bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of the Shape of a Microwave Chamber for Heating a Dielectric Object
Authors: Kisel N N , Vaganova A A , Vaganov I A
Published: April 2021

Currently, microwave energy is actively used in various industrial spheres for heating dielectric materials. In order to ensure uniform heating, it is necessary to obtain a uniform distribution of absorbed power in the volume of a dielectric. In this paper, we consider two models of a microwave chamber for heating a dielectric object – a rectangular chamber and a cylindrical chamber. Computer simulation was performed in the FEKO software for several cases: using two and four radiation sources and using two different dielectrics, with parameters corresponding to water and wheat. The results show that a cylindrical chamber provides a more uniform distribution of absorbed power in the inner volume, and therefore, allows to obtain a more uniform heating of the dielectric object inside it, than a rectangular chamber. One possible variant of implementation of a chamber for microwave heating of a dielectric object may be a rotating cylindrical chamber. Its application will allow obtaining uniform heating with a smaller number of emitters due to the choice of the optimal cylinder rotation speed.
Preliminary study of black aspergilli inhabiting Piper rhizosphere from Eka Karya Botanical Garden, Bedugul Bali
Authors: Ilyas M , Nurcahyanto D A , Yuliani Y , Mangunwardoyo W , Hidayat and I
Published: April 2021

The black aspergilli (Aspergillus section Nigri ) occupy a broad spectrum of habitat, and they are an essential group of species in food mycology, medical mycology, and biotechnology. This study aimed to isolate and identify the black aspergilli inhabiting five samples of Piper rhizosphere collected from Eka Karya Botanical Garden, Bedugul Bali. In this study, 71 strains of black aspergilli were isolated, and 20 strains of them have selected and characterized using morphological, molecular, and phylogenetic analysis. Morphological data results are useful for preliminary identification, but they did not have been totally effective in describing and elucidating 20 selected strains into species level. Further molecular identification and phylogenetic analysis based on ITS rDNA showed that from 20 selected strains, four strains were identified as Aspergillus aculeatus sensu stricto, three strains were identified as Aspergillus japonicus sensu stricto, four strains were identified as Aspergillus niger sensu lato, and nine strains were identified as Aspergillus tubingensis sensu stricto. Preliminary exploration of fungi through isolation and identification was the first step to discover the potential strains that able to produce the promising metabolites and bioactive materials. The study results are expected to be the initial microbial resources and information for screening and utilizing the black aspergilli through bioprospecting.
Morpho-Physiological responses of brown-seeded soybean genotypes under low light intensity
Authors: Kisman  , Aryana IGP M , Santoso B B , Susilawati L E
Published: April 2021

The objective of the study was to know the responses of morphological and physiological traits of brown-seeded soybeanunder low light intensity. The study was conducted using the Experimental Method and the Split Plot Design was used in the experiment. The main plot was light intensity (L) and the subplot was genotypes (G). The main plot consists of L0 (fully light intensity) and L1(low light intensity, under black shading net of 65% light intensity). The brown-seeded soybean consists of 13 genotypes (KH 7B, KH 7C, KH 7D, KH 9, KH 14, KH 50B, KH 35, KH 8B, KH 31A, KH 35E, Ceneng, Burangrang, and KH1). The 13 genotypes were planted in pots in three replicates. Results of the study showed that: (1)The morpho-physiological responses of brown-seeded soybean varied under the low light intensity: the plant height, the leaf area, and the chlorophyll A and B contents increased, but the number of productive branches, the number of leaves, the specific leaf weight, the number of seeds per plant, the number of filled pods, the number of empty pods, and the seed weight per plant decreased. (2) Under the low light intensity, KH9 indicated the highest plant height, number of productive branches, number of leaves, and chlorophyll b content but the lowest seed size (100 seed weight), KH35E produced a high number of seeds per plant and filled pods, KH1 indicated the highest of the 100 seed weight, KH35 tends to produce the highest seed weight per plant, chlorophyll A content, and stable of the seed weight per plant.
BOD and DO Models of Krukut River, Jakarta
Authors: Amira Siti , Soesilo Tri E.B , Moersidik Setyo S
Published: April 2021

Urban areas in developing countries, such as Jakarta, have the potential to experience serious river water pollution problems. Pollution control is a measure to maintain water quality in waterways; therefore, this study aims to build a water quality model (based on BOD and DO parameter) in the Krukut River, Jakarta. The model can be used as a tool to simulate pollution control. This study applies the Streeter Phelps principle by adopting the system dynamics method. The research also includes social and economic aspects of the pollution control scenario. The Krukut River water quality model is valid because it has an absolute mean error (AME) values below 30%. In details, the AME value of each model are 0.7% for the population model, 7.05% for the BOD model, and 4.5% for the DO model. With community participation intervention in the sanitation sector, the simulation results of the model show an improvement in Krukut River water quality compared to the ‘business as usual’ simulation. However, this improvement still does not meet existing quality standards.
Assessment on the governance of fisheries management at fishery management area in Indonesia
Authors: Muawanah Umi , Kurniasari Nendah , Pramodha Radityo , Zulham Armen , Rosyidah Lathifatul
Published: April 2021

Given Indonesia’s enormous sea area, decentralization is inevitable in managing fishery resources, so-called Fishery Management Areas (FMAs). The governance of FMAs has been endorsed by MMAF Decree No. 33/2019. However, there were many challenges in its implementation. At the same time, Indonesia’s Long Term Development Plan of 2020-2024 specified that strengthening the governance of the FMAs will be one of the fishery development priorities. This study’s will assess the current design and implementation of FMA governance, namely the Fishery Management Councils (FMC). We gathered data and information using field observation, interviews with policymakers, and members of FMCs in several FMAs. We then carried out two analyses, namely, formal and informal analysis. The formal analysis was done by comparing each FMC component’s function and task based on the written guideline for operating FMC and the FMC of FMA and real observation. The informal analysis evaluates the critical management function and attributes of the existing FMC governance and compares them with the ideal function. From the formal analysis, we find that each component of FMC’s tasks and functions as written on the documents marginally/partially implemented by FMC members. From the informal analysis, we find that many challenges and gaps in the operationalization of the FMCs.
How digital knowledge sharing affects innovation work behavior and organizational innovation capability in term of sustainability development goals
Authors: Nugraha Amalia , Irwansyah  , Purwadi
Published: April 2021

This study seeks to analyze the antecedent factors of digital knowledge sharing that affect innovation work behavior and organizational innovation capability of employees working in government organizations. This study identifies four antecedents of digital knowledge sharing, namely demographics, environment, individuals, and organizations that have an influence on innovation work behavior and organizational innovation capability through indicators of knowledge donating and knowledge collecting from digital knowledge sharing. The online survey method was used to collect data from respondents, a number of 1000 employees of the Secretariat General, Ministry of Finance of the Republic of Indonesia. The data analysis of this study used Partial Least Square-Structural Equation Modeling (PLS-SEM) with the SmartPLS 3.2.9 application. The results showed that the four antecedents of digital knowledge sharing had a significant effect on innovation work behavior and organizational innovation capability through indicators of knowledge donating and knowledge collecting from digital knowledge sharing. In addition, it was also found that the knowledge donating indicator was a better contributor in facilitating innovation work behavior and organizational innovation capability of government employees compared to knowledge collecting indicators. This study also lead the digital knowledge sharing, innovation works behavior, and organizational innovation capacity into a part of sustainability development goals.
Edible straw formulation from caragenant and gelatin as a solution in reducing plastic waste
Authors: A’yun S N , Triastuti J , Saputra E
Published: April 2021

This study has been undertaken to determine the effect of bioplastic formulations of carrageenan and gelatin on the manufacture of edible straws with water resistance. The research design used was 2 factorial complete random designs (RAL). Edible straws with 20% gelatin addition formulation have the best water resistance value of 65.18%. Based on these results it shows that there is a correlation between the gelatin added and the temperature used in the use of edible straws. Bioplastic formulations can be used as edible straws with the best formulation of carrageenan 3 grams with the addition of 20% gelatin which can be applied to 4°C cold drinks and is best applied to drinks at 25°C.
X-Ray Determination of Debye Temperature and Microhardness of Some HCP Elements Re, Os and Tl
Authors: Endla Purushotham
Published: April 2021

The studies on the microhardness have been calculated the hexagonal close packed metals rhenium (Re), osmium (Os) and thallium (Tl). In this paper, the Vickers’s pyramidal indenter and the true hardness values has been evaluated. Debye temperatures of hexagonal close packed (HCP) of these three metals have been calculated by using X- ray diffraction intensities pattern with Philips 3020 powder diffractometer fixed with a proportional counter using filtered CuKα radiation; all the values have been evaluated at room temperature In this present work the calculated Debye temperature values θH 338 K, 426 K and 74 for Re, Os and Tl respectively. The calculated Debye temperatures of these hcp metals have been estimated from the hardness H values 135, 400, 27 kg/mm2 and are compared with those obtained from Debye temperature of specific heats (θD), Debye temperature of elastic constants (θE) and Debye temperature of X-ray intensity measurements (θM).
Optimized Scale Invariant HOG Descriptors for Object and Human Detection
Authors: Akila K , Pavithra P
Published: April 2021

This article presents a scale variation approach to identify objects and humans in video sequences using histogram of gradient descriptor. A significant restriction in HOG descriptors is its variations with scale changes and illumination changes, as is frequently the considered case. We recommend unique SIO-HOG descriptors that are figured to be invariant to scale changes. The system associates the benefits of adoptive bin selections and sample resizing in the object recognition process. We analyze the effect of PCA transform based feature selection process on object detection performance, ultimately the finite scale range, adoptive orientation binning in non-overlapping descriptors is all main thing for nominal detection rate. HOG feature vector over complete search window is computationally more exclusive, to acquire more precise set of features with finite Euclidean distance to classify them using KNN classifier. This new approach provides near-perfect ways of separating humans from other objects. The whole object detection system was assessed on a few test samples from real-world data sets and compared beside a publicly available pedestrian detection data base.
Study of Cloud Computing Business Framework by Pre-cloud recognition
Authors: Tiwari N , Sharma N
Published: April 2021

The current study strongly analyzes the factors that determine the acceptance of cloud companies (SASS model), and this strategy to do their job. The research model is designed to explore factors that affect the use of computers, including host technology (TAM) models and other external such as organizational size and technical complexity. Data compiled from 200 companies are used to test the ideas. The results of this study show what important factors need to be considered and how they relate to each other. They highlight the needs of companies, especially those related to cloud operations, for those who want to use a real digital governance model. These technologies and technology-related applications that use virtual technology and operate in a distributed network that is accessible to sites and social networking sites. Developed and upgraded to cloud computing systems, cloud grid and computers.
Analysing Uber Trips using PySpark
Authors: Pradhan Rahul , Mannepallli Praveen Kumar , Rajpoot Vikram
Published: April 2021

All the enterprise has a lot of data. To develop business, on occasion records evaluation required. By examining facts, we get vital matters on which work out and make our graph for the future via which made best future decisions. Most of the organizations going on line the place the statistics generate will increase day by using day. To develop commercial enterprise with this aggressive surroundings records evaluation is necessary. This analytics venture is very important to recognize the use of records analytics. Through initiatives like this, many organizations can recognize a number of complicated operations. Uber Data Analysis task permits us to recognize the complicated facts visualization of this large organization. It is developed with the assist of ‘R’ programming language. In this venture we analyze the Daily, Monthly and Yearly Uber Pickups in New York City. This mission is primarily based on Data Visualization that will information you toward use of ggplot2 library for perception the data.
Tailoring the excited-state energy landscape in supramolecular nanostructures
Authors: Kreger Klaus , Schmidt Hans-Werner , Hildner Richard
Published: April 2021

Nature’s photosynthetic machinery uses precisely arranged pigment-protein complexes, often representing superstructures, for efficient light-harvesting and transport of excitation energy (excitons) during the initial steps of photosynthesis. This function is achieved by defined electronic Coulomb interactions between the conjugated molecules resulting in tailored excited-state energy landscapes. While such complex natural structures are synthetically difficult to achieve, supramolecular chemistry is now on its advent to realize defined artificial supramolecular nanostructures with tailored functionalities via controlled self-assembly processes of small molecules. In this review, we focus on recent work reporting photophysical studies on self-assembled and hierarchical nanostructures as well as complex superstructures. We discuss how the resulting excited-state energy landscapes influence energy transport. Progress in the field of supramolecular chemistry allows for the realization of distinct kinds of H- or J-aggregates with well-defined morphologies on the mesoscale. Advances in the field of optical spectroscopy and microscopy have permitted to resolve the incoherent/coherent dynamics of exciton transport in such systems down to the level of single nanostructures. Although outstanding diffusion lengths of up to several μm were found in selected nanostructures, a full understanding of the underlying principles is still missing. In particular, the unavoidable structural and electronic disorder in these systems influences the excited-state energy landscapes and thus the transport characteristics, which can be exploited to refine the molecular design criteria of supramolecular nanostructures and complex superstructures. Despite the rapid progress in the field of functional supramolecular nanostructures, we believe that revealing the full potential of such systems is far from complete. In particular, criteria for tailored and optimized (hierarchical) supramolecular nanostructures in view of applications are not yet established. Finally, we outline current challenges and future perspectives for optical and optoelectronic applications of supramolecular nanostructures.
A two-step PCR assembly for construction of gene variants across large mutational distances
Authors: Routh Shreya , Acharyya Anamika , Dhar Riddhiman
Published: April 2021

Construction of empirical fitness landscapes has transformed our understanding of genotype–phenotype relationships across genes. However, most empirical fitness landscapes have been constrained to the local genotype neighbourhood of a gene primarily due to our limited ability to systematically construct genotypes that differ by a large number of mutations. Although a few methods have been proposed in the literature, these techniques are complex owing to several steps of construction or contain a large number of amplification cycles that increase chances of non-specific mutations. A few other described methods require amplification of the whole vector, thereby increasing the chances of vector backbone mutations that can have unintended consequences for study of fitness landscapes. Thus, this has substantially constrained us from traversing large mutational distances in the genotype network, thereby limiting our understanding of the interactions between multiple mutations and the role these interactions play in evolution of novel phenotypes. In the current work, we present a simple but powerful approach that allows us to systematically and accurately construct gene variants at large mutational distances. Our approach relies on building-up small fragments containing targeted mutations in the first step followed by assembly of these fragments into the complete gene fragment by polymerase chain reaction (PCR). We demonstrate the utility of our approach by constructing variants that differ by up to 11 mutations in a model gene. Our work thus provides an accurate method for construction of multi-mutant variants of genes and therefore will transform the studies of empirical fitness landscapes by enabling exploration of genotypes that are far away from a starting genotype.
Diversity and host assemblage of avian haemosporidians in different terrestrial ecoregions of Peru
Authors: Garcia-Longoria Luz , Muriel Jaime , Magallanes Sergio , Villa-Galarce Zaira Hellen , Ricopa Leonila , Inga-Díaz Wilson Giancarlo , Fong Esteban , Vecco Daniel , Guerra-SaldaÑa César , Salas-Rengifo Teresa , Flores-Saavedra Wendy , Espinoza Kathya , Mendoza Carlos , SaldaÑa Blanca , González-Blázquez Manuel , Gonzales-Pinedo Henry , Luján-Vega Charlene , Del Águila Carlos Alberto , Vilca-Herrera Yessica , Pineda Carlos Alberto , Reategui Carmen , Cárdenas-Callirgos Jorge Manuel , Iannacone José Alberto , Mendoza Jorge Luis , Sehgal Ravinder N M , Marzal Alfonso
Published: April 2021

Characterizing the diversity and structure of host–parasite communities is crucial to understanding their eco-evolutionary dynamics. Malaria and related haemosporidian parasites are responsible for fitness loss and mortality in bird species worldwide. However, despite exhibiting the greatest ornithological biodiversity, avian haemosporidians from Neotropical regions are quite unexplored. Here, we analyze the genetic diversity of bird haemosporidian parasites (Plasmodium and Haemoproteus) in 1,336 individuals belonging to 206 bird species to explore for differences in diversity of parasite lineages and bird species across 5 well-differentiated Peruvian ecoregions. We detected 70 different haemosporidian lineages infecting 74 bird species. We showed that 25 out of the 70 haplotypes had not been previously recorded. Moreover, we also identified 81 new host–parasite interactions representing new host records for these haemosporidian parasites. Our outcomes revealed that the effective diversity (as well as the richness, abundance, and Shannon–Weaver index) for both birds and parasite lineages was higher in Amazon basin ecoregions. Furthermore, we also showed that ecoregions with greater diversity of bird species also had high parasite richness, hence suggesting that host community is crucial in explaining parasite richness. Generalist parasites were found in ecoregions with lower bird diversity, implying that the abundance and richness of hosts may shape the exploitation strategy followed by haemosporidian parasites. These outcomes reveal that Neotropical region is a major reservoir of unidentified haemosporidian lineages. Further studies analyzing host distribution and specificity of these parasites in the tropics will provide important knowledge about phylogenetic relationships, phylogeography, and patterns of evolution and distribution of haemosporidian parasites.
The Atrial Fibrillation Better Care pathway for managing atrial fibrillation: a review
Authors: Stevens David , Harrison Stephanie L , Kolamunnage-Dona Ruwanthi , Lip Gregory Y H , Lane Deirdre A
Published: April 2021

The 2020 European Society of Cardiology guidelines endorse the Atrial Fibrillation Better Care (ABC) pathway as a structured approach for the management of atrial fibrillation (AF), addressing three principal elements: ‘A’ – avoid stroke (with oral anticoagulation), ‘B’ – patient-focused better symptom management, and ‘C’ – cardiovascular and comorbidity risk factor reduction and management. This review summarizes the definitions used for the ABC criteria in different studies and the impact of adherence/non-adherence on clinical outcomes, from 12 studies on seven different cohorts. All studies consistently showed statistically significant reductions in the risk of stroke, myocardial infarction, and mortality among those with ABC pathway adherent treatment. The ABC pathway provides a simple decision-making framework to enable consistent equitable care from clinicians in primary and secondary/tertiary care. Further research examining the impact of ABC pathway implementation in prospective cohorts utilizing consistent inclusion criteria and definitions of ‘A’, ‘B’, and ‘C’ adherent care is warranted.
Chromosomal Inversion Polymorphisms in Two Sympatric Ascidian Lineages
Authors: Satou Yutaka , Sato Atsuko , Yasuo Hitoyoshi , Mihirogi Yukie , Bishop John , Fujie Manabu , Kawamitsu Mayumi , Hisata Kanako , Satoh Noriyuki
Published: April 2021

Chromosomal rearrangements can reduce fitness of heterozygotes and can thereby prevent gene flow. Therefore, such rearrangements can play a role in local adaptation and speciation. In particular, inversions are considered to be a major potential cause for chromosomal speciation. There are two closely related, partially sympatric lineages of ascidians in the genus Ciona, which we call type-A and type-B animals in the present study. Although these invertebrate chordates are largely isolated reproductively, hybrids can be found in wild populations, suggesting incomplete prezygotic barriers. Although the genome of type-A animals has been decoded and widely used, the genome for type-B animals has not been decoded at the chromosomal level. In the present study, we sequenced the genomes of two type-B individuals from different sides of the English Channel (in the zone of sympatry with type-A individuals) and compared them at the chromosomal level with the type-A genome. Although the overall structures were well conserved between type A and type B, chromosomal alignments revealed many inversions differentiating these two types of Ciona; it is probable that the frequent inversions have contributed to separation between these two lineages. In addition, comparisons of the genomes between the two type-B individuals revealed that type B had high rates of inversion polymorphisms and nucleotide polymorphisms, and thus type B might be in the process of differentiation into multiple new types or species. Our results suggest an important role of inversions in chromosomal speciation of these broadcasting spawners.
Development of a Psychological Intervention to Promote Meaningful Activity in People Living With Mild Dementia: An Intervention Mapping Approach
Authors: Orgeta Vasiliki , Palpatzis Eleni , See Yi Na , Tuijt Remco , Verdaguer Elisabet Sole , Leung Phuong
Published: April 2021

Background and Objectives

Despite the importance of meaningful activity in mild dementia, only limited data are available on the development of interventions supporting people with mild dementia to engage in meaningful activity. In this article, we describe the development of an intervention that responds to this need.

Research Design and Methods

Intervention mapping (IM), an evidence-based approach, was used to develop STAYING ACTIVE (STAYing well and active—schedulINg meaninGful and enjoyAble aCTIvities to promote Vitality and wEll-being in mild dementia). The first step, a needs assessment, comprised a literature review, focus groups, and individual interviews with service users. Performance objectives of the intervention were formulated in Step 2, followed by the development of theory-based methods in Step 3. In Step 4, the new intervention was developed based on data collected in previous steps, existing interventions, and pilot testing. Qualitative data were analyzed using framework analysis.

Results

The needs assessment indicated that people with dementia and their carers view “staying active” as an important part of “enjoying life.” Adapting to loss through compensation and receiving support were key facilitators of engaging in meaningful activity. Ecological, psychosocial, and activity-oriented theories guided the development of theory-based intervention strategies, which were based on awareness, skills, and addressing barriers of meaningful activity.

Discussion and Implications

STAYING ACTIVE is grounded on theory, and service user experiences and aims at promoting meaningful activity in mild dementia. The IM framework may be useful in the development of future psychosocial interventions for people with dementia, facilitating transparency when efficacy is evaluated.
Weight Loss through Lifestyle Intervention Improves Mobility in Older Adults
Authors: Albert Steven M , Venditti Elizabeth M , Boudreau Robert M , Kieffer Lori A , Rager Judith R , Zgibor Janice C , Vander Bilt Joni , Danielson Michelle E , Burke Lora E , Glynn Nancy W , Jakicic John M , Smith Kenneth J , Semler Linda N , Newman Anne B
Published: April 2021

Background and Objectives

The high prevalence of overweight or obesity in older adults is a public health concern because obesity affects health, including the risk of mobility disability.

Research Design and Methods

The Mobility and Vitality Lifestyle Program, delivered by community health workers (CHWs), enrolled 303 community-dwelling adults to assess the impact of a 32-session behavioral weight management intervention. Participants completed the program at 26 sites led by 22 CHWs. Participation was limited to people aged 60–75 who had a body mass index (BMI) of 27–45 kg/m2. The primary outcome was the performance on the Short Physical Performance Battery (SPPB) over 12 months.

Results

Participants were aged 67.7 (SD 4.1) and mostly female (87%); 22.7% were racial minorities. The mean (SD) BMI at baseline was 34.7 (4.7). Participants attended a median of 24 of 32 sessions; 240 (80.3%) completed the 9- or 13-month outcome assessment. Median weight loss in the sample was 5% of baseline body weight. SPPB total scores improved by +0.31 units (p < .006), gait speed by +0.04 m/s (p < .0001), and time to complete chair stands by −0.95 s (p < .0001). Weight loss of at least 5% was associated with a gain of +0.73 in SPPB scores. Increases in activity (by self-report or device) were not independently associated with SPPB outcomes but did reduce the effect of weight loss.

Discussion and Implications

Promoting weight management in a community group setting may be an effective strategy for reducing the risk of disability in older adults.
A distortion matrix framework for high-resolution passive seismic 3-D imaging: application to the San Jacinto fault zone, California
Authors: Touma Rita , Blondel Thibaud , Derode Arnaud , Campillo Michel , Aubry Alexandre
Published: April 2021

Reflection seismic imaging usually suffers from a loss of resolution and contrast because of the fluctuations of the wave velocities in the Earth’s crust. In the literature, phase distortion issues are generally circumvented by means of a background wave velocity model. However, it requires a prior tomography of the wave velocity distribution in the medium, which is often not possible, especially in depth. In this paper, a matrix approach of seismic imaging is developed to retrieve a 3-D image of the subsoil, despite a rough knowledge of the background wave velocity. To do so, passive noise cross-correlations between geophones of a seismic array are investigated under a matrix formalism. They form a reflection matrix that contains all the information available on the medium. A set of matrix operations can then be applied in order to extract the relevant information as a function of the problem considered. On the one hand, the background seismic wave velocity can be estimated and its fluctuations quantified by projecting the reflection matrix in a focused basis. It consists in investigating the response between virtual sources and detectors synthesized at any point in the medium. The minimization of their cross-talk can then be used as a guide star for approaching the actual wave velocity distribution. On the other hand, the detrimental effect of wave velocity fluctuations on imaging is overcome by introducing a novel mathematical object: The distortion matrix. This operator essentially connects any virtual source inside the medium with the distortion that a wavefront, emitted from that point, experiences due to heterogeneities. A time reversal analysis of the distortion matrix enables the estimation of the transmission matrix that links each real geophone at the surface and each virtual geophone in depth. Phase distortions can then be compensated for any point of the underground. Applied to passive seismic data recorded along the Clark branch of the San Jacinto fault zone (SJFZ), the present method is shown to provide an image of the fault until a depth of 4 km over the frequency range 10–20Hz with an horizontal resolution of 80 m. Strikingly, this resolution is almost one eighth below the diffraction limit imposed by the geophone array aperture. The heterogeneities of the subsoil play the role of a scattering lens and of a transverse waveguide which increase drastically the array aperture. The contrast is also optimized since most of the incoherent noise is eliminated by the iterative time reversal process. Beyond the specific case of the SJFZ, the reported approach can be applied to any scales and areas for which a reflection matrix is available at a spatial sampling satisfying the Nyquist criterion.
Developing a checklist for reporting research using simulated patient methodology (CRiSP): a consensus study
Authors: Amaratunge Suvini , Harrison Morgan , Clifford Rhonda , Seubert Liza , Page Amy , Bond Christine
Published: April 2021

Objectives

Simulated patients are increasingly used to measure outcomes in health services but reporting is suboptimal. This study aims to create a checklist for the reporting of simulated patient (SP) methodology.

Methods

This was a Delphi study. The authors of health service research studies using SP methodology were invited to participate. Round 1 questionnaire assessed the applicability of the TIDieR (Template for Intervention Description and Replication) reporting checklist for SP methodology and asked for rewording of/additional items. Responses were thematically analysed to generate Round 2 items in which participants rated each item for importance (seven-point Likert scale) and median, mode and IQR were calculated. In Round 3, participants were invited to rescore their Round 2 responses. Consensus was defined as an IQR ≤ 1 (Extremely important) and median ≤ 2 (Very important). All consensus items were considered for inclusion in the checklist. Similarly, worded items were rationalised and items not specific to SP methodology or other existing checklists were excluded.

Key findings

Twenty-nine authors participated in Round 1 and a further seven for Rounds 2 and 3. Twenty-six responses were analysed for Round 1, 30 for Round 2 and 28 for Round 3. There was consensus on 29 of 54 items in Round 2 and 45 of 63 items in Round 3. The final checklist comprised 28 items.

Conclusions

A new reporting checklist to guide the reporting of studies, using simulated patients, complementary to CONSORT or STROBE, has been developed and will now be tested for usability.
T1 Initial Results of the American Burn Association (ABA) Multi-Center Evaluation on the Effectiveness of the Burn Navigator
Authors: Rizzo Julie A , Serio-Melvin Maria L , Coates Elsa , Liu Nehemiah T , Salinas Jose
Published: April 2021

Introduction

The Burn Navigator (BN) is an FDA-cleared clinical decision support tool used to aid fluid resuscitation after major burn injury. The BN provides users with hourly recommendations for fluid titration during the initial resuscitation based on various factors. The objective of this multi-center observational study was to evaluate the resuscitation volumes and related outcomes of patients admitted to five ABA verified burn centers who underwent intravenous fluid resuscitation utilizing the BN.

Methods

Data was collected from 300 patients who were resuscitated utilizing the BN. Two analyses were performed: examination of the first 24 hours of resuscitation after burn injury and examination of 24 hours of resuscitation using the BN, regardless of when the resuscitation began, to account for patients who presented in a delayed fashion. Patients were classified as having followed the BN device if all hourly fluid rates were within 40 mL of the BN recommendations (20 mL above or below) for that hour at least 75% of the time.

Results

For 285 patients, average age, weight, and TBSA were 45.6 ± 16.8 years, 87.0 ± 22.8 kg, and 39.0 ± 17.8%, with partial/full thickness percentages of 22.2 ± 15.2% and 17.0 ± 19.7%, respectively. Analysis of 286 patients in the first 24 hours of resuscitation revealed an average of 4.07 ± 1.76 mL/kg/TBSA and 151.48 ± 77.46 mL/kg of primary crystalloid fluid. When considering all fluids administered to include colloids and medications, enteral and oral feeds, and oral resuscitation fluids, average volumes in the first 24 hours were 4.68 ± 2.06 mL/kg/TBSA and 175.01 ± 92.22 mL/kg. To account for delayed presentation after burn injury, examining 24 hours of resuscitation regardless of the initiation of resuscitation, average volumes for primary and total fluids were 5.28 ± 2.54 mL/kg/TBSA, 201.11 ± 106.53 mL/kg, 6.35 ± 2.95 mL/kg/TBSA and 244.08 ± 133.5 mL/kg respectively. There was a significant decrease incidence of shock in the BN-guided group versus the non-BN-guided group (p< 0.05).

Conclusions

The Burn Navigator provides comparable resuscitation volumes of primary crystalloid fluid to the Parkland Formula. When all fluids are considered, the BN device recommends total fluid infusion less than the Ivy Index (250 mL/kg/24 hrs) and was associated with a decreased incidence of shock. Early initiation of the BN device resulted in lower overall fluid volumes during the first 24 hours of resuscitation.
10 A Multi-center Study Analyzing Association of Vitamin D Deficiency and Replacement with Infectious Outcomes in Patients with Burn Injuries
Authors: Garner Katelyn , Zavala Sarah , Pape Kate , Walroth Todd A , Reger Melissa A , Kiracofe Brittany , Thomas Wendy L , Adams Beatrice , Hill David M
Published: April 2021

Introduction

Vitamin D (25OHD) deficiency has been associated with poor outcomes in intensive care populations. A recent single-center, burn study found a high incidence of 25OHD deficiency. A difference was noted in infectious complications, but was underpowered. The primary objective of this multi-center study was to determine if 25OHD deficiency is associated with infectious outcomes in adult burn patients.

Methods

Adult patients were eligible for inclusion in this 7 center, retrospective study if admitted January 1, 2016 - July 25, 2019 and had a 25OHD concentration drawn within the first 7 days of admission. Patients were excluded if admitted for a non-burn injury, had total body surface area (TBSA) burned of less than 5%, a readmission, pregnant, incarcerated, or made comfort care or expired within 48 hours of admission. Expecting a 3:1 enrollment, goal was at least 250 total patients to be appropriately powered (β = 0.2; α = 0.05) to detect a 33% difference in composite infectious outcome (bacteremia, pneumonia, urinary tract infection, wound infection, graft loss, or death) between patients with 25OHD deficiency (< 20 ng/mL) and control (≥ 20 ng/mL). Generalized linear mixed modelling was used to control for center effect, % TBSA, age, and presence of inhalation injury and find the most predictive model.

Results

A total of 1147 patients were initially included. After exclusions, 234 (56.8%) in the deficient and 178 in the control group remained. Patients in the control group had their concentration drawn earlier (p < 0.001), were more likely to be male (p = 0.006), Caucasian (p < 0.001), lower body mass index (p = 0.009), lower % TBSA burn (p = 0.002), and taking a 25OHD supplement prior to admission (p < 0.001). Deficient patients were more likely to have an infectious outcome (52.1% vs 36.0%, p = 0.002), acute kidney injury requiring renal replacement therapy (p = 0.009), less ventilator free days in the first 28 days (p < 0.001), and more days requiring vasopressors (p = 0.008). After controlling for center, % TBSA, age, and inhalation injury the best model also included presence of deficiency (odds ratio = 2.425 [1.035 - 1.252]), days until 25OHD supplement initiation (1.139 [1.035 - 1.252]), and choice of cholecalciferol over ergocalciferol 2.112 [1.151 - 3.877]).

Conclusions

Dilution concerns were controlled by including %TBSA in the regression model. Even if low 25OHD concentrations were an acute reaction to burn injury and not representative of true deficiency, low concentrations and delay in supplementation were independently associated with increased risk of an infectious outcome.
17 Long-Term Pulmonary Sequelae After Inhalation Injury: A Retrospective Cohort Study
Authors: Wier Julian , Hulsebos Ian F , Yenikomshian Haig A , Gillenwater Justin
Published: April 2021

Introduction

Inhalation injury (INHI) has strong associations with increased rates of in-patient mortality and pneumonia. Data describing long-term health outcomes after inhalation injury are scarce and the true sequelae are largely unknown. The aim of the study is to review long-term pulmonary outcomes in inhalation injury patients. We hypothesize that INHI patients are at greater risk of developing long-term pulmonary sequelae.

Methods

We present a retrospective case-control of burn patients admitted to an ABA certified facility. We included burn patients with or without medically confirmed INHI who were admitted between 06/2016 to 11/2019 and were part of the regional Department of Health Services (DHS) system. The experimental group was patients with bronchoscopy confirmed INHI. The control groups were ventilated patients with confirmed non-inhalation injury (V) and non-ventilated patients with confirmed non-inhalation injury (NV). These were matched for age, TBSA, sex, previous comorbid pulmonary disease, and smoking status. Primary study outcomes were rates of post-discharge pulmonary sequelae, including ineffective airway clearance, infections, shortness of breath, and malignancy. Secondary outcomes included rates of post-discharge surgeries and readmission, post-discharge non-pulmonary sequelae, and post-discharge days to pulmonary/non-pulmonary sequelae.

Results

The study population included 33 INHI, 45 V, and 50 NV patients. There were no significant differences in age (P=.98), sex (P=.68), TBSA (P=.18), pulmonary comorbidity (P=.5), or smoking status (P=.92). Outpatient pulmonary sequelae were significantly higher for both INHI and V groups as compared to NV (21% and 17% vs 4%, P=.023, .043). The number of days from discharge to pulmonary sequelae was significantly shorter in the INHI group versus the V group (162±139 days vs 513±314 days, P=.024). Multinomial logistic regression for both INHI and V groups using the variables comorbid pulmonary disease, smoking status, and inpatient course and complications, indicated no effect on post-discharge pulmonary sequelae (all P >.05). All other measures were not significant when comparing INHI to V or NV (all P >.05).

Conclusions

Both INHI and V groups resulted in higher rates of outpatient pulmonary sequelae independent of inpatient course as compared to NV. While outpatient pulmonary sequelae were not significantly different between INHI and V, the INHI patients presented with complaints earlier. Thus one can conclude that ventilation alone is a significant contributing factor for the long-term pulmonary sequelae reported in this patient population.
18 The Risks of Sedation and Pain Control in the ICU: Can Increased Sedation Lead to Over-Resuscitation and More Hypotension?
Authors: McClellan John M , Sheckter Clifford C , O’Neal Jessie , Anderson Jeffrey , Mandell Samuel P
Published: April 2021

Introduction

Pain control and sedation of burn patients is a complex and necessary aspect of initial care and resuscitation. Each patient’s pain experience is unique. Balancing pain needs with obtundation and hemodynamic changes can be difficult, even for experienced clinicians. We hypothesize that in the first 48 hours of ICU admission, increased sedation in burned patients will be associated with increased resuscitation and hemodynamic instability.

Methods

A 6-year (2014–19) retrospective review of our hospital’s burn database collected patients admitted to the ICU with greater than 20% TBSA burns. In the first 48 hours of admission, we compared total amounts of sedation/pain medications (morphine milligram equivalents (MME), propofol, dexmedetomidine, benzodiazepines) given with total resuscitation and hemodynamic data. A linear regression model was chosen to determine if higher amounts of sedation/pain medication could predict greater resuscitation and episodes of hypotension (MAP < 65).

Results

208 patients were included with median age, %TBSA, and resuscitation of 43 years (0–99), 31% (20–93), and 3.3 ml/kg/%TBSA (0.13–19.05), respectively. The majority of our patients were white (80%) males (68%). Patients received a combination of MMEs (99% of patients), propofol (31%), dexmedetomidine (11%), and benzodiazepines (73%). Using a multivariable linear regression model, we found associations between total MMEs given and greater resuscitation (95% CI: 0.15–0.54, p=0.01) as well as number of hypotensive events (95% CI: 1.57–2.7, p< 0.001) in the first 48 hours of admission. No associations were noted with other sedative medications when comparing the number of hypotensive events and increased resuscitation.

Conclusions

While acute pain and sedation management is crucial in treating critically-ill burn patients, it often becomes routine. We find that pain management is not without physiological consequences and should be carefully monitored during resuscitation.
22 Acute Kidney Injury in Burn Patients Following Combination Antibiotic Therapy: A Large Database Analysis
Authors: El Ayadi Amina , Africa Robert , Prasai Anesh , Ozhathil Deepak K , Golovko George , Song Juquan , Lee Jong , Wolf Steven E
Published: April 2021

Introduction

Burn patients are prone to infections, which often warrants broad-spectrum antibiotic coverage. Vancomycin is a common antibiotic used at burn centers and is administered alone, or in combination with other agents such as piperacillin-tazobactam (Pip/Tazo). A recent study showed that this combination therapy was associated with increased rates of acute kidney injury (AKI) in adult and pediatric burn patients when compared to vancomycin in combination with other antibiotics. However, other studies failed to demonstrate these findings. The degree of nephrotoxic effect of the combination therapy relative to its drug components has not been demonstrated in burn patients. Using a large national database encompassing 41 health care organizations, we sought to determine whether a combination of vancomycin and Pip/Tazo exacerbates AKI in burn patients.

Methods

Using the TriNetX Global Health Research Network, we identified the population of burn patients with ICD-10 codes T20-T25 and T30-T32 between 2000–2020. We then grouped this population into 4 cohorts based on the administration of broad-spectrum antibiotics they received after the burn incident: vancomycin, Pip/Tazo alone, combination, and neither vancomycin nor Pip/Tazo. All cohorts were balanced for age, gender, and race. We explored the distribution of these cohorts and conducted comparative outcome analysis to determine the relative risk of developing AKI using the ICD10 code N17.

Results

Comparative analysis showed burn patients who received vancomycin had a 4.81% increased associated risk with AKI compared to those who did not receive either vancomycin or Pip/Tazo (p< 0.0001, RR =3.35, 95%CI= 2.63–4.26). Patients who received Pip/Tazo monotherapy had a 5.1% increased association with AKI compared to those who did not receive either drug (p< 0.0001, RR =3.57, 95%CI: 2.33–5.45). The combination of vancomycin with Pip/Tazo increased the association with AKI by 9.49% compared to patients who did not receive either drug (p< 0.00001, RR=5.65, 95%CI: 4.40–7.26). Combination therapy also increased the risk of AKI when compared to the vancomycin monotherapy (5.01%, p< 0.00001, RR= 1.69, 95%CI: 1.42–2.00) and Pip/Tazo monotherapy (4.85%, p< 0.00002, RR= 1.62, 95%CI: 4.40–7.26).

Conclusions

The use of broad-spectrum antibiotics in burn patients is associated with a higher risk of AKI. The combination of these drugs affords an increased relative risk of AKI when compared to monotherapy with the respective component drugs. Whether this is associated with selection bias or drug-effect warrants further investigation.