bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk analysis of reservoir sedimentation under non‐stationary flows
Authors: Tsai Christina W. , Yeh Ting‐Gu , Hsu Yaowen , Wu Kuan‐Ting , Liu Wen‐Jia
Published: March 2021

Reservoir sustainability is strongly impacted by the reservoir sedimentation processes. Most of the substantial sedimentation processes occur in non‐stationary flows such as in the case of flash floods, surges and tidal waves. However, a stationary probability assumption is normally adopted to reduce mathematical model complexity. This work develops a non‐stationary Gambler's ruin model using the Monte‐Carlo simulation method. Daily water‐level data for the Xia‐Yun station are used to predict the effective risk that the maximum capacity of the water treatment plant in the Shihmen Reservoir is reached. This non‐stationary model yields fairly accurate probabilities of sedimentation by the transitional probability of a reservoir reaching different levels of turbidity, and the average time to reach a designated reservoir maximum handling turbidity. The extended capacity of the proposed model demonstrates the major particle processes during non‐stationary flows. Such analytical results offer water resources agency to scientifically evaluate the dredging/remediation strategies with the existing reservoirs. Transport capacities of rivers and streams, and the potential consequences of flood risks in response to reservoir sedimentation can then be comprehensively estimated in order to allow effective contingency planning for public safety.
A systematic review of the effectiveness of machine learning for predicting psychosocial outcomes in acquired brain injury: Which algorithms are used and why?
Authors: Mawdsley Emma , Reynolds Bronagh , Cullen Breda
Published: March 2021

Clinicians working in the field of acquired brain injury (ABI, an injury to the brain sustained after birth) are challenged to develop suitable care pathways for an individual client’s needs. Being able to predict psychosocial outcomes after ABI would enable clinicians and service providers to make advance decisions and better tailor care plans. Machine learning (ML, a predictive method from the field of artificial intelligence) is increasingly used for predicting ABI outcomes. This review aimed to examine the efficacy of using ML to make psychosocial predictions in ABI, evaluate the methodological quality of studies, and understand researchers’ rationale for their choice of ML algorithms. Nine studies were reviewed from five databases, predicting a range of psychosocial outcomes from stroke, traumatic brain injury, and concussion. Eleven types of ML were employed with a total of 75 ML models. Every model was evaluated as having high risk of bias, unable to provide adequate evidence for predictive performance due to poor methodological quality. Overall, there was limited rationale for the choice of ML algorithms and poor evaluation of the methodological limitations by study authors. Considerations for overcoming methodological shortcomings are discussed, along with suggestions for assessing the suitability of data and suitability of ML algorithms for different ABI research questions.
Barriers to Family Resilience in Caregivers of People Who Have Schizophrenia
Authors: Fernandes Júlio Belo , Fernandes Sónia Belo , Almeida Ana Silva , Cunningham Rhona Cruzet
Published: March 2021

Purpose

To explore the barriers to family resilience in caregivers of people who have schizophrenia.

Design

A qualitative descriptive approach was used.

Methods

Semistructured interviews were conducted with family caregivers of patients with schizophrenia registered at the psychiatry outpatient unit of a hospital center. Content analysis was performed on audio‐recorded and verbatim‐transcribed interviews. The consolidated criteria for reporting qualitative research (COREQ) checklist was applied to this study.

Results

A total of 31 family caregivers participated, the majority of whom were female (71%) with an average age of 57.5 years. Most participants lived with and cared for their relative (90.3%). The caregiver role was assumed mostly by mothers (54.8%) and fathers (22.6%). Barriers to family resilience in caregivers of people experiencing schizophrenia broadly fall under five categories: lack of knowledge about the disease, social stigma, expressed emotion, involvement in the relationship, and blame.

Conclusions

In view of the paucity of studies exploring and understanding the barriers to family resilience, this study presents itself as one of the first in this area. There are different barriers to family resilience. This research provides an overview and an understanding of key barriers to family resilience in caregivers of people experiencing schizophrenia.

Clinical Relevance

There is a need for nurses to help families to be resilient. By understanding the barriers to resilience, nurses are able to focus on these factors and help families to remove or reduce their influence.
Xenografts in the post‐operative wound management of interpolation flaps
Authors: Benedetto Conrad J. , Salloum Antoine , Benedetto Anthony V. , Benedetto Paul X.
Published: March 2021

Introduction

Safeguarding the integrity of the donor site during the initial suspension phase of an interpolation flap is difficult. There are a variety of approaches and no consensus on post‐operative management of the donor site or pedicle following the creation of the flap. The use of xenografts at the donor site of postauricular interpolation flaps simplifies post‐operative wound care and prevents infection, desiccation of tissue, reduces pain, and assists with hemostasis.

Methods

A porcine acellular dermal skin substitute can be utilized for the purpose of care‐free interpolation flap wound care. First, the flap is designed and raised using standard surgical technique. The porcine xenograft is then sutured into the donor site and to the exposed subcutaneous side of the flap pedicle using nylon suture material. The flap then is interpolated and sutured into the surgical defect of the auricle. Silicone gel is applied to the surface of the xenograft. A pressure dressing is then placed over the surgical site.

Results

A total of 4 patients had postauricular interpolation flaps to the ipsilateral helix. All four patients had a xenograft placed at the donor site and flap pedicle at the time of the flap creation and suspension. No infections and no incidence of post‐operative bleeding requiring intervention were noted.

Conclusion

Utilizing a dermal skin substitute as a biological dressing for an interpolation flap prior to division and inset of the flap provides a useful alternative to traditional wound care during this interim period.
In vitro and clinical evaluation of umbilical cord‐derived mesenchymal stromal cell‐conditioned media for hair regeneration
Authors: Mathen Caroline , Dsouza Wilfrid
Published: March 2021

Background

The field of regenerative medicine may present a non‐drug, non‐steroid, and non‐invasive alternative toward addressing male and female pattern hair loss, a global concern.

Objective

The aim was to carry out the in vitro and in vivo safety and efficacy evaluation of human umbilical cord‐derived mesenchymal stromal cell‐conditioned media (MSC‐CM) for hair regeneration.

Methods

Various in vitro parameters were used to estimate the consistency across various batches of MSC‐CM. Total protein content was measured by the Biuret method and antioxidant activity by the 2,2‐diphenyl‐1‐picryl hydrazyl (DPPH) assay. Fourier transform infrared spectroscopy (FTIR) analysis was used to determine spectral signatures and biocompatibility was carried out by the Neutral Red Uptake (NRU) and Sulforhodamine B (SRB) assays. In vivo safety and efficacy was evaluated in an experimental pilot study on 15 volunteers.

Results

The in vitro results confirmed stability in the protein content (7 mg/ml), antioxidant activity (49.50%), and FTIR fingerprints of the MSC‐CM. In the biocompatibility experiments by both SRB and NRU methods, no IC50 value could be derived at 100% concentration indicating safety at the cellular level. The in vivo results indicated safety with no side effects or adverse reactions, while 86.6% of the subjects experienced a positive effect of hair regeneration.

Conclusion

MSC‐CM comprises a rich cocktail of physiologically balanced growth factors, cytokines, and beneficial proteins which may explain the bioactivity and mechanism of action in hair regrowth. This may indicate a biocompatible, gentle, and safe regenerative approach to address hair loss.
Maximum bite force in children with juvenile idiopathic arthritis with and without clinical established temporomandibular joint involvement and in healthy children: a cross‐sectional study
Authors: de Sonnaville Willemijn F. C , Speksnijder Caroline M. , Zuithoff Nicolaas P. A. , Verkouteren Daan R. C , Wulffraat Nico W. , Steenks Michel H. , Rosenberg Antoine J. W. P.
Published: March 2021

Background

In children with juvenile idiopathic arthritis (JIA), the temporomandibular joint (TMJ) can be involved, resulting in dysfunction of the masticatory system. Bite force is one of the variables that reflects the function of the masticatory system. The aim of this study was to compare maximum bite force in children with JIA, with and without TMJ involvement and with healthy children.

Methods

Children with JIA and healthy children between the ages 6 and 18 were included in this cross‐sectional study. The clinical examination consisted of measuring the anterior maximum voluntary bite force (AMVBF), assessment of the TMJ screening protocol items and TMJ, masseter and temporal muscle palpation pain. Unadjusted linear regression analyses were performed to evaluate the explanatory factors for AMVBF. Two adjusted models were constructed with corrections for age and gender differences: model 1 to compare children with JIA and healthy children and model 2 to compare children with JIA with and without TMJ involvement.

Results

In this cross‐sectional study, 298 children with JIA and 169 healthy children participated. AMVBF was 24 Newton (N) lower in children with JIA, when compared with healthy children (95%CI: −35.5–−12.4, p = .000). When children with JIA also had clinically established TMJ involvement, AMVBF was reduced 42 N (component JIA:−16.78, 95% CI −28.96–−4.59, p = .007 and component TMJ involvement:−25.36, 95% CI −40.08–−10.63, p = .001). Age and male gender increased AMVBF.

Conclusion

Children with JIA had a reduction in the AMVBF compared with healthy children. In children with JIA and clinically established TMJ involvement, AMVBF was more reduced.
Safety and utility of kidney biopsy in patients with estimated glomerular filtration rate < 30 ml/min/1.73 m2
Authors: Asad Riyaz Ahmed , Valson Anna T. , Kavitha Vijayakumar , Korula Anila , Eapen Anu , Rebekah Grace , Jacob Shibu , Pathak Harish , Alexander Suceena , Mohapatra Anjali , David Vinoi George , Varughese Santosh , Tamilarasi Veerasamy , Basu Gopal
Published: March 2021

Aim

Kidney biopsy (KBx) is the gold standard for evaluation of kidney disease, but is associated with a higher risk of complications in patients with reduced glomerular filtration rate (GFR). We studied the safety and utility of KBx in patients with eGFR <30 ml/min/1.73 m2.

Methods

Consecutive adult patients with eGFR <30 ml/min/1.73 m2, who were planned for a KBx and consented to participate were prospectively enrolled. Patients with solitary/transplant kidney or acute kidney injury were excluded. Haemoglobin was checked on the day of KBx and repeated 18–24 h later along with a screening ultrasound. Post‐KBx complications were noted and their risk‐factors analysed. The utility of the KBx was graded as effecting significant, some, or no change to subsequent management.

Results

Of the 126 patients included, 75% were male, 27.7% were diabetic, and the median eGFR was 13.5 ml/min/1.73m2. Major complications occurred in 5.6%. Peri‐renal haematomas were detected in 37.3%, and haematomas ≥2 cm were significantly more frequent in those with eGFR <15 ml/min/1.73 m2 (29.2% vs. 13%, p = .032). Dialysis was a risk factor, while pre KBx blood transfusion, diabetes and higher serum albumin were protective against any complication. KBx was more likely to make a significant difference in management in those with eGFR 15–29 ml/min/1.73m2 (44.1% vs. 11.1%, p < .001). Increasing age, lower serum creatinine and albumin were independently associated with KBx utility.

Conclusion

KBx is relatively safe in severe kidney disease but its risk to benefit balance needs to be carefully considered when eGFR is <15 ml/min/1.73m2.
New insight to the role of microbes in the methane exchange in trees: evidence from metagenomic sequencing
Authors: Putkinen Anuliina , Siljanen Henri M. P. , Laihonen Antti , Paasisalo Inga , Porkka Kaija , Tiirola Marja , Haikarainen Iikka , Tenhovirta Salla , Pihlatie Mari
Published: March 2021

Methane (CH4) exchange in tree stems and canopies and the processes involved are among the least understood components of the global CH4 cycle. Recent studies have focused on quantifying tree stems as sources of CH4 and understanding abiotic CH4 emissions in plant canopies, with the role of microbial in situ CH4 formation receiving less attention. Moreover, despite initial reports revealing CH4 consumption, studies have not adequately evaluated the potential of microbial CH4 oxidation within trees. In this paper, we discuss the current level of understanding on these processes. Further, we demonstrate the potential of novel metagenomic tools in revealing the involvement of microbes in the CH4 exchange of plants, and particularly in boreal trees. We detected CH4‐producing methanogens and novel monooxygenases, potentially involved in CH4 consumption, in coniferous plants. In addition, our field flux measurements from Norway spruce (Picea abies) canopies demonstrate both net CH4 emissions and uptake, giving further evidence that both production and consumption are relevant to the net CH4 exchange. Our findings, together with the emerging diversity of novel CH4‐producing microbial groups, strongly suggest microbial analyses should be integrated in the studies aiming to reveal the processes and drivers behind plant CH4 exchange.
Barriers and enablers to caregivers' responsive feeding behaviour: A systematic review to inform childhood obesity prevention
Authors: Redsell Sarah A. , Slater Vicki , Rose Jennie , Olander Ellinor K. , Matvienko‐Sikar Karen
Published: March 2021

Responsive infant feeding is a critical component of childhood obesity prevention. However, there is little guidance for caregivers on how to do this successfully. The first step to developing an intervention to promote responsive feeding is to systematically identify its barriers and enablers. Searches were conducted in CINAHL, Cochrane Library, Medline, Embase, PubMed, PsycINFO, Maternity, and Infant Care from inception to November 2020. All study designs were included if they reported a barrier or enabler to responsive feeding during the first 2 years of life. We used a “best fit” framework synthesis, with the Capacity, Opportunity, Motivation, and Behaviour (COM‐B) model. The Mixed Method Appraisal Tool (MMAT) was used to assess study quality. Forty‐three studies were included in the review. Barriers (n = 36) and enablers (n = 21) were identified across five COM‐B domains: psychological capacity, physical and social opportunity, and reflective and automatic motivation. Enablers were recognition of infant feeding cues, feeding knowledge and family and friends. Caregiver attitude toward control of feeding was a barrier, together with health care professional advice about formula feeding and breastfeeding expectation. These barriers and enablers provide a comprehensive evidence base to guide intervention development to improve responsive feeding and prevent obesity across individual and population levels.
MINING IN SOUTH‐WEST GAUL AT THE CROSSROADS OF THE CELTIC AND MEDITERRANEAN WORLDS. THE CASE OF THE MINING AREA OF THE ARIZE MOUNTAINS (CENTRAL PYRENEES) DURING THE FOURTH AND THIRD CENTURIES BC
Authors: Meunier Emmanuelle , Luaces Max
Published: March 2021

This paper presents new data about the silver‐bearing copper mining area of the Arize (Central Pyrenees) during the fourth and third centuries BC. The identification of amphorae sherds from Magna Graecia and the Strait of Gibraltar region sheds new light on this metal production and confirms a systematic exploration of the ores before the end of the third century BC. At a regional scale, the existence of several mines operating between the fourth and third centuries BC also suggests a production that exceeded the local needs. Parallels can be drawn between this important raw metal production and the socio‐economic changes observed in Celtic Europe in the same period. We also point out the need for further in‐depth study of the economic situation of this region, lying at a crossroads between the Celtic and Mediterranean worlds.
Body knowledge in children with spina bifida
Authors: Mano Hiroshi , Fujiwara Sayaka , Yabuki Sayumi , Tanaka Hiroshi , Takikawa Kazuharu , Haga Nobuhiko
Published: March 2021

Background

Patients with spina bifida suffer from motor paralysis and sensory disturbance, secondary deformation of the lower extremities, and development of decubitus ulcers. A deep understanding of one's body, such as identifying the names, functions, relationships, homology (e.g. upper and lower limbs) and relative position of body parts, may prevent secondary disorders. The awareness of the body and its characteristics in children with spina bifida has not been fully elucidated. This study aimed to investigate how children with spina bifida perceive their bodies, especially their paralyzed parts and related or homologous ones.

Methods

Participants included 36 children with spina bifida and 14 control children, aged 5–11 years. They were asked to draw self‐portraits, and to answer questions about the names of body parts. The number of drawn body parts in the pictures and the correct response rates to the questions were quantified and compared between children with spina bifida and control children.

Results

Children with spina bifida drew fewer hands, legs, and feet than control children. In the verbal tests, children with spina bifida had a lower correct response rate than control children on questions concerning the upper limbs, hands, trunk, and feet.

Conclusions

Children with spina bifida have diminished visuospatial and lexical‐semantic body knowledge of the paralyzed parts and related organs.
Sustaining peer support groups: Insights from women living with HIV in rural Kenya
Authors: Kako Peninnah M. , Ngui Emmanuel , Kako Tavonna , Ndakuya‐Fitzgerald Florine , Mkandawire‐Valhmu Lucy , Dressel Anne E. , Kiplagat Augustine , Egede Leonard E.
Published: March 2021

Objective

As HIV transitions to a chronic disease, measures that foster continued health are critical. Peer support groups can help in reducing stigma and ensuring wellbeing for those living with HIV. The purpose of our study was to gain an understanding of the ways in which women living with HIV in rural areas sustain peer support groups.

Design and sample

For this descriptive qualitative study, 20 women living with HIV participated in the study. Women were randomly divided into two peer support groups of ten women each; the groups met over a 12‐month period. monthly for the first two months and then every three months for the remainder of the year.

Results

Discussion themes indicated women found ways to sustain the groups by using them as a platform for engaging in income generation; starting and participating in table banking; addressing food security; and finding financial and moral support. Problem‐solving challenges of sustaining peer support groups was also a major theme.

Conclusion

As people live longer with HIV, long‐term peer support will be needed to maintain wellbeing. Community‐based peer support groups can be sustained by engaging women in common income‐generation activities.
Medicaid expansion and accessibility to healthcare: The Illinois experience
Authors: Dalstrom Matthew , Weinzimmer Laurence G. , Foulger Roopa , Klein Colleen J.
Published: March 2021

Objective

The study examined the impact that the Medicaid expansion in Illinois had upon insurance rates, access to medical care, dental care, pharmaceuticals, and mental‐health counseling between rural and urban counties.

Design and Sample

A serial cross‐sectional design was used to assess the health perceptions of adults living in Illinois.

Measures

Survey data were collected in 2012 (n = 6,149) before the Medicaid expansion in Illinois and in 2015 (n = 3,532) after the expansion from rural (n = 4) and urban counties (n = 4).

Intervention

Medicaid expansion reduced the uninsured rate in both rural (16.39%–4.87%) and urban counties (17.05%–5.2%) and improved self‐reported health. It also increased access to all types of healthcare, with the biggest increase in dental coverage.

Results

Path analysis indicated that the Medicaid expansion β = −1.03 (p < .01) and poor versus not poor β = −1.50 (p < .01) were a significant predictor to no healthcare access. Rural verses urban location was not significant (β = 0.04); however, race/ethnicity was significantly different (p < .01).

Conclusion

Findings suggest that although the expansion has increased access to care overall, those who are the most vulnerable are still not benefiting equally from the expansion. Therefore, strategies to assist high‐risk adults in enrolling and using their Medicaid coverage need to developed and implemented.
Personality and Public Administration: Policymaker Tolerance of Administrative Burdens in Welfare Services
Authors: Aarøe Lene , Baekgaard Martin , Christensen Julian , Moynihan Donald P.
Published: March 2021

While related fields have turned to personality to understand human behavior, we know relatively little about its role and impact in public administration. We review how personality has been studied in public administration and offer an empirical test of how it relates to policymaker attitudes about administrative arrangements. Using the “Big Five” framework and a sample of elected politicians, we conduct two studies showing how personality is associated with policymaker tolerance of the administrative burdens that social welfare recipients experience. Politicians with high conscientiousness are more tolerant of burdens, suggesting that they expect similar attention to detail from others. Conversely, politicians who score higher on the trait of openness to experience are less tolerant of burdens, implying that greater empathy toward the experience of others reduces burden tolerance. These relationships hold even after controlling for political ideology, the standard explanation for burden tolerance in welfare programs.
Sustainable aquaculture development: a review on the roles of cloud computing, internet of things and artificial intelligence (CIA)
Authors: Mustapha Umar Farouk , Alhassan Abdul‐Wadud , Jiang Dong‐Neng , Li Guang‐Li
Published: March 2021

Each year, there is a significant rise in demand for global food production due to population increase and a rise in demand for protein food sources. This puts pressure on capture fishery as fish is a preferred protein source worldwide. However, the more resources we put into the capture fisheries to obtain maximum catch, the faster the fisheries stock becomes depleted. The best option left to produce enough fish to meet demand is relying on advanced aquaculture. Unfortunately, the impact of technological advancement in the aquaculture sector is not profound compared to the agricultural and manufacturing sectors. The advent of Cloud computing, Internet of Things, and Artificial Intelligence (CIA) has expanded numerous possibilities for applying and integrating information technology in all works of life. This article reviews the emergence of research development on CIA and the potential to revolutionize the aquaculture industry. The use of CIA techniques and tools such as drones, nano and micro‐sensors, bionic robots, remote cameras, intelligent sorting, energy‐saving processing equipment, statistical modules, and algorithms will reduce human intervention and increase aquaculture productivity. Also, the application of CIA in the aquaculture value chain to ensure effectiveness in traceability, feeding, disease detection, growth prediction, environmental monitoring, market information, and others is key to increasing aquaculture productivity and sustainability. Therefore, the future of aquaculture operations with less human labour, effective maintenance, and resource utilization largely depend on innovative technologies. Here, we outlined the need for adopting innovative technologies and the limiting factors that hinge on CIA adoption in the aquaculture industry.
An integrative view on vacuolar pH homeostasis in Arabidopsis thaliana: Combining mathematical modeling and experimentation
Authors: Holzheu Pascal , Krebs Melanie , Larasati Catharina , Schumacher Karin , Kummer Ursula
Published: March 2021

The acidification of plant vacuoles is of great importance for various physiological processes, as a multitude of secondary active transporters utilize the proton gradient established across the vacuolar membrane. Vacuolar‐type H+‐translocating ATPases and a pyrophosphatase are thought to enable vacuoles to accumulate protons against their electrochemical potential. However, recent studies pointed to the ATPase located at the trans‐Golgi network/early endosome (TGN/EE) to contribute to vacuolar acidification in a manner not understood as of now. Here, we combined experimental data and computational modeling to test different hypotheses for vacuolar acidification mechanisms. For this, we analyzed different models with respect to their ability to describe existing experimental data. To better differentiate between alternative acidification mechanisms, new experimental data have been generated. By fitting the models to the experimental data, we were able to prioritize the hypothesis in which vesicular trafficking of Ca2+/H+‐antiporters from the TGN/EE to the vacuolar membrane and the activity of ATP‐dependent Ca2+‐pumps at the tonoplast might explain the residual acidification observed in Arabidopsis mutants defective in vacuolar proton pump activity. The presented modeling approach provides an integrative perspective on vacuolar pH regulation in Arabidopsis and holds potential to guide further experimental work.
An Assessment of the Legal Provisions for the Maintenance and Welfare of Parents and Senior Citizens Act, 2007 and the Maintenance and Welfare of Parents and Senior Citizens (Amendment) Bill, 2019 in India
Authors: Khan Mumtaz Zabeen
Published: March 2021

Longevity is a fundamental dream of all living things. In traditional Indian culture, elders have been accorded a high status and a symbol of reverence. Each child has a virtuous duty to hold his parents as true images of Brahma, Vishnu, and Mahesh, which God has put on them. However, the winds of change are blowing all around us, and new situations are arising. The elderly have faced economic, social, and political challenges as a result of the nuclear family structure, modernization, industrialization, population growth, globalisation, rising unemployment, and poverty, among other factors. Physical, physiological, and emotional violence, as well as a lack of financial support, add insult to injury. Is it for this that a parent has dedicated his whole life? This shift in conduct necessitates the provision of defence and social welfare. Parents were increasingly oppressed, as they were compared to Godly creatures and addressed as "Matru-deo Bhava," "Pitrudeo Bhava," and so on, which was not the customary common practise. The author was moved to tears by the current situation, so he conducted this research study on the legislation for The Maintenance and Welfare of Parents and Senior Citizens Act, 2007, in accordance with the provisions of Article 41 read with Entry 23 of the Concurrent List (Schedule VIII) of the Constitution of India. To bring to light which protective legislations, as well as Penal Provisions, were designed to provide social protection to elderly parents? And what amendments to current laws would be needed to improve Indian cultural roots? And how effective has the judiciary been in promoting and preserving the right of this vulnerable group of people, namely older parents and senior citizens, to live in dignity?
Atomic layer deposition and characterization of Zn-doped Ga2O3 films
Authors: Baji Zsófia , Cora Ildikó , Horváth Zsolt Endre , Agócs Emil , Szabó Zoltán
Published: March 2021

The present work focuses on the atomic layer deposition (ALD), annealing, and Zn doping of gallium oxide (Ga2O3) films using a novel Ga precursor, hexakis-dimethylamino-digallium. As ALD deposited Ga2O3 films are always amorphous, the optimal annealing procedure had to be found to achieve crystalline β-Ga2O3. The bandgaps and dielectric properties of the layers were measured and the effects of the deposition parameters and postdeposition annealing on the electrical properties were determined. The effects of Zn doping on the electrical properties were analyzed, and some crucial issues for application as a UV sensor were addressed.
Influence of primary electron incident angle and electron bombardment on the secondary electron yield of laser-treated copper
Authors: Wang Yigang , Zhang Wenli , Wang Sihui , Wei Wei , Fang Jianwei , Zhu Bangle , Wang Yong
Published: March 2021

Electron cloud is a persistent problem in operating modern accelerators. It might be eliminated by reducing the secondary electron yield (SEY), which is a property of the material of vacuum chambers. In the present study, the SEYs of oxygen-free copper samples are dramatically mitigated by grooving their surfaces with a laser-etching technique. Such mitigation is realized by trapping incident primary electrons and their induced secondary electrons in the grooves. The SEYs of the laser-etched samples are dependent on the geometrical characteristics of the grooves and the incident angles of the primary electrons, i.e., reducing the incident angle can lead to a reduction in the SEY. Electron bombardment of the grooved surface with an electron dose of 2 × 10−2 C mm−2 will further reduce its maximum SEY from 1.15 to 0.98, which might be attributed to the formation of Cu2O and graphite-like C—C bonds and the removal of surface contaminants.
Acoustic radiation torque on a compressible spheroid
Authors: Jerome Thomas S. , Ilinskii Yurii A. , Zabolotskaya Evgenia A. , Hamilton Mark F.
Published: March 2021

Starting with the theoretical framework for calculating the acoustic radiation force on a compressible spheroid [Jerome et al., J. Acoust. Soc. Am. 148, 2403–2415 (2020)], the present work develops a model for the corresponding acoustic radiation torque. A general result is obtained that may be applied to an object of arbitrary size, shape, and impedance in an arbitrary incident sound field. Like for the radiation force, the general result for the radiation torque is a summation of terms involving products of the coefficients in spherical wave expansions of the incident and scattered fields. For the compressible spheroid under consideration, spheroidal wave expansions are employed to satisfy the boundary conditions on the surface of the spheroid to obtain the scattering coefficients. Results are presented for the radiation torque exerted on a compressible spheroid by a progressive or standing incident plane wave. The results illustrate the dependence of the radiation torque on the size, aspect ratio, and impedance of the spheroid and on its orientation with respect to the incident wave field.
First participant diagnosed with Creutzfeldt-Jakob disease in the population-based Rotterdam Study was classified with mild cognitive impairment
Authors: Karamujić-Čomić Hata , Rozemuller Annemieke J M , Ikram M Arfan , van Duijn Cornelia M
Published: March 2021

Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare, fatal, neurodegenerative disease caused by accumulation of abnormally folded prion protein. sCJD can have a long asymptomatic incubation period, with little known about this period. We describe the first-ever participant within the population-based Rotterdam Study diagnosed with sCJD. We retrieved clinical data from both the population-based Rotterdam Study and the National Prion Disease Registry. In 2011, a female participant of the Rotterdam Study was diagnosed with probable sCJD and registered into the Registry. Four months earlier, she was classified as having mild cognitive impairment based on assessment in the Rotterdam Study. Clinical deterioration was rapid, with the patient dying 7 months after the research centre visit. Postmortem brain autopsy confirmed the diagnosis of sCJD. In conclusion, we describe the first case diagnosed with sCJD who during diagnostic workup for sCJD was classified as having mild cognitive impairment in a population-based cohort study.
Tracheocarotid artery fistula in a patient who had tracheostomy successfully treated with a saphenous vein graft
Authors: Dahill Katherine Elizabeth , Dempsey Ged
Published: March 2021

Tracheoarterial fistula is a complication of tracheostomy with a high associated mortality. A 25-year-old male patient with Duchenne’s muscular dystrophy underwent a percutaneous tracheostomy using the single tapered dilator (Blue Rhino) technique to facilitate weaning from mechanical ventilation. Nine weeks after the procedure, he developed significant upper airway bleeding, leading to haemodynamic instability. A CT angiogram of the neck and thorax did not reveal a source of the bleeding. The patient was subsequently transferred to the operating theatre where a 1 cm defect in the right common carotid artery was found and repaired with a graft from the left short saphenous vein. Clinicians who undertake tracheostomy formation should be aware of the possibility of tracheoarterial defect and may wish to discuss it at tracheostomy formation. It should be considered early in the event of a significant bleed. This case identifies deep tissue infection and misplacement of the tracheostomy tube as major contributing factors to fistula formation.
Reducing suspicion of sexual abuse in paediatric chlamydial conjunctivitis usingompAgenotyping
Authors: Mitchell Alexander , Patel Mitul , Manning Chloe , Abbott Joseph
Published: March 2021

Chlamydia trachomatisis a Gram-negative bacterium that causes urogenital tract infections, and ocular infections including trachoma, neonatal conjunctivitis and adult chlamydial inclusion conjunctivitis. A positiveC. trachomatisdiagnosis in children often raises suspicions of sexual abuse. While outer membrane protein A (ompA) genotypes A–C are non-invasive and are associated with trachoma;ompAgenotypes D–K are often associated with sexually transmitted urogenital infections or sexually acquired chlamydial conjunctivitis. A 10-year-old female presented with a 7-month history of unilateral conjunctivitis with itching, watering and hyperaemia. She had recently moved from an urban centre in Afghanistan to the UK. A conjunctival swab taken from the child tested positive forC. trachomatis. Application ofompAgenotyping to conjunctival swab chlamydial DNA demonstrated that theC. trachomatishad anompAgenotype C. Chlamydial strains with thisompAgenotype cause trachoma and have never previously been associated with urogenital infection. This result supported cessation of child protection investigations.
Unexpected inferior vena cava syndrome: leiomyosarcoma
Authors: Oliveira Raquel , Pires Verena , Macedo Cristiane , Madeira Joana
Published: March 2021

Leiomyosarcomas arising directly from the blood vessels are rare. These tumours are formed from the muscular wall of either a major vein or artery. The authors describe the case of an 84-year-old woman with lower back pain with bilateral abdominal irradiation and marked peripheral oedema, who was diagnosed with leiomyosarcoma of the inferior vena cava after biopsy of an infrahepatic mass. An endovascular prosthesis was placed as the patient was proposed for palliative care. Leiomyosarcomas of the inferior vena cava may present with non-specific symptoms. Therefore, the authors aim to draw attention to the diagnosis process, as well as imaging findings related to this pathology.
Late presentation of myocardial infarction (MI) during the COVID-19 pandemic
Authors: Chinniah Chidambaram , Conway Brian , Yager Neil
Published: March 2021

A 65-year-old man presented to emergency department with progressive worsening dyspnoea, which was preceded by crushing, substernal chest pain 3 weeks prior that lasted for over 2 days. At the time the patient thought that this was a symptom of COVID-19 so he stayed at home and self-quarantined, until his symptoms worsened to the point of needing hospitalisation. The patient was found to have had myocardial infarction, with coronary angiography showing 100% occlusion of the Left Anterior Descending artery (LAD). Medical management was recommended given late presentation and risk of reperfusion injury.
Spontaneous dissection of bilateral internal carotid and vertebral arteries
Authors: Ewida Amr , Ahmed Rashid , Luo Anqi , Masoud Hesham
Published: March 2021

Spontaneous dissection of the major arteries of the neck is known to increase the risk of stroke or transient ischaemic attack in young and middle-aged adults. Most of the reported cases of arterial dissections in the neck involve one or both paired extracranial carotid or vertebral arteries. Spontaneous dissection of the bilateral internal carotid and vertebral arteries is extremely rare. We report a case of spontaneous bilateral internal carotid artery and vertebral artery dissection while using a prescribed pill for weight loss which contained amphetamine derivative. A review of literature is also provided.
Protocol for an ‘efficient design’ cluster randomised controlled trial to evaluate a complex intervention to improve antibiotic prescribing for CHIldren presenting to primary care with acute COugh and respiratory tract infection: the CHICO study
Authors: Seume Penny , Bevan Scott , Young Grace , Ingram Jenny , Clement Clare , Cabral Christie , Lucas Patricia Jane , Beech Elizabeth , Taylor Jodi , Horwood Jeremy , Dixon Padraig , Gulliford Martin C , Francis Nick , Creavin Sam T , Lane Athene , Hay Alastair D , Blair Peter S
Published: March 2021

Introduction

Respiratory tract infections (RTIs) in children are common and present major resource implications for primary care. Unnecessary use of antibiotics is associated with the development and proliferation of antimicrobial resistance. In 2016, the National Institute for Health Research (NIHR)-funded ‘TARGET’ programme developed a prognostic algorithm to identify children with acute cough and RTI at very low risk of 30-day hospitalisation and unlikely to need antibiotics. The intervention includes: (1) explicit elicitation of parental concerns, (2) the results of the prognostic algorithm accompanied by prescribing guidance and (3) provision of a printout for carers including safety netting advice. The CHIldren’s COugh feasibility study suggested differential recruitment of healthier patients in control practices. This phase III ‘efficiently designed’ trial uses routinely collected data at the practice level, thus avoiding individual patient consent. The aim is to assess whether embedding a multifaceted intervention into general practitioner (GP) practice Information Technology (IT) systems will result in reductions of antibiotic prescribing without impacting on hospital attendance for RTI.

Methods and analysis

The coprimary outcomes are (1) practice rate of dispensed amoxicillin and macrolide antibiotics, (2) hospital admission rate for RTI using routinely collected data by Clinical Commissioning Groups (CCGs). Data will be collected for children aged 0–9 years registered at 310 practices (155 intervention, 155 usual care) over a 12-month period. Recruitment and randomisation of practices (using the Egton Medical Information Systems web data management system) is conducted via each CCG stratified for children registered and baseline dispensing rates of each practice. Secondary outcomes will explore intervention effect modifiers. Qualitative interviews will explore intervention usage. The economic evaluation will be limited to a between-arm comparison in a cost–consequence analysis.

Ethics and dissemination

Research ethics approval was given by London-Camden and Kings Cross Research Ethics Committee (ref:18/LO/0345). This manuscript refers to protocol V.4.0. Results will be disseminated through peer-reviewed journals and international conferences.

Trial registration number

ISRCTN11405239.
Factors affecting anaemia among women of reproductive age in Nepal: a multilevel and spatial analysis
Authors: Sunuwar Dev Ram , Singh Devendra Raj , Adhikari Bipin , Shrestha Santosh , Pradhan Pranil Man Singh
Published: March 2021

Objective

The main objective of this study was to explore the factors affecting anaemia among women of reproductive age (WRA) in Nepal using spatial and multilevel epidemiological analysis.

Design

This cross-sectional study analysed data from the 2016 Nepal Demographic and Health Survey. Spatial analysis was performed using ArcGIS software V.10.8 to identify the hot and cold spots of anaemia among WRA (15–49 years). Data were analysed using multilevel mixed-effect logistic regression analysis.

Setting

Nepal.

Participants

A total of 6414 WRA were included in the analysis.

Main outcome measure

Anaemia defined by WHO as haemoglobin level less than 120 g/L in non-pregnant women and less than 110 g/L in pregnant women.

Results

The spatial analysis showed that statistically significant hotspots of anaemia were in the southern Terai region (four districts in province 1, eight districts in province 2, one district in Bagmati province, two districts in province 5 and one district in Sudurpaschim province) of Nepal. At the individual level, women who underwent female sterilisation (adjusted OR, aOR: 3.61, 95% CI 1.10 to 11.84), with no education (aOR: 1.99, 95% CI: 1.17 to 3.39), and from middle socioeconomic class families (aOR: 1.65, 95% CI: 1.02 to 2.68) were more likely to be anaemic, whereas, older women (>35 years) (aOR: 0.51, 95% CI: 0.26 to 0.97) and those women who were using hormonal contraceptives (aOR: 0.63, 95% CI: 0.43 to 0.90) were less likely to be anaemic. At the community level, women from province 2 (aOR=2.97, 95% CI: 1.52 to 5.82) had higher odds of being anaemic.

Conclusion

WRA had higher odds of developing anaemia, and it varied by the geographical regions. Nutrition-specific and nutrition-sensitive interventions can be tailored based on the factors identified in this study to curb the high burden of anaemia.
COVID-19 in Oromia Region of Ethiopia: a review of the first 6 months’ surveillance data
Authors: Gudina Esayas Kebede , Gobena Dabesa , Debela Tessema , Yilma Daniel , Girma Tsinuel , Mekonnen Zeleke , Woldie Mirkuzie , Abdena Dereje , Shume Gemechu , Kenate Birhanu , Lemi Meles , Diriba Dereje , Degfie Tizta Tilahun
Published: March 2021

Introduction

Despite unrelenting efforts to contain its spread, COVID-19 is still causing unprecedented global crises. Ethiopia reported its first case on 13 March 2020 but has an accelerated case load and geographical distribution recently. In this article, we described the epidemiology of COVID-19 in Oromia Region, the largest and most populous region in Ethiopia, during the early months of the outbreak.

Methods

We analysed data from the COVID-19 surveillance database of the Oromia Regional Health Bureau. We included all reverse transcription-PCR-confirmed cases reported from the region between 13 March and 13 September 2020.

Results

COVID-19 was confirmed in 8955 (5.5%) of 164 206 tested individuals. The test positivity rate increased from an average of 1.0% in the first 3 months to 6.3% in August and September. About 70% (6230) of the cases were men; the mean age was 30.0 years (SD=13.3), and 90.5% were <50 years of age. Only 64 (0.7%) of the cases had symptoms at diagnosis. Cough was the most common among symptomatic cases reported in 48 (75.0%), while fever was the least. Overall, 4346 (48.5%) have recovered from the virus; and a total of 52 deaths were reported with a case fatality rate of 1.2%. However, we should interpret the reported case fatality rate cautiously since in 44 (84.6%) of those reported as COVID-19 death, the virus was detected from dead bodies.

Conclusion

Despite the steady increase in the number of reported COVID-19 cases, Ethiopia has so far avoided the feared catastrophe from the pandemic due to the milder and asymptomatic nature of the disease. However, with the current pattern of widespread community transmission, the danger posed by the pandemic remains real. Thus, the country should focus on averting COVID-19-related humanitarian crisis through strengthening COVID-19 surveillance and targeted testing for the most vulnerable groups.
Effect of dapagliflozin in patients with heart failure
Authors: Khong Teck K , Au Yeung Joshua
Published: March 2021

Commentary on:McMurray JJV, Solomon SD, Inzucchi SE,et al. Dapagliflozin in patients with heart failure and reduced ejection fraction.N Engl J Med2019;381:1995–2008.

Series Editor:Dr Teck Khong, DTB Associate Editor, Clinical Pharmacology, St George’s, University of London, UK.
Medical education challenges and innovations during COVID-19 pandemic
Authors: Papapanou Michail , Routsi Eleni , Tsamakis Konstantinos , Fotis Lampros , Marinos Georgios , Lidoriki Irene , Karamanou Marianna , Papaioannou Theodore G , Tsiptsios Dimitrios , Smyrnis Nikolaos , Rizos Emmanouil , Schizas Dimitrios
Published: March 2021

COVID-19 pandemic has undoubtedly disrupted the well-established, traditional structure of medical education. Τhe new limitations of physical presence have accelerated the development of an online learning environment, comprising both of asynchronous and synchronous distance education, and the introduction of novel ways of student assessment. At the same time, this prolonged crisis had serious implications on the lives of medical students including their psychological well-being and the impact on their academic trajectories. The new reality has, on many occasions, triggered the ‘acting up’ of medical students as frontline healthcare staff, which has been perceived by many of them as a positive learning and contributing experience, and has led to a variety of responses from the educational institutions. All things considered, the urgency for rapid and novel adaptations to the new circumstances has functioned as a springboard for remarkable innovations in medical education,including the promotion of a more “evidence-based” approach.
The proton charge radius extracted from the initial-state radiation experiment at MAMI
Authors: Mihovilovič M. , Achenbach P. , Beranek T. , Beričič J. , Bernauer J. C. , Böhm R. , Bosnar D. , Cardinali M. , Correa L. , Debenjak L. , Denig A. , Distler M. O. , Esser A. , Ferretti Bondy M. I. , Fonvieille H. , Friedrich J. M. , Friščić I. , Hoek M. , Kegel S. , Merkel H. , Middleton D. G. , Müller U. , Pochodzalla J. , Schlimme B. S. , Schoth M. , Schulz F. , Sfienti C. , Širca S. , Štajner S. , Stöttinger Y. , Thiel M. , Tyukin A. , Vanderhaeghen M. , Weber A. B.
Published: March 2021

We report on a comprehensive reinterpretation of the existing cross-section data for elastic electron-proton scattering obtained by the initial-state radiation technique, resulting in a significantly improved accuracy of the extracted proton charge radius. By refining the external energy corrections we have achieved an outstanding description of the radiative tail, essential for a detailed investigation of the proton finite-size effects on the measured cross sections. This development, together with a novel framework for determining the radius, based on a regression analysis of the cross sections employing a polynomial model for the form factor, led us to a new value for the charge radius, which is $$(0.878 \pm 0.011_\mathrm {stat.}\pm 0.031_\mathrm {sys.}\pm 0.002_\mathrm {mod.})\,\mathrm {fm}$$

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