bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomechanical agreement between different imitation jumps and hill jumps in ski jumping
Authors: Ketterer Jakob , Gollhofer Albert , Lauber Benedikt
Published: September 2020

Even though the take‐off in ski jumping is decisive, athletes only have a very limited number of training trials on the actual ski jump to practice under real ski jump conditions. Hence, various imitation jumps aiming to mimic the hill jump are performed during daily training. These imitation jumps should therefore mimic the kinematic pattern of hill jumps appropriately. This study aimed to identify imitation jumps that resemble hill jumps regarding four performance‐related biomechanical criteria: maximal vertical take‐off velocity, maximal knee extension velocity, maximal forward‐directed angular momentum and anterior shift of the center of mass. Therefore, a three‐dimensional analysis of the take‐off during six different modalities of imitation jumps as well as hill jumps for validation was carried out in nine professional ski jumpers. Imitation jumps from a rolling platform show better agreement than stationary jumps and three out of the four parameters were best resembled via an imitation jump that included ski jumping boots. Thus, non‐hill take‐off training should be performed with complex imitation jumps to mimic the actual ski jump. Except for the vertical take‐off velocity, we could identify one imitation jump type that is not statistically different to the hill. Consequently, the individual deficiencies of the athletes can be addressed and specifically trained using the appropriate imitation jump. These information about the similarity between imitation jumps and real hill jumps are highly relevant for trainers and athletes in order to effectively design their training programs.
Basal glucose excretion in dogs: The impact of feeding, obesity, sex, and age
Authors: Zeugswetter Florian K. , Schwendenwein Ilse
Published: September 2020

Background

The urine glucose (UG) measurements are an integral part of urinalyses, especially in dogs with polyuria and polydipsia. A positive dipstick result is considered pathologic for disease. This paradigm has been challenged by new ultrasensitive tests, where the manufacturers recommend tolerating slightly positive results. It implies that, as in other species, basal urine glucose losses can exceed the lower limits of detection using ultrasensitive glucose dipsticks in healthy dogs.

Objectives

We aimed to determine whether glucose is routinely detectable using a sensitive quantitative wet chemistry method in the urine of nondiabetic, nonazotemic dogs, and investigate the impact of food intake, obesity, sex, castration status, and age.

Methods

Serial UG measurements were performed in healthy clinic‐owned Beagle dogs that were randomly fasted or fed. Glucose was measured in morning urine samples from normal‐weight healthy and obese dogs, and the university's electronic database was searched for quantitative UG measurements (Gluco‐quant Enzyme Kit/Roche Diagnostics).

Results

Small amounts of glucose were detected in 555 (99.1%) of 560 urine samples analyzed. All urine samples from the clinic‐owned Beagle dogs, as well as from privately owned obese and normal‐weight healthy dogs that tested positive for glucose. The median (range) UG concentration obtained from the university's electronic database was 0.39 (0‐1.55) mmol/L, and 2.2% of the samples tested negative. Feeding, obesity, gender, castration status, and age did not affect UG concentrations.

Conclusions

Studies, including a larger number of healthy dogs, are warranted to define a cut‐off between physiologic and pathologic glucosuria.
Chip‐based duplex real‐time PCR for water quality monitoring concerning Legionella pneumophila and Legionella spp.
Authors: Reuter Cornelia , Hentschel Stefanie , Breitenstein Antje , Heinrich Eileen , Aehlig Oliver , Henkel Thomas , Csáki Andrea , Fritzsche Wolfgang
Published: September 2020

Based on biomolecular methods, rapid and selective identification of human pathogenic water organisms becomes an important issue. Legionella spp., are pathogenic water bacteria with worldwide significance. Prevalent detection methods for these microorganisms are time and/or cost intensive. We describe a detection setup and relating DNA assay. A miniaturized real‐time polymerase chain reaction (real‐time PCR) for direct on‐line discrimination of Legionella pneumophila and Legionella spp. was established and integrated into a real‐time PCR‐chip‐system. The PCR‐chip device combines a temperature controlling unit and a fluorescence intensity measurement. It was designed to achieve rapid amplification, using an approach of real‐time fluorescence read out with the intercalating dye EvaGreen® and melting curve analysis, without requiring multiple probes. The presented results exhibit reproducibility and good sensitivity, showing that the setup is suitable for robust, rapid and cost‐efficient detection and monitoring of a variety of Legionella spp.in urban water samples.
Dilemmas of integrated water resources management implementation in the Awash River Basin, Ethiopia: irrigation development versus environmental flows
Authors: Mersha Adey Nigatu , de Fraiture Charlotte , Masih Ilyas , Alamirew Tena
Published: September 2020

Environmental flows allocation is an intrinsic part of Integrated Water Resources Management (IWRM). This paper analyses socio‐political issues and effects of environmental flows integration on water availability under the context of increased agricultural intensification in an effort to tackle food insecurity. Lack of appropriate framework comprising the procedural requirements and strategic directions as well as prevalence of politically motivated ad hoc development programmes are among major challenges identified. Introducing environmental flows to a perceived satisfactory level would result in a significant increase of unmet irrigation water demand, yet, “productivity first” norm overtakes. This is presumed to be due to skewed focus on irrigation expansion and low awareness on the possible consequences. The particular challenges highlighted generally unveil the inherent contradictions in the IWRM concept putting its claim that the set of principles and entire course stand universally accepted as a means to balance socio‐economic and environmental outcomes under question.
Enhanced threat of tick‐borne infections within cities? Assessing public health risks due to ticks in urban green spaces in Helsinki, Finland
Authors: Sormunen Jani Jukka , Kulha Niko , Klemola Tero , Mäkelä Satu , Vesilahti Ella‐Maria , Vesterinen Eero Juhani
Published: September 2020

Most tick‐related studies in Europe have been conducted in nonurban areas, but ticks and tick‐borne pathogens also occur in urban green spaces. From a public health perspective, risks regarding tick‐borne infections should be studied in these urban areas, where contacts between infected ticks and humans may be more frequent than elsewhere, due to high human activity. We examined the risk of encountering an infected tick in urban green spaces in Helsinki, Finland. We collected ticks at nine sites throughout Helsinki, recorded the prevalence of several pathogens and identified areas with a high potential for contacts between infected ticks and humans. Moreover, we explored the relationship between the density of Borrelia burgdorferi sensu lato‐infected ticks and locally diagnosed cases of borreliosis and compared the potential for human‐tick encounters in Helsinki to those in nonurban areas in south‐western Finland. During 34.8 km of cloth dragging, 2,417 Ixodes ricinus were caught (402 adults, 1,399 nymphs and 616 larvae). From analysed nymphs, we found 11 distinct tick‐borne pathogens, with 31.5% of nymphs carrying at least one pathogen. Tick activity was highest in August and September, leading to the density of nymphs infected with B. burgdorferi s.l., and concurrently infection risk, to also be highest during this time. Nymph densities varied between the sampling sites, with obvious implications to spatial variation in infection risk. While ticks and tick‐borne pathogens were found in both Helsinki and nonurban areas in south‐western Finland, the estimates of human activity were generally higher in urban green spaces, leading to a higher potential for human‐tick contacts therein. The presence of ticks and tick‐borne pathogens and high local human activity in urban green spaces suggest that they form potential foci regarding the acquisition of tick‐borne infections. Risk areas within cities should be identified and knowledge regarding urban ticks increased.
Dynamical Simulation of High-Pressure Gas Kick in Ultra-Deepwater Riserless Drilling
Authors: Mao Liangjie , Cai Mingjie , Liu Qingyou , Wang Guorong
Published: September 2020

During riserless drilling for ultra-deepwater gas wells, well control challenges induced by high-pressure gas kick will be faced. A two-phase flow model with consideration of high-pressure gas invasion during riserless drilling was proposed, and the model was proved to be more accurate for predicting high-pressure gas kick during riserless drilling by reproducing field data and comparison with published models. Then, a dynamical simulation of high-pressure gas kick in ultra-deepwater riserless drilling was presented. Results showed that during ultra-deepwater riserless drilling, the bottom hole pressure will be underestimated, while pit gain will be over-estimated without considering the gas acceleration effect. With the consideration of gas acceleration effect at high-pressure well bottom, the gas influx rate increases rapidly with the kick time and tends to be stable after a period of time as negative pressure difference at well bottom increases. During riserless drilling, according to the timeliness and effectivity of kick detection methods, pit gain is prior for kick detection, following bottom hole pressure, standpipe pressure, and return rate. Moreover, if early gas kick was not detected, the rapid increase in change rate of standpipe pressure and return rate can be regarded as an indicator, showing that gas is reaching mud line. Besides, the effects of shutoff time, drilling displacement, drilling fluid density increases, geothermal gradient, and reservoir permeability on kick indicators and wellbore pressure have been discussed. The research results could provide important theoretical bases and technical guidance for well control aspects of riserless drilling.
Hydrodynamic Analysis Techniques for Coupled Seakeeping–Sloshing in Zero Speed Vessels: A Review
Authors: Igbadumhe Jane-Frances , Fürth Mirjam
Published: September 2020

With more recent discoveries of oil and gas reserves in the deep ocean locations like Guyana and Ghana, floating vessels such as floating production storage and offloading (FPSO) and floating liquified natural gas (FLNG) are in high demand. Good seakeeping characteristics of floating vessels are relevant because they are expected to be in operation all year round regardless of the weather conditions they may encounter. One phenomenon that affects the motion responses of floating vessels in severe weather conditions is sloshing in the cargo tanks. Vessel wave responses and sloshing may, individually and combined, cause damaging and dangerous motions. The availability of fast and accurate techniques for predicting and analyzing the motions and tank behavior in extreme weather conditions plays a significant role in the design and operations of floating vessels. Over the years, investigations have been carried out on the hydrodynamics of vessel motions, sloshing as a separate phenomenon as well as coupled vessel motions with sloshing analysis. This study reviews the existing techniques that are applicable for analyzing coupled vessel motions and sloshing in the tanks of floating vessels moored offshore. The pros and cons of each technique have been discussed, with the aim to help future researchers and engineers select the most appropriate method for design and analysis. This paper also identifies methods that are yet to be fully applied for coupled seakeeping—sloshing analysis.
Effects of Materials on the Heat Transfer Coefficient During Condensation and Evaporation of R410A
Authors: Tang Weiyu , Khan Tariq Amin , Zheng Boren , Wang Lei , Li Wei , Sherif S. A.
Published: September 2020

An experimental investigation was conducted to demonstrate the effects of materials on the heat transfer characteristics of R410A during evaporation and condensation inside two horizontal plain tubes with the same inner diameter of 6 mm, but with two different materials of aluminum and stainless steel. The variation of vapor quality for the test section was kept in the range of 0.2–0.9, while mass velocities were allowed to vary from 100 to 400 kg/m2/s1. First, a series of single-phase and repetitive experiments were conducted to verify the accuracy and reliability of the test rig. Results of the evaporation experiments show that the plain aluminum tube performs best for all tested mass velocities. Several different correlations were employed to predict the present data, and their predictive ability was compared and discussed. Results indicate that the Liu and Winterton correlation could accurately predict the present results except for low mass velocities. Roughness effects were accounted for employing a correction factor. The larger roughness of the stainless steel tube was supposed to make the stainless steel tube perform better if roughness effects were accounted for, so the better performance of the aluminum tube was mainly attributed to the material effects. The pool boiling heat transfer as predicted by the VDI model was compared with the experimental results, and more obvious material effects have been found for pool boiling conditions. The minor differences between the two tubes in this case may be explained by the nucleate boiling suppression and incomplete wetting. For the condensation experiments, little difference was found between the two tested tubes, which means that the material and roughness effects may have had little influence on the thermal performance during condensation.
Analysis of a Fluidized-Bed Particle/Supercritical-CO2 Heat Exchanger in a Concentrating Solar Power System
Authors: Ma Zhiwen , Martinek Janna
Published: September 2020

Concentrating solar power (CSP) development has focused on increasing the energy conversion efficiency and lowering the capital cost. To improve performance, CSP research is moving to high-temperature and high-efficiency designs. One technology approach is to use inexpensive, high-temperature heat transfer fluids and storage, integrated with a high-efficiency power cycle such as the supercritical carbon dioxide (sCO2) Brayton power cycle. The sCO2 Brayton power cycle has strong potential to achieve performance targets of 50% thermal-to-electric efficiency and dry cooling at an ambient temperature of up to 40 °C and to reduce the cost of power generation. Solid particles have been proposed as a possible high-temperature heat transfer or storage medium that is inexpensive and stable at high temperatures above 1000 °C. The particle/sCO2 heat exchanger (HX) provides a connection between the particles and sCO2 fluid in emerging sCO2 power cycles. This article presents heat transfer modeling to analyze the particle/sCO2 HX design and assess design tradeoffs including the HX cost. The heat transfer process was modeled based on a particle/sCO2 counterflow configuration, and empirical heat transfer correlations for the fluidized bed and sCO2 were used to calculate heat transfer area and estimate the HX cost. A computational fluid dynamics simulation was applied to characterize particle distribution and fluidization. This article shows a path to achieve the cost and performance objectives for a particle/sCO2 HX design by using fluidized-bed technology.
Analytical Solution of the Transient Heat Conduction in the Absorber Tube of a Parabolic Trough Solar Collector Under Quasi-Steady Conditions
Authors: Cundapí Roger , Moya Sara L. , Cazarez Octavio
Published: September 2020

Temperature fields and their transient behaviors are essential subjects to be considered for modeling and design of absorber tubes in concentrated solar power plants. Both subjects have been addressed by various authors. However, the first subject has been primarily solved in the steady state. While the second has been solved by considering transient variations in the environmental or operating conditions, but with a heat conduction model in steady state. To the best of our knowledge, there are no analytical transient two-dimensional (2D) (r, φ) solutions involving nonuniform heat flux distribution (NUHFD) on the absorber tube of a parabolic trough solar collector (PTC). This study aims to obtain an analytical solution for the transient heat conduction in 2D of the absorber tube. The analytical solution was obtained using the method of separation of variables and the superposition principle. Two NUHFD functions were analyzed: a step function and a local concentration ratio (LCR) function. To the first function, the effect of the inlet fluid temperature and efficiency were also studied. The results agree with experimental and numerical results from the literature. The maximum average root-mean-square was near 6.4% for the step function, while the maximum average error was 1% for LCR function. The theoretical energy balances corroborate the validity of the analytical solution. The analytical solution could be useful to compare other theoretical studies (e.g., to prove new numerical schemes), to simulate other parameters of design, and to calibrate experimental tests. Even this work could be extended for nonlinear boundary conditions.
Spectro-Spatial Wave Features in Nonlinear Metamaterials: Theoretical and Computational Studies
Authors: Bukhari Mohammad , Farzaneh Joubaneh Eshagh , Barry Oumar
Published: September 2020

Considerable attention has been given to nonlinear metamaterials because they offer some interesting phenomena such as solitons, frequency shifts, and tunable bandgaps. However, only little is known about the spectro-spatial properties of a wave propagating in nonlinear periodic chains, particularly, a cell with multiple nonlinear resonators. This problem is investigated here. Our study examines both hardening and softening nonlinearities in the chains and in the local resonators. Explicit expressions for the nonlinear dispersion relations are derived by the method of multiple scales. We validate our analytical results using numerical simulations. The numerical simulation is based on spectro-spatial analysis using signal processing techniques such as spatial-spectrogram and wave filtering. The spectro-spatial analysis provides detailed information about the interactions of dispersive and nonlinear phenomena of waveform in both short- and long-wavelength domains. Furthermore, we validate and demonstrate the theoretically obtained bandgaps, wave distortion, and birth of solitary waves through a computational study using finite element software, ansys. The findings, in both theoretical and computational analyses, suggest that nonlinear resonators can have more effect on the waveform than the nonlinear chains. This observation is valid in both short and long wavelength limits.
Preparing to adapt is key for Olympic curling robots
Authors: Stork Johannes A.
Published: September 2020

Continued advances in machine learning could enable robots to solve tasks on a human level and adapt to changing conditions.
PTEN status determines chemosensitivity to proteasome inhibition in cholangiocarcinoma
Authors: Jiang Tian-Yi , Pan Yu-Fei , Wan Zheng-Hua , Lin Yun-Kai , Zhu Bin , Yuan Zhen-gang , Ma Yun-Han , Shi Yuan-Yuan , Zeng Tian-Mei , Dong Li-Wei , Tan Ye-Xiong , Wang Hong-Yang
Published: September 2020

PTEN loss promotes the expression of genes encoding proteasome subunits and facilitates bortezomib chemosensitivity.
Therapeutic targeting of KSP in preclinical models of high-risk neuroblastoma
Authors: Hansson Karin , Radke Katarzyna , Aaltonen Kristina , Saarela Jani , Mañas Adriana , Sjölund Jonas , Smith Emma M. , Pietras Kristian , Påhlman Sven , Wennerberg Krister , Gisselsson David , Bexell Daniel
Published: September 2020

KSP inhibition results in cell death through mitotic arrest and causes regression of neuroblastoma PDX tumors in mice.
A stepped-wedge randomized trial and qualitative survey of HIV pre-exposure prophylaxis uptake in the Eswatini population
Authors: Geldsetzer Pascal , Bärnighausen Kate , Hettema Anita , McMahon Shannon A. , Dalal Shona , Chase Rachel P. , Oldenburg Catherine E. , Kohler Stefan , Chen Simiao , Dlamini Phiwayinkhosi , Mavuso Mxolisi , Hughey Allison B. , Matse Sindy , Bärnighausen Till
Published: September 2020

Promoting HIV pre-exposure prophylaxis at primary care clinics in Eswatini led to an increase in uptake among at-risk adults.
Improved Virus Isoelectric Point Estimation by Exclusion of Known and Predicted Genome-Binding Regions
Authors: Heffron Joe , Mayer Brooke K.
Published: September 2020

This model fits predicted pIs to empirical values for a diverse set of viruses. The results suggest that many previously reported discrepancies between theoretical and empirical virus pIs can be explained by coulombic neutralization of PBRs of the inner capsid. Given the diversity of virus capsid structures, this nonarbitrary, heuristic approach to predicting virus pI offers an effective alternative to a simplistic, one-size-fits-all charge model of the virion. The accurate, structure-based prediction of PBRs of the virus capsid employed here may also be of general interest to structural virologists.
Completion of paediatric training: trends across 2011–2017 cohorts
Authors: Redman Melody Grace , Carzedda Davide , Jay Nicola , Clark Simon J , Rogers Marie
Published: September 2020

Objective

To determine trends in the demographics and destinations of doctors who have recently completed paediatric training in the UK.

Design

A survey was sent to all new paediatric certificate holders 1 year on from completing specialty training every year from 2011 to 2017.

Setting

Retrospective survey.

Outcome measures

Demographics, career destinations, time to complete training, working patterns, subspecialty registration, numbers of job applications, and use of the period of grace are reported.

Results

1262 people who gained their paediatric certificate in the UK between 2011 and 2017 completed the survey (60.6% response rate). 58.5% (n=738) of respondents were female, and 32.4% (n=224) of women work less than full time, compared with 4.6% (n=23) of men. 85.9% (n=1056) of respondents were in a UK consultant post. 7.6% (n=94) were working overseas. 65.1% (n=722) remained in the region they trained in. 64.8% (n=1348) were registered for general paediatrics, whereas 35.2% (n=733) had subspecialised.

Respondents who held a non-UK medical degree (47.5%, n=501) made more job applications on average (mean=2.2; 95% CI 2.0 to 2.5) than those with a UK degree (52.5%, n=554) (mean=1.1; 95% CI 1.0 to 1.2) (p<0.001). Average training time increased from 9.8 years (95% CI 9.4 to 10.2) to 11.3 years (95% CI 11.1 to 11.6) (p<0.001). Respondents’ use of their grace period reduced from 42.7% (n=47) to 20.6% (n=29) (p<0.001).

Conclusions

The data reflect the diverse paediatric workforce and doctors’ working patterns following the completion of paediatric training in the UK. The trends demonstrated are vital to consider for evidence-based workforce planning.
Sodium glucose cotransporter 2 inhibitors and risk of major adverse cardiovascular events: multi-database retrospective cohort study
Authors: Filion Kristian B , Lix Lisa M , Yu Oriana HY , Dell’Aniello Sophie , Douros Antonios , Shah Baiju R , St-Jean Audray , Fisher Anat , Tremblay Eric , Bugden Shawn C , Alessi-Severini Silvia , Ronksley Paul E , Hu Nianping , Dormuth Colin R , Ernst Pierre , Suissa Samy
Published: September 2020

Objective

To compare the risk of cardiovascular events between sodium glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors among people with type 2 diabetes in a real world context of clinical practice.

Design

Multi-database retrospective cohort study using a prevalent new user design with subsequent meta-analysis.

Setting

Canadian Network for Observational Drug Effect Studies (CNODES), with administrative healthcare databases from seven Canadian provinces and the United Kingdom, 2013-18.

Population

209 867 new users of a SGLT2 inhibitor matched to 209 867 users of a DPP-4 inhibitor on time conditional propensity score and followed for a mean of 0.9 years.

Main outcome measures

The primary outcome was major adverse cardiovascular events (MACE, a composite of myocardial infarction, ischaemic stroke, or cardiovascular death). Secondary outcomes were the individual components of MACE, heart failure, and all cause mortality. Cox proportional hazards models were used to estimate site specific adjusted hazards ratios and 95% confidence intervals, comparing use of SGLT2 inhibitors with use of DPP-4 inhibitors in an as treated approach. Site specific results were pooled using random effects meta-analysis.

Results

Compared with DPP-4 inhibitors, SGLT2 inhibitors were associated with decreased risks of MACE (incidence rate per 1000 person years: 11.4
v
16.5; hazard ratio 0.76, 95% confidence interval 0.69 to 0.84), myocardial infarction (5.1
v
6.4; 0.82, 0.70 to 0.96), cardiovascular death (3.9
v
7.7; 0.60, 0.54 to 0.67), heart failure (3.1
v
7.7; 0.43, 0.37 to 0.51), and all cause mortality (8.7
v
17.3; 0.60, 0.54 to 0.67). SGLT2 inhibitors had more modest benefits for ischaemic stroke (2.6
v
3.5; 0.85, 0.72 to 1.01). Similar benefits for MACE were observed with canagliflozin (0.79, 0.66 to 0.94), dapagliflozin (0.73, 0.63 to 0.85), and empagliflozin (0.77, 0.68 to 0.87).

Conclusions

In this large observational study conducted in a real world clinical practice context, the short term use of SGLT2 inhibitors was associated with a decreased risk of cardiovascular events compared with the use of DPP-4 inhibitors.

Trial registration

ClinicalTrials.gov
NCT03939624
.
Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional study
Authors: Lumbantoruan Christina , Kelaher Margaret , Kermode Michelle , Budihastuti Endang
Published: September 2020

Objectives

Despite the national effort to integrate the Prevention of Mother-to-Child Transmission (PMTCT) programme into antenatal care clinics in Indonesia, the rate of mother-to-child HIV transmission remains high. This national study was conducted to describe PMTCT programme performance and to identify health facility characteristics associated with this performance in order to inform programme planning and policy development.

Design

A retrospective cross-sectional study in December 2017.

Setting

All health facilities providing PMTCT programmes in Indonesia.

Participants

All health facilities registering at least one woman in antenatal care in 2017.

Intervention

PMTCT data extraction from the national reporting system on HIV/AIDS and government reports.

Outcomes

Women retention in the PMTCT programme for at least 3 months and associated health facility characteristics.

Results

A total of 373 health facilities registering 6502 HIV-positive women in antenatal care were included in the analysis. One-third of women (2099) never started antiretroviral treatment. Of the 4403 women who started, 2610 (57%) were retained; 462 (10%) were not retained; and the retention status of 1252 (28%) women referred out of the health facilities was unknown. Compared with primary health centres, hospitals were more likely to retain women (OR=2.88, 95% CI 2.19 to 3.79). The odds of retention were higher in hospital types A and B (OR=3.89, 95% CI 3.19 to 4.76), located within concentrated HIV epidemic areas (OR=2.09, 95% CI 1.83 to 2.38) and a high-priority area for the HIV programme (OR=1.83, 95% CI 1.60 to 2.09). We observed no differential retention between women who initiated PMTCT under different options (B+/non-B+).

Conclusions

We observed low retention of HIV-positive pregnant women in the PMTCT programme in Indonesia in 2017. Additional efforts are needed to improve women’s retention in the PMTCT programme. Retention could be increased through the delivery of PMTCT programmes by replicating strategies implemented at hospital types A and B located in concentrated HIV epidemic areas where an HIV programme is a high priority.
Retrospective analysis of medical malpractice claims in tertiary hospitals of China: the view from patient safety
Authors: Li Heng , Dong Shengjie , Liao Ziyi , Yao Yao , Yuan Suwei , Cui Yujie , Li Guohong
Published: September 2020

Objectives

The study analysed medical malpractice claims to assess patient safety in hospitals. The information derived from malpractice claims reflects potential risks and could help lead to reducing medical errors and improving patient safety.

Design, setting

We analysed 4380 medical malpractice claims from 351 grade-A tertiary hospitals in China for 2008–2017. We examined the characteristics of medical errors and patient safety, including the types of medical errors, proportionate liabilities and payments for medical malpractice in different clinical specialties.

Main outcome measures

We assessed claim characteristics, payment amounts and liability.

Results

Our data analysis demonstrated that 72.5% of the claims involved medical errors, with average payments of US$31 430. The hospital’s errors in medical malpractice resulted in 41.4% average liability in patient injury payments. Most medical malpractice cases occurred in Shanghai (817 claims, 18.7%) and Beijing (468 claims, 10.7%). The highest risks for medical error and malpractice claims were related to orthopaedics (11.3% of all claims, 72.8% with medical errors) and obstetrics and gynaecology (10.0% of all claims, 76.0% with medical errors). The highest rates related to proportionate liabilities were observed in otolaryngology (51.9%) and endocrinology (47.7%). Respiratory medicine had the highest proportion of claims in death rates (77.3%). Medical technology errors accounted for 91.8% of the claims and medical ethics errors for 5.8%. The highest average payment was found in cardiovascular surgery (US$41 733) and the lowest in stomatology (US$8822).

Conclusions

A previous study found that grade-A tertiary hospitals in China have similar medical error rates to general Chinese hospitals. 36Different specialties had different risk characteristics regarding medical errors, payments and proportionate liabilities. Orthopaedics had the highest number of malpractices claims and higher proportionate liability but lower death rates.
Work-related stressors among hospital physicians: a qualitative interview study in the Tokyo metropolitan area
Authors: Ihara Yuko , Son Daisuke , Nochi Masahiro , Takizawa Ryu
Published: September 2020

Objectives

We explored Japanese physicians’ work-related stressors and identified those unique to this population, as well as clarified the influence of cultural and medical system diversity on these stressors to determine the content of future stress-reducing interventions for hospital physicians in Japan.

Design

We conducted a semistructured, face-to-face interview-based qualitative study between August and October 2017. The collected data were analysed using the grounded theory approach.

Setting

Hospitals around the Tokyo metropolitan area, Japan.

Participants

Sixteen hospital physicians (mean age (SD)=33.9 (4.2) years; 11 men, 5 women). Seven worked in internal medicine and nine in surgery.

Results

We found unique stressors related to the Japanese medical system and culture, such as continuous all-day work after night shifts, and a hierarchical organisational system calledIkyoku. The results also indicated that Japanese physicians shared several stressors with Western physicians, such as sleep deprivation, high pressure and the limits of medicine.

Conclusions

Our study clarifies some sources of work-related stressors among hospital physicians in Japan. While the key components of Western interventions might be useful in a Japanese context, the original evidence obtained from this study highlights the necessity of initiating interventions addressing the unique stressors of Japanese physicians. To reduce physicians’ stress and enhance their well-being, psychological interventions for hospital physicians must be introduced in Japan.
Postoperative mortality in New Zealand following general anaesthetic: demographic patterns and temporal trends
Authors: Gurney Jason K , McLeod Melissa , Stanley James , Campbell Doug , Boyle Luke , Dennett Elizabeth , Jackson Sarah , Koea Jonathan , Ongley Dick , Sarfati Diana
Published: September 2020

Objectives

In this manuscript, we describe broad trends in postoperative mortality in New Zealand (a country with universal healthcare) for acute and elective/waiting list procedures conducted between 2005 and 2017.

Design, participants and setting

We use high-quality national-level hospitalisation data to compare the risk of postoperative mortality between demographic subgroups after adjusting for key patient-level confounders and mediators. We also present temporal trends and consider how rates in postoperative death following acute and elective/waiting list procedures have changed over this time period.

Results and conclusion

A total of 1 836 683 unique patients accounted for 3 117 374 admissions in which a procedure was performed under general anaesthetic over the study period. We observed an overall 30-day mortality rate of 0.5 per 100 procedures and a 90-day mortality rate of 0.9 per 100. For acute procedures, we observed a 30-day mortality rate of 1.6 per 100, compared with 0.2 per 100 for elective/waiting list procedures. In terms of procedure specialty, respiratory and cardiovascular procedures had the highest rate of 30-day mortality (age-standardised rate, acute procedures: 3–6 per 100; elective/waiting list: 0.7-1 per 100). As in other contexts, we observed that the likelihood of postoperative death was not proportionally distributed within our population: older patients, Māori patients, those living in areas with higher deprivation and those with comorbidity were at increased risk of postoperative death, even after adjusting for all available factors that might explain differences between these groups. Increasing procedure risk (measured using the Johns Hopkins Surgical Risk Classification System) was also associated with an increased risk of postoperative death. Encouragingly, it appears that risk of postoperative mortality has declined over the past decade, possibly reflecting improvements in perioperative quality of care; however, this decline did not occur equally across procedure specialties.
Consequences of early life exposure to the 1983–1985 Ethiopian Great Famine on cognitive function in adults: a historical cohort study
Authors: Arage Getachew , Belachew Tefera , Abera Mubarek , Abdulhay Fedilu , Abdulahi Misra , Hassen Abate Kalkidan
Published: September 2020

Objectives

To investigate the association between early life famine exposure and cognitive function in adults.

Design

Historical cohort study

Setting

North Wollo Zone, Northeast Ethiopia.

Participants

We recruited 1047 adult men and women aged 30–38 years who had history of early life exposure to Ethiopian great famine. Based on self-reported age and birth date, participants were categorised into famine exposed in early life (prenatal/postnatal) and non-exposed groups.

Outcome measures

The primary outcome measure of this study was cognitive function in adults after early life exposure to famine. Cognitive function was measured using Montreal Cognitive Assessment—basic. Associations between exposure and outcome variables were examined by linear regression analysis models.

Results

Adjusted for covariates, early life exposure to famine showed 1.29 (β=−1.29; 95% CI −2.16 to -0.52) points lower cognitive function score compared with non-exposed. Based on subanalysis for timing of famine exposure, postnatal exposure to famine resulted in 2.26 (β=−2.26; 95% CI −3.12 to -1.36) points lower cognitive function score compared with non-exposed groups. Prenatal famine exposure had 1.26 (β=−1.26; 95% CI −2.35 to 0.94) points lower cognitive function score although not statistically significant.

Conclusions

Famine exposure in early life was associated with cognitive functions in adults. While the overall findings highlight the importance of optimal nutrition in early life for brain growth and development, the association observed between postnatal famine exposure and adult cognitive function may indicate the relative importance of learning and experience during early childhood for optimal brain development after birth. Further studies are needed to elucidate the potential mechanism behind this association.
Self-reported secondhand smoke exposure following the adoption of a national smoke-free policy in Poland: analysis of serial, cross-sectional, representative surveys, 2009–2019
Authors: Jankowski Mateusz , Rees Vaughan , Zgliczyński Wojciech Stefan , Kaleta Dorota , Gujski Mariusz , Pinkas Jarosław
Published: September 2020

Objective

We assessed changes in secondhand smoke (SHS) exposure in workplaces and public venues in Poland over a 9-year period following the adoption of a smoke-free policy in Poland in 2010.

Design

Six waves of cross-sectional surveys were carried out between 2009 and 2019.

Participants

A nationally representative sample of adult Polish residents (age 15 years and older) was surveyed.

Survey respondents self-reported SHS exposure in the workplace and 12 different public venues. Data were analysed separately for samples consisting of (1) all respondents and (2) non-smokers only.

SHS exposure was defined based on self-report, which may invoke error such as demand bias or recall bias and study protocol do not include participation of paediatric populations that are key limitations of this study.

Results

Within a year of adopting the smoke-free policy in 2010, the proportion of non-smokers exposed to SHS in Polish workplaces decreased by more than half (from 19.2% in 2009 to 9.5% in 2011). Over 10 years, a substantial reduction in SHS exposure was observed in all public venues. The highest decrease in SHS exposure was observed in transport services (decreased from 45.7% to 11.7% among all respondents and from 44.2% to 11.7% among non-smokers) and in bars/pubs (SHS exposure decreased from 45.0% to 7.0% among all respondents and from 39.4% to 7.0% among non-smokers).

Conclusions

This study demonstrates the substantial success of a national smoke-free law. Nevertheless, smoke-free laws must continue to be refined in terms of their legal boundaries as well as implementation strategies to eliminate disparities in SHS exposure in certain types of venues.
Nationwide incidence of central retinal artery occlusion in Japan: an exploratory descriptive study using the National Database of Health Insurance Claims (2011–2015)
Authors: Kido Ai , Tamura Hiroshi , Ikeda Hanako Ohashi , Miyake Masahiro , Hiragi Shusuke , Tsujikawa Akitaka
Published: September 2020

Aims

The latest evidence in the incidence of central retinal artery occlusion (CRAO) is needed to support the development of novel treatments as orphan drugs. However, up-to-date information on the incidence of CRAO in the ageing or aged population is limited. We aimed to investigate the nationwide epidemiological and clinical characteristics of CRAO in Japan, using nationwide health insurance claims data.

Methods

We analysed a total of 16 069 762 claims data in the sampling dataset of the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), which is the nationwide health insurance claims database of 127 million whole Japanese individuals. CRAO was identified using the International Classification of Diseases 10th edition diagnostic code H34.1. The crude incidence rates and age-standardised incidence rates of CRAO, according to the standard age-structure population of the WHO, were calculated.

Results

The crude incidence rate of CRAO in Japan was 5.84 (95% CI, 5.71 to 5.97) per 100 000 person-years. With respect to the sex-related incidence, the rate was higher 1.40 times in men than in women (6.85 (95% CI, 6.65 to 7.06) vs 4.88 (95% CI, 4.71 to 5.05), p<0.001). The age-standardised incidence rate was 2.53 (95% CI, 2.29 to 2.76) per 100 000 person-years.

Conclusions

The crude incidence rate of CRAO was higher in Japan than in other countries, as reported previously, reflecting the Japanese population structure as a super-aged society. These findings can be helpful for the development of appropriate healthcare policies to address the increasing incidence of CRAO with the ageing population.
How fisher behavior can bias stock assessment: insights from an agent-based modeling approach
Authors: Saul Steven , Brooks Elizabeth N. , Die David
Published: September 2020

During stock assessment, fishery-dependent observations are often used to develop indices of abundance or biomass from catch per unit of effort (CPUE) and contribute catch at size or age information. However, fisher behavior, rather than scientific sampling protocols, determines the spatial and temporal locations of fishery-dependent observations. As a result, trends from fishery-dependent data may be a function of fishing activity rather than fish population changes. This study evaluates whether data collected from commercial fishing fleets in the Gulf of Mexico are representative of trends in fish population size. A coupled bioeconomic agent-based model was developed to generate simulated fishery data, which were used to populate an age-structured stock assessment. Comparison of stock assessment results with simulated fish population dynamics showed that management advice from assessment models based on fishery-dependent data could be biased. Assessment of fish with small home ranges harvested by fishing fleets that frequent the same fishing grounds could cause overestimation of fishing mortality. Not accounting for the spatial structure of the fishers or fish can cause biased estimates of population status.
Antiarrhythmic and cardiac electrophysiological effects of SZV-270, a novel compound with combined Class I/B and Class III effects, in rabbits and dogs
Authors: Varga Richárd S. , Hornyik Tibor , Husti Zoltán , Kohajda Zsófia , Krajsovszky Gábor , Nagy Norbert , Jost Norbert , Virág László , Tálosi László , Mátyus Péter , Varró András , Baczkó István
Published: September 2020

Cardiovascular diseases are the leading causes of mortality. Sudden cardiac death is most commonly caused by ventricular fibrillation (VF). Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a major cause of stroke and heart failure. Pharmacological management of VF and AF remains suboptimal due to limited efficacy of antiarrhythmic drugs and their ventricular proarrhythmic adverse effects. In this study, the antiarrhythmic and cardiac cellular electrophysiological effects of SZV-270, a novel compound, were investigated in rabbit and canine models. SZV-270 significantly reduced the incidence of VF in rabbits subjected to coronary artery occlusion/reperfusion and reduced the incidence of burst-induced AF in a tachypaced conscious canine model of AF. SZV-270 prolonged the frequency-corrected QT interval, lengthened action potential duration and effective refractory period in ventricular and atrial preparations, blocked IKrin isolated cardiomyocytes (Class III effects), and reduced the maximum rate of depolarization (Vmax) at cycle lengths smaller than 1000 ms in ventricular preparations (Class I/B effect). Importantly, SZV-270 did not provoke Torsades de Pointes arrhythmia in an anesthetized rabbit proarrhythmia model characterized by impaired repolarization reserve. In conclusion, SZV-270 with its combined Class I/B and III effects can prevent reentry arrhythmias with reduced risk of provoking drug-induced Torsades de Pointes.
Influence of porosity and alloy addition on the wear behaviour of sinter-forged C45 steel using Taguchi method
Authors: Naveen E. , Shanmugam R. , Roshan N. , Ramanan N. , Sripada Raghavendra K.N.
Published: September 2020

Elemental powders of iron (Fe), molybdenum (Mo), and carbon (C) were mixed in a pot mill to obtain the compositions of C45, C45–1% Mo, and C45–2% Mo steels. They were then compacted and sintered. The sintered preforms had a density of 75% of the theoretical density (TD). Then, the sintered preforms were subjected to densification to obtain the two densities of 80% and 85% TD through forging. The sintered and densified preforms of the alloy steel were subsequently machined to obtain the required wear test specimens. The experiments were conducted on a pin-on-disc tribometer, conforming to ASTM G99 standards, on a rotating EN32 disc. Using Minitab 16 software, dry sliding wear experiments were planned using a L27 orthogonal array. The percentage TD of the specimens (%Theoretical density + %Porosity = 1), percentage Mo addition, load, and sliding velocity were taken as input parameters, and mass loss was the output parameter. It was observed that increasing the density of the alloy steel adversely affects the wear resistance of the alloy steel, and thus the mass loss is increased. The addition of Mo to the C45 steel improves the wear resistance irrespective of density, owing to hard-phase carbides present in the microstructure. Empirical correlations for mass loss with respect to input parameters were developed using regression analysis. The hardness of the alloy steel was directly related to the density of the alloy. Mo addition contributed to an increase in hardness of the alloy steel. It was observed from optical images of the wear pattern that the C45 steel is subjected to uniform wear, as an evenly spread wear track appeared in the images. On the other hand, it was observed that the C45–Mo-alloyed steel exhibited non-uniform wear because of hard-phases present in the microstructure.
Refined existence and regularity results for a class of semilinear dissipative SPDEs
Authors: Marinelli Carlo , Scarpa Luca
Published: September 2020

We prove the existence and uniqueness of solutions to a class of stochastic semilinear evolution equations with a monotone nonlinear drift term and multiplicative noise, considerably extending corresponding results obtained in previous work of ours. In particular, we assume the initial datum to be only measurable and we allow the diffusion coefficient to be locally Lipschitz-continuous. Moreover, we show, in a quantitative fashion, how the finiteness of the [Formula: see text]th moment of solutions depends on the integrability of the initial datum, in the whole range [Formula: see text]. Lipschitz continuity of the solution map in [Formula: see text]th moment is established, under a Lipschitz continuity assumption on the diffusion coefficient, in the even larger range [Formula: see text]. A key role is played by an Itô formula for the square of the norm in the variational setting for processes satisfying minimal integrability conditions, which yields pathwise continuity of solutions. Moreover, we show how the regularity of the initial datum and of the diffusion coefficient improves the regularity of the solution and, if applicable, of the invariant measures.
Construction of g-fusion frames in Hilbert spaces
Authors: Sadri Vahid , Rahimlou Gholamreza , Ahmadi Reza , Farfar Ramazan Zarghami
Published: September 2020

After introducing g-frames and fusion frames by Sun and Casazza, respectively, combining these frames together is an interesting topic for research. In this paper, we introduce the generalized fusion frames or g-fusion frames for Hilbert spaces and give characterizations of these frames from the viewpoint of closed range and g-fusion frame sequences. Also, the canonical dual g-fusion frames are presented and we introduce a Parseval g-fusion frame.