bluuebunny/crossref_metadata_2025 huggingface dataset:
Double peak quasi-periodic pulsations in a circular-ribbon flare
Authors: Altyntsev A. T. , Meshalkina N. S. , Sych R. A. , Kolotkov D. Y.
Published: June 2022

We study quasi-periodic pulsations (QPPs) during the impulsive phase of the C8.3 flare SOL2002-08-06T01:43. The shape of an extended 5.7 GHz source is similar to a tadpole with the head located above the region of a negative magnetic polarity, surrounded by positive polarity patches and with a remote tail source. The flare configuration includes bright extreme ultraviolet (EUV) ropes with footpoints near the boundary of the negative magnetic field region and it can be identified as a circular ribbon flare. We use simultaneous observations carried out by the Siberian Solar Radio Telescope at 5.7 GHz, the Nobeyama Radio Heliograph (NoRH) at 17 and 34 GHz, the Reuven Ramaty High Energy Solar Spectroscopic Imager (RHESSI)/HXR, and the Transition Region and Coronal Explorer (TRACE) imaging in the extreme ultraviolet. The flare HXR emission is produced by a compact source located at the south periphery of the Negative Magnetic field Region (NMR). The QPPs are observed during a one-minute interval after the start of the impulsive phase, when this HXR source appeared. The remote source is detected on the variation maps of the of the brightness temperature at 17 GHz and is located at the end of tadpole tail about 60 arcsec eastward. More than a dozen cotemporal HXR and microwave pulses with timescales from 1.5 s up to about 8 s were observed in the flare kernel. At 5.7 GHz, the pulses are more prominent near the remote source where they are highly polarized and generated by the electron beams propagating from the flare kernel. The main tone of the QPP periodicity corresponds to the oscillations with a period of 8 s and is accompanied by the variations in the hardness of nonthermal electrons, that is, in the efficiency of the acceleration mechanism. The second intensity harmonic (about a 3-s period) appears due to a double peak structure of the QPP event. Such pulse shapes suggest oscillations of the current sheet during the loop coalescence as a modulation mechanism of the flare energy release.
Übersetzung, Test-Retest-Reliabilität und Konstruktvalidität der deutschen Version der Exercise Self-Efficacy Scale für körperliche Aktivität bei Personen mit axialer Spondyloarthritis
Authors: Saba Riana , Bruderer-Hofstetter Marina , Rausch Anne-Kathrin , Niedermann Karin
Published: June 2022

Hintergrund Körperliche Aktivität kann die Symptomatik von Personen mit axialer Spondyloarthritis (axSpA) verbessern. Die Selbstwirksamkeit ist dabei ein wichtiger prädiktiver Faktor. Mit dem Fragebogen „Exercise Self-Efficacy Scale“ (ESES) kann die Selbstwirksamkeit für körperliche Aktivität erfasst werden. Bislang gab es noch keine deutsche, validierte Version des Fragebogens.

Ziel Untersuchung der transkulturell adaptierten deutschen Version der ESES (ESES-D) bezüglich Test-Retest-Reliabilität, interner Konsistenz sowie Konstruktvalidität bei Personen mit axSpA.

Methode Die ESES-D wurde anhand des TRAPD-Team-Translation-Models in die deutsche Sprache übersetzt und in einer Beobachtungsstudie evaluiert. Die interne Konsistenz wurde mittels Cronbachs Alpha und die Test-Retest-Reliabilität mittels Intraklassen-Koeffizienten (ICC, Two-way Mixed Effects Model) überprüft. Die Konstruktvalidität wurde aufgrund a priori definierter Hypothesen mittels Korrelationen zwischen der ESES-D, demografischer Merkmale und Messinstrumente zu krankheitsbedingten Symptomen, Funktionseinschränkungen, körperlicher Aktivität sowie Ergebniserwartung für das Training untersucht. Bei Erfüllung von 6 von 8 Hypothesen galt die Konstruktvalidität als bestätigt.

Ergebnisse Die ESES wurde in die deutsche Sprache übersetzt. Es wurden 52 Personen mit axSpA zwischen 31 und 80 Jahren in die Studie eingeschlossen. Die deutsche Version der ESES demonstrierte gute Werte bezüglich der Reliabilität mit einem ICC von 0,78 (95 % CI; 0,63–0,88) und einem Cronbachs Alpha von 0,85. 5 von 8 a priori definierte Hypothesen zur Überprüfung der Konstruktvalidität wurden bestätigt.

Schlussfolgerung Die ESES-D erfasst die Selbstwirksamkeit für körperliche Aktivität mit guter Test-Retest-Reliabilität und interner Konsistenz. Die Konstruktvalidität konnte nicht abschließend bestätigt werden. Weitere Forschung zur Konstruktvalidität und Responsivität wird empfohlen.
MR Enterography in Crohnʼs Disease: Comparison of Contrast Imaging with Diffusion-weighted Imaging and a special Form of Color Coding
Authors: Jakob Maja , Backes Maik , Schaefer Christian , Albert Joerg , Geissler Angela
Published: June 2022

We compared contrast-enhanced MR enterography with diffusion-weighted sequences to evaluate the validity of diffusion-weighted sequences for activity assessment in Crohnʼs disease compared to endoscopy. In addition, we investigated a new color-coded image post-processing technique in comparison with standard sequences and endoscopy.

Included were 197 MR enterographies (2015–2017) performed by using standardized examination protocols. The intestine was divided into 7 segments, which were compared separately. The accuracy of the MR examinations with regard to disease activity was validated using the Seo and MaRIA score and endoscopy findings. In addition, the image data were post-processed using a color-coded evaluation method (DCE tool on OsiriX).

The comparison between contrast-enhanced and diffusion-weighted sequences showed a highly significant correlation for all bowel sections with a mean Spearman correlation coefficient of 0.876 (0.809–0.928). The color-coded image post-processing showed a sensitivity of 83.2 % and a specificity of 70.5 % in comparison with the MaRIA score. In comparison to endoscopy, a sensitivity of 81.3 % and a specificity of 70.5 %. In comparison with endoscopy, the MaRIA score showed a sensitivity of 80.2 % and a specificity of 84.0 % at a cut-off of 7. The visual score according to Seo showed a sensitivity of 85.7 % with a specificity of 77.0 % in the contrast-weighted examination and a sensitivity of 87.9 % and a specificity of 71.8 % for diffusion weighted images.

Diffusion-weighted sequences are as good as contrast-weighted sequences for assessing inflammatory activity in Crohnʼs disease. Contrast is often helpful for assessing complications, but this was not the purpose of this study. Visual imaging using color-coded data sets was similarly good at detecting inflammation.
A Broad Examination of Health Policy Barriers to Access and Affordability of Hearing Treatment for Medicare Beneficiaries
Authors: Myers Clarice , Reed Nicholas S. , Lin Frank R. , Willink Amber
Published: June 2022

In 2016, the National Academies on Science, Engineering, and Medicine (NASEM) released a report titled, “Hearing Health Care for Adults,” which detailed the challenges and provided recommendations for improving the access to affordable hearing care for adults in the United States. Arguably the most significant outcome from this report was the subsequent passage of the Over-the-Counter Hearing Aid Act in 2017, which requires the Food and Drug Administration to develop regulations for a class of hearing aids that address mild to moderate hearing loss to be available for sale over the counter (OTC). While this presents an important step toward improving access and affordability of hearing treatment, it does not represent a complete solution. In fact, optimizing the new landscape of hearing care for individuals with hearing loss also may require new policy solutions. This article reflects on the progress achieved since the NASEM report and the policy issues that remain to improve accessibility and affordability of hearing care among older adults.
Homozygous TBCE Gene Mutation c.155-166del in a Libyan Patient with Sanjad-Sakati Syndrome: Same Gene Mutation Responsible in All Arab Ethnic Patients
Authors: Ghawil Millad , Omar Nesrin Ben , Doggah Milad
Published: June 2022

Sanjad-Sakati syndrome (SSS) (Online Mendelian Inheritance in Man 241410) is a rare autosomal recessive disorder also known as hypoparathyroidism-retardation-dysmorphism syndrome. It is characterized by congenital hypoparathyroidism, growth retardation, typical facial features, and variable developmental delay. SSS is caused due to mutations of the tubulin-specific chaperone E (TBCE) gene. In this article, we reported the first Libyan child of first parental consanguinity with SSS and whole exome sequencing results identified the homozygous missense variant c.155–166del and it encodes p.(Ser52-Gly55del) (chr1:235564867) located in the TBCE gene, chromosome 1q42.3. In addition, the patient was also diagnosed with congenital hypothyroidism and presented with acquired bilateral cataract in the first year of life. Most likely, all Arab patients with SSS syndrome have the same TBCE gene mutation.
Ultrafast opto-magnetic effects induced by nitrogen-vacancy centers in diamond crystals
Authors: Sakurai Ryosuke , Kainuma Yuta , An Toshu , Shigekawa Hidemi , Hase Muneaki
Published: June 2022

The current generation of quantum sensing technologies using color centers in diamond crystals is primarily based on the principle that the resonant microwave frequency of the luminescence between quantum levels of the nitrogen-vacancy (NV) center varies with temperature and electric and magnetic fields. This principle enables us to measure, for instance, magnetic and electric fields, as well as local temperature with nanometer resolution in conjunction with a scanning probe microscope (SPM). However, the time resolution of conventional quantum sensing technologies has been limited to microseconds due to the limited luminescence lifetime. Here, we investigate ultrafast opto-magnetic effects in diamond crystals containing NV centers to improve the time resolution of quantum sensing to sub-picosecond time scales. The spin ensemble from diamond NV centers induces an inverse Cotton–Mouton effect (ICME) in the form of a sub-picosecond optical response in a femtosecond pump–probe measurement. The helicity and quadratic power dependence of the ICME can be interpreted as a second-order opto-magnetic effect in which ensembles of NV electron spins act as a source for the ICME. The results provide fundamental guidelines for enabling high-resolution spatial-time quantum sensing technologies when combined with SPM techniques.
Invariants for determining entanglements pattern
Authors: Artawan I Nengah , Purwanto Agus , Yuwana Lila
Published: June 2022

We propose an invariant, i.e., a trace of the square of reduced density matrix, to determine the entanglement pattern of

n

-qubits state. The substate is separable from its complement substate if the invariant of this substate equals one. Meanwhile, the substate is entangled if the invariant is less than one. Only two types of states that the number of evaluations can be determined. First, a completely separable state can be determined after evaluating

n
−
1

invariants of a reduced single qubit. Second, a completely separable state can be indicated after

2

n
−
1

−
1

consecutive calculations of invariants, which started from reduced single state, then was followed with reduced double state, reduced triple state, etc, where each invariant is less than one. On the other hand, the number of evaluations of invariants cannot be determined and depend on the pattern of the compound entangle state.
Planar cw N2O laser with RF excitation
Authors: Mineev A P , Nefedov S M , Goncharov P A , Stelmakh O M
Published: June 2022

The article presents the results of studying and optimizing the output power and spectral characteristics of radiation of a sealed-off continuous wave (cw) planar N2O laser depending on the input radio frequency power and the size of the interelectrode gap in the discharge, on the composition and pressure of the working gas mixture N2O:N2:He:Xe, on the time of continuous operation of the laser. The effect of adding carbon monoxide CO to the working gas mixture is discussed. The maximum values of the output power—17.5 W and the efficiency—7.3% were obtained in a sealed-off cw N2O laser, which significantly exceed the known values. When N2 was replaced by air in the gas mixture: N2O:Air:He:Xe = 2.3:2.3:5:0.4, the laser output power was 10.6 W. The radiation powers of N2O and CO2 lasers are 13.1 W and 18.6 W, respectively, when the working mixture in the emitter is replaced and the same operating conditions are applied—the input power is 180 W and the pressure of the working gas mixture is 30 Torr.
Soft- and hardware platform for spectral analysis systems based on tunable semiconductor lasers
Authors: Stepanov Eugene V , Glushko Alexander N , Konyukhov Vadim K , Lapshin Dmitriy A
Published: June 2022

A soft- and hardware platform is described for supporting the operation of spectral analysis devices and systems based on tunable semiconductor lasers. The wide spectral range covered by lasers of this type and the versatility of methods for controlling their spectral parameters make it possible to solve various problems within the framework of a single instrumental approach. This includes the most complex tasks of spectral analysis of multicomponent gas mixtures including atmospheric and exhaled air. Main areas of the platform application include IR molecular spectroscopy, chemical technologies, atmospheric pollution control, diagnostics of low-temperature plasma components, biomedical diagnostics.
Implementation of combined steganography and cryptography vigenere cipher, caesar cipher and converting periodic tables for securing secret message
Authors: Hammad Rifqi , Latif Kurniadin Abdul , Amrullah Ahmad Zuli , Hairani  , Subki Ahmad , Irfan Pahrul , Zulfikri Muhammad , M Lalu Zazuli Azhar , Innuddin Muhammad , Marzuki Khairan
Published: June 2022

The development of the communication technology era has made it easier in the process of exchanging information from various parties. However, not all of the information provided can be used by many parties. Sometimes the information is intended for partial purposes only or is confidential. So, it is necessary to process information security. Several ways can be used such as cryptography. This method is used to encrypt messages or information. Methods that can be used in cryptography include vigenere cipher and caesar cipher methods. Both of these methods use the technique of replacing each original character with a character or letter. Substitution is based on keywords or character position shift command. However, this method is quite easy to solve by using the Brute Force method and the frequency of letters that often appear. Based on this problem, it is necessary to modify or combine it so that it is more difficult to crack. This research describes the combination of the vigenere cipher and the caesar cipher methods. The two methods were then converted to the names of the chemical elements in the periodic table. Furthermore, the steganography process is carried out as a place to insert messages or information. From this process, it is expected that the encryption results will be more difficult to crack
Dynamic physical characteristics of DC arc on arcing horn for HVDC grounding electrode line
Authors: LIU 刘 Yicen 益岑 , YANG 杨 Chenguang 晨光 , GUO 郭 Yujun 裕钧 , ZHANG 张 Xueqin 血琴 , XIAO 肖 Song 嵩 , GAO 高 Guoqiang 国强 , WU 吴 Guangning 广宁
Published: June 2022

The dynamic physical characteristics of a DC arc on an arcing horn for a high voltage direct current (HVDC) grounding electrode line are significantly different from those of the switching device arc, secondary arc, AC fault arc and pantograph-catenary arc. In this work, an experimental platform for the DC arc on the arcing horn was built, and mechanisms of the arc column short circuit and arc root movement were studied. This work further analyzes the characteristics and mechanisms of the arc motion when wind speed and direction, magnetic field and the expansion angle of the electrode are varied. Arc root movement is more likely to occur at the upper electrode. There is a competitive relationship between arc expansion and the transferring effect. The effect of wind on the arc column is greater than the effect on the arc root. The magnetic field has a significant driving effect on both the arc column and the arc root. The research results provide a comprehensive experimental basis for further probing the method of DC arc suppression, and the improvement of the arcing horn.
Thin-film transistor arrays for biological sensing systems
Authors: Wang Dongping , Liu Zhe , Li Jun , Tang Wei , Huang Yukun , Yu Jun , Xu Longqian , Huang Qi , Song Yawen , Wang Linzhi , Jin Haihan , Xi Kerui , Feng Linrun , Guo Xiaojun , Nathan Arokia , Ma Hanbin
Published: June 2022

Thin-film transistor (TFT) active matrix (AM) arrays have been developed to achieve many applications, including flat panel displays, digital x-rays, digital microfluidics (DMF) and high-throughput biosensors. Here, we focus on a review on TFT array technologies for biological sensing systems, which are regarded as one of the most promising emerging application fields of TFTs. As an important part of the biological sensing system, the DMF chip will be introduced. In particular, development of the TFT-based AM DMF (AM-DMF) chips, which possess the characteristics of higher throughput and higher flexibility of manipulating liquid samples, will be discussed in details. Further, the developed TFT array based biological sensing systems will be summarized and discussed as well. Finally, we present prospects for AM-DMF chips and biosensors, along with a brief conclusion.
Vertical integration: a key concept for future flexible and printed electronics
Authors: Han Heesung , Kim Chang-Hyun , Jung Sungyeop
Published: June 2022

This review aims at introducing a vertical integration approach as a promising new driver of field-effect transistor circuits and systems, which can overcome limitations of flexible and printed electronics. A large portion of this article is dedicated to systematic categorization and illustration of important and recent demonstrations of vertically integrated circuit building blocks incorporating organic materials, metal-oxide semiconductors, nanotubes, and nanosheets. Key features of each of these materials platforms and their fabrication issues are also broadly discussed. Then, common technical requirements for high-performance devices and circuits are critically evaluated in view of the specific geometrical and theoretical aspects of vertically connected complementary digital logic inverters. Prominent technological opportunities and challenges for the vertical and three-dimensional transistor integration are finally addressed to further motivate active multidisciplinary research on related materials, devices, and systems.
The impacts of climate change and smallholder farmers’ adaptive capacities on rice production in Chengdu, China: macro-micro analysis
Authors: Pickson Robert Becker , He Ge , Boateng Elliot
Published: June 2022

Among other cultivated crops, rice is the most sensitive to climate variability over its growing season. As such, over-reliance on climate conditions for rice farming calls for a wide range of strategies critical to curtailing the adverse impact of climate change on rice production. Notwithstanding, there remain considerable gaps in our knowledge of adaptive capacities among China’s small-scale farmers who depend on climate conditions for farming. This study is broadly divided into two parts that are distinct but connected. First, we assess the effects of climate change on rice production in Chengdu (China), covering the period 2000Q1-2016Q4. We show that mean rainfall and temperature induce rice production positively in the long and short run. While temperature variability insignificantly impacts rice production in the long run, it plays a substantial role in the short run. Rainfall variability and the interaction term between temperature and precipitation are unfavourable to rice production in the long and short run. The results reveal that energy usage and fertilizer application support rice production, although the impact of energy consumption is significant in the short run. Second, we used a survey of 383 smallholder rice growers in Chengdu to examine farmers’ adaptive capacities to climate change in rice production. The results show that farmers’ adaptive capabilities significantly affect rice production. We argue that the centrepiece of improving rice production under continuous climate change is for farmers to develop a high adaptive capacity to the changing climatic conditions. This is achieved through intensive education on available adaptation strategies and their long-term implications.
Investigation of thermally sprayed NiCrAlY/TiO2 and NiCrAlY/Cr2O3/YSZ cermet composite coatings on titanium alloys
Authors: Madhu Sudana Reddy G , Prasad C Durga , Patil Pradeep , Shetty Gagan , Ramesh M R , Nageswara Rao T
Published: June 2022

The present work investigates the hot corrosion behavior of thermally sprayed 65 pct NiCrAlY + 35 pct TiO2 and 65 pct NiCrAlY + 30 pct Cr2O3 + 5 pct YSZ coatings on titanium 15 alloys. The coatings on the titanium 15 alloy substrates exhibit a near-uniform, dense, and adherent microstructure with a porosity of 2.7 to 2.9%. Thermogravimetric studies are made to examine the hot corrosion performance of coatings in a molten salt environment of Na2SO4 + 60%V2O5 at the temperature of 700 °C for 50 cycles. One cycle is carried out by heating for a period of one hour and cooling the sample at ambient conditions. The corrosion products are analyzed based on scanning electron microscopy, energy dispersive analysis, and X-ray diffraction techniques to study the morphology, phase composition, and abundance of the high-temperature corrosion constituents. The bare titanium-15 alloy, 65 pct NiCrAlY + 35 pct TiO2 coating and 65 pct NiCrAlY + 35 pct Cr2O3 + 5 pct YSZ coating produced a weight gain of 307.92 mg cm−2, 42.16 mg cm−2 and 44.02 mg cm−2 respectively after the period of 50 cycles. The effective resistance of the coatings is due to the formation of Ni3V2O8, NiCr2O4, Cr2O3 & AlV2O4 phases.
Why large time-stepping methods for the Cahn-Hilliard equation is stable
Authors: Li Dong
Published: June 2022

We consider the Cahn-Hilliard equation with standard double-well potential. We employ a prototypical class of first order in time semi-implicit methods with implicit treatment of the linear dissipation term and explicit extrapolation of the nonlinear term. When the dissipation coefficient is held small, a conventional wisdom is to add a judiciously chosen stabilization term in order to afford relatively large time stepping and speed up the simulation. In practical numerical implementations it has been long observed that the resulting system exhibits remarkable stability properties in the regime where the stabilization parameter is

O

(
1
)

\mathcal O(1)

, the dissipation coefficient is vanishingly small and the size of the time step is moderately large. In this work we develop a new stability theory to address this perplexing phenomenon.
A noncommutative Gretsky–Ostroy theorem and its applications
Authors: Huang Jinghao , Pliev Marat , Sukochev Fedor
Published: June 2022

Let

H

\mathcal {H}

be a separable Hilbert space and let

B
(

H

)

B(\mathcal {H})

be the

∗
*

-algebra of all bounded linear operators on

H

\mathcal {H}

. In the present paper, we prove that a positive/regular operator from

L
1

(
0
,
1
)

L_1(0,1)

into an arbitrary separable operator ideal in

B
(

H

)

B(\mathcal {H})

is necessarily Dunford–Pettis, extending and strengthening results due to Gretsky and Ostroy [Glasgow Math. J. 28 (1986), pp. 113–114], and Holub [Proc. Amer. Math. Soc. 104 (1988), pp. 89–95]. Consequently, for an arbitrary atomless von Neumann algebra

M

\mathcal {M}

and an arbitrary KB-ideal

C
E

C_E

in

B
(

H

)

B(\mathcal {H})

, the predual

M

∗

\mathcal {M}_*

of

M

\mathcal {M}

is not isomorphic to any subspace of

C
E

C_E

. This observation complements several earlier results.
Polar exploration of complex surface germs
Authors: Belotto da Silva André , Fantini Lorenzo , Némethi András , Pichon Anne
Published: June 2022

We prove that the topological type of a normal surface singularity

(
X
,
0
)

(X,0)

provides finite bounds for the multiplicity and polar multiplicity of

(
X
,
0
)

(X,0)

, as well as for the combinatorics of the families of generic hyperplane sections and of polar curves of the generic plane projections of

(
X
,
0
)

(X,0)

. A key ingredient in our proof is a topological bound of the growth of the Mather discrepancies of

(
X
,
0
)

(X,0)

, which allows us to bound the number of point blowups necessary to achieve factorization of any resolution of

(
X
,
0
)

(X,0)

through its Nash transform. This fits in the program of polar explorations, the quest to determine the generic polar variety of a singular surface germ, to which the final part of the paper is devoted.
1005 HEALTH-RELATED QUALITY OF LIFE AND FUTURE RISK OF HEALTH OUTCOMES AMONG OLDER ADULTS LIVING IN AUSTRALIA AND THE UNITED STATES
Authors: Phyo A Z Z , Ryan J , Gonzalez-Chica D , Stocks N , Woods R , Murray A , Reid C , Nelson M , Tonkin A , Storey E , Gasevic D , Orchard  , Shah R , Freak-Poli R ,   on behalf of the ASPREE Investigator Group (www.aspree.org)
Published: June 2022

Introduction

Poor health-related quality of life (HRQoL) is associated with higher morbidity and mortality in patient populations. However, whether HRQoL is associated with health outcomes among community-dwelling older people requires further investigation. This study aimed to examine whether HRQoL predicts cognitive decline, dementia, cardiovascular disease (CVD), and mortality in community-dwelling older people living in Australia and the United States.

Method

A cohort of 19,106 individuals from the ASPirin in Reducing Events in the Elderly (ASPREE) study, aged 65–98 years, initially free of dementia or CVD, and who completed the HRQoL 12-item short form (SF-12, version-2) at baseline (2010–2014), were followed until June 2017. The physical (PCS) and mental component scores (MCS) of SF-12 were generated using standardized norm-based method.

Results

Over a median of 4.7 years, there were 2,412 cognitive declines, 574 dementia, 922 incident CVD events, and 1,052 deaths. Using Cox proportional-hazard regression adjusted for a range of covariates, every 10-unit increase in PCS was associated with a 6% lower risk of cognitive decline, a 14% lower risk of incident CVD, and 17% lower risk of all-cause mortality, but was not associated with incident dementia. In contrast, higher MCS was only associated with a 12% and 15% lower risk of cognitive decline and dementia, respectively. Findings did not differ by sex.

Conclusion

Our study provides some of the first evidence that HRQoL can be used in combination with clinical data to identify the future risks of health outcomes among older individuals living in the community. Our findings support the decision of the Australian Commission on Safety and Quality in Health Care to incorporate the SF-12 into the annual Patient-Reported Outcome Measures (PROMs assessment.
981 FIONA STANLEY FREMANTLE HOSPITAL GROUP'S CHOICE PROJECT SUPPORTS EARLY DISCHARGES AND MINIMISES LENGTH OF STAY FOR FRAIL PATIENT
Authors: Horrocks A , Mandal B
Published: June 2022

Background

In 2019, Fiona Stanley Fremantle Hospital Group (Western Australia) launched a project to support earlier than usual discharges for frail elderly patients. This project was branded CHOICE—Consider Home Over Inpatient Care Every time.

Introduction

Evidence suggests that older adults admitted to hospital are at greater risk of further complications and declining health than those cared for at home. Our problem is that the decision to prolong admission can be influenced by our perception of risk which can delay discharges and increase risks for deconditioning, functional decline, hospital acquired complications and early entry into residential care.

Method

CHOICE implemented 2 key strategies improve patient outcomes and reduce health care costs by minimising LOS: 1. Promotion of a home-first culture began in April 2019 using staff education, training and positive reinforcement. A focus was on positive risk taking behaviours that keep the unique values of our patients at the forefront of all decisions. 2. The CHOICE Team launched in November 2019 to support early diversion of care and assessment into the community. Key elements included an Allied Health led Discharge to Assess service, rapid response Geriatrician clinic and a Nursing outreach service.

Results

Outcomes achieved in the 20/21 financial year were compared against pre CHOICE (2018) data for patients aged greater than 75 years on target wards 1,756 bed days were saved for patients returning home 22% reduction in discharges directly into care facilities 444 additional home discharges 91% of surveyed patients (n100) felt completely satisfied having their health assessments completed at home Readmission rates did not increase.

Conclusion

The CHOICE model has been shown to be more cost-effective and clinically effective than traditional practice. CHOICE is now embedded into the operational budget with workforce costs offset by bed day savings and an increase in activity based funding.
Safety, Pharmacodynamic Response, and Treatment Satisfaction With OnabotulinumtoxinA 40 U, 60 U, and 80 U in Subjects With Moderate to Severe Dynamic Glabellar Lines
Authors: Joseph John H , Maas Corey , Palm Melanie D , Lain Edward , Glaser Dee Anna , Bruce Suzanne , Yoelin Steven , Cox Sue Ellen , Fagien Steven , Sangha Sara , Maltman John , Lei Xiaofang , Brin Mitchell F
Published: June 2022

Background

OnabotulinumtoxinA 20 U reduces glabellar line (GL) severity at maximum frown for approximately 3 to 4 months. Small studies have suggested that >20-U doses may increase the efficacy and duration of response for GLs.

Objectives

The aim of this study was to evaluate safety, pharmacodynamic response, and treatment satisfaction with onabotulinumtoxinA doses ≥20 U for GLs.

Methods

This 48-week, double-blind study compared 40, 60, and 80 U onabotulinumtoxinA vs 20 U and placebo in women with moderate or severe dynamic GLs on the Allergan Facial Wrinkle Scale. The following parameters were evaluated: the percentage of subjects with investigator-assessed ≥1-grade Facial Wrinkle Scale improvement from baseline at maximum frown (responders) at Week 24; the estimated median duration of response; the proportion of mostly/very satisfied responders on the Facial Line Satisfaction Questionnaire follow-up Items 1 to 5; and treatment-emergent adverse events.

Results

The modified intent-to-treat population (N = 226) had a mean age of 48.0 years, with similar baseline GL severity between treatment groups. Week 24 responder rates were 0% for placebo and 16.0%, 32.0%, 30.6%, and 38.5% for onabotulinumtoxinA 20, 40, 60, and 80 U, with significant (P < 0.05) differences for 40 and 80 U vs 20 U. Median duration of response was longer with all higher doses vs 20 U (≥24.0 vs 19.7 weeks; P < 0.05 vs 20 U at Week 24). Facial Line Satisfaction Questionnaire results indicated high subject satisfaction. The incidence and severity of treatment-emergent adverse events did not exhibit a dose-response effect.

Conclusions

GL treatment with onabotulinumtoxinA doses >20 U demonstrated longer duration of response and higher patient-reported satisfaction vs the on-label 20-U dose with no apparent impact on safety variables.

Level of Evidence: 2
Fat Grafting With Expanded Adipose-Derived Stromal Cells for Breast Augmentation: A Randomized Controlled Trial
Authors: Vester-Glowinski Peter V , Herly Mikkel , Ørholt Mathias , Rasmussen Bo S , Müller Felix C , Elberg Jens J , Thomsen Carsten , Drzewiecki Krzysztof T
Published: June 2022

Background

The main challenge with fat grafting is loss of some of the graft to postsurgery resorption. Previous studies suggest that adipose-derived stromal cells (ASCs) can improve the volume retention of fat grafts but there is a lack of randomized trials to support the use of ASCs in clinical practice.

Objectives

This trial aimed to investigate whether ASCs improve fat graft volume retention in patients undergoing breast augmentation with lipofilling.

Methods

This was a double-blind, randomized controlled trial of breast augmentation with ASC-enriched fat grafting. Healthy women aged 30 to 45 years were enrolled. First, the participants underwent liposuction to obtain fat for culture expansion of ASCs. Then, the participants were randomly assigned to undergo a 300- to 350-mL breast augmentation with ASC-enriched fat grafting (10 × 106 ASCs/mL fat graft) to 1 of their breasts and placebo-enriched fat grafting of identical volume to the contralateral breast. The primary outcome was fat graft volume retention after a 1-year follow-up measured with MRI. The trial is registered at www.clinicaltrialsregister.eu (EudraCT-2014-000510-59).

Results

Ten participants were included in the trial; all completed the treatment and follow-up. No serious adverse events occurred. Fat graft volume retention after 1 year was 54.0% (95% CI, 30.4%-77.6%) in the breasts treated with ASC-enriched fat grafting (n = 10) and 55.9% (95% CI, 28.9%-82.9%) in the contralateral breasts treated with placebo-enriched fat grafting (n = 10) (P = 0.566).

Conclusions

The findings of this trial do not support that ASC-enriched fat grafting is superior to standard fat grafting for breast augmentation.

Level of Evidence: 2
Inhibition of citral nanoemulsion to growth, spoilage ability and AI-2/luxS quorum sensing system of Shewanella putrefaciens CN-32: a study on bacteriostasis from in vitro culture and gene expression analysis
Authors: Hu Zhiheng , Chin Yaoxian , Huang Jiayin , Zhou Jiaying , Li Gaoshang , Hu Yaqin , Yuan Chunhong , Chen Jianchu
Published: June 2022

Objectives

The bacteriostatic effects of a citral nanoemulsion against Shewanella putrefaciens CN-32 (SHP CN-32) were investigated using in vitro culture and gene expression analysis, for building a potential application in spoilage microorganism control and aquatic products quality maintenance.

Materials and Methods

SHP CN-32 was treated by prepared citral nanoemulsion when the minimal inhibitory concentration (MIC) was verified. The growth curve, membrane integrity, scanning electron microscope (SEM) observation, biofilm formation and quorum sensing (QS) signaling molecule AI-2 content were evaluated in different MIC treatment groups (0 to 1.00 MIC). The gene expression status of SHP CN-32 in 0 and 0.50 MIC groups were compared using transcriptome sequencing and quantitative polymerase chain reaction (PCR).

Results

The in vitro culture revealed that the citral nanoemulsion could inhibit the growth of SHP CN-32 with MIC of approximately 200 μg/mL. Images of membrane integrity, SEM and biofilm formation suggested significant biological structure damage in bacteria after treatment. Meanwhile, the QS signaling molecule AI-2 content showed a decline with increasing treatment concentration. Transcriptome sequencing and quantitative PCR revealed that the majority genes related diversified functional metabolic pathways of SHP CN-32 were downregulated at varying degree.

Conclusion

A significant bacteriostasis of citral nanoemulsion against SHP CN-32 was verified via the results of growth inhibition, structural destruction, signal molecular decrease and gene expression downregulation of strains. These synergies significantly affect the characteristic expression of SHP CN-32, revealing the application potential as bacteriostat, QS inhibitor and preservative in aquatic products.
RISE: A Conceptual Model of Integrated and Restorative Elder Abuse Intervention
Authors: Burnes David , Connolly Marie-Therese , Salvo Erin , Kimball Patricia F , Rogers Geoff , Lewis Stuart
Published: June 2022

Despite a growing number of elder abuse (EA) cases nationwide, response programs such as adult protective services (APS) lack a defined, prolonged intervention phase to address these complex situations. This article presents RISE, a model of EA intervention that works alongside APS or other systems that interact with at-risk older adults. Informed by an ecological-systems perspective and adapting evidence-based modalities from other fields (including motivational interviewing, teaming, restorative justice, and goal attainment scaling), the RISE model intervenes at levels of the individual older adult victim, individual harmer, their relationship, and community to address EA risk and strengthen systems of support surrounding the victim-harmer dyad. The RISE model addresses an intervention gap in existing systems to better meet the needs of EA victims and others in their lives, leading to more sustainable outcomes.
A Decade of GigaScience: The Challenges of Gigapixel Pathology Images
Authors: Litjens Geert , Ciompi Francesco , van der Laak Jeroen
Published: June 2022

In the last decade, the field of computational pathology has advanced at a rapid pace because of the availability of deep neural networks, which achieved their first successes in computer vision tasks in 2012. An important driver for the progress of the field were public competitions, so called ‘Grand Challenges’, in which increasingly large data sets were offered to the public to solve clinically relevant tasks. Going from the first Pathology challenges, which had data obtained from 23 patients, to current challenges sharing data of thousands of patients, performance of developed deep learning solutions has reached (and sometimes surpassed) the level of experienced pathologists for specific tasks. We expect future challenges to broaden the horizon, for instance by combining data from radiology, pathology and tumor genetics, and to extract prognostic and predictive information independent of currently used grading schemes.
Stop Suffering! Economic Downturns and Pentecostal Upsurge
Authors: Costa Francisco , Marcantonio Angelo , Rocha Rudi
Published: June 2022

This paper estimates the effects of economic downturns on the expansion of Pentecostal Evangelicalism in Brazil. Regions more exposed to economic distress experienced a persistent rise both in Pentecostal affiliation and in the vote share of candidates connected to Pentecostal churches in national legislative elections. Once elected, these politicians carry out an agenda with greater emphasis on issues that are sensitive to fundamental religious principles. We, therefore, find that recessions led to the rise of religious fundamentalism in tandem with the transfer of political capital to elected Pentecostal leaders.
Effect of Baseline Simple Ovarian Cyst on Ovulation Induction/Intrauterine Insemination Cycle Outcomes [A326]
Authors: Bethel Karen , Warwar Rachel , Thakore Suruchi , Hurley Emily
Published: June 2022

INTRODUCTION:

A simple ovarian cyst at baseline ultrasound for ovulation induction/intrauterine insemination (OI/IUI) is a finding of unclear clinical significance, and its effect on achieving pregnancy remains undetermined. Establishing the effects of a baseline ovarian cyst(s) is necessary to optimize OI/IUI cycle outcomes.

METHODS:

A retrospective cohort analysis of OI/IUI cycles from 2011-2021 at the UC Health Center for Reproductive Health was performed with institutional review board approval. The exposure variable was a simple appearing ovarian cyst(s) diagnosed at baseline ultrasound measuring >10 mm with estradiol level <75 ng/ml. The primary outcome analyzed was an ultrasound-confirmed intrauterine pregnancy. Secondary outcomes included positive pregnancy test and live birth. STATA was used to perform unpaired t-tests for continuous variables, Chi-square tests for dichotomous variables and a generalized linear model for regression analysis.

RESULTS:

A total of 161 cycles with inactive cysts were compared to 300 control cycles. Polycystic ovarian syndrome was more common in the control group and diminished ovarian reserve was more common in the baseline cyst group. Other specific diagnoses were similar between groups. The clinical pregnancy rate was higher in cycles without a baseline cyst compared to those with a cyst present, (15% vs. 9.3%, RR 0.63 [0.36–1.1]). After adjusting for body mass index and age, cycles with baseline cyst(s) were 35% less likely to result in a clinical pregnancy (adjusted RR=0.65 [0.37–1.1]).

CONCLUSION:

A baseline ovarian cyst is associated with a lower clinical pregnancy rate in OI/IUI cycles. This finding is clinically significant and patients should be counseled accordingly.
The Impact of Mandated Insurance Coverage on Early Care Discontinuation in Assisted Reproductive Technology [A329]
Authors: Lee Jacqueline C. , DeSantis Carol E. , Yartel Anthony K. , Kissin Dmitry M. , Kawwass Jennifer
Published: June 2022

INTRODUCTION:

Given the high cost of assisted reproductive technology (ART) in the United States, we assessed the association between state-mandated insurance coverage for fertility services with rates of care discontinuation after an initial ART cycle that did not result in a live birth.

METHODS:

This retrospective cohort study using data from the National ART Surveillance System included patients who began their first autologous ART cycle between 2016-2017 and did not have a live birth. Patients were divided into those that continued and discontinued ART care within 12 months. Multivariable analyses were conducted to evaluate factors associated with discontinuation, including categories of state-mandated insurance coverage. Institutional review board approval was obtained.

RESULTS:

Among 91,234 patients who underwent their first autologous ART cycle that did not result in live birth, 24,072 (26%) discontinued care. Compared to patients who lived in states with comprehensive mandated insurance coverage (≥3 ART cycles), states with mandated insurance coverage excluding ART, or states with no mandated insurance coverage, were 46% (adjusted relative risk [aRR] 1.46; 95% CI, 1.31–1.63) and 26% (aRR 1.26; 95% CI, 1.15–1.39) more likely to discontinue care, respectively, after controlling for patient and cycle characteristics. Increasing patient age, distance from clinic >50 miles, prior live birth, fewer oocytes retrieved, and not having embryos cryopreserved were also associated with higher rates of discontinuation. Non-Hispanic Black, non-Hispanic Asian, and Hispanic patients had higher rates of care discontinuation compared to non-Hispanic White patients for any insurance coverage level.

CONCLUSION:

Comprehensive mandated insurance coverage for ART is associated with lower rates of ART care discontinuation.
Differences in Congenital Anomalies in In-Vitro Fertilization (IVF) Versus Non-IVF Dichorionic-Diamniotic Twin Pregnancies [A333]
Authors: Schwartz Hannah , McCabe Meaghan G. , Koelper Nathanael C. , Dugoff Lorraine
Published: June 2022

INTRODUCTION:

The aim of this study was to evaluate the incidence of congenital anomalies in dichorionic-diamniotic twins conceived with in-vitro fertilization (IVF) versus non-IVF in a large geographically diverse population.

METHODS:

This is a secondary analysis of data from a retrospective cohort study of twin pregnancies seen at 17 centers between 12/2011-2/2020. Institutional review board approval was obtained. Monochorionic, vanishing twins, triplets, and cases with chromosomal abnormalities or incomplete follow-up were excluded. Neonates with an abnormal newborn exam were evaluated for having a major or minor congenital anomaly, and anomalies were further classified by organ system (cardiac, renal/genitourinary, gastrointestinal, and musculoskeletal). Chi-squared, Fisher’s exact tests, and multivariate logistic regression were used.

RESULTS:

Of the 1,112 dichorionic-diamniotic twin pregnancies included, 523 (47.0%) were conceived with IVF and 589 (53.0%) were conceived spontaneously or with other assisted reproductive technology (ART). Congenital anomalies were found in 91 pregnancies (8.18%). Of those, 42 were found in IVF pregnancies (8.03%) versus 49 non-IVF pregnancies (8.32%; P=.86). There were no significant differences between IVF and non-IVF for major anomalies (P=.57) or minor anomalies (P=.62). There was no significant difference between IVF and non-IVF pregnancies when classifying anomalies by system, and this held true when adjusting for maternal age, race, BMI, and parity.

CONCLUSION:

In this large cohort of twin pregnancies, there is no significant difference in the incidence of anomalies for pregnancies conceived by IVF versus non-IVF. Given that previous data has shown increased incidence of congenital heart defects in IVF pregnancies, this should be further evaluated specifically in dichorionic-diamniotic twin pregnancies.
Developmental Expression of Bone Morphogenetic Protein 2 (BMP2)-Induced Genes in Fetal Mouse Ovaries [A335]
Authors: Anderson Rebecca L. , Chakraborty Prabuddha , Roy Shyamal
Published: June 2022

INTRODUCTION:

Granulosa cells (GCs) and oocytes assemble to form the primordial follicle (PF) reserve. Reduced PF reserve results in consequential infertility and menopause-related disorders. Ovarian transcriptome analysis was done to understand the mechanism of bone morphogenetic proteins (BMPs) or estradiol-17β (E2)induced PF formation.

METHODS:

RNA from fetal (E16-E19) and postnatal (P1 and P2) mouse ovaries and E16 ovaries cultured with or without BMP2 or E2 for 24 hours were analyzed by RNA sequencing and bioinformatics. In vivo and in vitro expression of selected candidate genes and spatio-temporal expression of corresponding proteins were examined using real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) and immunofluorescence localization, respectively.

RESULTS:

Remarkable increases in Gata2, Gata4, Egr2 and Hepsin mRNA were evident on E18 (one day prior to PF formation). Protein immunosignal was present in somatic cells (SC) but the intensity was higher in GCs on E18 through P1. BMP2 or E2 upregulated gene expression in vivo and in vitro; however, the effect of E2 was less for Gata4 and Egr2. BMP2 significantly upregulated all proteins in GCs, whereas E2 upregulated GATA2 and HEPSIN proteins in SCs as well.

CONCLUSION:

In summary, Gata2, Gata4, Egr2 and Hepsin mRNA levels increase around PF formation. Correspondingly, intensities of immunosignal increase in differentiating GCs. BMP2 or E2 may induce differentiation of ovarian SCs into GCs by cell-specific activation of Gata2, Gata4 and/or Egr2. Hepsin, a serine proteinase, may participate in ovary remodeling. We conclude that BMP2-induced GATA2, GATA4, EGR2 and Hepsin may regulate SC to GC transition, leading to the formation of PFs.