxidation pathway
Authors: Yu Ho Kyung , Ok Seong-Ho , Kim Sunmin , Sohn Ju-Tae
Published: April 2022

Carnitine is essential for the transport of long-chain fatty acids from the cytoplasm to the mitochondrial matrix. The carnitine shuttle transports long-chain fatty acylcarnitine to the mitochondrial matrix. Subsequently, long-chain fatty acyl CoA, which is split from long-chain fatty acylcarnitine by carnitine palmitoyltransferase II, undergoes fatty acid β-oxidation. Acetyl CoA is produced from long-chain fatty acyl CoA via fatty acid β-oxidation and aids in the synthesis of adenosine triphosphate via the tricarboxylic acid cycle and electron transport chain. In addition, in the fasting state, it leads to ketone body production in the liver and glucose production via gluconeogenesis. However, patients with compromised fatty acid β-oxidation, owing to carnitine deficiency as well as defects in carnitine transport and the fatty acid β-oxidation pathway, develop hypoglycemia, cardiomyopathy, arrhythmia, and hypotonia. These conditions are attributed to the accumulation of released fatty acids and acylcarnitine. This review aimed to shed light on the anesthetic management of patients with compromised fatty acid β-oxidation undergoing various surgeries by assessing relevant case reports associated with fatty acid β-oxidation disorder in PubMed. Pre-anesthetic and intraoperative evaluation should include monitoring of glucose and carnitine levels and specific cardiac tests, such as echocardiography. Considering that propofol is dissolved in 10% long-chain fatty acids, propofol infusion should be avoided because of increased long-chain fatty acid loading in patients with compromised fatty acid β-oxidation. Thus, anesthesia using opioids (remifentanil and fentanyl), midazolam, dexmedetomidine, etomidate, and non-depolarizing neuromuscular blocking agents would be appropriate in such patients.
Allele frequency and the associations of HLA-DRB1 and HLA-DQB1 polymorphisms with pemphigus subtypes and disease severity
Authors: Le Thanh Thai Van , Vuong Thanh The Bich , Ong Thinh Phuc , Do Minh Duc
Published: April 2022

Pemphigus is a rare, devastating, bullous autoimmune disease that damages the skin and mucous membranes, and has high morbidity and mortality. Studies have shown associations of pemphigus vulgaris (PV) and pemphigus foliaceus (PF) with human leukocyte antigen (HLA) class II polymorphisms.

This study examined the frequency of Major Histocompatibility Complex, Class II, DR Beta 1, a Protein Coding gene (HLA-DRB1) and Major Histocompatibility Complex, Class II, DQ Beta 1 (HLA-DQB1) alleles in Vietnamese PV and PF patients, and the association of these polymorphisms with pemphigus subtypes and disease severity.

The study enrolled 31 unrelated Vietnamese who underwent HLA typing using Sanger sequencing.

HLA-DRB1∗14:54 was the most frequent allele in both PV (20.5%) and PF (33.3%) patients. The percentage of HLA-DQB1∗03:02 was significantly higher in PF than PV patients, while the percentage of HLA-DQB1∗05:03 was approximately 10 times higher in PV patients. Pemphigus patients who have the HLA-DRB1∗04 alleles are more likely to have mild or moderate disease.

The HLA-DRB1 and DQB1 alleles may influence susceptibility to pemphigus subtypes, with DQB1∗05:03 being specific for PV and DQB1∗03:02 for PF. Our findings suggest that the DRB1∗04 alleles are likely to be associated with mild and moderate disease.
Expanded dengue syndrome presented with rhabdomyolysis, compartment syndrome, and acute kidney injury
Authors: Arif Aabiya , Abdul Razzaque Muhammad Raheel , Kogut Lucas Marian , Tebha Sameer Saleem , Shahid Filza , Essar Mohammad Yasir
Published: April 2022

Rationale:

Expanded dengue syndrome (EDS) is the phenomenon coined by the World Health Organization for cases of dengue fever (DF) with rare but dangerous consequences. EDS mainly leads to complications involving the vital organs, thus is also associated with a higher mortality rate. This case report presents the first-ever case where a patient developed EDS with both rhabdomyolysis-induced acute kidney injury and compartment syndrome of the limbs.

Patient concerns:

Our patient, an 18-year-old Pakistani male, presented with fever, colicky abdominal pain, vomiting, diarrhea, dark-colored urine, and oliguria.

Diagnoses:

Dengue rapid NS-1 test came back positive. Along with myoglobinuria both serum creatine phosphokinase and creatine levels were abnormal. Hence, the patient was diagnosed with rhabdomyolysis-induced acute kidney injury. On physical examination, his right arm was painful and tender with restricted movement at the elbow. A Doppler ultrasound of the arm revealed thickening of the skin and underlying muscles, as well as edematous abnormalities affecting the entire right upper limb, both of which are indications of compartment syndrome.

Interventions and outcome:

The management included rehydration, administration of dextrose and bicarbonate (bicarbonate infusion) prepared by adding 150 mEq sodium bicarbonate in 850 mL dextrose 5%, pain killers, along with platelet, and packed red cell transfusions. Additionally, right upper limb was kept elevated at 90° for 30 minutes every 2 hours to reduce edema and crept bandages were applied. The patient was discharged after 11 days and the follow-up was uneventful.

Lesson:

Physicians should be aware that rhabdomyolysis-induced acute kidney damage and limb compartment syndrome are also possible DF consequences, and they should be on the lookout for any indications pointing to these complications in DF. A prompt diagnosis can prevent further complications and fatality.