bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and facilitators affecting implementation of the Canadian clinical practice guidelines for the diagnosis of acute aortic syndrome
Authors: Dmitriew Caitlin , Ohle Robert
Published: June 2021

Background

Acute aortic syndrome (AAS) is an uncommon, life-threatening emergency that is frequently misdiagnosed. The 2020 Canadian clinical practice guidelines for the diagnosis of AAS incorporate all available evidence into four key recommendations. In order to facilitate the implementation of these recommendations, a clinical decision aid was created. The objective of this study was to identify barriers and facilitators among physicians prior to implementation of the guideline recommendations in a multicentre step wedge cluster randomized control trial.

Methods

We conducted semi-structured interviews with nine emergency room physicians working at five sites distributed between urban academic and rural settings. We used purposive sampling, contacting physicians until data saturation was reached. Interview questions were designed to understand potential barriers and facilitators to guideline recommendation uptake and use. Responses were analysed according to the Theoretical Domains Framework, and overarching themes describing these barriers and facilitators were identified.

Results

Two themes and six subthemes encompassing 13 theoretical domains were identified. These included clinical decision-making support, awareness of the evidence, social factors, expected consequences, ability of physicians to acquire the necessary data and ease of use. A majority of interviewees anticipated that the guideline recommendations would support clinical decision making and more effectively risk-stratify patients. Other facilitators included endorsement of the guidelines by professional organizations and peers. Barriers to implementation include the fact that laboratory testing and knowledge of the rationale for its use in the investigation of AAS were not widespread. The complexity of the clinical decision aid and concerns about test specificity were also identified as potential barriers to use.

Conclusion

Physicians were amenable to using the AAS guideline recommendations to support clinical decision-making and to reduce resource use. A structured intervention should be developed to address the identified barriers and leverage the facilitators in order to ensure successful implementation. Our findings may have implications for the implementation of other guidelines used in emergency departments.
Metacognitive knowledge and experience across multiple cognitive domains in euthymic bipolar disorder
Authors: Torres Ivan J. , Hidiroglu Ceren , Mackala Sylvia A. , Ahn Sharon , Yatham Lakshmi N. , Ozerdem Eysegul , Michalak Erin E.
Published: June 2021

Background

Metacognitive knowledge (MK; general awareness of cognitive functioning) and metacognitive experience (ME; awareness of cognitive performance on a specific cognitive task) represent two facets of metacognition that are critical for daily functioning, but are understudied in bipolar disorder. This study was conducted to evaluate MK and ME across multiple cognitive domains in individuals diagnosed with bipolar disorder and unaffected volunteers, and to investigate the association between metacognition and quality of life (QoL).

Methods

Fifty-seven euthymic participants with bipolar disorder and 55 demographically similar unaffected volunteers provided prediction and postdiction ratings of cognitive task performance across multiple cognitive domains. Self-ratings were compared to objective task performance, and indices of MK and ME accuracy were generated and compared between groups. Participants rated QoL on the Quality of Life in Bipolar Disorder Scale (QoL.BD).

Results

Metacognitive inaccuracies in both MK and ME were observed in participants with bipolar disorder, but only in select cognitive domains. Furthermore, most metacognitive inaccuracies involved underestimation of cognitive ability. Metacognitive indices were minimally associated with medication variables and mood symptoms, but several indices were related to QoL.

Conclusions

Individuals with bipolar disorder demonstrate inaccuracies in rating their cognitive functioning and in rating their online cognitive task performance, but only on select cognitive functions. The tendency to underestimate performance may reflect a negative information processing bias characteristic of mood disorders. Metacognitive variables were also predictive of QoL, indicating that further understanding of cognitive self-appraisals in persons with bipolar disorder has significant clinical relevance.
Implementation of Electronic Patient-Reported Outcomes for Symptom Monitoring in a Large Multisite Community Oncology Practice: Dancing the Texas Two-Step Through a Pandemic
Authors: Patt Debra , Wilfong Lalan , Hudson Kathryn Elizabeth , Patel Amila , Books Holly , Pearson Ben , Boren Rhonda , Patil Shrutika , Olson-Celli Kristin , Basch Ethan
Published: June 2021

PURPOSE

Among patients receiving chemotherapy, symptom monitoring with electronic patient-reported outcomes (ePROs) is associated with improved clinical outcomes, satisfaction, and compliance with therapy. Standard approaches for ePRO implementation are not established, warranting evaluation in community cancer practices. We present implementation findings of ePRO symptom monitoring across a large multisite community oncology practice network.

METHODS

Patients initiating a new systemic therapy at one of the 210 practice sites at Texas Oncology were invited to use the Navigating Cancer ePRO platform, with stepped-wedge implementation from July to December 2020. Participating patients received a weekly prompt by text message or e-mail to self-report common symptoms and well-being. Severe self-reported symptoms triggered a real-time notification to nursing triage to address the symptom. Enrollment and compliance were systematically tracked weekly with evaluation of barriers and facilitators to adoption and sustainability.

RESULTS

Four thousand three hundred seventy-five patients planning systemic treatment were enrolled and participated. Seventy-three percent (1,841 of 2,522) of enrolled patients completed at least one ePRO assessment. Among these individuals, 64% (16,299 of 25,061) of available weekly ePRO assessments were completed. Over a 10-week period, compliance declined from 72% to 52%. Barriers currently being addressed include lack of a second reminder text or e-mail prompt, inconsistent discussion of reported ePROs by clinicians at visits, and COVID-related changes in workflow. Facilitators included ease of use and patient and staff engagement on the importance of PROs for symptom management.

CONCLUSION

ePROs can be effectively implemented in community oncology practice. Utilization of ePROs is high but diminishes over time without attention to barriers. Ongoing work to address barriers and optimize compliance are underway.
Association of a Remote Patient Monitoring (RPM) Program With Reduced Hospitalizations in Cancer Patients With COVID-19
Authors: Pritchett Joshua C. , Borah Bijan J. , Desai Aakash P. , Xie Zhuoer , Saliba Antoine N. , Leventakos Konstantinos , Coffey Jordan D. , Pearson Kristina K. , Speicher Leigh L. , Orenstein Robert , Virk Abinash , Ganesh Ravindra , Paludo Jonas , Halfdanarson Thorvardur R. , Haddad Tufia C.
Published: June 2021

PURPOSE:

The goal of this study was to assess the impact of an interdisciplinary remote patient monitoring (RPM) program on clinical outcomes and acute care utilization in cancer patients with COVID-19.

METHODS:

This is a cross-sectional analysis following a prospective observational study performed at Mayo Clinic Cancer Center. Adult patients receiving cancer-directed therapy or in recent remission on active surveillance with polymerase chain reaction–confirmed SARS-CoV-2 infection between March 18 and July 31, 2020, were included. RPM was composed of in-home technology to assess symptoms and physiologic data with centralized nursing and physician oversight.

RESULTS:

During the study timeframe, 224 patients with cancer were diagnosed with COVID-19. Of the 187 patients (83%) initially managed in the outpatient setting, those who did not receive RPM were significantly more likely to experience hospitalization than those receiving RPM. Following balancing of patient characteristics by inverse propensity score weighting, rates of hospitalization for RPM and non-RPM patients were 2.8% and 13%, respectively, implying that the use of RPM was associated with a 78% relative risk reduction in hospital admission rate (95% CI, 54 to 102; P = .002). Furthermore, when hospitalized, these patients experienced a shorter length of stay and fewer prolonged hospitalizations, intensive care unit admissions, and deaths, although these trends did not reach statistical significance.

CONCLUSION:

The use of RPM and a centralized virtual care team was associated with a reduction in hospital admission rate and lower overall acute care resource utilization among cancer patients with COVID-19.
Tissue architecture delineates field cancerization in BRAFV600E-induced tumor development
Authors: Schoultz Elin , Johansson Ellen , Moccia Carmen , Jakubikova Iva , Ravi Naveen , Liang Shawn , Carlsson Therese , Montelius Mikael , Patyra Konrad , Kero Jukka , Paulsson Kajsa , Fagman Henrik , Bergo Martin O. , Nilsson Mikael
Published: June 2021

Cancer cells hijack developmental growth mechanisms but whether tissue morphogenesis and architecture modify tumorigenesis is unknown. Here, we characterized a new mouse model of sporadic thyroid carcinogenesis based on inducible expression of BRAF carrying a Val600 Glu (V600E) point mutation (BRAFV600E) from the thyroglobulin promoter (TgCreERT2). Spontaneous activation of this Braf-mutant allele due to leaky activity of the Cre recombinase revealed that intrinsic properties of thyroid follicles determined BRAF-mutant cell fate. Papillary thyroid carcinomas developed multicentrically within a normal microenvironment. Each tumor originated from a single follicle that provided a confined space for growth of a distinct tumor phenotype. Lineage tracing revealed oligoclonal tumor development in infancy and early selection of BRAFV600E kinase inhibitor-resistant clones. Somatic mutations were few, non-recurrent and limited to advanced tumors. Female mice developed larger tumors than males, reproducing the gender difference of human thyroid cancer. These data indicate that BRAFV600E-induced tumorigenesis is spatiotemporally regulated depending on the maturity and heterogeneity of follicles. Moreover, thyroid tissue organization seems to determine whether a BRAF-mutant lineage becomes a cancerized lineage. The TgCreERT2;BrafCA/+ sporadic thyroid cancer mouse model provides a new tool to evaluate drug therapy at different stages of tumor evolution.

This article has an associated First Person interview with the first author of the paper.
Composite Materials by Building Block Chemistry Using Weak Interaction
Authors: Akashi Mitsuru , Akagi Takami
Published: June 2021

Layer-by-Layer (LbL) assembly of interactive polymers onto surfaces leads to the construction of multilayered ultrathin films, which can be done simply by alternately dipping the substrate into various solutions. The range of applications of this LbL assembly can be broadened by introducing molecular recognition mechanisms for polymers and proteins, and by using weak interactions such as van der Waals interactions and biological recognition. As a specific example, it can be applied to the formation of stereocomplexes of poly(methyl methacrylate) (PMMA), poly-lactide (PLA), and fibronectin-collagen as extracellular matrix proteins. In weakly interacting LbL assemblies, the polymer chain tends to be placed in the most structurally stable state. This feature has been successfully used for template polymerization of stereoregular polymers, significant morphological control of biodegradable nanomaterials, and fabrication of three-dimensional (3D) cellular tissue constructs. LbL assembly based on weak interactions is expected to further stimulate interest in the interdisciplinary fields of bioscience and polymer chemistry. Using LbL technology to create functional 3D tissues, such as skin models (LbL-3D Skin) and heart models (LbL-3D Heart), will be a breakthrough in science and technology.
Perceptions of Strength Training in Dance
Authors: Farmer Claire , Brouner James
Published: June 2021

The aim of this study was to ascertain current perceptions of strength training (ST) in dance from the viewpoint of the professional dancer, dance teacher, and student dancers across dance genres. A total of 168 responses (149 females, 19 males) to the modified Training Information
Survey (TIS) were analyzed for differences in perceptions of ST between dance students, professional dancers, and dance teachers. Some significant differences were found between professionals and teachers (p > 0.05) and between students and teachers (p > 0.001). In all instances, dance
teachers were less likely to agree with the following: ST is essential to my overall development as a dancer, women should participate in ST, men should participate in ST, ST should be part of every training program regardless of dance style, ST is beneficial to women, and ST increases bodyweight.
It is evident that perceptions of ST still vary across the dance sector, and it is postulated that further education for dancers on the role ST has to play on the development of a dancer would help to break down barriers to participation. From this investigation, it can also be concluded that
the perception that dancers have a fear of muscle hypertrophy and a negative impact on aesthetics is no longer widely prevalent, although it still permeates throughout the dance sector.
Άσκηση με τεχνικές των παραστατικών τεχνών και θεραπευτική άσκηση για τη λειτουργική διαχείριση του χρόνιου μυοσκελετικού πόνου στη σπονδυλική στήλη
Authors: Δασκαλάκη Αικατερίνη
Published: June 2021

Όπως έχει διατυπωθεί, τον 21ο αιώνα οι Τέχνες θα διαδραματίσουν σημαντικό ρόλο στους τομείς της υγείας. Στο πεδίο της άσκησης, ήδη κάποιες έρευνες έχουν επιστρατεύσει τις τέχνες ως μέσο για την ανακούφιση σοβαρών ασθενειών, όμως, η οργανωμένη χρήση καλλιτεχνικών μεθόδων για τη λειτουργική διαχείριση μυοσκελετικών θεμάτων, όπως ο χρόνιος πόνος στη σπονδυλική στήλη (ΧΠΣΣ), δεν έχει ακόμη διερευνηθεί. Όσον αφορά εστιασμένα στο καταλληλότερο είδος άσκησης για τον ΧΠΣΣ, παρόλο που σύμφωνα με νέες θεωρητικές προσεγγίσεις, ο «κρίκος που λείπει» για τη διαχείρισή του είναι διάφορες μορφές «μυοπεριτονιακής προπόνησης», στην πράξη υπάρχει έλλειψη ερευνών που να εξετάζουν την επίδραση αυτών των τεχνικών στη μείωση του μυοσκελετικού πόνου μέσω της άσκησης. Τέλος, παρότι υπάρχουν πολυάριθμες διαδικτυακές εφαρμογές για την αυτοδιαχείριση μυοσκελετικών δυσχερειών, ελάχιστες μελέτες έχουν διερευνήσει την αποτελεσματικότητα των διαδικτυακών προγραμμάτων στην αντιμετώπιση του ΧΠΣΣ. Σκοπός της έρευνας ήταν να εξεταστούν και να συγκριθούν δύο διαδικτυακά προγράμματα μυοπεριτονιακής προπόνησης («Θεραπευτική Άσκηση» και «Άσκηση με τεχνικές των παραστατικών τεχνών») ως προς την αποτελεσματικότητά τους στη μείωση του πόνου, τη βελτίωση της σωματικής λειτουργικότητας, την αύξηση της ευλυγισίας και τη βελτίωση της ποιότητας ζωής. Στην έρευνα συμμετείχαν 36 γυναίκες με ΧΠΣΣ, ηλικίας 47.21±7.31 ετών, οι οποίες χωρίστηκαν σε 3 ομάδες («ομάδα άσκηση», «ομάδα τέχνη», «ομάδα ελέγχου»). Το πρωτόκολλο άσκησης ήταν ίδιο και για τις 2 πειραματικές ομάδες («μυοπεριτονιακές διατάσεις» και αυτοεφαρμοζόμενη μυοπεριτονιακή απελευθέρωση με Foam Rollers), όμως, η «ομάδα τέχνη», κατά τη διάρκεια των ασκήσεων, λάμβανε επιπρόσθετες οδηγίες οι οποίες εκπορευόνταν από τεχνικές των παραστατικών τεχνών. Η παρέμβαση είχε διάρκεια 6 εβδομάδες (18 μισάωρες προπονήσεις). Σύμφωνα με τα αποτελέσματα, τα δύο προγράμματα ήταν εξίσου αποτελεσματικά στη στατιστικά σημαντική βελτίωση των περισσότερων μεταβλητών, φανερώνοντας παρεμφερείς επιδράσεις στη βελτίωση σωματικών παραμέτρων (αύξηση λειτουργικότητας και ευλυγισίας), όμως, μόνο το πρόγραμμα «Άσκηση με τεχνικές των παραστατικών τεχνών» επέφερε στατιστικά σημαντικές βελτιώσεις στη μείωση του πόνου και σε ψυχολογικές παραμέτρους της ποιότητας ζωής. Ως εκ τούτου, συμπεραίνεται ότι η μυοπεριτονιακή προπόνηση είναι ένας αποτελεσματικός τρόπος άσκησης, τα διαδικτυακά προγράμματα μπορούν να αποτελέσουν μια ασφαλή επιλογή για τη λειτουργική διαχείριση του ΧΠΣΣ και η «Άσκηση με τεχνικές των παραστατικών τεχνών» είναι ακόμα πιο αποτελεσματική στη βελτίωση παραμέτρων που επηρεάζονται από ψυχολογικούς παράγοντες, λόγω, πιθανώς, της ολιστικής της φύσης.
Characterization of CTX-M-15-Klebsiella pneumoniae from inpatients and outpatients of a teaching hospital
Authors: Muzaheed Muzaheed , Sattar Shaikh Naveed , Sattar Shaikh Saeed , Acharya Sadananda , Sarwar Moosa Shajiya , Habeeb Shaikh Mohammad , M. Alzahrani Faisal , Ibrahim Alomar Amer
Published: June 2021

Background 

The presence of Extended-spectrum β-lactamase (ESBL) positive bacteria in hospital setting is an aggravating influential factor for hospitalized patients, and its consequences may be hazardous. Therefore, there is a need for rapid detection methods for newly emerging drug-resistant bacteria. This study was aimed at the molecular characterization of ESBL-positive Klebsiella pneumoniae isolates recovered from clinical samples.  

Methods 

A total of 513 K. pneumoniae isolates were obtained from various clinical samples during June 2019 to May 2020. The collected isolates were investigated for antimicrobial susceptibility (antibiogram), and PCR and DNA sequencing were performed to analyse the ESBL genes.  

Results 

Among the 513 isolates, as many as 359 (69.9%) were ESBL producers and 87.5% were multi-drug resistant, while none had resistance to imipenem. PCR scored 3% blaTEM, 3% blaSHV, and 60% blaCTX-M-15 genes for the tested isolates.  

Conclusion 

The study showed that CTX-M-15 was the major prevalent ESBL type among the isolates. Additionally, all the isolates were susceptible to carbapenems. Screening and detection of ESBL tests are necessary among all isolates from the enterobacteriaceae family in routine microbiology laboratory to prevent associated nosocomial infections. A larger study is essential to understand molecular epidemiology of ESBL producing organisms to minimize morbidities due to these multidrug resistant organisms.
The Salem simulator version 2.0: a tool for predicting the productivity of pure and mixed stands and simulating management operations
Authors: Aussenac Raphaël , Pérot Thomas , Fortin Mathieu , de Coligny Francois , Monnet Jean-Matthieu , Vallet Patrick
Published: June 2021

A growing body of research suggests mixed-species stands are generally more productive than pure stands. However, this effect of mixture depends on species assemblages and environmental conditions and forest managers often lack tools to assess the potential benefit of shifting from pure to mixed stands. Here we present Salem, a simulator filling this gap. Salem predicts the dynamics of pure and mixed even-aged stands and makes it possible to simulate management operations. Its purpose is to be a decision support tool for forest managers and stakeholders as well as for policy makers. It is also designed to conduct virtual experiments and help answer research questions.

In Salem, we parameterised the growth in pure stand of 12 common tree species of Europe and we assessed the effect of mixture on species growth for 24 species pairs (made up of the 12 species mentioned above). Thus, Salem makes it possible to compare the productivity of 36 different pure and mixed stands depending on environmental conditions and user-defined management strategies. Salem is essentially based on the analysis of National Forest Inventory data. A major outcome of this analysis is that we found species mixture most often increases species growth, in particular at the poorest sites. Independently from the simulator, foresters and researchers can also consider using the species-specific models that constitute Salem: the growth models including or excluding mixture effect, the bark models, the diameter distribution models, the circumference-height relationship models, as well as the volume equations for the 12 parameterised species. Salem runs on Windows, Linux, or Mac. Its user-friendly graphical user interface makes it easy to use for non-modellers. Finally, it is distributed under a LGPL license and is therefore free and open source.
Trends and predictors of HIV positivity and time since last test at voluntary counselling and testing encounters among adults in Kilifi, Kenya, 2006-2017
Authors: Mugo Peter M. , Agutu Clara A. , Wahome Elizabeth , Juma Margaret , Nzioka Joseph , Mohamed Khamisi , Mumba Teresia , Shally Mahmoud , Fauz Ibrahim , Omar Anisa , Rinke de Wit Tobias F. , van der Elst Elise M. , Graham Susan M. , Sanders Eduard J.
Published: June 2021

Background: Little is known about HIV retesting uptake among key populations (KP) and general populations (GP) in Kenya. We assessed trends and predictors of first-time testing (FTT), late retesting (previous test more than one year ago for GP or three months for KP), and test positivity at three voluntary counselling and testing (VCT) centres in coastal Kenya.

Methods: Routine VCT data covering 2006-2017 was collected from three VCT centres in Kilifi County. We analysed HIV testing history and test results from encounters among adults 18-39 years, categorized as GP men, GP women, men who have sex with men (MSM), and female sex workers (FSW).    

Results: Based on 24,728 test encounters (32% FTT), we observed declines in HIV positivity (proportion of encounters where the result was positive) among GP men, GP women, first-time testers and MSM but not among FSW. The proportion of encounters for FTT and late retesting decreased for both GP and KP but remained much higher in KP than GP. HIV positivity was higher at FTT and late retesting encounters; at FSW and MSM encounters; and at encounters with clients reporting lower educational attainment and sexually transmitted infection (STI) symptoms. HIV positivity was lower in GP men, never married clients and those less than 35 years of age. FTT was associated with town, risk group, age 18-24 years, never-married status, low educational attainment, and STI symptoms. Late retesting was less common among encounters with GP individuals who were never married, had Muslim or no religious affiliation, had lower educational attainment, or reported STI symptoms.

Conclusions: HIV positive test results were most common at encounters with first-time testers and late re-testers. While the proportion of encounters at which late retesting was reported decreased steadily over the period reviewed, efforts are needed to increase retesting among the most at-risk populations.
Induction-phase treatment costs for cryptococcal meningitis in high HIV-burden African countries: New opportunities with lower costs
Authors: Larson Bruce , Shroufi Amir , Muthoga Charles , Oladele Rita , Rajasingham Radha , Jordan Alexander , Jarvis Joseph N. , Chiller Tom M. , Govender Nelesh P.
Published: June 2021

Introduction: Access to and the cost of induction treatment for cryptococcal meningitis (CM) is rapidly changing. The newly-announced price for flucytosine ($0.75 per 500 mg pill) and possibly lower prices for liposomal amphotericin B (AmB-L) create opportunities to reduce CM treatment costs compared to the current standard treatment in low- and middle-income countries.

Methods: We developed an Excel-based cost model to estimate health system treatment costs for CM over a two-week induction phase for multiple treatment combinations, newly feasible with improved access to flucytosine and AmB-L. CM treatment costs include medications, laboratory tests and other hospital-based costs (bed-day costs and healthcare worker time). We report results from applying the model using country-specific information for South Africa, Uganda, Nigeria, and Botswana.

Results: A 14-day induction-phase of seven days of inpatient AmB-D with flucytosine, followed by seven days of high-dose fluconazole as an outpatient, will cost health systems less than a 14-day hospital stay with AmB-D and fluconazole. If daily AmB-L replaces AmB-D for those with baseline renal dysfunction, with a cost of $50 or less per 50 mg vial, incremental costs would still be less than the AmB-D with fluconazole regimen. Simple oral combinations (e.g., seven days of flucytosine with fluconazole as an inpatient) are practical when AmB-D is not available, and treatment costs would remain less than the current standard treatment.

Conclusions: Improved access to, and lower prices for flucytosine and AmB-L create opportunities for improving CM treatment regimens. An induction regimen of flucytosine and AmB-D for seven days is less costly than standard care in the settings studied here. As this regimen has also been shown to be more effective than current standard care, countries should prioritize scaling up flucytosine access. The cost of AmB-L based regimens is highly dependent on the price of AmB-L, which currently remains unclear.
Towards an integration of two aspects of semiosis – A cognitive semiotic perspective
Authors: Konderak Piotr
Published: June 2021

Meaning-making processes, understood hierarchically, in line with the Semiotic Hierarchy framework, change on various timescales. To account for and predict these changes, one can take a cognitive view on semiosis. I adopt an interdisciplinary approach combining semiotic studies and cognitive studies in an attempt to account for meaning-making activity and to predict the course of semiosis. In this context, I consider meaning-making activity as shaped by both “external” (to a semiotic system) as well as “internal” factors. I also show how both the “external” and “internal” sources of the dynamicity of meaning-making should be framed in terms of studies on cognition.

I start with a non-standard, 4e approach to meaning-making. According to this framework, meaning-making processes are constituted by (and not just dependent on) environmental and bodily factors. The dynamicity of semiosis can be accounted for in terms of an experiencing, embodied subject (agent) enacting her/his/its own domain of meaningful phenomena. As I argue, this perspective on meaning-making is the cognitive foundation of the first two levels of the Semiotic Hierarchy.

In the following sections I present the Peircean view on signs and semiosis, according to which semiosis is a result of the very nature of a sign and a sign system. In this view, the dynamicity of semiosis has primarily “internal” sources: it stems from the unavoidable fallibility of interpretation and synechism of signs. As I show, this aspect of semiosis can be addressed by means of standard (cognitivist) cognitive science and by means of cognitive modelling.

Ultimately, I sketch a proposal of an attempt to develop a uniform cognitive framework allowing for integration of the above-mentioned aspects of semiosis – a framework based on Rowlands’ idea of the Amalgamated Mind.
Impact of a Hospitalist‐Run Procedure Service on Time to Paracentesis and Length of Stay
Authors: Ritter Evan , Malik Manpreet , Qayyum Rehan
Published: June 2021

Hospitals are establishing procedure services to address resident training and patient safety. We examined whether a hospitalist procedure service affects a patient's hospital length of stay (LOS) and the time from admission to paracentesis (A2P). We queried our electronic medical records for all inpatient peritoneal fluid samples from July 1, 2016, to May 31, 2019. LOS and A2P time were compared among patients who had paracentesis by the procedure service, by residents, or by radiology. Of the 1,321 procedures, 509 (38.5%) were performed by the procedure service. In the adjusted analysis, as compared with procedure service, the group that underwent paracentesis by the radiology service had a 27% longer LOS (95% CI, 2%‐58%) and 40% longer A2P time (95% CI, 5%‐87%). The resident group had shorter A2P (–19%; 95% CI, –33% to 0.2%; P = .05) than the procedure service group but similar LOS. To our knowledge, this is the first study that suggests patient‐centered benefits of a hospitalist procedure service.
Layout Design of Parking Lots with Mathematical Programming
Authors: Stephan Konrad , Weidinger Felix , Boysen Nils
Published: June 2021

There is a vivid debate in cities all over the world on how to distribute the restricted space in urban areas among stakeholders. Urban design movements such as new pedestrianism or Copenhagenization advocate that too much space is attributed to cars. In this context, our research investigates the optimization of parking lots with the help of mathematical programming. For the given ground plot of a parking lot, we maximize the number of parking spaces each reachable via a driving lane, so that the urban space attributed to the parking of cars is efficiently used. Based on a grid of squares in which we rasterize the ground plot, this paper presents mixed-integer programs based on three different resolutions for orthogonal parking. Our computational study explores the tradeoff between the additional parking spaces promised by a higher resolution and the increased computational effort because of the larger solution space (and vice versa). We compare our optimization approaches with a sample of 177 real-world parking lots and show that optimization can be a serviceable car park design tool with the help of a case study.
Language difficulties: Assessment and action
Authors: Parrott Nicky
Published: June 2021

Given the importance of language skills, the assessment of difficulties early on is vital. SENCO Nicky Parrott discusses her schools' approach to spotting problems and some of their interventions to improve outcomes
Difficult conversations
Authors: Frostick Helen
Published: June 2021

All this year, National Leader of Education Helen Frostick is offering term-by-term advice for new headteachers to help them prioritise their work and reflect on areas for improvement and focus. This time, she focuses on one of the most challenging areas for new leaders – difficult conversations
Unable to stand still: the necessary rise of the virtual consultation
Authors: Dennison Tracey
Published: June 2021

In a bid to keep afloat during the COVID-19 pandemic, aesthetic business owners turned away from in-clinic daily practice to consulting with patients through online means, such as Zoom. Tracey Dennison explores the implications of this and what the future may hold for the aesthetics sector
Parametric Optimization of Mechanical Properties via FSW on AA5052 Using Taguchi Based Grey Relational Analysis
Authors: CHANAKYAN C. , SIVASANKAR S. , MEIGNANAMOORTHY M. , ALAGARSAMY S. V.
Published: June 2021

The Friction stir processing benefits of aluminium composites contain advanced exploration in the region of aluminium alloy Friction Stir Welding - FSW. The modern advancements in Friction Stir Welding are concentrated on the optimization of welding parameters for multi response attributes. The investigations were carried out with the tool pin profiles, tool rotational speed and traverse speed as predictable process parameters for multi response optimization in Friction Stir Welding of 5052 aluminium alloy. GRG (grey relational grade) was obtained by the grey relational analysis of the friction stir welding process through different qualities, particularly, UTS-ultimate tensile strength and micro hardness. The significant process variables on GRG and most substantial parameters traverse speed and tool pin profiles are examined by ANOVA. Excluding tool rotational speed, tool pin profiles and traverse speed were likewise observed to be significant. To approve the investigation, verification of tests was completed at optimal parameters arrangement and predicted outcomes were observed to be in great concurrence with test values.
Practical application using the hexapod robot for interior inspection of a Boeing 737-300 aircraft fuel tank
Authors: GAINA Maria-Giorgiana
Published: June 2021

This paper focuses on the dangers assoicated with the entry into aircraft fuel tank. The analysis will help to demonstrate that in the future a mobil robot will make this work easier for the human factor. There are number of advantages from this automation to make the job of the human factor easier and to work in a safe environment. The risk of contamination with harmful substances is reduced because we can put the robot to work. After detailed analysis of the working environment to which a mechanic is exposed in the aviation world, it has come to light that the introduction of a robot makes it minimal. I tried to analyze several types of mobile robots, and after this analysis I decided that the most suitable mobile robot is the hexapod.
Angular selectivity based on a double-resonance periodic array of scatterers
Authors: Zhou Lin , Shen Zhongxiang
Published: June 2021

A double-resonance periodic array of scatterers is proposed to achieve angular selectivity in this paper. By properly designing the scatterers’ structure and dimensions, bandpass and band-stop resonances are produced by the periodic array at the same frequency under the normal and oblique incidences, respectively, resulting in excellent angular selectivity. The periodic array consists of two identical scatterer layers stacked together with an air spacer. To demonstrate the design concept, a sample of the periodic array with an operating frequency of 10 GHz is designed for the angular selectivity of TE-polarized incident waves. Measurements of the sample are conducted for verification. The simulated and measured results both show good angular selectivity with high transmission under the normal incidence and low transmission under the oblique incidence of large angles.
Low-crosstalk and fabrication-tolerant four-channel CWDM filter based on dispersion-engineered Mach-Zehnder interferometers
Authors: Xu Hongnan , Dai Daoxin , Shi Yaocheng
Published: June 2021

The O-band coarse wavelength-division (de)multiplexing (CWDM) has been extensively used in data-center optical communications, whereas it’s still challenging to reduce crosstalk and enhance fabrication tolerances for a CWDM filter. In this paper, we propose and experimentally demonstrate a low-crosstalk and fabrication-tolerant four-channel CWDM filter by utilizing dispersion-engineered Mach-Zehnder interferometers. The multi-sectional phase shifters are exploited to eliminate the phase errors induced by width deviations, leading to ultra-precise phase shifts and ultra-large width-error tolerances. The random-phase errors are also inhibited by using multi-mode waveguides as phase-shifting sections. The two-stage-coupler scheme is utilized to flatten the strong coupling-ratio dispersions for directional couplers, so that low crosstalk can be achieved over the whole O-band. The experimental results show both low insertion losses (< 1.2 dB) and low crosstalk (< −22.2 dB) over the whole working wavelength range. The measured width-error tolerance is also as large as ≈ 70 nm.
Broadband long-wave infrared metamaterial absorber based on single-sized cut-wire resonators
Authors: Qin Zheng , Meng Dejia , Yang Fuming , Shi Xiaoyan , Liang Zhongzhu , Xu Haiyang , Smith David R. , Liu Yichun
Published: June 2021

Broadband absorption is critical for the applications of metamaterial absorbers. In this work, a broadband long-wave infrared (LWIR) absorber with classical metal-dielectric-metal configuration is numerically demonstrated. The absorber consists of single-sized cut-wire arrays that show broadband and high extinction ratio, attributed to polarization-selective simultaneous excitation of propagated and localized surface plasmon resonances. The average absorption rate of the TM wave reaches 91.7% and 90% of the incident light is absorbed by the resonator in the wavelength range of 7.5–13.25µm so that the average extinction ratio in the resonator layer reaches 125. The polarization insensitive broadband absorption can be obtained by a cross resonator which can be treated as a pair of cut-wires perpendicular to each other. Our metamaterial absorber with single-sized resonators shows spatially concentrated broadband absorption and may have promising applications for hot-electron devices, infrared imaging, and thermal detection.
Asymmetric hologram with a single-size nanostructured metasurface
Authors: Liang Xiao , Deng Liangui , Shan Xin , Li Zile , Zhou Zhou , Guan Zhiqiang , Zheng Guoxing
Published: June 2021

Geometric metasurfaces, governed by PB phase, have shown their strong polarization sensitivity and can generate opposite phase delay when the handedness of incident circularly-polarized (CP) light is opposite. Here, we show this interesting characteristic can be employed to generate asymmetric forward and backward propagation with the same incident left- or right-handed CP light, which is hard to achieve with conventional optical elements and devices. Specifically, with the modified holographic design algorithm to consider both forward and backward CP light, an asymmetric meta-hologram is designed, which can project two different holographic images in the forward and backward directions, respectively. We demonstrate this concept by fabricating an asymmetric hologram with a single-size nanostructured metasurface, and the experimentally obtained holographic images in both directions have shown their advantages of high fidelity, broadband response and low crosstalk. The proposed asymmetric metasurface can play an important role in data storages, anti-counterfeitings, optical communications, displays and many other related fields.
Millimeter-level recognition capability of BOTDA based on a transient pump pulse and algorithm enhancement
Authors: Zhou Dengwang , Ba Dexin , Wang Benzhang , Qiu Liqiang , Hasi Wuliji , Dong Yongkang
Published: June 2021

Brillouin optical time-domain analysis requires a pulsed pump to obtain a distributed Brillouin gain spectrum (BGS) containing environmental information, whose width corresponds to spatial resolution (SR). We propose a rising edge demodulation (RED) algorithm acting on Brillouin information generated by a transient pump pulse (

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lifetime) via a nonlinear weight matrix to enhance SR. The distributed BGS generated by using an 8-ns transient pump pulse is processed by the RED algorithm, and its SR is enhanced from 0.8 m to 1 mm (i.e., 800-fold improvement) in the simulation and 8 mm (i.e., 100-fold improvement) in the experiment.
Cross-phase modulation aberrations in time lenses
Authors: Duadi Hamootal , Klein Avi , Sibony Inbar , Meir Sara , Fridman Moti
Published: June 2021

We study the aberrations of four-wave mixing based time lenses resulting from the cross-phase modulations of the pump wave. These temporal aberrations have no spatial equivalent and are important when imaging weak signals with strong pump waves. We show that as the pump power increases, the cross-phase modulations of the pump are responsible for shifting, defocusing, and imposing temporal coma aberrations on the image. We present experimental results of these aberrations with high agreement to analytical and numerical calculations.
Self-powered solar-blind ultraviolet photodetector based on α-Ga2O3 nanorod arrays fabricated by the water bath method
Authors: Huang Lijuan , Hu Zhengrui , He Xianwang , Ma Tengyu , Li Mengcheng , Zhang Hong , Xiong Yuanqiang , Kong Chunyang , Ye Lijuan , Li Honglin , Li Wanjun
Published: June 2021

In this paper, α-Ga2O3 nanorod arrays (NRAs) with preferential growth along the (110) direction were successfully prepared on the FTO substrate by the water bath method. With the help of a scanning electron microscope (SEM), X-ray diffractometer (XRD), and Raman spectrometer (Raman), the crystal structure and morphology characteristics of α-Ga2O3 NRAs were studied. On this basis, a photoelectrochemical (PEC) solar-blind ultraviolet photodetector based on the α-Ga2O3 NRAs was fabricated, and the photoelectric performance of the device was analyzed in detail through the PEC test system, and the working mechanism of the device was further discussed. The results show that the prepared α-Ga2O3 NRAs have good crystal quality which is closely arranged on the substrate and a quadrangular prism shape from the top view. The constructed α-Ga2O3 NRAs PEC photodetector shows typical solar-blind ultraviolet response characteristics and stable self-powered ability. Meanwhile, the device exhibited a high photo-dark current ratio (PDCR), responsivity (R) and detectivity (D*) of 1.01×103, 11.34 mA/W and 2.68×1011 Jones, respectively, as well as superior wavelength selectivity and fast response. This work confirms that α-Ga2O3 NRAs prepared by the water bath method have potential application prospects in highly sensitive and fast response PEC self-powered solar-blind ultraviolet photodetectors.
Demonstration of a non-Abelian geometric controlled-NOT gate in a superconducting circuit
Authors: Xu Kai , Ning Wen , Huang Xin-Jie , Han Pei-Rong , Li Hekang , Yang Zhen-Biao , Zheng Dongning , Fan Heng , Zheng Shi-Biao
Published: June 2021

Holonomies, arising from non-Abelian geometric transformations of quantum states in Hilbert space, offer a promising way for quantum computation. These holonomies are not commutable and thus can be used for the realization of a universal set of quantum logic gates, where the global geometric feature may result in some noise-resilient advantages. Here we report, to our knowledge, the first on-chip realization of a non-Abelian geometric controlled-NOT gate in a superconducting circuit, which is a building block for constructing a holonomic quantum computer. The conditional dynamics is achieved in an all-to-all connected architecture involving multiple frequency-tunable superconducting qubits controllably coupled to a resonator; a holonomic gate between any two qubits can be implemented by tuning their frequencies on-resonance with the resonator and applying a two-tone drive to one of them. This gate represents an important step towards the all-geometric realization of scalable quantum computation on a superconducting platform.
Improving germline transmission efficiency in chimeric chickens using a multi-stage injection approach
Authors: Naseri Danial , Dormiani Kianoush , Hajian Mehdi , Jafarpour Farnoosh , Forouzanfar Mahboobeh , Karimi Naeimeh , Nasr-Esfahani Mohammad Hossein
Published: June 2021

Although different strategies have been developed to generate transgenic poultry, low efficiency of germline transgene transmission has remained a challenge in poultry transgenesis. Herein, we developed an efficient germline transgenesis method using a lentiviral vector system in chickens through multiple injections of transgenes into embryos at different stages of development. The embryo chorioallantoic membrane (CAM) vasculature was successfully used as a novel route of gene transfer into germline tissues. Compared to the other routes of viral vector administration, the embryo’s bloodstream at Hamburger-Hamilton (HH) stages 14–15 achieved the highest rate of germline transmission (GT), 7.7%. Single injection of viral vectors into the CAM vasculature resulted in a GT efficiency of 2.7%, which was significantly higher than the 0.4% obtained by injection into embryos at the blastoderm stage. Double injection of viral vectors into the bloodstream at HH stages 14–15 and through CAM was the most efficient method for producing germline chimeras, giving a GT rate of 13.6%. The authors suggest that the new method described in this study could be efficiently used to produce transgenic poultry in virus-mediated gene transfer systems.
Potential application of novel technology developed for instant decontamination of personal protective equipment before the doffing step
Authors: Brêda Mascarenhas Luís Alberto , Machado Bruna Aparecida Souza , Rodrigues Leticia de Alencar Pereira , Saraiva Hodel Katharine Valéria , Bandeira Santos Alex Álisson , Freitas Neves Paulo Roberto , da Silva Andrade Leone Peter Correia , Soares Milena Botelho , de Andrade Jailson Bittencourt , Badaró Roberto
Published: June 2021

The use of personal protective equipment (PPE) has been considered the most effective way to avoid the contamination of healthcare workers by different microorganisms, including SARS-CoV-2. A spray disinfection technology (chamber) was developed, and its efficacy in instant decontamination of previously contaminated surfaces was evaluated in two exposure times. Seven test microorganisms were prepared and inoculated on the surface of seven types of PPE (respirator mask, face shield, shoe, glove, cap, safety glasses and lab coat). The tests were performed on previously contaminated PPE using a manikin with a motion device for exposure to the chamber with biocidal agent (sodium hypochlorite) for 10 and 30s. In 96.93% of the experimental conditions analyzed, the percentage reduction was >99% (the number of viable cells found on the surface ranged from 4.3x106 to <10 CFU/mL). The samples of E. faecalis collected from the glove showed the lowest percentages reduction, with 86.000 and 86.500% for exposure times of 10 and 30 s, respectively. The log10 reduction values varied between 0.85 log10 (E. faecalis at 30 s in glove surface) and 9.69 log10 (E. coli at 10 and 30 s in lab coat surface). In general, E. coli, S. aureus, C. freundii, P. mirabilis, C. albicans and C. parapsilosis showed susceptibility to the biocidal agent under the tested conditions, with >99% reduction after 10 and 30s, while E. faecalis and P. aeruginosa showed a lower susceptibility. The 30s exposure time was more effective for the inactivation of the tested microorganisms. The results show that the spray disinfection technology has the potential for instant decontamination of PPE, which can contribute to an additional barrier for infection control of healthcare workers in the hospital environment.