bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing Hospital Admissions for Patients With Heart Failure by Implementing the Chronic Care Management Framework: A Cost, Quality, and Satisfaction Improvement Project
Authors: Koutlas Alexis , Jenkins Peggy
Published: May 2022

Objective

To reduce the rate of hospital admissions, and increase the perception of coordinated care for patients with heart failure and associated co-morbidities through improvement of interdisciplinary communication.

Background

Heart failure patients with associated multi-morbidities and multiple provider visits are often left to navigate the health system independently. Limited provider to provider communication contributes to care fragmentation, unnecessary utilization and decreased satisfaction.

Methods

A nurse-led complex care management improvement project imbedded care plans and formal and informal collaborative care conferences to improve interprofessional communication across the care continuum.

Results

Hospital admissions decreased by 62% and length of stay decreased by 73% (n = 47, p < .001). Using paired t-test, satisfaction questions improved post intervention, and one was statistically significant (p < 0.05).

Conclusion

Improved communication strategies decreased hospital admissions and length of stay in one large Pacific Northwest health system. Days subject to readmission penalties decreased by 98% with a variance in pre-post charges of $615,000.

Implication for Nurses

Nurses and nurse leaders play a significant role in achieving the Triple Aim and can be instrumental in developing small multidisciplinary teams targeting improved coordination across settings and sectors.
Homeowner Characteristics Associated With the Occurrence of Negative Home Equity
Authors: Green Leslie E. , Park Narang
Published: May 2022

Negative home equity is due to declines in home values, largely driven by economic factors, and increases in mortgage debt, a decision made by individuals. Yet, empirical research assessing the individual’s role in the occurrence of negative home equity is limited. This study used the 2018 National Financial Capability Study to explore the association between financial literacy, savings, and debt at the individual level on the occurrence of negative home equity. The findings revealed that objective financial knowledge and financial security were negatively associated with the occurrence of negative home equity, while having a home equity loan, using a payday loan, having medical debt, and exceeding credit card limits were positively associated with the occurrence of negative home equity.
Make the Invisible Underbanked Visible: Who Are the Underbanked?
Authors: Chen Zibei , Friedline Terri
Published: May 2022

When the COVID-19 pandemic caused businesses to close and triggered high unemployment in 2020, millions of unbanked U.S. households, those without a bank account, had to wait for weeks and months for their stimulus checks to arrive. The delayed delivery of stimulus checks issued by the Coronavirus Aid, Relief, and Economic Security (CARES) Act sheds light on the critical role that safe, affordable financial services and products play in people’s ability to cope with financial shocks. Dialogues over banking practices have been framed with a banked-unbanked dichotomous framework that masks more nuanced understandings of households’ financial realities, including the underbanked, who use a bank account and alternative financial services simultaneously. Using data from the 2015 National Financial Capability Study, this study identifies and compares predictors of being underbanked and unbanked, respectively. We found that the underbanked group is a sizable, distinctively different group. Income volatility and welfare benefit receipt are both associated with being underbanked rather than unbanked. Our findings call for expanding the current, limited framework to gain more complete, nuanced understandings of banking practices.
Racial/Ethnic Differences and Retirement Involvement: A Latent Profile Analysis
Authors: Tran Alisia G.T.T.
Published: May 2022

This study examined attitudes about the relevance of retirement planning and affect associated with it (retirement involvement) of adults (18–65-years-old), taking racial/ethnic status into consideration. Drawing on online survey data, between-group significance testing revealed that racial/ethnic minority (REM;n= 355) and White (n= 543) participants did not differ in mean levels of retirement involvement, but the REM sample perceived retirement involvement as less relevant to their respective racial/ethnic groups. Similar four-profile solutions consisting of Low, Moderate, High, and Mixed-Reactive Retirement Involvement latent subgroups emerged for both samples in Latent Profile Analyses. Findings revealed distinct racial/ethnic variations in demographic and financial capacity predictors of profile subgroup classification. Results signaled a need for more culturally focused financial counseling and planning research and interventions.
Estudio experimental del comportamiento mecánico del suelo gravoso arcilloso reforzado con polietileno tereftlalato (PET) reciclado
Authors:   , Paucar Choque Giancarlo , Córdova Suero José Alfredo
Published: May 2022

El ángulo de fricción y la cohesión son parámetros de resistencia al corte establecidos por el modelo de Morh Coulomb, siendo estos necesarios para el diseño de estructuras geotécnicas utilizadas tanto en obras civiles como en obras mineras. Si durante la investigación geotécnica se concluye que las características de resistencia del material son menores a los requeridos, entonces es necesario realizar mejoras en terreno de fundación. Una de estas mejoras corresponde al uso de partículas PET, la misma que es mezclada con el suelo del terreno natural, obteniéndose un suelo con mejores características geotécnicas. El uso de las partículas PET como material de reforzamiento mecánico del suelo, nace de la necesidad técnica de obtener mejores características en el suelo y la búsqueda de reducir el impacto ambiental. La presente investigación busca encontrar el porcentaje óptimo de PET, que mejore el comportamiento geotécnico de un suelo gravoso arcilloso. Se preparó 5 probetas, donde se mezcló el suelo con porcentajes de 1%, 1.5%, 2%, 2.5% y 3 % de PET. Mediante el ensayo de corte directo se estimó la influencia del PET en la resistencia al corte del suelo. Los resultados obtenidos demuestran que el 2% de PET añadido a la grava arcillosa, aumenta la resistencia al corte en un 8.3% respecto al suelo sin refuerzo.
Formación Ciudadana Democrática Intercultural en Niñas de Contextos Rurales Peruanos
Authors:   , Camayo Tolentino Emiruth Valeria , Minaya Del Valle Rosario Alejandra
Published: May 2022

Esta investigación identifica los factores que influyen en el sistema de formación ciudadana democrática intercultural de niñas rurales en el Perú, así como los actores que lo afectan. La ciudadanía democrática intercultural promueve el reconocimiento y valoración de las identidades para el fortalecimiento de los derechos y deberes sociales a partir del diálogo intercultural. Para ello, se utilizó un diseño exploratorio y de enfoque cualitativo empleando algunas técnicas prospectivas conducentes a determinar los factores clave que resultan más influyentes y dependientes, revisados por un grupo de expertos en la temática. Los resultados indican que los factores clave para el sistema son: 1) deserción escolar, 2) jornada y clima escolar, 3) aprendizajes logrados, y 4) estrategias de aprendizaje dentro y fuera del aula. Asimismo, el Ministerio de Educación del Perú, que tiene la responsabilidad de mejorar la formación ciudadana de las niñas rurales, demostró ser el agente más influyente en el sistema. A partir de los resultados conviene indagar sobre las brechas de género entre los niños y niñas rurales en la formación de una ciudadanía democrática en la escuela y la construcción de una ciudadanía democrática intercultural específica en los diferentes contextos del Perú.
A szoptatás és a kizárólagos anyatejes táplálás gyakorisága és korrelátumai a csecsemő születésétől hat hónapos koráig
Authors: Kopcsó Krisztina , Boros Julianna , Leitheiser Fruzsina , Veroszta Zsuzsanna
Published: May 2022

A nemzetközi és – ehhez hangolva – a hazai ajánlások egyaránt az igény szerinti, kizárólagos anyatejes táplálást szorgalmazzák a csecsemő 6 hónapos koráig. Ezt az időtartamot számos tényező befolyásolja, amelyek feltárása hozzájárulhat a szoptatási arány hatékony növeléséhez. A kizárólagos anyatejes táplálásra vonatkozó statisztikákat ugyanakkor eltérő mérésmódszertan és a definíciók különbözősége jellemzi. A tanulmány a mérésmódszertanok összevetése után reprezentatív magyarországi mintán, a Kohorsz ’18 Magyar Születési Kohorszvizsgálat első két, a várandósság idején és a csecsemő 6 hónapos korában megvalósult hullámának longitudinális adatbázisán azonosítja a szoptatás/anyatejes táplálás (54%) és a kizárólagos szoptatás/anyatejes táplálás (25%) relatív gyakoriságát a csecsemő 24 hetes korában. Ezt követően a szerzők hazai és nemzetközi kutatási eredményekre alapozva vizsgálják, hogy a kizárólagos anyatejes táplálás arányával miként függnek össze bizonyos szociodemográfiai, egészségi és pszichológiai tényezők. A 6 hónapos csecsemők kizárólagos anyatejes táplálásával összefüggésben a szakirodalomban feltárt szociodemográfiai tényezők közül az anyai iskolai végzettség, az életkor, a házas párkapcsolati helyzet, a kedvezőbb anyagi háttér és a lakóhely településméretének pozitív kapcsolatát mutatják a hazai gyakorisági adatok.
Desempenho térmico de habitação emergencial por simulação evolutiva
Authors: Sebben Thaíse , Leitzke Rodrigo Karine , Maciel Thalita dos Santos , Silva Thaísa Leal da , Cunha Eduardo Grala da , Ribeiro Lauro André
Published: May 2022

A problemática do déficit habitacional no país e a necessidade de construção de moradias emergenciais de caráter provisório geram inúmeras consequências, tanto para o território com a falta de infraestrutura urbana, como para os moradores, relacionados à saúde e ao conforto em virtude das condições construtivas inadequadas. O objetivo deste trabalho foi encontrar soluções técnicas de projeto para a estrutura de uma habitação emergencial de madeira existente, revestida internamente com embalagens Tetra Pak®, de modo a minimizar o desconforto térmico em virtude das baixas temperaturas no sul do Brasil. Para isso, utilizou-se dos processos de otimização do algoritmo evolutivo NSGA-II e a análise de Pareto com a implementação de soluções construtivas simples. Dados iniciais de desempenho térmico da moradia realizados por simulação computacional simplificada mostraram o baixo percentual em horas de conforto, atingindo cerca de 22% para 80% de aceitabilidade de indivíduos, de acordo com a ASHRAE 55 (2017). Com a implementação de estratégias passivas de projeto e de material para otimização de desempenho da edificação por simulações computacionais multiobjetivo, foi possível atingir percentuais de conforto térmico de até 58,88% para uma aceitabilidade de 80% da população. Este trabalho serve como embasamento para futuras pesquisas sobre habitações emergenciais e o uso de embalagens cartonadas como isolante térmico e a busca por melhoria na qualidade de vida dos moradores.
O papel mediador das instituições educacionais nas políticas de desenvolvimento econômico-social
Authors: Moura Aline de Carvalho , Souza Alexandre Augusto e
Published: May 2022

Neste artigo, nos propomos a discutir sobre o papel mediador das instituições educacionais como tema de pesquisa. O trabalho tem como objetivo discutir a relação mediadora das instituições educacionais junto às políticas de desenvolvimento econômico-social no Brasil. Trata-se de uma pesquisa bibliográfica, na qual a principal base de referencial teórico para esse debate é o autor Florestan Fernandes, considerando suas análises quanto às transformações histórico-sociais e, especificamente, a participação das instituições nos processos de desenvolvimento. Considerando uma abordagem teórico-metodológica que se pauta nas relações entre educação, sociedade e história, argumenta-se que as instituições educacionais são mediadoras entre os aspectos materiais e as formas ideais concebidas para a organização das relações econômico-político-sociais. Algumas instituições educacionais destacaram-se mais do que outras no processo de implementação de debates e projetos no campo educacional, como é o caso do Instituto Nacional de Estudos Pedagógicos (Inep), que, desde sua inauguração na década de 1930, vem contribuindo para as transformações econômico-políticas através das políticas educacionais. Conclui-se que as instituições educacionais podem ser compreendidas como parte dos processos de transformação econômica e política, de intervenção social, promovendo a acomodação de uma série de forças políticas em disputa, restringindo e/ou eliminando desvios prejudiciais para o equilíbrio e o rendimento das mais variadas relações de poder.
O hino, o sermão e a ordem do dia
Authors: Bahia Fernanda
Published: May 2022

HORTA, J. S. B. O hino, o sermão e a ordem do dia: regime autoritário e educação no Brasil (1930-1945). 2. ed. rev. Campinas, SP: Autores Associados, 2012.
O golpe de 2016, as fragilidades da democracia liberal brasileira e o papel da educação
Authors: Hermida Jorge Fernando , Lira Jailton de Souza
Published: May 2022

O artigo apresenta uma análise das causas pelas quais a democracia liberal – instituída no Brasil após vinte anos de ditadura militar – vem sendo desconstruída desde a concretização do Golpe jurídico-midiático-parlamentar de 2016. Fundamentado no materialismo histórico e dialético e na pedagogia histórico-crítica, traz uma caracterização da dinâmica democrática, das formas de fazer política pós-Golpe de 2016 e dos modelos de Estado e democracia na realidade brasileira. Também ressalta o protagonismo que a educação exerce nos processos de formação de cidadãos críticos e compromissados com a mudança social. O artigo conclui que, historicamente, a cultura democrática sempre foi mal assimilada pelas classes dominantes no Brasil. Nesse contexto, a educação precisa ser concebida, definitivamente, como uma modalidade primordial da prática social global para a garantia da posse do saber objetivo produzido historicamente pela sociedade. Quando trabalhada sob perspectivas críticas, a educação torna-se ainda mais essencial para a formação de mulheres e homens críticos, criativos e comprometidos com princípios e valores solidários, inclusivos e democráticos.
Peripheral nerve allograft: how innovation has changed surgical practice
Authors: Buncke Gregory
Published: May 2022

The landscape of available technology and surgical technique has changed over the last several decades, thus leading to changes in the peripheral nerve repair surgical algorithm. Neurorrhaphy is a common procedure; however, it is well recognized that nerve repair should be performed tensionless, thus preventing the ability to perform direct repair with a nerve gap. Historically, nerve gaps were repaired with autograft. However, autograft surgery has been associated with complications such as numbness and chronic pain, which left surgeons searching for alternatives. Nerve allografts were first utilized in the 1800s but failed due to the immune response. In the modern era, they were again utilized in the 1980s, but did not gain popularity because of the need for the use of immunosuppressants. It was evident through the 1990s that continued innovation in peripheral nerve repair was needed, as studies showed that only approximately 50% of patients with nerve gap repair achieved good or excellent outcomes. In the 2000s, the advent of an engineered nerve allograft (Avance® Nerve Graft) changed the landscape of peripheral nerve repair. Early clinical evaluation of Avance showed that adequate sensation was able to be achieved in nerve gaps up to 30 mm, providing an alternative to autografts. As engineered nerve allograft use became more conventional, studies showed 87.3% meaningful recovery in nerve gaps up to 50 mm. Furthermore, recent studies have shown that gaps between 50-70 mm have shown 69% meaningful recovery. While technology and surgical technique continue to improve, these results are promising for large nerve gap repair.
Graduate employability skills: The voice of Agricultural Technical Vocational Education and Training (ATVET) students in Zimbabwe
Authors: Edziwa X. , Blignaut S.
Published: May 2022

The graduate employability has seen most governments, institutions of higher learning and industries engaging each other, as industries feel universities and colleges are churning out graduates that are not work ready. This has led to many strands to the discourse of graduate employability. One strand of the discourse is whether the higher education institutions should produce work-ready graduates. Another strand of the discourse is on how these institutions can make their graduates work ready, if it is an expectation that the graduates should be work ready. There is also another strand of the discourse on what constitutes graduate employability, that is, what skills make graduates work ready. This article looks at the latter from the perspectives of Agricultural Technical and Vocational Education and Training (ATVET) students in Zimbabwe. The article reports on part of a major study that was conducted on student internship and employability. Data was collected through focus group discussions with final year students from three agricultural colleges, that were selected using an eclectic sampling strategy which incorporated both typical case and maximal variation. The study showed that students view soft skills, namely entrepreneurship, financial literacy, innovativeness, ethics, problem-solving, honesty and some technical skills as essential to them.
Perceptions of staff and students about the NC(V) model of workplace Engineering artisan training offered by South African TVET colleges
Authors: Du Plooy B. , Du Preez K.
Published: May 2022

Vocational training is a contentious issue in South Africa, where large per centages are regularly cited for unemployment statistics, and in particular for youth and post-school unemployment. Vocational study programmes at Technical and Vocational Education and Training (TVET) colleges are often seen as one possible remedy to these problems. The Department of Higher Education and Training’s (DHET) long-term objective is to increase the number of learners that will qualify as artisans, which represent a major scarce/critical skills area in South Africa. However, the throughput and certification rates of TVET students are disconcertingly low, with National Certificate (Vocational) (NC(V)) Engineering courses regularly cited as having some of the lowest rates. This article reports on a small research study on the perceptions of TVET staff and students about NC(V) Engineering programmes, conducted at two TVET colleges in South Africa. Qualitative and quantitative methods were used to collect data from NC(V) Engineering students and lecturers. The most important findings of the study include that there is a critical collaboration gap between industry and the TVET sector and that both NC(V) staff and students experience the need for addressing the (im)balance of time spent on practical versus theoretical training as part of NC(V) programmes. A clear understanding of the perceptions and concerns of TVET NC(V) Engineering lecturers and students may assist in addressing issues locally, at individual TVET colleges, and globally, at national policy and Sector Education and Training Authority (SETA) level, that could in future serve to contribute to improved academic performance, including higher throughput and certification rates, of NC(V) Engineering students.
Oral Health and Public Engagement
Authors:   University of Dundee, Rodriguez Andrea , Polson Shannon , Cairns Declan , McGoldrick Niall , Fancourt Matthew , Biazus-Dalcin Camila , Kidd Evelyn , Galella Sabrina , Mackay Moira , Hanlon Lynne , Murray Chris , Laird Cat
Published: May 2022

This comic shows the importance of understanding and undertaking public engagement with responsiveness. Research driven by the commitment to engage with different stakeholders reflects a principle where we all learn by creating and sharing knowledge.
Borsa İstanbul’da İçeriden Öğrenenlerin Getirileri
Authors: UNAL Serkan
Published: May 2022

Amaç: Bu çalışmada Borsa İstanbul’da içeriden öğrenenlerin işlem yaptığı hisselerin performansları analiz edilmiştir.

Tasarım/Yöntem: Araştırmada 2015 ve 2020 yılları arasında içeriden öğrenenler tarafından KAP’a sunulan 2131 adet bildirim indirilmiştir. t testleri vasıtasıyla bu bildirimlere konu olan hisselerin performansları analiz edilmiştir.

Bulgular: İçeriden öğrenenler piyasayı etkin bir şekilde zamanlayabilmektedirler. Genellikle düşük performans göstermiş hisseleri almakta ve yüksek performans göstermiş hisseleri satmaktadırlar. Alım tutarlarının yüksekliği ile elde ettikleri performans arasında anlamlı bir ilişki bulunmamaktadır. Davranışsal olarak yüksek performans gösteren hisseleri satma, düşük performans gösteren hisseleri ise alma yönünde yanlılık göstermektedirler.

Sınırlılıklar: Araştırma yalnızca BIST100 hisselerini ve 2015-2020 zaman aralığını kapsamaktadır.

Özgünlük/Değer: Çalışmanın dönemi, 15 Temmuz 2016 darbe girişimi, 2018 Ağustosundaki kur şoku ve sermaye piyasalarında 2020 yılı Mart ayında Covid 19 nedeniyle yaşanan sert düşüş gibi önemli olayları kapsamaktadır. Bu sayede içeriden öğrenen işlemlerinin değişik piyasa şartlarında değerlendirilebilmesi mümkün olmaktadır. Ayrıca içeriden öğrenen işlemlerinde, geçmiş hisse performanslarının oluşturduğu yanlılık etkisi de incelenmiştir.
Progressive Development of a Distributed Ductile Shear Zone beneath the Patagonian Retroarc Fold-Thrust Belt, Chile
Authors: Betka Paul , Mosher Sharon , Klepeis Keith
Published: May 2022

The southern Patagonian Andes record Late Cretaceous–Paleogene compressional inversion of the Rocas Verdes backarc basin (RVB) and development of the Patagonian fold-thrust belt (FTB). A ductile décollement formed in the middle crust and accommodated underthrusting, thickening, and tectonic burial of the continental margin (Cordillera Darwin Metamorphic Complex (CDMC)) beneath the RVB. We present new geologic mapping, quartz microstructure, and crystallographic preferred orientation (CPO) fabric analyses to document the kinematic evolution and deformation conditions of the décollement. Within the CDMC, the décollement is defined by a quartz/chlorite composite schistose foliation (S1-2) that is progressively refolded by two generations of noncylindrical, tight, and isoclinal folds (F3–F4). Strain intensifies near the top of the CDMC, forming a >5 km thick shear zone that is defined by a penetrative L-S tectonite (S2/L2) and progressive noncylindrical folding (F3). Younger kink folds and steeply inclined tight folds (F4) with both north- and south-­dipping axial planes (S4) overprint D2 and D3 structures. Quartz textures from D2 fabrics show subgrain rotation and grain boundary migration recrystallization equivalent to regime 3, and quartz CPO patterns indicate mixed prism  and [c] slip systems with c-axis opening angles indicative of deformation temperatures between ~500° and >650°C. Approximately 40 km toward the foreland, the shear zone thins (~1 km thick) and is defined by the L-S tectonite (S2/L2) and tightening of recumbent isoclinal folds (F3). Quartz textures and CPO patterns indicate subgrain rotation recrystallization typical of regime 2 and dominantly basal  slip, and c-axis opening angles are consistent with deformation temperatures between ~375° and 575°C. Deformation occurred under greenschist and amphibolite facies conditions in the foreland and hinterland, respectively, indicating that the shear zone dipped shallowly toward the hinterland. The Magallanes décollement is an example of a regional ductile shear zone that accommodated distributed middle to lower crustal thickening below a retroarc FTB.
Nomogram predicting overall survival after surgical resection for retroperitoneal leiomyosarcoma patients
Authors: Zhuang Aobo , Zhang Yong , Fang Yuan , Ma Lijie , Lu Weiqi , Tong Hanxing , Zhuang Rongyuan , Wang Zhiming , Ding Yuqin , Ji Zhengbiao , Wang Yichao , Zhang Li , Yang Jue , luo Rongkui , Yang Hua , Zhou Yuhong
Published: May 2022

Background
Surgery is the best way to cure the retroperitoneal leiomyosarcoma (RLMS), and there is currently no prediction model on RLMS after surgical resection. The objective of this study was to develop a nomogram to predict the overall survival (OS) of patients with RLMS after surgical resection.
Methods
Patients who underwent surgical resection from September 2010 to December 2020 were included. The nomogram was constructed based on the COX regression model, and the discrimination was assessed using the concordance index. The predicted OS and actual OS were evaluated with the assistance of calibration plots.
Results
118 patients were included. The median OS for all patients was 47.8 (95% confidence interval (CI), 35.9–59.7) months. Most tumor were completely resected (n = 106, 89.8%). The proportions of French National Federation of Comprehensive Cancer Centres (FNCLCC) classification were equal as grade 1, grade 2, and grade 3 (31.4%, 30.5%, and 38.1%, respectively). The tumor diameter of 73.7% (n = 85) patients was greater than 5 cm, the lesions of 23.7% (n = 28) were multifocal, and 55.1% (n = 65) patients had more than one organ resected. The OS nomogram was constructed based on the number of resected organs, tumor diameter, FNCLCC grade, and multifocal lesions. The concordance index of the nomogram was 0.779 (95% CI, 0.659–0.898), the predicted OS and actual OS were in good fitness in calibration curves.
Conclusion
The nomogram prediction model established in this study is helpful for postoperative consultation and the selection of patients for clinical trial enrollment.
Pollutant emissions in livestock buildings: influence of indoor environment, rearing systems, and manure management
Authors: Andrade Leonardo de Brito , Martín-Gómez César , Zuazua-Ros Amaia , Ariño Arturo H.
Published: May 2022

The issue of air pollutants from livestock buildings is prevalent in the literature. Because they and their emissions impact both animal production and livestock building users as well as the outdoor environment. This paper aims to compile and review data available in the scientific literature on the types of pollutants for a better understanding of their generation form, their distribution according to the kind of animal, and the main factors affecting their generation and concentration, i.e., the rearing system, the indoor microclimate, and the manure management. The elevated generation of pollutants in animal buildings is tied to the dense occupancy in this industrial activity. The indoor air quality is defined according to the type of livestock in animal housing, considering its welfare needs, and the types and concentrations of pollutants generated as a function of the family of animal and the management used in production. The main gases generated are CH4, CO2, H2S, NH3, N2O, in addition to particulate matter and airborne microorganisms such as fungi and bacteria that very negatively affect the health of animals and users of the animal buildings. Furthermore, knowledge about the main contaminants generated, the form of generation, their origin, their concentrations, and their distribution throughout the shed is essential to achieve a permanent and adequate indoor air quality and, with that, a high-quality product that will lead to high production yield without neglecting animal welfare.
Third-generation cephalosporin resistant gram-negative bacteraemia in patients with haematological malignancy; the value of a surveillance-culture-guided empirical therapy approach
Authors: Court Jara R. de la , Woudt Sjoukje H. S. , Schoffelen Annelot F. , Heijmans Jarom , de Jonge Nick A. , Bruggen Tjomme van der , Bomers Marije K. , Lambregts Merel M. C. , Schade Rogier P. , Sigaloff Kim C.E.
Published: May 2022

ObjectivesAmong patients with haematological malignancy, bacteraemia is a common complication during chemotherapy-induced neutropenia. Resistance of gram-negative pathogens to third-generation cephalosporins is increasing. We aimed to provide rationale for surveillance-culture-guided (SCG) empirical therapy for this population.MethodsUsing 11 years of data (2008-2018) from the Dutch national antimicrobial resistance surveillance system, we assessed the prevalence of third-generation cephalosporin resistant Gram-negative bacteria (3GCR-GNB) in episodes of bacteraemia, and the proportion of 3GCR-GNB bacteraemia that was preceded by 3GCR-GNB colonization (identified using surveillance cultures) in the year before.ResultsWe included 3,887 patients, representing 4,142 episodes of bacteraemia. GNB were identified in 715/4,142 (17.3%), of which 221 (30.9%) were 3GCR-GNB. In (106/139) 76.2% of patients with a 3GCR-GNB bacteraemia and available GNB surveillance cultures in the preceding year, 3GCR-GNB colonization had been previously identified.ConclusionsThis multi-centre study shows that in patients with haematological malignancy, the majority of 3GCR-GNB bacteraemia is preceded by 3GCR-GNB colonization. This approach thereby reduces the risk of inappropriately treated 3GCR-GNB bacteraemia without the necessity to administer carbapenems to all high-risk neutropenic patients with fever.
Modeling of Inversion Layer Capacitance of III-V Double Gate MOSFETs using Neural Network based Regression Technique
Authors: Maity Subir Kumar , Pandit Soumya
Published: May 2022

This work presents a data-driven regression model of inversion layer capacitance of double gate III-V channel MOSFETs implemented using an artificial neural network. The training dataset is generated using a Schroedinger-Poisson solver for different channel thicknesses, carrier effective masses, oxide thickness, barrier height, and a wide range of gate bias voltages. The neural network predicted capacitance value is compared with Schroedinger-Poisson solver data and a physics-based analytical model result. The model effectively captures the variation in channel thickness, barrier height, carrier effective mass, and oxide thickness. Furthermore, extensive error analysis has been performed to demonstrate the correctness and degree of accuracy of the predicted result.
Exponential Stability for the T-S Fuzzy Systems with Distributed Time Delays under Quantization
Authors: Aslam Muhammad Shamrooz
Published: May 2022

A nonlinear system with distributed delays is investigated in this study under the quantization effect. A new fuzzy filter, as opposed to the existing one, receives both the quantized delay output and the quantized output of the system. It is the aim of this research to design a delay fuzzy filter to ensure that the considered error system satisfies an H ∞ performance index with a time–varying delay under quantization features. Using a new version of the Lyapunov–Krasovskii-functional as a starting point, we derive sufficient conditions at which the filtering error system is stable and performs well. Therefore, linear matrix inequalities (LMIs) are derived as a theory for determining whether desired filters exist under delay-dependent and decay-rate-dependent conditions. The filter coefficients can be calculated with feasible solutions of the LMIs . The proposed method is illustrated by a numerical example as a demonstration of its effectiveness.
The Infomóvel - An Information system for managing HIV/AIDS patients in rural areas of Mozambique: A Design Science Research Approach
Authors: Karajeanes Esmeralda Maria Montenegro , BILA Dulce Celina , LUIS Mildrad , TOVELA Milagre , RAMANLAL Nehaben , Anjos Custódio Dos , Vaz Paula , LAPÃO Luis
Published: May 2022

Background: Mobile health (mHealth) is gradually revolutionizing the way medical care is delivered worldwide. In Mozambique, a country with a high human immunodeficiency virus (HIV) prevalence where antiretroviral treatment (ART) coverage is s77% accompanied by 67% of retention rate, the use of mHealth technology may boost the ART, by delivering care beyond health facilities and reaching underrepresented groups. Leveraging new technologies is crucial to reach the 95-95-95 UN (United Nations) target by 2030. Here we describe the design, implementation and piloting phase of development of a mHealth platform (“Infomóvel”) whose intended use is coupled to community health workers (CHW) and aims at improving access, adherence and retention to HIV care services.Infomóvel was designed, developed and implemented using the Design Science Research Methodology (DSRM). In this paper, DSRM’s different activities are explained, from the definition of the problem through observational study following of objectives for a solution, which leads to the design and development of platform proposal. Demonstration phase was carried out in one region of Mozambique, before the usability evaluation of the web platform was carried out to made adjustment on the platform. Results: The Infomóvel flowchart and physical process architecture start with ART patients registered in patients tracking system who have accepted home visits. The case manager checks the file and through the website www.commcarehq.org, imports the file into the database of Infomóvel set on the cloud server. Case manager application, performs synchronization with Infomóvel Server database, allowing to import recent data and to access to the list of CHW and the list of new patients. The CHW with his phone accesses in his application the list of patients by priority, type of visit and allows to record the geographical coordinates.Conclusion: Results obtained from Infomóvel bring a growing body of evidence that supports the use of mHealth approaches in Mozambique, and it can be scaled-up and better exploited to manage patients with chronic diseases, if the patients are stable. However, additional studies should be conducted after this pilot in order to quantify the resources needed to implement the approach on a larger scale.
Inhibit of low water activity on conidia germination in Aspergillus flavus
Authors: Jia Sifan , Qi Desheng
Published: May 2022

In this study, we explored the mechanism underlying Aspergillus flavus conidia germination inhibited by decreased water activity. The impact of low water activity was analyzed at 4 h, 8 h and 12 h. Additionally, we demonstrated that low water activity affected cell shape and decreased cell sizes. Transcriptomics found numerous differentially expressed genes (DEGs) during the first 12 h of germination, with 654 DEGs observed among 4 h, 8 h and 12 h. Especially, more DEGs were detected at 8 h of germinating. Therefore, proteomics was performed at 8 h, and 209 differentially expressed proteins (DEPs) were speculated, with 94 up-regulated and 115 down-regulated. Combined analysis of KEGG of transcriptomics and proteomics demonstrated that the dominant pathways were nutrient metabolism and translation. We also found several DEGs and DEPs in Mitogen Activated Protein Kinase (MAPK) pathway. Therefore, we concluded that low water activity inhibited conidia germination, caused unregular morphology. Also, low water activity influenced expression of creA, TreB in carbohydrate metabolism, Clr4, RmtA in amino acid metabolism and RPL37, RPL3 in translation in Aspergillus flavus.
Exploration and revision of the content for "Mental Health Scale for Middle School Students (MSSMHS)"---Expert consensus and analysis of reliability and validity
Authors: Chen Xiong , Liu Zhongchun , Ai Chunqi
Published: May 2022

Objective
Primary and secondary school students in a unique stage of development, has a unique psychological age characteristics, their mental health screening should be appropriate for their psychological development characteristics. The contents of middle school students mental health Scale (MSSMHS) were explored and revised, and the reliability and validity of the revised scale were tested.
Methods
The middle school and high school students in Shiyan city of Hubei province were selected by random cluster sampling, and the revised mental health scale for middle school students was used to investigate. The 57 items of the original scale were revised, and SPSS25.0 statistical software was used for statistical analysis of the data. Cronbach's Alpha coefficient under Alpha was used to test the reliability of the scale. Factor analysis was used for structural validity analysis.
Results
The results of factor analysis, correlation analysis and internal consistency coefficient showed that the revised scale had high reliability, and its validity also met the requirements of psychological measurement.
Conclusion
The revised content of "MSSMHS" reasonably avoids cultural taboos and sensitive words of "suicide", and has good reliability and validity, which is worth popularizing in the practice of psychological assessment of middle school students.
Knowledge, Attitudes and Practices of sex workers of three South African towns towards female condom use and contraceptives
Authors: Sitonga Noluvuyo , Nomatshila Sibusiso C. , Phalane Mahlane , Chitha Wezile W. , Mabunda Sikhumbuzo A.
Published: May 2022

Background: Female sex workers are a marginalised and highly vulnerable population who are at risk of HIV and other sexually transmitted diseases, harassment and unplanned pregnancies. However, little is known about the acceptability and usage of female condoms and contraceptives among sex workers in small South African towns like Brits, Rustenburg and Grahamstown. Methods: This study is a quantitative study design with both descriptive and analytical components, undertaken in September 2018. A validated, researcher-administered questionnaire adapted from the South African Youth Risk Behaviour Survey was used. Data were analysed using STATA 14.1. Normally distributed numerical data are summarised using the mean, standard deviation and range. Numerical data that were not normally distributed are summarised using the median and interquartile range. Simple linear regression is used to compare two numerical variables. The prevalence ratio (PR) is used to determine the association of two categorical variables. The level of significance is p-value<0.05.Results: Sixty-nine (69) participants are reported on in this study which recorded an HIV prevalence of 30.4% (n=21/69). A high number of participants had completed high school (60.9%); the median age of entry into sex work was 16 and the median sexual debut was 15 years. More than half of the participants (37/69 or 53.6%) were cohabiting. In general, condom use during transactional sex was not consistent as it affected their income. Participants who reported barriers to condom use were 90% more likely to have adequate knowledge than those who did not and this was statistically significant (PR=1.9; p-value<0.0001).Conclusion: Sex workers, like all members of society have a right to access to promotive, preventive and curative healthcare and should thus have their health needs known and addressed. This study is one of few such efforts for small rural towns in South Africa.
Utilizing Three-Dimensional Head-Lesser Trochanter Distance Could Further Reduce Leg Length Inequality in Primary Bipolar Hemiarthroplasty: A Retrospective Cohort Study with Propensity Score Matching
Authors: Oh Seungbae , Kim Yong-Sik , Kwon Soon-Yong , Lim Young-Wook , Park Hyunwoo , Park Jongwoo , Song Joo-Hyoun
Published: May 2022

Background
The aim of this study was to investigate whether the use of three-dimentional (3-D) computed tomography (CT) based head-lesser trochanter distance (HLD) could reduce leg length discrepancy (LLD) more than the use of a two-dimentional (2-D) plain film method in primary bipolar hemiarthroplasty.
Methods
Propensity score matching (PSM) analysis was used to adjust confounding factors. A retrospective comparative analysis of 128 patients was performed. In the control group, the leg length was equalized using the 2-D plain film based HLD. In the study group, primary bipolar hemiarthroplasty was performed using the 3-D CT based HLD method. Postoperative LLDs were compared between the two groups using the method of Ranawat. In addition, Harris Hip Score (HHS) was evaluated and compared at one year after surgery.
Results
Significant difference was observed in mean postoperative LLD between the 2-D HLD group and the 3-D CT HLD group: 1.6 ± 1.2 mm (range, 0.1-6.0 mm) and 1.1 ± 1.2 mm (range, 0.1–5.1 mm), respectively (p < 0.05). Also, a higher percentage of patients in the 3-D CT HLD group had an LLD less than 2 mm. Mean HHS at one year after surgery showed no significant difference between the two groups.
Conclusions
To minimize the occurrence of LLD, HLD measurement from a CT scanner may be more accurate than an X-ray. 2-D and 3-D HLD difference in the 3-D CT HLD group was statistically significant. Using 3-D CT based HLD method might decrease the possibility of an LLD over 2 mm.
Rapid Relapse of Symptomatic Omicron SARS-CoV-2 Infection Following Early Suppression with Nirmatrelvir/Ritonavir
Authors: Charness Michael , Gupta Kalpana , Stack Gary , Strymish Judith , Adams Eleanor , Lindy David , Mohri Hiroshi , Ho David
Published: May 2022

We describe relapse of COVID-19 symptoms and SARS-CoV-2 viral load following nirmatrelvir/ritonavir (NM/R) in 10 non-immunocompromised patients aged 31 to 71-years-old. Most patients improved rapidly after treatment with NM/R and had negative antigen or PCR tests prior to relapse on Days 9-12 of their illness. Relapse symptoms were described most frequently as cold symptoms, though some patients experiencing a recurrence of fatigue and headache. All relapses resolved without additional antiviral treatment. Viral load during relapse was comparable to levels during initial infection. Sequencing in three patients indicated that relapse was not due to a treatment-emergent mutation or infection with a different viral strain. One symptomatic and one presymptomatic patient transmitted SARS-CoV-2 to family members during relapse. The presence of high viral load and the occurrence of two transmission events suggest that patients with relapse should isolate until antigen testing is negative.
A Deep Learning Approach with Cascade-network Design for Eyelid Tumors Diagnosis Based on Gigapixel Histopathology Images
Authors: Ye Juan , Wang Linyan , lv Dailin , Wang Yaqi , Chen Lirong , Huang Yuan , Huang Fengbo , Ashraf Davin C. Ashraf , Kersten Robert , Shao An , Ma Jingjing , Sun Lingling
Published: May 2022

The intricate anatomy of the eyelid, and the subspecialization trend in pathology made it more difficult for general surgical pathologists to maintain high accuracy across the entire range of diverse eyelid lesions. A lack of access to subspecialty expertise, and misalignment of diagnosis for eye pathology can slow diagnostic speed, resulting in intraorbital and intracranial extension and/or systemic spread which could threaten vision and life. Here, we developed a robust diagnostic deep learning system (DLS) to detect eyelid tumors using digital histopathological sections based on 473,037 pathological patches from 794 haematoxylin-eosin [H&E] stained whole slide images (WSIs) from two hospitals. This 9-class diagnosis task included top five benign and four malignant eyelid tumors. We first proposed a cascade-network instead of single network, to use the features from both histologic pattern and cellular atypia in a holistic pattern. Our model utilizing cascade-network design achieved 1.0 and 0.946 accuracy in the test and independent test set, respectively, for benign and malignant binary classification; without cascade-network design, accuracy was 0.957 and 0.887, respectively. For multiple classification of individual disease, the DLS with cascade-network design achieved 0.989 and 0.931 overall accuracy for WSI diagnosis in the test set (9-class) and independent test set (8-class) respectively, while without cascade design achieved 0.774 and 0.662. In conclusion, this DLS, using cascade-network design, can automatically detect malignancy in histopathologic slides of common eyelid tumors with a high degree of accuracy, which also has potential to augment histopathological diagnosis for a wide range of tumors.
Comprehensive Computational Analysis Revealed Seven Novel Mutations in Human Insulin gene
Authors: Alharthi Nahed , Essa Nidal
Published: May 2022

Background: Insulin gene mapped on chromosome 11p15.5 consists of 3 exons, which translated to 51 residues of small globular protein secreted from the secretory granules in β-cells of the pancreatic gland. In this study, we used various computational approaches to identify nsSNPs, which probably be deleterious to the structure and/or function of insulin protein that might be associated with different disease pathophysiology. Methods: The data on human insulin gene retrieved from dbSNP/NCBI. Three functional analysis tools SIFT, Polyphen-2, Provean used to predict whether the effect of retrieved SNPs on the biological function of Insulin based on sequence homology, position-specific independent count scores and the impact of amino acid substitution on protein 3D structure. Then the shortlisted SNPs tested by three disease-associated SNPs predicting tools; Predictor of human Deleterious Single Nucleotide Polymorphisms, Pathogenic mutation prediction and SNPS&GO. Then the disease-causing SNPs analyzed to check protein stability analysis using I-mutant 2.0, and we used RaptorX server for homology modeling and its visualization analysis applied by Chimera through entering the native wild type protein structure and the mutant protein residues as input inquiry. Results: After retrieval of SNPs from the NCBI database, 130 SNPs classified as missense SNPs. From functional analysis software, 60 SNPs were predicted to be deleterious then they analyzed by disease – related software resulted on 28 SNPs, which checked for protein stability, and the final analysis revealed seven novel SNPs that decreased protein stability. Conclusion: These seven novel mutations within the proinsulin gene will give a clue for their effect on the biological function of insulin and might contribute on developing new biomarkers that will used on therapeutic and diagnostic area of different diseases.