bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Heart Rate and Cardiac Output on Retrograde Flow in the Human Thoracic Aorta
Authors: Fuchs Alexander , Berg Niclas , Parker Louis P. , Prahl Wittberg Lisa
Published: May 2022

Changes in aortic flow characteristics have previously been linked with cardiovascular disease (CVD). The purpose of the study is to determine the effects of heart rate (HR), cardiac output (CO), and the temporal flow profile on retrograde flow and wall shear stress (WSS) in the thoracic aorta. Pulsatile flow in a human thoracic aorta model was simulated for eleven combinations of HR (60–150 beats per minutes, BPM), CO and temporal flow profiles. Retrograde flow and WSS effects were characterized with common biomechanical metrics along with new markers. The results underpin the importance of temporal variation of the cardiac flow rate and the impact of the deceleration phase of systole and diastole on retrograde flow. During retrograde flow, the near-wall region may be stagnant (with low WSS) at low HR. At high HR, the WSS increases and becomes oscillatory in space and time. This finding may explain the clinical observation that increasing HR is associated with risk for CVD.
Assessment of Optimization Strategies for Battery Electrode-Active Particles Based on Chemomechanical Analysis
Authors: Tang Weiyang , Chen Zongli , Zhao Ying
Published: May 2022

In the article, we employed and extended the chemomechanical model for a hollow spherical particle to account for different optimization strategies for improved battery performance. In particular, we assessed the influence of surface tension and coating on a hollow particle. We have shown that hollow spherical particles can significantly reduce the charging time with only a small sacrifice of the theoretical capacity. Surface tension, however, plays a negligible role in the hollow as in a solid spherical particle, when the particle is synthesized at micro-level. Finally, we assess the influence of the coating on the hollow particle and found that it can effectively push the whole active particle into a compressive state.
Using a Multi-Inlet/Outlet Manifold to Improve Heat Transfer and Flow Distribution of a Pin Fin Heat Sink
Authors: Gharaibeh Ahmad R. , Manaserh Yaman M. , Tradat Mohammad I. , AlShatnawi Firas W. , Schiffres Scott N. , Sammakia Bahgat G.
Published: May 2022

The increased power consumption and continued miniaturization of high-powered electronic components have presented many challenges to their thermal management. To improve the efficiency and reliability of these devices, the high amount of heat that they generate must be properly removed. In this paper, a three-dimensional numerical model has been developed and experimentally validated for several manifold heat sink designs. The goal was to enhance the heat sink's thermal performance while reducing the required pumping power by lowering the pressure drop across the heat sink. The considered designs were benchmarked to a commercially available heat sink in terms of their thermal and hydraulic performances. The proposed manifolds were designed to distribute fluid through alternating inlet and outlet branched internal channels. It was found that using the manifold design with 3 channels reduced the thermal resistance from 0.061 to 0.054 °C/W with a pressure drop reduction of 0.77 kPa from the commercial cold plate. A geometric parametric study was performed to investigate the effect of the manifold's internal channel width on the thermohydraulic performance of the proposed designs. It was found that the thermal resistance decreased as the manifold's channel width decreased, up until a certain width value, below which the thermal resistance started to increase while maintaining low-pressure drop values. Where the thermal resistance significantly decreased in the 7 channels design by 16.4% and maintained a lower pressure drop value below 0.6 kPa.
Electrothermal Analysis of System in Package for Aerospace Application
Authors: Su Hao-hang , Fu Shuai , Li Su-yuan , Bian Jiang
Published: May 2022

Aiming at the failure problem of aerospace electronic product at the complex space environment, the electrothermal coupling method has been used to analyze the reliability of the ten channels independently adjustable voltage conversion system in package (SIP) module based on integrated forming package, which has supplied the voltage to the remote sensing camera detector. First, the electromagnetic model and thermal model have been made based on the SIP module; second, the electrothermal coupling simulation of three working conditions at normal environment have been made, and the maximum temperature of the SIP has been calculated; then, the maximum temperature of the SIP has been also calculated at vacuum and 45 °C to analyze the performance of this SIP in the space environment; at last, some test have been made of the SIP product. Compared with the measured results, the electrothermal coupling method has much more accurate than traditional thermal method. At normal environment, the simulated temperature relative error is 2.8%. At vacuum and 45 °C environment, the simulated temperature relative error is 9%. This method ensured the performance and accuracy of the design of the SIP, which has verified the reliability of aerospace SIP module at early stage.
Interfacial Characteristics of Power-Law Viscoelastic Fluid With Heat and Mass Transfer in Planar Configuration
Authors: Shukla Atul Kumar , Awasthi Mukesh Kumar
Published: May 2022

In this study, a linear stability principle is utilized to investigate the Rayleigh–Taylor stability at the power-law viscoelastic fluid/inviscid gas interface. The power-law viscoelastic fluid lies above the gas and heat is transferred from the upper phase to the lower phase and vice versa. The simplified formulation for heat transport derived by Hsieh (1972, “The Effect of Heat and Mass on Rayleigh Taylor Instability,” ASME J. Basic Eng., 94(1), pp. 156–160) is utilized here. In the perturbed state, the mathematical equations are linearized and the well-known normal mode procedure is employed to examine the stability. An implicit dispersion relationship in the terms of growth rate parameter is achieved and solved through the Newton–Raphson method. The various plots are made to study the behavior of flow variables on the stability of the interface. It is found that the instability of the interface decreases if the transfer of heat is increased. The power-law fluid interface is more stable than the inviscid fluid interface while it is more unstable than the corresponding Newtonian fluid interface. The high power-law index makes the system more stable while a denser power-law fluid reduces the interfacial stability. The consistency coefficient and viscosity of power-law fluid both have a stabilizing character.
Effect of V/III ratio and growth pressure on surface and crystal quality of AlN grown on sapphire by metal-organic chemical vapor deposition
Authors: Streicher Isabel , Leone Stefano , Kirste Lutz , Ambacher Oliver
Published: May 2022

The epitaxial growth of high-quality AlN on sapphire substrates is challenging due to high lattice and thermal mismatch and low Al-adatom mobility, which cause high dislocation density and rough surface morphology. High-temperature AlN (deposited at 1130 °C) was grown on low-temperature AlN nucleation layers (880 °C) with different V/III ratios and reactor pressures by metal-organic chemical vapor deposition. Surface and crystal quality was optimized using high V/III ratios. Thereby, slow layer-by-layer growth at high V/III laterally overgrows the 3D nucleation layer reducing the dislocation density, twist, and tilt in the crystal. This was as effective as multistep growth with increasing V/III. At high pressure of 95 mbar, step-bunching occurred. This indicates low surface supersaturation due to parasitic reactions in the gas phase. This was suppressed by low growth pressure of 50 mbar, while the crystal quality worsened.
Building an Astrophysics/Astrochemistry Laboratory
from Scratch
Authors: White Douglas W.
Published: May 2022

Laboratory astrophysics and astrochemistry are emerging fields highlighting the importance of laboratory simulations and experiments to benefit remote observations. In particular, ice mixtures found in the outer solar system may offer insight into the early evolution of organic molecules. H2O-ice mixtures containing other species such as NH3, CH3OH, CH4, CO2, etc. also provide interesting research avenues to explore via IR absorption spectroscopy towards building a laboratory database astronomers can use. As such, the astrochemistry laboratory at USC Aiken strives to fill this niche while fostering a rich environment for undergraduate research. Constructing such a laboratory environment, particularly one that emphasizes undergraduate research, is nevertheless difficult. In this article, procedures for obtaining, building, and operating new equipment are discussed, along with crafting a suitable learning environment for students.
Howling winds and swinging sticks: An acoustical analysis
Authors: Kasper Lutz , Vogt Patrik
Published: May 2022

The phenomenon of the “howling wind” is very well known to many. It occurs as strong winds whip around bare tree branches and electrical transmission lines. This phenomenon has been known for a long time and was used to make music with the ancient Aeolian harp. We can create this sound in the lab by swinging sticks quickly through the air. A short characteristic “howl” is produced; the frequencies present depend upon the swinging speed and the diameter of the rod.
Electronic telescopes and their use in astronomy education
Authors: Sibbernsen Kendra
Published: May 2022

As a member of a pilot group for the NASA Community College Network (NCCN), now called the Unistellar College Astronomy Network (UCAN), I was awarded an eVscope from Unistellar and the SETI Institute1 to test and incorporate into my teaching. The eVscope is a 4.5-inch telescope that produces a digital image viewed on an app on a smart device (Fig. 1). It has the ability to stack images from four-second exposures in “Enhanced Vision,” remove background noise, and enhance dim deep space objects. Although the telescope can resolve planetary objects such as Saturn and Jupiter, it really excels with faint objects such as nebulae and galaxies. The cost of the eQuinox eVscope is $2699 and is available through the Unistellar website (https://unistellaroptics.com/equinox-en-us/).
The game of grades and the hidden curriculum
Authors: Erickson Stephanie S.
Published: May 2022

As teachers, we want students to be motivated and excited about learning and engaging with new concepts. We provide what we hope are stimulating lessons and laboratory experiences that spark curiosity and motivate students to learn more and to dig deeper into the scientific concepts. More often than not, however, students ask questions such as, “Will this be on the test?” and “How many points is this assignment worth?” Even more frustrating is students chasing points to get a better grade, or asking for “extra credit.” Traditional grading systems reward students who are savvy with their time, know how much each assignment is worth, and ask professors and teachers for points back that they feel were unfairly taken away. They are rewarded with high grades that translate to being recognized with placement on honor rolls, access to scholarships, and opportunities to take advanced course work. By the time students are in their first physics class, often taught at the end of their K-12 science education, many “high achievers” have mastered this game of grades. Still, others either choose not to participate in the game or simply have not learned the rules. Grading practices and these unwritten rules of the game are part of the hidden curriculum. The hidden curriculum involves the aspects of education that are not transparent and are the unwritten lessons and expectations of schooling. These lessons and expectations are oftentimes rooted in cultural practices and, in the case of many education settings in the United States, a homogenized white middle-class culture. The hidden curriculum is an aspect of education that is harder for students outside of the dominant culture, or who are otherwise oppressed, to access. It is critical that we examine our grading practices for the hidden curriculum embedded in it if we are to make assessment more equitable and less punitive, and motivate learning for learning’s sake.
An Intuitive Approach to Earth’s Centrifugal Bulge
Authors: Greenstein George
Published: May 2022

We describe a simple, intuitively appealing interpretation of the observed ellipsoidal shape of the rotating Earth: it is that surface everywhere perpendicular to the net force upon it.
Introductory Physics Labs: A Tale of Two Transformations
Authors: Wolf Steven Frederick , Sprague Mark W.
Published: May 2022

A significant challenge physics faculty face teaching introductory labs is engaging students in authentic science practices. Another has been highlighted given the current global pandemic—how to engage students in our laboratory courses while maintaining appropriate social distancing and hygiene standards. We have chosen to answer these challenges by transforming our labs…twice. We discuss the rationale behind the first transformation to a practice-focused curriculum. In March 2020 we needed to transform our labs again, this time to accommodate online learning. This paper discusses two chief questions: “What are we doing to engage students in science practices?” and “How did we make all of this work online?”
The Thomson Jumping Ring Experiment and Ideal Transformer
Authors: Ng Chiu-king
Published: May 2022

In this paper, we utilize the readily known theory of the ideal transformer to furnish a self-contained qualitative explanation on the AC-powered Thomson jumping ring (TJR) experiment.
Acceleration Measurement Using Arduino and a Smartphone for the Motion of Objects on an Inclined Plane
Authors: Chen Huai-Yi , Nieh Hwa-Ming , Ko Shih-Wei
Published: May 2022

In conventional physics teaching, acceleration measurement is demonstrated using motion sensors and carts on inclined tracks, and relevant data are collected using specific professional software. This approach entails the connection of computers and interface boxes, and requires high cost and large space. Air-track carts can be used to perform these experiments to reduce the errors caused by track friction; however, this approach has various disadvantages, including a large-size track and an air blower connecting to the track. In recent years, Arduino microcontrollers have gradually served as tools and platforms commonly used by makers and applied in STEM education. In addition, smartphones have been popular among most high school and university students. Therefore, various physics experiments have been performed using Arduino microcontrollers and smartphones. This study improved the weaknesses of conventional motion sensors for measuring the acceleration of objects on inclined planes by utilizing Arduino microcontrollers and smartphones. Specifically, common steel balls and U-shaped aluminum strips were used to replace the carts and tracks in relevant experiments. A readily available Arduino development board, smartphone app, and electronic components were also used to record and analyze the experimental data. Accordingly, a user-friendly tool for teaching acceleration measurement was created. This tool is small, light, portable, inexpensive, easily assembled, and yields small experimental errors, facilitating students’ participation in hands-on activities and demonstrations of textbook theories.
Putting Potential at the Core of Teaching Electric Circuits
Authors: Burde Jan-Philipp , Weatherby Thomas Sean , Wilhelm Thomas
Published: May 2022

Electricity has shaped modern civilization in a way few other discoveries have. Nonetheless, few students successfully develop a basic understanding of voltage, current, and resistance or their mutual relationship in simple DC circuits. Despite teachers’ best efforts in the classroom, so-called “alternative conceptions” often prevail after traditional instruction. In particular, voltage has proven to be a difficult concept to teach—many students erroneously think of voltage as a property of electric current. Furthermore, a battery is often considered to be a source of constant current rather than constant voltage. In order to help students develop a better understanding of simple DC circuits, we developed a new curriculum with an accompanying computer simulation that illustrates potential differences in circuits in order to make voltage rather than current the students’ primary concept when analyzing circuits. To this end, the curriculum takes typical alternative conceptions into account and builds on students’ everyday experiences with air pressure in order to provide them with an immediately tangible counterpart in electric potential. In analogy to air pressure differences that cause an air flow, voltage is introduced as an “electric pressure difference” that causes an electric current. Using the accompanying computer simulation, potential differences are visualized in simple DC circuits using color coding and a height representation. The new curriculum including teaching resources as well as the newly developed computer simulation are both freely available online to teachers and students alike.
Promoting Problem Solving Through Interactive Video-Enhanced Tutorials
Authors: Koenig Kathleen , Maries Alexandru , Teese Robert , Chabot Michelle
Published: May 2022

Students in introductory college physics often have wide ranges of preparation, making it challenging to deliver effective instruction for all. While numerous educational products and strategies have been shown to be broadly effective, there is a need for research-based online materials that support personalized learning and focus specifically on improving problem-solving abilities. Building from our Interactive Video Vignettes (IVVs), we are developing freely available Interactive Video-Enhanced Tutorials (IVETs). These combine videos of real instructors who guide students through an expert-like problem-solving process using a series of required questions that motivate students to interact with the material. Research on the effectiveness of the IVETs is underway and preliminary results are encouraging.
Visualizing Double-Slit Interference on a Shoestring
Authors: Parks Beth , Benze Hans
Published: May 2022

Student misconceptions of the double-slit experiment (Fig. 1) are abundant. The most common ones that we observe include: (1) belief that constructive interference requires both pathlengths to be integer multiples of the wavelength (“L1 = n1λ” and “L2 = n2λ”) rather than only the pathlength difference (ΔL ≡ |L1 – L2| = nλ); (2) failure to understand that the justification for d sin θ = nλ is that d sin θ is a good approximation to ΔL; (3) confusion about the limits in which the approximation d sin θ = nλ is valid; and (4) confusion about the limits in which the approximation sin θ = tan θ = y/D is valid. Most of these misconceptions have been observed in the past. We consider the first of these to be the most damaging, since it will hinder students from understanding interference in other contexts in the future. To address this misconception, we have designed an exercise that strongly reinforces the correct understanding (ΔL = nλ) while also helping overcome the other misconceptions.
Methods for the calibration of bone conduction transducers at frequencies from 5 to 20 kHz
Authors: Remenschneider Aaron K. , Cheng Jeffrey Tao , Rosowski John J.
Published: May 2022

Techniques for standardizing the output of bone conduction transducers over the 5–20 kHz range are presented. The techniques include definitions of the standard artificial mastoid (AM) impedance and force sensitivity in that high-frequency range using an impedance head coupled to a vibration source. The AM impedance is shown to vary with the contact area of the vibration source. The AM force sensitivity does not vary with the contact area but does exhibit sharp frequency dependences over the 14–20 kHz range. The sharp frequency dependence complicates the use of the AM force sensor as a stand-alone calibration device at these high frequencies. An alternative calibration scheme that uses an accelerometer interposed between the vibrator and the AM impedance is described. Comparisons of the two schemes demonstrate that the accelerometer method produces more consistent results. Comparisons of the force and acceleration output of one bone conduction vibrator at high frequencies suggest those outputs depend on the driven load. The loads used in the two calibration schemes are compared to what is known of the impedance of the skin-covered head.
Dance as an Intervention to Reduce Fall Risk in Older Adults: A Systematic Review With a Meta-Analysis
Authors: Blanco-Rambo Eduarda , Bandeira-Guimarães Marcelo , Vieira Alexandra F. , Pietta-Dias Caroline , Izquierdo Mikel , Cadore Eduardo L.
Published: May 2022

The purpose of this study was to summarize the evidence from randomized clinical trials on the effects of dance on fall risk in older adults through a systematic review with meta-analysis. Fall risk was assessed through timed up and go, Berg Balance Scale, or one-leg stand tests. Data are presented as mean differences for timed up and go test and standardized mean differences for Berg Balance Scale and one-leg stand tests between treatments with 95% confidence intervals, and calculations were performed using random effects models. Significance was accepted when p < .05. A significant difference was found between dance interventions and the control groups in the general analysis of fall risk assessed by timed up and go (mean differences: −1.446 s; 95% confidence interval [−1.586, −1.306]; p < .001) and Berg Balance Scale and one-leg stand tests (standardized mean differences: 0.737; 95% confidence interval [0.508, 0.966]; p < .001) in favor of the intervention group. Different dance interventions decreased the fall risk in older practitioners.
In Vitro
Activity of Ertapenem against Neisseria gonorrhoeae Clinical Isolates with Decreased Susceptibility or Resistance to Extended-Spectrum Cephalosporins in Nanjing, China (2013 to 2019)
Authors: Li Xuechun , Le Wenjing , Lou Xiangdi , Genco Caroline A. , Rice Peter A. , Su Xiaohong
Published: May 2022

Neisseria gonorrhoeae
isolates collected in Nanjing, China, that possessed decreased susceptibility (or resistance) to extended-spectrum cephalosporins (ESCs) were examined for susceptibility to ertapenem, and their sequence types were determined. Ceftriaxone and cefixime MICs of ≥0.125 mg/L and ≥0.25 mg/L, respectively, were first determined in 259 strains isolated between 2013 and 2019, and then MICs of ertapenem were measured using the antimicrobial gradient Epsilometer test (Etest).
Plantaricin A, Derived from Lactiplantibacillus plantarum, Reduces the Intrinsic Resistance of Gram-Negative Bacteria to Hydrophobic Antibiotics
Authors: Meng Fanqiang , Liu Yanan , Nie Ting , Tang Chao , Lyu Fengxia , Bie Xiaomei , Lu Yingjian , Zhao Mingwen , Lu Zhaoxin
Published: May 2022

Antibiotic resistance is a global health concern due to indiscriminate use of antibiotics, resistance transfer, and intrinsic resistance of certain Gram-negative bacteria. The asymmetric bacterial outer membrane prevents the entry of hydrophobic antibiotics and renders them ineffective.
Diagnosis of Congenital Toxoplasmosis: Performance of Four IgG and IgM Automated Assays at Birth in a Tricentric Evaluation
Authors: Avignon Marine , Lévêque Maude F. , Guemas Emilie , Sasso Milène , Albaba Sahar , Lachaud Laurence , Fillaux Judith
Published: May 2022

For postnatal diagnosis of congenital toxoplasmosis (CT), the gold standard for the detection of anti-
Toxoplasma
IgM in newborns relies on the immunosorbent agglutination assay (ISAGA), which is manufactured from whole
Toxoplasma
parasites that become difficult to maintain. For IgG, only the Platelia assay provides a validated assay for cord blood according to the manufacturer, allowing its use in this context.
Organizing the Global Diversity of Microviruses
Authors: Kirchberger Paul C. , Martinez Zachary A. , Ochman Howard
Published: May 2022

Microviruses are the most abundant single-stranded DNA phages on the planet and an important component of the human gut virome. And yet, productive research into their biology is hampered by the inadequacies of current taxonomic ordering: microviruses are lumped into a single family and treated as a monolithic group, thereby obscuring the extent of their diversity and resulting in little comparative research.
Genomic and Phenotypic Characterization of Clostridium botulinum Isolates from an Infant Botulism Case Suggests Adaptation Signatures to the Gut
Authors: Douillard François P. , Derman Yağmur , Woudstra Cédric , Selby Katja , Mäklin Tommi , Dorner Martin B. , Saxén Harri , Dorner Brigitte G. , Korkeala Hannu , Lindström Miia
Published: May 2022

While the clinical aspects of infant botulism and the mode of action of BoNT have been thoroughly investigated, little is known on the pathogenesis and adaptive mechanisms of
C. botulinum
in the gut. Here, we provide for the first time a comprehensive view on the genomic dynamics and plasticity of
C. botulinum
over time in a case of infant botulism.
The PTS
Ntr
-KdpDE-KdpFABC Pathway Contributes to Low Potassium Stress Adaptation and Competitive Nodulation of Sinorhizobium fredii
Authors: Feng Xue-Ying , Tian Yu , Cui Wen-Jing , Li Yue-Zhen , Wang Dan , Liu Yanbo , Jiao Jian , Chen Wen-Xin , Tian Chang-Fu
Published: May 2022

In all ecological niches, potassium is actively consumed by diverse prokaryotes and their interacting eukaryote hosts. It is only just emerging that potassium is a key player in host-pathogen interactions, and the role of potassium in mutualistic interactions remains largely unknown.
Proteolytic Activity-Independent Activation of the Immune Response by Gingipains from Porphyromonas gingivalis
Authors: Ciaston Izabela , Budziaszek Joanna , Satala Dorota , Potempa Barbara , Fuchs Andrew , Rapala-Kozik Maria , Mizgalska Danuta , Dobosz Ewelina , Lamont Richard J. , Potempa Jan , Koziel Joanna
Published: May 2022

Gingipain cysteine proteases are essential virulence factors of
Porphyromonas gingivalis
, an oral bacterium implicated in development of periodontitis. Gingipains diffusing from anaerobic periodontal pockets lose proteolytic activity in the oxygenated environment of gingival tissues.
Comparative Analysis and Data Provenance for 1,113 Bacterial Genome Assemblies
Authors: Yarmosh David A. , Lopera Juan G. , Puthuveetil Nikhita P. , Combs Patrick Ford , Reese Amy L. , Tabron Corina , Pierola Amanda E. , Duncan James , Greenfield Samuel R. , Marlow Robert , King Stephen , Riojas Marco A. , Bagnoli John , Benton Briana , Jacobs Jonathan L.
Published: May 2022

The traceability of microbial genomics data to authenticated physical biological materials is not a requirement for depositing these data into public genome databases. This creates significant risks for the reliability and data provenance of these important genomics research resources, the impact of which is not well understood.
Three-Dimensional Genome Map of the Filamentous Fungus
Penicillium oxalicum
Authors: Li Cheng-Xi , Liu Lin , Zhang Ting , Luo Xue-Mei , Feng Jia-Xun , Zhao Shuai
Published: May 2022

The spatial structure of chromatin plays important roles in normal cell functions and the regulation of gene expression. The three-dimensional (3D) architectures of the genomes of many mammals and plants have been elucidated, but corresponding studies on filamentous fungi, which play vital roles as decomposers of organic matter in the soil, are very limited.
Penicillium oxalicum
is one of the predominant cellulolytic aerobic fungi in subtropical and tropical forest soils and can secrete integrative cellulase and xylanase under integrated regulatory control, degrading plant biomass highly efficiently.
Lactobacillus acidophilus, L. plantarum, L. rhamnosus, and L. reuteri Cell-Free Supernatants Inhibit Candida parapsilosis Pathogenic Potential upon Infection of Vaginal Epithelial Cells Monolayer and in a Transwell Coculture System
In Vitro
Authors: Spaggiari Luca , Sala Arianna , Ardizzoni Andrea , De Seta Francesco , Singh Dhirendra Kumar , Gacser Attila , Blasi Elisabetta , Pericolini Eva
Published: May 2022

The incidence of VVC by non-
albicans Candida
(NAC) species, such as
C. parapsilosis
, is increasing. Treatment failure is common in NAC-VVC because some species are resistant or poorly susceptible to the antifungal agents normally employed.
Gestational age and risk of intellectual disability: a population-based cohort study
Authors: Yin Weiyao , Döring Nora , Persson Monica S M , Persson Martina , Tedroff Kristina , Ådén Ulrika , Sandin Sven
Published: May 2022

Objective

To examine the association between gestational age at birth and risk of clinically diagnosed intellectual disability (ID) week by week to provide a detailed description of ID risk across the entire range of gestational ages and by severity of ID.

Methods

All individuals born alive in Sweden 1974–2017 were prospectively followed up from birth until 2017 using national registers. The HRs for ID according to weekly gestational age and gestational age categories were determined using Cox models. Sibling analyses were conducted to adjust for familial confounding.

Results

The study included 3 572 845 live births. During the follow-up, 26 596 ID cases were registered. The adjusted weekly estimates showed a gradual increase in risk of ID from week 40 to week 24 (adjusted HR37weeks=1.80 (1.74 to 1.87), aHR32weeks=3.93 (3.73 to 4.13), aHR28weeks=7.53 (6.95 to 8.16), aHR24weeks=21.58 (18.62 to 25.00)) and from week 41 onwards (aHR42weeks=1.26 (1.19 to 1.32)), with statistically significantly higher risks across the range of gestational age compared with infants born at week 40. The associations were consistent in mild, moderate and severe/profound ID but most prominent for severe/profound ID.

Conclusion

The risk of ID increased weekly as the date of delivery moved away from 40 weeks, both preterm and post-term. The results remained robust after detailed adjustment for confounding, including familial confounding.
Transcatheter aortic valve replacement: a palliative approach to infective endocarditis
Authors: Shen Christine P , Munsayac Marissa A , Robinson Austin A , Stinis Curtiss T
Published: May 2022

An 88-year-old man with small lymphocytic lymphoma presented to the hospital with shortness of breath and was diagnosed with heart failure. Serial blood cultures and echocardiography revealedStaphylococcus epidermidisendocarditis, complicated by severe aortic regurgitation. Despite intravenous antibiotic therapy and aggressive intravenous diuresis therapy in the hospital, he decompensated into cardiogenic shock, requiring invasive haemodynamic monitoring and inotrope therapy. With multidisciplinary discussion involving the patient and his children, there was a joint decision that at his advanced age, he would not pursue surgical aortic valve replacement and instead proceed with a transcatheter aortic valve replacement (TAVR) with palliative intent. He underwent TAVR with subsequent symptomatic and functional improvement as well as resolution of cardiogenic shock.
Prospective assessing metabolic abnormalities, lifestyle and dietary pattern in a Chinese population with heart failure: the MALD-HF study protocol
Authors: Jin Yao , Huang Hui , Zhou Qingfen , Dong Fengwei , Lu Lin , Gao Xiang , Wu Zhijun
Published: May 2022

Introduction

The evidence on predictive value of lifestyle behaviours and dietary pattern on the prognosis of heart failure (HF) is limited. Our aim is to identify these factors in the setting of secondary prevention of HF.

Methods and analysis

The Metabolic Abnormalities, Lifestyle and Dietary Pattern in Heart Failure study is an ongoing, prospective cohort, single-centre study that aims to recruit 1500 patients with HF from June 2016 to June 2021. At baseline, each participant completes a questionnaire on demographic characteristics, medical history, lifestyle behaviours, sleep duration and quality, bowel movements and regular diet. Biochemical measurements, blood pressure, carotid ultrasound, echocardiography, electrocardiography and cardiac magnetic resonance are obtained and analysed. Muscle strength is assessed using the handgrip dynamometer and the MicroFet2 hand-held dynamometer. Each patient is followed for 5 years or until the occurrence of death. The primary outcome is a composite of cardiovascular mortality or hospitalisation due to worsening heart failure. The secondary end points are cardiovascular deaths and the hospitalisations due to worsening HF. The incidence of mortality and cardiovascular events is documented biennially.

Ethics and dissemination

The study protocol has been approved by the Ethics Committee of the Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and follows the norms of the World’s Association Declaration of Helsinki. The results of this study will be disseminated in peer-reviewed journals and academic conferences.

Trial registration number

NCT03951311.
Assessing patient experience with patient safety in primary care: development and validation of the ASK-ME-questionnaire
Authors: Stahl Katja , Reisinger Anna , Groene Oliver
Published: May 2022

Objective

To develop and test the validity and reliability of a tool measuring patient experiences with patient safety in ambulatory care that is suitable for routine use in general practitioner and specialist practices.

Design

Instrument development was based on a literature review, a 3-round Delphi survey with a multidisciplinary expert panel and cognitive interviews with patients. The instrument was piloted in 22 practices using a cross-sectional survey. Exploratory (EFA) and confirmatory factor analysis (CFA) were performed to test construct validity. Internal consistency and the ability of the questionnaire to differentiate between selected subgroups and at the level of individual practices was examined.

Setting

General practitioner and specialist practices.

Participants

Patients aged >18 years seeking care in ambulatory care practices between February and June 2020.

Results

The final ASK-ME-questionnaire consisted of 22 items covering 5 theoretical dimensions. A total of 3042 patients (71.1%) completed the questionnaire. Median item non-response rate was 4.2% (IQR 3.4%–4.7%). EFA yielded 3 factors comprising 14 items explaining 64.8% of the variance representing contributing factors to patient safety incidents. CFA confirmed the factorial structure suggested by EFA. The model fit the data satisfactorily (comparative fit index=0.92, root mean square error of approximation=0.08, standardised root mean square residual=0.08). Internal consistency values ranged from 0.7 to 0.9. Discriminant validity was supported by significant differences between patients of different age and differences in self-reported health status. The factors distinguished well between practices.

Conclusion

The ASK-ME-questionnaire showed good psychometric properties. It is suitable for routine use in patient safety measurement and improvement systems in ambulatory care. Further research is required to adequately assess number and type of experienced events in routine measurements.
Reliability and validity of the Chinese version of the Family Resilience Questionnaire (FaRE Questionnaire) in patients with breast cancer: a cross-sectional study
Authors: Li Mengmeng , Ma Rui , Zhang Shanfeng , Wang Shanshan , Jiao Jiawei , Liu Lamei , Wang Panpan , Zhang Zhenxiang , Wang Peng , Li Xiaoyan
Published: May 2022

Objective

The aim of this study was to assess the reliability and validity of the Chinese version of the Family Resilience (FaRE) Questionnaire among patients with breast cancer in China.

Design

It was a cross-sectional study, which involved translation, back-translation, cultural adjustment and psychometric testing of a 24-item FaRE Questionnaire.

Setting

Three tertiary hospitals in Zhengzhou, China: respectively are the First Affiliated Hospital of Zhengzhou University, Second Hospital Affiliated to Zhengzhou University and Henan Provincial People’s hospital.

Participants

A total of 559 patients with breast cancer volunteered to participate in the study

Primary outcome measures

Data analysis was performed using the IBM SPSS software V.21.0 and AMOS software V.21.0. Cronbach’s α coefficient was used to examine the internal consistency. The test–retest reliability was calculated using the intraclass correlation coefficient on 30 participants. The content validity index was calculated based on the values obtained from six expert opinions. Construct validity test was performed using factor analysis including exploratory factor analysis and confirmatory factor analysis.

Results

For the Chinese version of FaRE Questionnaire, the Cronbach’s α coefficient of the total questionnaire was 0.909, and Cronbach’s α coefficients of four factors were 0.902, 0.932, 0.905 and 0.963, respectively. The test–retest reliability index of the total questionnaire was 0.905. The Scale-Content Validity Index was 0.97, and Item-Content Validity Index ranged from 0.83 to 1.00. The questionnaire included 24 items, exploratory factor analysis extracted four factors with loading >0.4, which could explain 72.146% of the total variance. Confirmatory factor analysis showed the Chinese version of FaRE Questionnaire had an excellent four-factor model consistent with the original questionnaire.

Conclusion

The Chinese version of FaRE Questionnaire has acceptable reliability and validity among patients with breast cancer in China. It can effectively assess family resilience and provide basis for personalised family resilience interventions for patients with breast cancer.
Knowledge of preconception care among reproductive-age women in Debre Berhan Town, Ethiopia: a community-based, cross-sectional study
Authors: Lemma Tesfanesh , Silesh Mulualem , Taye Birhan Tsegaw
Published: May 2022

Objectives

Preconception care can have a major public health impact by reducing maternal and childhood mortality and morbidity. Despite this importance, preconception care is still not implemented in majority of developing countries. Therefore, this study aimed to assess the proportion of knowledge of preconception care and its associated factors among reproductive-age women in Debre Berhan Town, Ethiopia.

Design and methods

A community-based, cross-sectional study was employed from 1 March to 30 March 2019 among reproductive-age women. Data were collected via a face-to-face, interviewer-administered questionnaire. Data were entered into EpiData V.4.6 and exported to SPSS V.25 for analysis. In a multivariable logistic regression analysis, variables with p<0.05 were declared statistically significant. The strength of statistical association was measured using adjusted OR (AOR) and 95% CI.

Setting and participants

The study was conducted in Debre Berhan Town, Ethiopia. A total of 414 reproductive-age women were enrolled in the study.

Outcome

Knowledge of preconception (good or poor).

Results

Of the total 414 participants, 71 (17.1%) had good knowledge about preconception care. Women’s occupation (AOR: 8.68, 95% CI 1.25 to 60.3), monthly income (AOR: 9.89, 95% CI 1.93 to 50.76), gravidity (AOR: 0.28, 95% CI 0.14 to 0.58), contraceptive use (AOR: 4.95, 95% CI 1.09 to 22.39), history of congenital abnormality (AOR: 7.53, 95% CI 2.03 to 27.96), history of neonatal death (AOR: 6.51, 95% CI 1.62 to 26.18) and time to reach a health facility (AOR: 0.37, 95% CI 0.17 to 0.79) were statistically associated with knowledge about preconception care.

Conclusions

In this study area, only less than one-fifth of reproductive-age women had good knowledge of preconception care. Therefore, to improve women’s knowledge about preconception care, a strong collaborative effort including several sectors should be made.
Treatment persistence and exacerbations in patients with asthma initiating treatment with inhaled corticosteroids and beta-adrenergic agonists: retrospective cohort study
Authors: Sicras-Mainar Antoni , Gómez Rodríguez Belén , Traseira-Lugilde Susana , Fernández-Sánchez Toni , Velasco Garrido José Luis
Published: May 2022

Objective

To determine treatment persistence and exacerbations in patients initiating inhaler treatment with fixed-dose combinations of inhaled corticosteroids/long-acting beta-2-adrenergic agonists (ICS/LABA) for the treatment of asthma.

Design

Retrospective observational study conducted by review of electronic medical records (database: Fundación RediSS).

Setting

Retrospective cohort study. The follow-up period was 1 year.

Participants

The study included patients aged ≥18 years who started treatment with ICS/LABA and met the inclusion/exclusion criteria.

Main outcomes and measures

The study groups were fluticasone propionate/salmeterol (FP/SAL), beclomethasone/formoterol (BDP/FORM), budesonide/formoterol (BUD/FORM), fluticasone furoate/vilanterol (FF/VI) and fluticasone propionate/formoterol (FP/FORM). The main measurements were persistence, medication possession ratio (MPR) and exacerbations. Statistical significance was established as p<0.05.

Results

In total, 3203 patients were recruited for the study. By groups, 31.1% FP/SAL, 28.6% BDP/FORM, 25.0% BUD/FORM, 8.2% FF/VI and 7.0% FP/FORM. The mean age was 52.2 years, 60.8% were female and 44.9% had persistent-moderate asthma. Treatment persistence was 61.7% (95% CI 60.0% to 63.4%) and by study group it was FP/SAL: 60.7%, BDP/FORM: 61.2%, BUD/FORM: 60.3%, FF/VI: 66.7% and FP/FORM: 67.6% (p=0.046). MPR by study group was FP/SAL: 74.3%, BDP/FORM: 73.8%, BUD/FORM: 74.6%, FF/VI: 79.4% and FP/FORM: 80.6% (p=0.028). The mortality rate was 2.9%. By treatment group, exacerbations were FP/SAL: 21.9% (95% CI 19.3% to 24.5%), BDP/FORM: 22.2% (95% CI 19.5% to 24.9%), BUD/FORM: 22.8% (95% CI 19.9% to 25.7%), FF/VI: 17.9% (95% CI 14.9% to 20.7%) and FP/FORM: 16.0% (95% CI 12.2% to 19.3%), p=0.036.

Conclusions

Patients undergoing treatment with FP/FORM and FF/VI versus FP/SAL, BDP/FORM and BUD/FORM were associated with greater treatment adherence (persistence, MPR) and lower rates of exacerbations. However, further studies will be needed to strengthen the consistency of the results.
Frequency of data collection and estimation of trajectories of physical functioning and their associations with survival in older men: analyses of longitudinal data from the Manitoba Follow-Up Study
Authors: Liu Yixiu , Jiang Depeng , Tate Robert , St. John Philip
Published: May 2022

Objective

In studies of trajectories of physical functioning among older people, the data cannot be measured continuously, but only at certain time points in prespecified cycles. We examine how data collection cycles can affect the estimation of trajectories and their associations with survival.

Study design and setting

Longitudinal data from the Manitoba Follow-Up Study (MFUS), with 12 measurements collected annually from 2004 to 2015, are analysed using a summary measures of physical functioning from the Short Form-36 questionnaire. Based on the joint models of the functioning trajectories and risk of death, we compare the estimations among models using different frequency of data collection (annually, biennially and triennially).

Results

Our 2004 baseline includes 964 men who were survivors from the original MFUS cohort with mean age of 84 years and range between 75 and 94 years. Results from analysis of annual data indicate that the mean physical functioning is significantly decreasing over time. Further, the rate of decline is increasing over time. The current value of physical functioning is significantly associated with the hazard of death (p<0.001), whereas the association between the change rate and mortality is marginally significant (p<0.10). Results from analysis of biennial and triennial data reveal similar trajectory patterns of physical functioning, but could not reveal the association between the change rate of physical functioning and mortality. The frequency of data collection also impacts substantially on the estimation of heterogeneity of functioning trajectory. The prediction of mortality risk obtained using annual measurements of physical functioning are better than using biennial or triennial measurements, while the predictions obtained using biennial or triennial measurements are almost equivalent.

Conclusion

The impact of frequency of data collection depends on the shape of functional trajectories and its linking structure to survival outcome.
Road traffic casualties in Great Britain at daylight savings time transitions: a causal regression discontinuity design analysis
Authors: Singh Ramandeep , Sood Rohan , Graham Daniel J
Published: May 2022

Objective

To determine whether daylight savings time (DST) transitions have an effect on road traffic casualties in Great Britain using causal regression discontinuity design (RDD) analysis. We undertake aggregate and disaggregate spatial and temporal analyses to test the commonly referenced sleep and light hypotheses.

Design

The study takes the form of a natural experiment in which the DST transitions are interventions to be evaluated. Two outcomes are tested: (1) the total number of casualties of all severities and (2) the number of fatalities.

Data

Data were obtained from the UK Department for Transport STATS19 database. Over a period of 14 years between 2005 and 2018, 311 766 total casualties and 5429 fatalities occurred 3 weeks on either side of the Spring DST transition and 367 291 total casualties and 6650 fatalities occurred 3 weeks on either side of the Autumn DST transition.

Primary outcome measure

An RDD method was applied. The presence of a causal effect was determined via the degree of statistical significance and the magnitude of the average treatment effect.

Results

All significant average treatment effects are negative (54 significant models out of 287 estimated), indicating that there are fewer casualties following the transitions. Overall, bootstrapped summary statistics indicate a reduction of 0.75 in the number of fatalities (95% CI −1.61 to –0.04) and a reduction of 4.73 in the number of total casualties (95% CI −6.08 to –3.27) on average per year at both the Spring and Autumn DST transitions combined.

Conclusions

The results indicate minor reductions in the number of fatalities following the DST transitions, and thus, our analysis does not support the most recent UK parliamentary estimate that there would be 30 fewer fatalities in Great Britain if DST was to be abolished. Furthermore, the results do not provide conclusive support for either the sleep or light hypotheses.