bluuebunny/crossref_metadata_2025 huggingface dataset:
Elliptic curves with complex multiplication and abelian division fields
Authors: Hamakiotes Asimina S. , Lozano‐Robledo Álvaro
Published: November 2024

Let be an imaginary quadratic field, and let be the order in of conductor . Let be an elliptic curve with complex multiplication by , such that is defined by a model over , where . In this article, we classify the values of and the elliptic curves such that (i) the division field is an abelian extension of , and (ii) the ‐division field coincides with the th cyclotomic extension of the base field.
Self-Assembly of Lamellae by Elastocapillarity in the Presence of Gravity: Experiments and Modeling
Authors: Li Chengzhang , Tawfick Sameh
Published: November 2024

Elastocapillarity describes the self-organization of elastic structures under liquid surface forces, for applications to micro- and nanoscale self-assembly. It has recently become evident that precise prediction of elastocapillary self-assembly is challenged by the various phenomena arising due to fluid flow. In this study, we present experiments and a corresponding reduced-order model for the dynamic coalescence of flexible lamellae arrays. Vertical arrays of elastomeric lamellae attached to a substrate at the bottom are fabricated using 3D-printed molds. The lamellae have sub-mm thickness and a few millimeters height, a size scale that cannot be achieved by traditional microfabrication. The gaps between the elastic lamellae are filled with liquid while the tips of the lamellae, which are at the top with respect to gravity, are initially fixed, and then, they are released which leads to their spontaneous bending and coalescence. We study the cluster size as a function of system variables both experimentally and numerically. The solid lamellae are modeled as discrete rigid elements connected by torsional springs to the substrate, while the fluid flow uses lubrication theory and capillarity. Importantly, the model incorporates the gravitational forces to effectively capture the systems’ behavior ranging from the microscale with negligible gravity effect to the macroscale where gravity significantly influences the dynamics. We further derive a linearized continuum model from our nonlinear formulation, providing an analytical universal scaling law for the lamellae cluster size. This work is relevant for new polymorphic fins and lamellae devices, capillary self-folding and origami.
On the Quasi-Diagonalization and Uncoupling of Gyroscopic Circulatory Multi-Degree-of-Freedom Systems
Authors: Bulatovic Ranislav M. , Udwadia Firdaus E.
Published: November 2024

A new central result that gives the necessary and sufficient conditions for two n by n skew-symmetric matrices and one symmetric matrix to be simultaneously quasi-diagonalized by a real orthogonal congruence is proved. Based on this result, the decomposition of linear multi-degree-of-freedom dynamical systems with gyroscopic, circulatory, and potential forces is investigated through a real linear coordinate transformation generated by an orthogonal matrix. Several sets of conditions, applicable to real-life structural and mechanical systems arising in aerospace, civil, and mechanical engineering, under which such a coordinate transformation exists are found, thereby allowing these systems to be decomposed into independent, uncoupled subsystems, each with a maximum of two degrees of freedom. The conditions are expressed in terms of the coefficient matrices of the system. A specific form for the circulatory (gyroscopic) matrix is posited, and when the gyroscopic (circulatory) matrix is simple—a situation that commonly appears in real-life applications—it is shown that just a single necessary and sufficient condition is required for the decomposition of the multi-degree-of-freedom system. Numerical examples are provided throughout to demonstrate the analytical results.
A Study on the Influence of Polypropylene Melt Flow Index on Nonwoven Fibers Produced Through Hot Melt Centrifugal Spinning
Authors: Gunther Jason , Girard Mélanie , Dubé Martine , Tabiai Ilyass
Published: November 2024

A hot melt centrifugal spinning process is used to manufacture polypropylene nonwoven textile such as those found in the filtering layers of medical masks. The fiber morphology and diameter distribution is influenced by the extrusion geometry and the polymer viscosity, often characterized by its melt flow index. These important geometric and physical aspects and their effects on the fiber quality are investigated in this work. The characteristics of the obtained nonwoven textile are also compared to those of the filtering layers found in a medical mask, usually made with the meltblown process. A custom-designed open-source lab-scale centrifugal spinning apparatus and the spinneret from a commercial cotton candy machine were used. This device was built at a very low cost while good quality fibers may be obtained compared to electrospinning. Its versatility allows to easily change the extrusion features. Here, a grid, nozzles, and a nozzlefree geometry, in which the polymer is extruded through a slit, were used. The behavior of five grades of polypropylene with five different melt flow indexes were compared in this process. Results show that fiber morphology improves when using the nozzle and nozzlefree geometries with a high melt flow index polymer, which were closer to the medical mask filtering layer.
Arc Characteristics of Aluminum Alloy Double-Wire High-Frequency Pulsed GMAW
Authors: Wu Kaiyuan , Wu Yongming , Chen Qianrun , Liu Zitao , Huang Hao , Hong Xiaobin
Published: November 2024

The present study used a novel double-wire pulsed gas metal arc welding (GMAW) method, enhanced with high-frequency pulses, for welding aluminum (Al) alloy. A digital oscilloscope and high-speed photography were used to capture the voltage and current waveforms at various phases and high-frequency pulse frequencies, along with the corresponding double arc profiles. The influence mechanism of high-frequency pulse frequency on the arc average current density and arc conductivity was combined to investigate the effects of phase and high-frequency pulse frequency on arc characteristics. The experimental results revealed that arc voltage, arc power, and arc length initially decreased and then increased as the high-frequency pulse frequency rose. The phase had a significant impact on the deflection angle of the arc. The reverse phase exhibited a smaller peak deflection angle compared to the synchronous phase due to the different ratios of leading and trailing currents. However, the deflection angle of the arc remained relatively unaffected by the high-frequency pulse frequency.
Full Forward Solution of Large Deflection, End Loaded Cantilever Beams Using Elliptic Integrals
Authors: Jensen Brian D. , Erickson Jared
Published: November 2024

This paper presents an algorithm to solve for all solutions to the forward problem for large deflections of inextensible end loaded Euler beams, a problem often encountered in compliant mechanism design and analysis. The forward problem is characterized by known end moment and end force (magnitude and direction), and the horizontal, vertical, and rotational deflections of the end of the beam must be found. Previous solutions have relied on the use of numerical solvers, which normally result in finding a single solution, but are unable to find all possible solutions for a given loading condition. The algorithm presented here works by reformulating the problem to have a single unknown, the end angle of the beam. Using this reformulation, a search vector of possible end angles can be used to find all solutions within desired bounds for the rotation of the end of the beam. The results were compared to nonlinear finite element modeling for verification. The results show that the vast majority of possible load conditions result in multiple (at least two) solutions, with larger end forces generally leading to more solutions. This finding suggests that such solutions may be used to design novel multi-stable compliant mechanisms, including the possibility of metamaterials with variable volume.
Stochastic lattice model for atomic layer deposition and area-selective deposition of metal oxides: Visualization and analysis of lateral overgrowth during area-selective deposition
Authors: Carroll Nicholas M. , Parsons Gregory N.
Published: November 2024

Although area-selective deposition (ASD) has developed to augment lithographic patterning of nanoscale device features, computational modeling of ASD remains limited. As pitch sizes shrink, the extent of lateral overgrowth at the feature edge becomes critical to ASD processing. We report a stochastic lattice model that describes atomic layer deposition (ALD) and ASD of Al2O3 using trimethylaluminum and water as an example system. The reactant/surface interactions are constrained such that the resulting ALD film properties, i.e., Al/O atom ratio, fraction of unreacted (blocked) –OH groups, fraction of “void” sites, and growth per cycle, are reasonably consistent with the experimental results for Al2O3 ALD. In the ASD model, the film nucleates in a localized “growth” region and extends laterally over a co-planar adjacent “nongrowth” region, thereby simulating lateral growth evolution. Under the “base ALD” condition, the extent of lateral growth is equivalent to vertical growth, and the contact angle between the film and the substrate is 90°. Introducing additional constraints on reactant/nongrowth surface interactions leads to changes in the extent, shape, and contact angle of the lateral growth, enabling insight into chemical and physical mechanisms that influence the shape and extent of lateral overgrowth. The 3D model visualizations are directly compared with example ASD results, demonstrating consistency between the model output and experiments. Comparing the mechanisms introduced to the model with the experimental ASD processes and conditions provides insight into the mechanisms that drive film shape evolution and lateral overgrowth, enhancing understanding of means to control lateral profile evolution during ASD.
Fabrication and characteristics of double-gate zinc oxide nanowire field emitter arrays
Authors: Ou Zhuoran , Wang Chengyun , Zhang Guofu , Li Xinran , Ou Hai , Deng Shaozhi , Xu Ningsheng , She Juncong , Chen Jun
Published: November 2024

Large area addressable zinc oxide (ZnO) nanowire field emitter arrays (FEAs) have important applications in vacuum microelectronic devices such as flat panel x-ray sources. However, further work on increasing the performance of gated ZnO nanowire FEAs is needed. In this work, we propose double-gate ZnO nanowire FEAs. Simulation results show that the double-gate structure can realize higher gate modulation capability compared with the single-gate structure. Double-gate ZnO nanowire FEAs have been fabricated, and their performance has been studied. The maximum emission current density (3.32 mA/cm2) and transconductance (2433 nS) obtained in this work are higher than the previously reported ZnO nanowire FEAs. The results verify that double-gate ZnO nanowire FEAs are promising for applications in large area vacuum microelectronic devices.
Draft genome sequence of
Bacillus thuringiensis
serovar. toumanoffi NRRL B-4059: identification of a novel Cry protein candidate
Authors: Murdoch Robert W. , Gemler Bryan T. , Wallace Nathan , Heater Bradley S.
Published: November 2024

Here, we report the high-quality draft genome of
Bacillus thuringiensis
serovar. toumanoffi NRRL B-4059, with a complete circular chromosome and nine circular plasmids. The assembly is 7,031,170 bp and encodes 6,974 protein-coding genes, 42 rRNA genes, 107 tRNA genes, and has 34.7% GC content. Nine genes encoding Cry proteins were identified, including one previously unidentified Cry protein candidate.
Metagenome-assembled genomes of freshwater
Hyphomicrobium
sp. G-191 and
Methylophilus
sp. enriched from Cedar Swamp, Woods Hole, MA
Authors: Huang Yolanda , Schomer Rebecca , Reyes María José Rodríguez , Costa Kyle , Parales Rebecca E. , Whitaker Rachel , Dawson Scott C.
Published: November 2024

Hyphomicrobium
are facultative denitrifying anaerobes capable of using one-carbon compounds as a sole carbon source.
Hyphomicrobium
sp. G-191 was enriched from Cedar Swamp, Woods Hole, Massachusetts, using a selective medium for methanol-utilizing bacteria. We present two draft metagenome-assembled genomes (MAGs) of a
Hyphomicrobium
and a
Methylophilus
species.
Complete genome sequences of mycobacteriophages Ashwin from cluster O and Chanagan from cluster A1
Authors: Machowski Edith Erika , Gordhan Khel , Madhav Chandni , Ealand Christopher , Kana Bavesh
Published: November 2024

Ashwin and Chanagan are double-stranded
siphoviral
mycobacteriophages isolated from a single soil sample from a lavender flowerpot in Johannesburg, South Africa. Both are capable of infecting and lyzing
Mycobacterium smegmatis
and are predicted to contain 122 and 91 open reading frames, respectively, most without known function.
Astragalus polysaccharide enhances maternal mucosal immunity against PEDV
Authors: Tang Jianli , Wang Shuaiyong , Tang Jianmei , Li Jinming
Published: November 2024

Porcine epidemic diarrhea virus (PEDV), the major causative pathogen of porcine epidemic diarrhea, poses a severe threat to the swine industry, particularly affecting neonatal piglets. Maternal milk-derived IgA antibody is crucial for protecting piglets from PEDV infection. Despite the effectiveness of current intramuscularly administered PEDV vaccines in inducing strong systemic immune responses, their ability to generate high levels of maternal milk IgA is limited. This study explores the potential of Astragalus polysaccharide (APS) to enhance PEDV vaccine efficacy, specifically focusing on maternal milk IgA levels. We first evaluated anti-PEDV antibody levels in the blood and colostrum of sows vaccinated with PEDV or subjected to feedback feeding. Our results indicated that while vaccination induced robust serum PEDV-specific IgG and IgA, milk IgA levels were lower compared to the feedback group. To address this limitation, APS was administered orally to sows before PEDV vaccination. APS supplementation significantly increased both serum and milk PEDV-specific IgA levels and enhanced cellular immune responses, as evidenced by elevated cytokine levels. Further analysis demonstrated that APS improved intestinal immune function and homeostasis in piglets. Overall, APS supplementation proved to be an effective immune booster, enhancing PEDV vaccine-induced mucosal immunity and providing a promising strategy for improving maternal immunity and piglet protection against PEDV.

IMPORTANCE

This study highlights the limitations of current porcine epidemic diarrhea virus (PEDV) vaccines in inducing sufficient maternal milk IgA, which is crucial for protecting neonatal piglets. By supplementing Astragalus polysaccharide (APS) into the vaccination regimen, we demonstrated a significant enhancement in milk PEDV-specific IgA levels, as well as improved cellular immune responses. APS also bolstered intestinal immune function and homeostasis in piglets. These findings suggest that APS supplementation could serve as an immune booster to enhance maternal immunity, offering a promising approach to better protect piglets against PEDV.
Pullulan nanoparticles inhibit the pathogenicity of
Candida albicans
by regulating hypha-related gene expression
Authors: Hong Sujin , Kim Seo-Kyung , Chung Christine H. , Yun Cheol-Heui , Lee Junho , Cho Chong-Su , Huh Won-Ki
Published: November 2024

Candida albicans
is a prevalent opportunistic pathogenic fungus that resides in the skin and gastrointestinal (GI) tract of humans. Under specific conditions,
C. albicans
cells transition from a commensal to a pathogenic state, leading to both superficial and invasive infections. Although systemic candidiasis poses a life-threatening risk, a limited number of antifungal drugs are employed for its treatment. Moreover, the emergence of resistant strains to antifungal agents underscores the pressing need for new treatment options. In this study, we propose the use of polysaccharide nanoparticles as a strategy for treating candidiasis. We synthesized phthalic pullulan nanoparticles (PPNPs) and examined their ability to inhibit the pathogenicity of
C. albicans
. We observed that PPNPs inhibit hyphal growth, adhesion to abiotic surfaces, and biofilm formation of
C. albicans
in a dose-dependent manner. This inhibitory effect is mediated by transcriptional modulation, particularly the downregulation of hypha-related genes and the upregulation of stress-responsive genes, involving the Ras/cAMP/PKA signaling pathway. Furthermore, we observed that PPNPs inhibit the adhesion of
C. albicans
to human epithelial cells without inducing toxicity in human cells. In addition, PPNPs inhibited the
in vivo
pathogenicity of
C. albicans
in
Caenorhabditis elegans
, suggesting an antagonistic effect on candidiasis. Our findings suggest that PPNPs exhibit inhibitory effects on
C. albicans
biofilm formation and
in vivo
pathogenicity, indicating their potential as a novel therapeutic agent for candidiasis.

IMPORTANCE

The pathogenic process of
Candida albicans
, the primary causative species of candidiasis, involves hyphal growth, biofilm formation, and secretion of virulence factors. Of these factors, the biofilm, created by the secretion of extracellular matrix from adherent cells, shields cells from external threats, enabling them to withstand high concentrations of antifungal agents. Therefore, suppressing biofilm formation is a crucial aspect of combating candidiasis. This study developed phthalic pullulan nanoparticles (PPNPs) as a novel material for inhibiting
C. albicans
’ pathogenicity. PPNPs were internalized within
Candida
cells and reduced pathogenicity at the gene expression level, resulting in reduced
in vitro
biofilm formation, adhesion to human cells, and mortality of infected
Caenorhabditis elegans
. Moreover, PPNPs exhibited these effects without toxicity to human cells and host animals. These findings not only indicate that PPNPs can be employed to hinder
in vitro
biofilm formation but also suggest their potential as a novel treatment for candidiasis.
Genomic characteristics of
Salmonella enterica
serovar Blockley
Authors: Izumiya Hidemasa , Chiou Chien-Shun , Morita Masatomo , Sato Toshio , Noguchi Akio , Harada Tetsuya , Akeda Yukihiro , Ohnishi Makoto
Published: November 2024

Non-typhoidal
Salmonella
(NTS) is a significant cause of foodborne illness worldwide, with increasing antimicrobial resistance posing a public health concern.
Salmonella enterica
serovar Blockley (
S
. Blockley) is relatively uncommon, and its antimicrobial resistance profile and population structure have been understudied. This study presents a comprehensive genomic analysis of 264
S
. Blockley isolates from diverse geographical regions to elucidate antimicrobial resistance patterns and population structure. Bayesian analysis classified these genomes into 10 distinct groups (BAPS A to BAPS J), further categorized into two lineages, R and S. Lineage R comprised six BAPS clusters (BAPSs A–F), predominantly found in Asia and Africa, all of which harbored the azithromycin resistance gene
mph(A
) and other resistance determinants. In contrast, lineage S, lacking
mph(A
), comprised the remaining four BAPS clusters, which were primarily found in Europe and the Americas. Several types of mutations in
gyrA
were found in lineage R, which were specific to BAPS clusters. These BAPS clusters exhibited distinct geographic distributions, with BAPS B, BAPS D, and BAPS E unique to China, Taiwan, and Japan, respectively, while BAPS H and BAPS I were predominantly found in the United States. Temporal phylogenetic analysis suggested that lineage R diverged in the 1980s, with notable microevolutionary changes. The presence of a genomic island with
mph(A
),
aph(3’)-Ia
,
aph(3”)-Ib
,
aph(6)-Id
, and
tet(A
) in lineage R underscores the public health threat, highlighting a need for continuous surveillance.

IMPORTANCE

Antimicrobial resistance in
Salmonella
is a global public health concern. In this study, we focused on serovar Blockley, and a whole-genome analysis revealed its global population structure. The results revealed the existence of azithromycin-resistant strains, which were characterized both phylogenetically and geographically. The resistance genes were transmitted via genomic islands, and their micro-scale evolution was also revealed. Our findings are the first to reveal the dissemination of antimicrobial resistance genes, including azithromycin, in serovar Blockley, and provide valuable insights into understanding the spread of antimicrobial resistance.
Are virtual wards for children safe and effective? A 3-year retrospective service evaluation of an urban Hospital at Home service for children and young people
Authors: Cheung C Ronny , Farnham Laura , Al-Mukhtar Rania , Chahal Anudeep , Karcz Klaudia , Nagano Chihiro , Abraham Beth
Published: November 2024

Objective

Service evaluation of an urban ‘Hospital at Home’ service which provides care in patients’ homes that would traditionally be delivered in the hospital setting.

Design

Retrospective longitudinal review of routinely collected data recorded contemporaneously for clinical use, analysed to elicit utilisation patterns and service impact.

Setting

A paediatric ‘Hospital at Home’ service delivered across two large acute hospitals, treating a total of 4427 patients across both primary and secondary care in South London from January 2018 to June 2022.

Patients

Children managed by the Hospital at Home service, aged 0–16 years

Main outcome measures

We describe patient outcomes and service performance including data on demographics, diagnoses, referral sources, hospital reattendances and bed day savings.

Results

Over the evaluation period, 11 092 bed days were saved as a direct result of this service at a cost of 1.09–1.25 nursing contacts required per bed day. Reattendance to hospital was 11.1% over the study period, however, parent/carer-initiated reattendance resulting in hospital admission was only 2.7%.

Conclusion

Hospital at Home services are a policy priority for the English National Health Service because of their potential to reduce admissions to and enable early discharge from hospital. This evaluation provides insight into an urban population of children managed under Hospital at Home care and demonstrates its feasibility and effectiveness. Our novel approach to the analysis of hospital reattendance data may have the potential as a template for future performance analysis of similar services.
Phakic corneal decompensation with cataract after bioptics: management challenges
Authors: Namdev Vaibhav , Kaur Manpreet , Bansal Manvi , Titiyal Jeewan S
Published: November 2024

A woman in her early 50s presented with diminution of vision, photophobia, pain and watering in right eye for 8 months. She had previously undergone radial keratotomy (RK) in the right eye, followed by bilateral angle-supported phakic intraocular lens (pIOL) implantation. On examination, 16 RK incisions were present in the right eye, with corneal decompensation, rigid angle-supported pIOL in situ, senile cataract and uncorrected distance visual acuity (UDVA) of counting fingers. Three major challenges were accurate biometry, incision management during phacoemulsification with rigid pIOL in situ and keratoplasty in the presence of RK incisions. Swept source optical coherence tomography-based optical biometer and Barrett Universal II formula were used for intraocular lens (IOL) power calculation. First-stage phacoemulsification was performed with pIOL in situ, followed by IOL implantation and pIOL explant via the same incision. Second-stage Descemet stripping automated endothelial keratoplasty (DSAEK) was performed after 1 week; DSAEK prevented splicing of RK incisions. Postoperative UDVA was 20/200, improving to 20/60 with semiscleral contact lens.
Challenges in diagnosing disseminated congenital tuberculosis in a neonate: outcome and maternal treatment opportunity
Authors: Ranganath Borra , Selvan Monica , Chaudhari Kiranben , Devi Usha
Published: November 2024

In India, congenital tuberculosis (TB) accounts for 1%–3% of the TB burden. We present the case of a term neonate admitted with respiratory distress, hepatosplenomegaly and abnormal coagulation profiles. The neonate’s condition rapidly deteriorated, progressing to respiratory failure within 72 hours of admission. Tuberculosis-specific tests (TB PCR and culture) in the neonate confirmed the diagnosis of disseminated congenital TB. However, the results arrived after the neonate succumbed to multiorgan failure following a brief hospital stay. Maternal chest imaging after these results revealed miliary TB and she was started on anti-TB treatment. Despite the concerning signs, congenital TB was not initially suspected due to the absence of relevant maternal history and the overlapping features with other infections. As a result, the initial differentials considered were bacterial sepsis, perinatal viral infections and immunodeficiency. This case underscores the need for earlier suspicion of congenital TB, particularly in TB-endemic areas, to avoid adverse outcomes.
Earliest location of glaucomatous retinal nerve fibre layer damage is determined by intact baseline RNFL thickness profile
Authors: Lee Eun Jung , Park Do Young , Han Jong Chul , Kee Changwon
Published: November 2024

Background/aims

To identify whether an intact retinal nerve fibre layer (RNFL) thickness profile could determine the location of the earliest RNFL defect in glaucoma.

Methods

Retrospective longitudinal cohort study of patients with initial unilateral glaucoma who eventually developed new glaucoma in the fellow eye. Guided progression analysis (GPA) of serial optical coherence tomography (OCT) examinations was used to identify the angular locations of the earliest RNFL defect, peak and temporal edge of the baseline RNFL profile and major vessels based on the peripapillary OCT scan circle.

Results

We identified 112 new RNFL defects in 109 fellow eyes of 109 consecutive patients. The locations of new defects were superotemporal (22 eyes), inferotemporal (87 eyes) and papillomacular bundle (3 eyes), respectively. Overall, the midpoint location of the earliest RNFL defect strongly coincided with the RNFL peak (p<0.001). Specifically, the location was mildly (4.3±12.0°) temporal to, rather than at the peak thickness, particularly in eyes with a focal thinning pattern of arcuate bundles (7.8±10.8°). The close topographical relationship was consistent regardless of the interindividual variability in the RNFL profile and vessels, as well as hemispheric locations, and after adjusting for potential factors including age, refractive error, baseline intraocular pressure, tilt ratio, tilt axis and glaucoma diagnosis.

Conclusion

The location of the earliest RNFL defect in glaucoma showed a close relationship with the intact RNFL profile within the same eye, regardless of variations in RNFL, hemispheric location and vessel distribution. In addition, the earliest defect was located mildly temporal to, rather than at, the peak RNFL thickness. The baseline RNFL profile may have a significant role in the regional vulnerability of glaucoma.
Safety of inpatient care in surgical settings: cohort study
Authors: Duclos Antoine , Frits Michelle L , Iannaccone Christine , Lipsitz Stuart R , Cooper Zara , Weissman Joel S , Bates David W
Published: November 2024

Objectives

To estimate the frequency, severity, and preventability of adverse events associated with perioperative care, and to describe the setting and professions concerned.

Design

Multicenter retrospective cohort study.

Setting

11 US hospitals.

Participants

1009 patients from a randomly selected sample of 64 121 adults admitted for surgery during 2018.

Main outcome measures

Adverse events during inpatient perioperative care were assessed using a trigger method, identifying information previously associated with similar events, and from a comprehensive review of electronic health records. Trained nurses reviewed all records and flagged admissions with possible adverse events, which were then adjudicated by physicians, who confirmed the occurrence and characteristics of the events. Adverse events were classified as major if they resulted in serious harm requiring substantial intervention or prolonged recovery, involved a life threatening event, or led to a fatal outcome. Potentially preventable events included those definitively, probably, or possibly preventable.

Results

Among 1009 patients reviewed, adverse events were identified in 38.0% (95% confidence interval 32.6 to 43.4), with major adverse events occurring in 15.9% (12.7 to 19.0). Of 593 identified adverse events, 353 (59.5%) were potentially preventable and 123 (20.7%) were definitely or probably preventable. The most common adverse events were related to surgical procedures (n=292, 49.3%), followed by adverse drug events (n=158, 26.6%), healthcare associated infections (n=74, 12.4%), patient care events (n=66, 11.2%), and blood transfusion reactions (n=3, 0.5%). Adverse events were most frequent in general care units (n=289, 48.8%), followed by operating rooms (n=155, 26.1%), intensive care units (n=77, 13.0%), recovery rooms (n=20, 3.3%), emergency departments (n=11, 1.8%), and other in-hospital locations (n=42, 7.0%). Professions most involved were attending physicians (n=531, 89.5%), followed by nurses (n=349, 58.9%), residents (n=294, 49.5%), advanced level practitioners (n=169, 28.5%), and fellows (n=68, 11.5%).

Conclusions

Adverse events were identified in more than one third of patients admitted to hospital for surgery, with nearly half of the events classified as major and most potentially preventable. These findings emphasize the critical need for ongoing improvement in patient safety, involving all health professionals, throughout perioperative care.
What are the risk factors for ascending aorta dilatation in the non-diabetic normotensive population? A cross-sectional study in China
Authors: Yang Xiangyu , Li Xinran , Ul Hassan Naeem , Ye Runyu , Zhang Xin , Ma Jun , Liao Hang , Zhang­ Xin , Wang Si , Chen Xiaoping
Published: November 2024

Objectives

Ascending aorta dilatation (AAD) has been suggested as a surrogate marker for vascular organ damage in the hypertensive population. However, limited data are available on AAD in normotensive individuals. This study aims to preliminarily explore the correlation between ascending aorta (AAO) and other established clinically significant target organ damage parameters and to investigate the possible risk factors of AAD in the non-diabetic normotensive individuals.

Design

Our study has a cross-sectional design.

Setting

All participants were recruited from the inpatient and outpatient departments of our hospital.

Participants

We recruited 634 normotensive participants (52.26±16.22 years, 39.43% male) who underwent both ambulatory blood pressure monitoring (ABPM) and echocardiography. The whole study population was divided into AAD and non-AAD groups according to age-gender-specific criteria. The baseline mean blood pressure (BP) of the two groups was 126.92/77.72 and 124.16/77.61 mm Hg, respectively.

Primary and secondary outcome measures

The relationship between AAO and other acknowledged cardiac damage indicators, as well as the associations of AAD with ABPM indexes in the non-diabetic normotensive individuals.

Results

We observed that AAO exhibited a significant correlation with left ventricular mass index (β=1.905, p<0.001), e’ (β=−0.324, p<0.001) and E/e’ (β=0.221, p<0.001). Among all the ABPM indexes, only those related to diastolic BP (DBP), specifically 24-hour DBP (OR=1.056, 95% CI 1.004 to 1.110, p<0.05) and night-time DBP (OR=1.071, 95% CI 1.011 to 1.134, p<0.05), were associated with AAD after adjustment for age, gender and other confounders. Furthermore, in the multivariate forward logistic regression analysis, night-time DBP was most strongly associated with AAD (OR=1.064, 95% CI 1.008 to 1.124, p<0.05).

Conclusions

We found that AAO was correlated with alterations in other acknowledged cardiac parameters, both structural and functional, in non-diabetic normotensive individuals, indicating AAD may be significant in these individuals. Notably, DBP, especially night-time DBP, showed a more significant correlation with AAD.

Trial registration number

ChiCTR2000030677.
Intracytoplasmic sperm injection compared with in vitro fertilisation in patients with non-male factor infertility with low oocyte retrieval: a single-centre, retrospective cohort study
Authors: Zhu Shaomi , Li Hengli , Lv Zili , Liang Xin , Dong Liang , Tian Dongmei
Published: November 2024

Objective

To investigate the effects of in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) on the clinical outcomes of non-male factor patients aged >35 with three or fewer oocytes retrieved.

Design

Retrospective cohort study.

Setting

Reproductive centre of a university-affiliated hospital in China.

Participants

547 women with non-male factor infertility who underwent assisted reproductive technology (ART) treatment with three or fewer oocytes retrieved were identified from June 2019 to May 2022. Of these 547 patients, 334 were treated with IVF and 213 with ICSI.

Outcome measures

The primary outcomes were normal fertilisation rate, live birth rate per transfer and cumulative live birth rate per retrieval.

Results

The baseline characteristics were comparable between the two groups, except for the proportion of primary infertility, which was higher in the ICSI group (17.66% vs 32.86%, p=0.000). Compared with the IVF group, the ICSI group showed higher normal fertilisation rate and lower cycle cancellation rate (65.99% vs 76.56%, p=0.002; 33.53% vs 24.41%, p=0.023). However, no significant differences were found in clinical pregnancy rate per transfer (23.86% vs 18.92%, p=0.545), miscarriage rate per fresh embryo transfer (19.05% vs 28.57%, p=0.595), live birth rate per transfer (17.05% vs 13.51%, p=0.623), cumulative clinical pregnancy rate per retrieval (12.87% vs 11.27%, p=0.576) and cumulative live birth rate per retrieval (9.28% vs 6.57%, p=0.261) between the two groups (p>0.05).

Conclusions

In non-male factor ART cycles, ICSI was not associated with improved pregnancy outcomes in older women with a low number of oocytes retrieved. Routine use of ICSI is not recommended in older women who are infertile due to non-male factors.
Exploring the lived experiences of deep vein thrombosis patients in Lahore, Pakistan: a qualitative phenomenological study on healthcare challenges, resilience and social support
Authors: Zameer Ahtasham , Saleem Javeria , Yazdani Naveed , Fatima Rabia , Shahzad Ruhma Binte , Zafar Afia , Ishaq Muhammad , Butt Muhammad Salman
Published: November 2024

Objective

This study aimed to explore and describe the lived psychological and emotional experiences of sufferers of deep vein thrombosis (DVT) and to narrate the effect of those experiences on their daily lives.

Design, setting and participants

For data collection, a phenomenological qualitative design was used using semistructured, in-depth interviews of patients with DVT aged 18–70 years. Data were transcribed and analysed using the interpretative inductive approach to identify emergent themes.

Results

The five major themes emerged were as follows: (1) experiences and challenges of managing pain and physical limitations in patients; (2) the high out-of-pocket cost of care as a financial challenge to access healthcare; (3) the struggle of patients with social isolation and lack of emotional support; (4) resilience and self-reliance in the face of illness for navigation through life and (5) inadequate healthcare system and challenges in accessing proper treatment.

Conclusions

Conclusively, chronic disease such as, DVT, negatively impacts the life of its sufferers in terms of their physical health, lifestyle and psychological behaviour. There is a high need to introduce rehabilitative services as a regular part of healthcare system, so that self-management strategies are promoted and the burden of long-term psychological, emotional and behaviour problems can be avoided.
Adherence to secondary antibiotic prophylaxis among patients with acute rheumatic fever and/or rheumatic heart disease: a systematic review and meta-analysis
Authors: Bimerew Melaku , Araya Freweyni Gebreegziabher , Ayalneh Manay
Published: November 2024

Objectives

Worldwide, a number of studies have been conducted to assess the prevalence of adherence to secondary antibiotic prophylaxis and to identify the associated factors (reasons) for poor adherence among patients with rheumatic heart disease or acute rheumatic fever (RHD/ARF). However, results were highly inconsistent with a prevalence ranging from 10% to 93%; and the reported reasons or associated factors have not been systematically reviewed. Therefore, this study aimed to assess the prevalence of adherence to secondary antibiotic prophylaxis among patients with RHD/ARF; and to review the associated factors (reasons) for poor adherence.

Design

Systematic review and meta-analysis.

Data sources

PubMed/Medline, Google Scholar, Cochrane Review and African Journals Online databases.

Eligibility criteria

Articles published in English from 1 January 2005 to 1 December 2022 and reported the prevalence of adherence using ≥80% cut-off points were included.

Data extraction and synthesis

Data were extracted using the Microsoft Excel and analysed by STATA V.11.0. A meta-analysis was conducted using the weighted inverse-variance random-effects model. Reasons for poor adherence were identified through thematic analysis.

Results

33 articles with a total sample size of 7158 patients were included. The pooled prevalence of adherence to secondary antibiotic prophylaxis among patients with RHD/ARF was found to be 58.5% (95% CI: 48.2% to 68.7%; I2=99.2%; p<0.001). Rural residency, lack of money, distance from the health institutions, inaccessibility, poor counselling, forgetting schedules, lack of disease knowledge and fear of injection pain were the reported factors or reasons for poor adherence.

Conclusion

About 41.5% of patients with RHD/ARF were found to have poor adherence. Long distance from health institutions, forgetting schedules, poor counselling and lack of knowledge and skill among healthcare workers were some of the modifiable reasons for poor adherence. Therefore, decentralisation of the follow-up care, creating schedule reminding systems and providing targeted health education might help to improve adherence.
Trends and patterns of antimicrobial consumption at Benjamin Mkapa Zonal Referral Hospital, Dodoma, Tanzania: a cross-sectional retrospective analysis
Authors: Zimbwe Kauke Bakari , Yona Yusto Julius , Chiwambo Charity Alphonce , Chandika Alphonce Bilola , Kiwelu Humphrey Sawira , Shabani Moshi Moshi
Published: November 2024

Objective

This study assessed the trends and patterns of antimicrobial consumption (AMC) from 2020 to 2021, 2021–2022 and 2022–2023 at the Benjamin Mkapa Zonal Referral Hospital (BMH) in Dodoma, Tanzania.

Design

A retrospective cross-sectional study was conducted to collect AMC data for three financial years with respective denominators. The data were computed using the AMC Tool 2019 v1.9.0 and defined daily dose per 1000 inhabitants per day (DID).

Setting

The BMH, Dodoma, Tanzania.

Participants

This study surveyed quantities of antimicrobials procured at the BMH. It did not have any human participants.

Outcome measures

AMC was quantified in DID. The comparisons were made based on the DID of all surveyed antimicrobials, taking into account oral and parenteral administration and based on pharmacological classes. Further, DIDs were presented based on the 2023 WHO Access (A), Watch (W) and Reserve (R) (AWaRe) classification.

Results

In 29 assessed antimicrobials, the DIDs for 2020–2021, 2021–2022 and 2022–2023 were 3.0852, 3.5892 and 3.9213, respectively. The average DID per year was 3.5319, with a mean of 2.4207±1.9765 DID per year. The topmost consumed antimicrobials over the 3 years (doxycycline, azithromycin, amoxicillin/beta-lactamase inhibitors, ampicillin/cloxacillin, amoxicillin/flucloxacillin, ceftriaxone, nitrofurantoin and clarithromycin) account over 90% of consumption. The most highly consumed therapeutic classes were beta-lactam antibacterial penicillins (34.71%), macrolides, lincosamides, streptogramins and others (25.75%), followed by tetracycline (23.88%). The AWaRe categorisation and antimicrobials not recommended (ANR) distribution were as follows: Access-51.61%, Watch-31.96%, Reserve-0.00%, and ANR-16.43%, respectively.

Conclusion

For every 1000 patients attending the BMH per day, our study found 2.4207±1.9765 DIDs of an antimicrobial were consumed. The most consumed antimicrobials include doxycycline, azithromycin, amoxicillin/beta-lactamase inhibitor, ceftriaxone and metronidazole. To combat antimicrobial resistance effectively, it is imperative to institute a hospital policy for antimicrobial stewardship that prioritises the utilisation of a hospital formulary and antibiograms for the procurement of antimicrobials at the BMH.
Analysis of clinical characteristics and risk factors on serrated polyps with synchronous advanced adenoma in elderly and non-elderly people: a retrospective cohort study
Authors: Chi Tianyu , Liu Ying , Yang Cuicui , Jia Qing , Zhao Quchuan
Published: November 2024

Objectives

Serrated polyps (SPs) with synchronous advanced adenoma (AA) may increase the incidence of colorectal cancer. However, current studies do not address this combination of SPs and AAs in detail with regard to their clinical characteristics in different age groups. The aim was to assess clinical characteristics and risk factors for SPs with synchronous AA in different age groups.

Design

Retrospective cohort study.

Setting

Electronic medical record data from January 2011 to January 2022 at three grade III class A hospitals were enrolled in the study.

Participants

A total of 1605 patients with SPs with synchronous AA, including 484 patients in the elderly group and 1121 patients in the non-elderly group, were studied.

Main exposure measure

The elderly group and the non-elderly group.

Main outcome measure

Sex, smoking history, drinking history, body mass index (BMI), SP location, size, morphology and pathology.

Results

The incidence of hyperplastic polyps (HPs) with synchronous AA in the elderly group was higher than that in the non-elderly group, while the incidence of sessile serrated adenomas/polyps (SSAs/Ps) with synchronous AA in the non-elderly group was higher than that in the elderly group. Male sex, drinking history and HP size (≤20 mm) were independent risk factors for HPs with synchronous AA in the non-elderly group, while drinking history and HP size (≤15 mm) were independent risk factors in the elderly group. For SSAs/Ps with synchronous AA, male sex, smoking history, drinking history, and SSA size (≥16 mm) were independent risk factors in the non-elderly group; high BMI was an independent risk factor in the elderly group.

Conclusions

SPs with synchronous AA showed different clinical characteristics and risk factors in different age groups.
Measurement of climate change-related food (in)security and food sovereignty in Canada’s northern communities and the circumpolar region: a scoping review protocol
Authors: Seto Iva , Worby Nicholas , Szurmak Joanna , Gerstle David , Tough Rebecca , Galloway Tracey
Published: November 2024

Introduction

Climate change impacts the circumpolar region (including northern Canada) at a greater magnitude than other parts of the world. This affects food (in)security as well as food sovereignty. This scoping review aims to map the methods of measuring food (in)security and food sovereignty across northern Canada and the circumpolar region in support of the Yukon Government’s climate change adaptation strategy.

Methods and analysis

We will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, and work will be conducted according to the Joanna Briggs Institute (JBI) manual chapter on scoping reviews. Academic librarians develop the academic literature and grey literature search strategies, and the search strategies are further revised through iterative stages of peer review. The search strategy includes 7 academic literature databases, 11 grey literature databases, over 50 websites and the University of Toronto Libraries catalogue. Covidence, an evidence synthesis software, will be used for screening and extraction. The extraction chart will be developed and piloted by our team. A minimum of two reviewers will conduct screening, and conflicts will be resolved through discussion. Data will be extracted by one reviewer and verified by a second. Conflicts will be resolved through discussion or by a third reviewer.

Ethics and dissemination

This project does not require ethical approval as it is secondary research; data will be extracted from published academic research papers, dissertations, and publicly available reports and documents. Our dissemination plan includes presentations at conferences, submission to international peer-reviewed journals and a workshop on the search strategies.
Understanding the transdiagnostic mechanisms underlying emerging psychopathology in adolescence: study protocol of a 1-year prospective epidemiological (EMERGE) study
Authors: Häfeli Xenia Anna , Hirsig Anja , Schmidt Stefanie J
Published: November 2024

Introduction

Adolescent mental health is a global public health challenge as most cases remain undetected and untreated, and consequently, have a high likelihood of persistence or recurrence. It is critical to improve early detection of mental disorders and to target individuals experiencing subclinical symptoms. However, most indicated prevention approaches have been developed for risk syndromes of specific mental disorders. This contradicts the increasing recognition of emerging psychopathology as a complex system characterised by rapid shifts in subclinical symptoms, cutting across diagnostic categories and interacting with each other over time. Therefore, this study aims to examine the dynamic course, pattern and network of subclinical symptoms and transdiagnostic mechanisms over time.

Method and analysis

The EMERGE-study is a prospective, naturalistic, 1-year follow-up study. A general population sample of 1196 adolescents will be recruited. Inclusion criteria are age between 11 and 17 years, German language skills, main residency in Switzerland and access to internet. Individuals will be excluded if they have a current or lifetime axis I mental disorder. Assessments of subclinical symptoms of several mental disorders and potential transdiagnostic mechanisms will be conducted at baseline and at 3-month, 6-month, 9-month and 12-month follow-up. Structural equation modelling will be used to estimate the homotypic and heterotypic patterns of subclinical symptoms and the associations with transdiagnostic mechanisms. Latent growth mixture modelling and growth mixture survival analysis will be carried out to identify subclasses of individuals with different trajectories of subclinical symptoms that may be predictive of an onset of a mental disorder. Network analysis will be applied to assess the centrality of subclinical symptoms and how networks of emerging psychopathology change over time.

Ethics and dissemination

Ethical approval was obtained from the Bern Cantonal Ethics Committee (ID 2020-02108). All findings will be disseminated by publication in peer-reviewed scientific journals and by presentation of the results to conferences and stakeholder organisation events.