bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of iatrogenic heart murmurs in a population of apparently healthy cats
Authors: Howell K. L. , Ferasin L. , Walls A. , Smith N.
Published: March 2022

Objectives

To determine the prevalence of iatrogenic heart murmurs in a population of apparently healthy cats and to investigate factors that may predispose cats to iatrogenic murmurs.

Materials and Methods

Apparently healthy cats presenting for routine examinations were prospectively enrolled. Following a physical examination to confirm there were no abnormalities, a cardiac examination was performed before and during a provocative manoeuvre performed independently by two clinicians. The provocative manoeuvre was performed on the right side of the chest wall by applying gentle pressure with a stethoscope to ascertain whether a murmur became audible, graded using a modified descriptive scale (soft/moderate). The cat's heart rate before and during the provocative manoeuvre and their age, sex, body condition score and bodyweight were recorded.

Results

One hundred and six cats were prospectively enrolled. The average prevalence of iatrogenic murmurs was 28.2% with good interobserver agreement recorded on both the presence (kappa 0.67 and 0.62) and grade of the murmur (kappa 0.6 and 0.53). A significant association was noted between age and body condition score, with iatrogenic murmurs more likely in cats with increasing age and decreasing body condition score. There was no association between heart rate and the presence of an iatrogenic murmur.

Clinical Significance

Iatrogenic murmurs are a common finding in cats with increasing prevalence noted in older and lean cats. Iatrogenic murmurs should therefore be considered as a differential diagnosis in a cat when an audible soft systolic right‐sided murmur occurs with gentle pressure application to the chest wall during auscultation.
Associations between Body Mass Index Trajectories in the first two years of life and Allergic Rhinitis, Eczema and Food Allergy outcomes up to early adulthood
Authors: Chang Chia‐Lun , Ali Gulshan Bano , Lodge Caroline J. , Abramson Michael J. , Erbas Bircan , Tang Mimi L. K. , Svanes Cecilie , Bui Dinh Son , Dharmage Shyamali C. , Lowe Adrian J.
Published: March 2022

Background

Early life body mass index (BMI) trajectories influence the risk of asthma at 18 years of age. However, it is unclear if these are also associated with other allergic diseases.

Objectives

We investigated the associations between BMI trajectories and subsequent allergic rhinitis, eczema and food sensitisation/allergies.

Methods

Parent‐reported anthropometric data were collected 18 times in the first two years of life from a cohort of 620 participants in a high‐risk cohort. Group‐based trajectory modelling was applied to develop BMI trajectories. Associations between trajectories and allergic rhinitis, eczema and food sensitisation at 6, 12 and 18 years of age were assessed using logistic regression models. Potential effect modifications by parental allergic disease, sex and allocated infant formula were assessed.

Results

We identified five BMI trajectories: average, below average, persistently low, early low and catch up, and persistently high. None showed an association with allergic rhinitis. In participants with maternal allergic rhinitis, ‘early‐low and catch‐up’ (OR = 2.83;95%CI 1.34‐5.96, Pint = 0.05) and ‘below average’ trajectories (OR = 2.39; 1.18‐7.23, Pint = 0.02) were associated with allergic rhinitis at 18 years of age compared with the average trajectory. No associations were observed with eczema or food sensitisation.

Conclusion

Infants with early‐low and catch‐up, or below average BMI growth, were at increased risk of allergic rhinitis at 18 years if they had a mother with allergic rhinitis. These results require replication, but suggest that interactions between poor intrauterine growth, failure to thrive and maternal allergies may influence the risk of allergic rhinitis.
Soil fauna and its potential use in the ecological restoration of dryland ecosystems
Authors: Morales‐Márquez Jimmy , Meloni Fernando
Published: March 2022

In dryland environments, where rain is scarce and unpredictable, ecological restoration of degraded ecosystems presents significant challenges. Several restoration techniques based on the functioning of ecosystems have emerged, emphasizing the ecological interactions that promote natural succession. In other environments, the use of soil fauna has been recommended to help accelerate ecological succession due to its effects on the maintenance and improvement of the physical–chemical and biological properties of the soil. Soil fauna is also a seed disperser. It indirectly contributes to the early regeneration of the aboveground community, controls pests, and directly contributes to the maintenance of biological processes in soil. However, its use to restore dryland environments has seldom been considered. Based on a bibliographic review, several key aspects of the importance and the use of soil fauna in the ecological restoration of dryland ecosystems are discussed, and several recommendations are given. The successional, spatial, and functional aspects are considered to focus on the restoration context. In addition, technical recommendations are provided to accelerate the rapid colonization of soil fauna and to foster the recovery of soil processes. And lastly, the importance of carrying out future manipulative studies investigating the effects of specific soil groups on dryland ecological restoration is highlighted, specifically regarding the improvement of functional parameters such as soil stability and quality.
Bronchoscopic approaches to sampling lung nodules: Aiming for the bulls eye
Authors: Garner Justin L. , Shah Pallav L.
Published: March 2022

See related article
A case study of strategies for intentionally building course community to support diverse learners in an introductory statistics course
Authors: Taylor Laura L. , Doehler Kirsten , VanKrevelen Ryne , Weaver Mark A. , Trocki Aaron D.
Published: March 2022

This article presents a multi‐part initiative to support diverse learners by building class community and peer networks in an introductory statistics course. This was accomplished through multiple techniques, such as implementing icebreaker questions and using randomly assigned student working groups. The Socrative online software utilized regularly by instructors allowed students to be randomized into groups to collaboratively answer questions provided by the instructors. A multi‐part group project was also administered where students worked cooperatively to analyze swim race data from the 2016 Olympics. Students completed a pre‐semester survey in which they provided feedback on previous mathematics or statistics courses related to the level of course engagement, the benefit of group learning, and their ability to discuss course content during class. A post‐semester survey was administered to answer similar questions regarding the statistics course they were currently taking.
Percepción de formas de discriminación en contextos cotidianos de mujeres inmigrantes usuarias de Centros de Salud Familiar de Valparaíso, Chile
Authors: Sánchez Segura Ximena del Carmen , Casanueva Valdés Daniela , Vilugrón Fabiola
Published: March 2022

Introducción. Los procesos migratorios han generado nuevas formas de exclusión territorial y de discriminación en Latinoamérica. Objetivo. Describir la discriminación percibida en distintos contextos por mujeres inmigrantes usuarias de los Centros de Salud Familiar (CESFAM) de la Corporación Municipal de Valparaíso, Chile. Métodos. Se realizó un estudio de tipo descriptivo-cualitativo con enfoque fenomenológico en el que participaron 17 mujeres inmigrantes usuarias de CESFAM. Se realizaron entrevistas semiestructuradas, con consentimiento informado y anonimato de la fuente. Se construyó una matriz de análisis sobre la discriminación que sufren las mujeres inmigrantes en espacios públicos, laborales, educativos y centros de salud. Resultados. Se observan como rasgos de la situación migratoria la nacionalidad y el color de piel motiva a realizar actos de discriminación. Conclusiones. Se necesita una mayor comprensión del fenómeno migratorio por su creciente aumento en el país. En este sentido, es importante, elaborar y orientar políticas públicas que permitan responder a las demandas existentes, en especial aquellas referidas a la integración y superación de las desigualdades.
O poder simbólico e a gestão dos hospitais em municípios de pequeno porte
Authors: Souza Francisco Eugenio Alves de , Nunes Elisabete de Fatima Polo de Almeida , Carvalho Brígida Gimenez , Mendonça Fernanda de Freitas , Narciso Argéria Maria Serraglio , Domingos Carolina Milena
Published: March 2022

Introdução. Nos pequenos municípios, a existência de hospitais de pequeno porte constitui-se mais em gerador de problemas do que de soluções. Objetivo. Compreender os aspectos que interferem na gestão dos hospitais de pequeno porte sob o enfoque de conceitos teóricos de Pierre Bourdieu. Métodos. Realizou-se um estudo qualitativo em hospitais de 14 municípios no norte do Paraná, Brasil. Foram utilizados dados secundários e entrevistas semiestruturadas com secretários de saúde e diretores dos hospitais. Finalmente, realizou-se uma análise compreensiva e interpretativa articulada às formulações de Bourdieu. Resultados. Os resultados foram organizados em duas categorias. A primeira tratou do desafio de manter um serviço de saúde que, além de gerar despesas onerosas, traz poucos resultados na prestação de serviços à população. A segunda revelou como o jogo político torna o processo de gestão dos hospitais de pequeno porte uma tarefa complexa e desafiadora. Conclusões. Apesar de os hospitais de pequeno porte não constituírem instituições eficientes para prover assistência à saúde para as populações às quais se destinam, têm-se mantido historicamente. Isso deve-se, por um lado, à influência do habitus coletivo cultural desse valor existente entre a população e, por outro, à força do poder simbólico que mobiliza os gestores/agentes políticos dominantes.
Knowledge Discovery in Engineering Applications Using Machine Learning Techniques
Authors: Kubik Christian , Molitor Dirk Alexander , Becker Marco , Groche Peter
Published: March 2022

Sensorial acquired process data combined with machine learning (ML) algorithms are fundamental for mastering the challenges of modern production systems, however, their potential is rarely exploited in real-world manufacturing applications. In this context, the literature presents systematic procedure models to generate knowledge from data, such as the cross industry standard process for data mining (CRISP-DM) model, which is used as a standard methodology for conducting data mining in industrial applications. However, these models do not take into account boundary conditions of manufacturing processes as well as the characteristics of the sensorial acquired data within these systems to generate knowledge. Therefore, this work presents a novel procedure model for knowledge discovery in time series and image data in engineering applications (KDT-EA). A holistic view of knowledge discovery in manufacturing processes becomes feasible with a strong focus on data acquisition, data preprocessing, and data transformation to generate reliable input data for ML models estimating the actual state of manufacturing processes. The process model supports operators in industry setting up a suitable measurement chain acquiring high-quality data and selecting preparation techniques depending on superimposed disturbances. Furthermore, it suggests data transformation techniques reducing the amount of data without losing informational value and establishing a basis for product-related inline monitoring. To quantify the benefits of KDT-EA and the impact of its phase on the quality of the generated knowledge, the novel procedure model is applied to an application in the field of inline wear detection on a sheet metal forming tool.
Experimental Investigations on Performance Analysis of a Wickless Thermosiphon Heat Pipe With Two Heat Sources and Multiple Branches
Authors: Bhatt Anand A. , Jain Sanjay V. , Patel Rajesh N.
Published: March 2022

In an electronic circuit of laptops, supercomputers with multiple central processing units, spacecraft etc., it is required to arrange the cooling system for multiple heat loads in the smallest possible space in view of power-saving opportunities. In the present study, the experimental investigations are carried out on a wickless multi-branch heat pipe in gravity-assisted mode with two evaporators and one condenser on each of the individual branches. The start-up and dynamic characteristics were studied with different filling ratios (range, 40–70%), with equal heat loads (range, 0–200 W) and unequal heat loads (range, 0–100 W) on evaporators. The results are analyzed in terms of temperature variation in axial direction, thermal resistance, and heat transfer coefficient for a multi-branch thermosiphon heat pipe (MBTHP). It was found that the optimal filling ratio depends on the applied heat load under tested conditions. In a thermosiphon mode, the heat pipe was capable of transporting a maximum heat load of 210 W and maximum heat flux of 20.31 W/cm2 with the maximum evaporator temperature lower than 100 °C. The minimum wickless thermal resistance of heat pipe was found to be 0.21 °C/W at 50% filling ratio and 160 W and maximum total heat transfer coefficient was found as 6.33 k W/m2 °C.
A theoretical and experimental investigation of the nonlinear acoustic response of acoustic insertion elements
Authors: Humphreys Luke H. , Van Horn Eric M. , Scarborough David E.
Published: March 2022

In a previous paper, a model was developed for the nonlinear acoustic resistance for compact insertion elements. Within the model, two loss coefficients are used to tune the model for each type of element, and data were used to empirically determine these coefficients for an area contraction. This paper extends the nonlinear model, developing expressions based on physical principles for the forward and reverse loss coefficients for both an area contraction and orifice. In addition, experimental data for the acoustic resistance of both elements was taken using an impedance tube. Utilizing the expressions developed, the model compares favorably with the experimental data.
Making the switch: The role of Gq in driving GRK selectivity at GPCRs
Authors: Sarma Parishmita , Saha Shirsha , Shukla Arun K.
Published: March 2022

Selective engagement of signal transducers such as G proteins and β-arrestins with GPCRs upon stimulation with biased agonists is thought to be due to distinct receptor conformations. Kawakami
et al.
propose an additional mechanism whereby activation of Gq determines GPCR kinase subtype selectivity to the activated angiotensin receptor, leading to distinct binding modalities of β-arrestins and functional outcomes.
Compartmentalized prions
Authors: VanHook Annalisa M.
Published: March 2022

The restriction of the yeast prion-like protein Whi3 to particular regions of the ER prevents its transmission to daughter cells.
Therapeutic treatment with an oral prodrug of the remdesivir parental nucleoside is protective against SARS-CoV-2 pathogenesis in mice
Authors: Schäfer Alexandra , Martinez David R. , Won John J. , Meganck Rita M. , Moreira Fernando R. , Brown Ariane J. , Gully Kendra L. , Zweigart Mark R. , Conrad William S. , May Samantha R. , Dong Stephanie , Kalla Rao , Chun Kwon , Du Pont Venice , Babusis Darius , Tang Jennifer , Murakami Eisuke , Subramanian Raju , Barrett Kimberly T. , Bleier Blake J. , Bannister Roy , Feng Joy Y. , Bilello John P. , Cihlar Tomas , Mackman Richard L. , Montgomery Stephanie A. , Baric Ralph S. , Sheahan Timothy P.
Published: March 2022

The coronavirus disease 2019 (COVID-19) pandemic remains uncontrolled despite the rapid rollout of safe and effective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines, underscoring the need to develop highly effective antivirals. In the setting of waning immunity from infection and vaccination, breakthrough infections are becoming increasingly common and treatment options remain limited. In addition, the emergence of SARS-CoV-2 variants of concern, with their potential to escape neutralization by therapeutic monoclonal antibodies, emphasizes the need to develop second-generation oral antivirals targeting highly conserved viral proteins that can be rapidly deployed to outpatients. Here, we demonstrate the in vitro antiviral activity and in vivo therapeutic efficacy of GS-621763, an orally bioavailable prodrug of GS-441524, the parent nucleoside of remdesivir, which targets the highly conserved virus RNA-dependent RNA polymerase. GS-621763 exhibited antiviral activity against SARS-CoV-2 in lung cell lines and two different human primary lung cell culture systems. GS-621763 was also potently antiviral against a genetically unrelated emerging coronavirus, Middle East respiratory syndrome CoV (MERS-CoV). The dose-proportional pharmacokinetic profile observed after oral administration of GS-621763 translated to dose-dependent antiviral activity in mice infected with SARS-CoV-2. Therapeutic GS-621763 administration reduced viral load and lung pathology; treatment also improved pulmonary function in COVID-19 mouse model. A direct comparison of GS-621763 with molnupiravir, an oral nucleoside analog antiviral that has recently received EUA approval, proved both drugs to be similarly efficacious in mice. These data support the exploration of GS-441524 oral prodrugs for the treatment of COVID-19.
A Resourceful Race: Bacterial Scavenging of Host Sulfur Metabolism during Colonization
Authors: Kies Paige J. , Hammer Neal D.
Published: March 2022

Sulfur is a requirement for life. Therefore, both the host and colonizing bacteria must regulate sulfur metabolism in a coordinated fashion to meet cellular demands.
Development and Validation of a Novel Anaerobic Carbapenem Inactivation Method (Ana-CIM) for the Detection of Carbapenemase Production in Bacteroides fragilis
Authors: Eberly Allison R. , Wallace Meghan A. , Shannon Samantha , Heitman Angela K. , Schuetz Audrey N. , Burnham Carey-Ann D. , Jean Sophonie
Published: March 2022

Antibiotic resistance, particularly to carbapenems, is of increasing concern in
Bacteroides fragilis
. Carbapenem resistance in
B. fragilis
is most often mediated by the activation of chromosomally encoded metallo-β-lactamase
cfiA
by the presence of an upstream insertion sequence (IS).
Modulation of Gut Microbiota Metabolism in Obesity-Related Type 2 Diabetes Reduces Osteomyelitis Severity
Authors: Bui Tina I. , Gill Ann Lindley , Mooney Robert A. , Gill Steven R.
Published: March 2022

Individuals with obesity-related type 2 diabetes (obesity/T2D) are at a five times increased risk for invasive
Staphylococcus aureus
osteomyelitis (bone infection) following orthopedic surgeries. With increasing antibiotic resistance and limited discoveries of novel antibiotics, it is imperative that we explore other avenues for therapeutics.
Genomic and Phenotypic Characterization of the Nontoxigenic Clostridioides difficile Strain CCUG37785 and Demonstration of Its Therapeutic Potential for the Prevention of C. difficile Infection
Authors: Wang Shaohui , Heuler Joshua , Wickramage Ishani , Sun Xingmin
Published: March 2022

Clostridioides difficile
infection (CDI) symptoms range from diarrhea to intestinal inflammation/lesion and death and are mainly caused by two exotoxins, TcdA and TcdB. Active vaccination provides the attractive opportunity to prevent CDI and recurrence.
Supplemental Material: Late Holocene increase of winter precipitation in mid-continental North America from a seasonally resolved speleothem record
Authors: Batchelor Cameron J. , al. et
Published: March 2022

Extended methods, further discussion of the interpretation of fluorescent banding, and supplemental figures.
Supplemental Material: Provenance of early Paleogene strata in the Bighorn Basin (Wyoming, USA): Implications for Laramide tectonism and basin-scale stratigraphic patterns
Authors: Welch J.L. , al. et
Published: March 2022

Table S1: Paleocurrent measurements and locations and Table S2: Point-count data
Ocular morbidity in Marfan syndrome: a nationwide epidemiological study
Authors: Kjeldsen Sia , Andersen Niels , Groth Kristian , Larsen Dorte , Hjortdal Jesper , Berglund Agnethe , Gravholt Claus , Stochholm Kirstine
Published: March 2022

Background

Ophthalmic complications are profound in Marfan syndrome (MFS). However, the overall burden is not well described. Our purpose was to evaluate the ocular morbidity in a nationwide perspective.

Methods

We identified the ocular morbidity in patients with MFS (n=407) by use of Danish national healthcare registers, using number and timing of hospital contacts related to ophthalmic diagnoses, to ophthalmic surgery and to prescriptions for ophthalmic medication. An age-matched and gender-matched background population (n=40 700) was used as comparator.

Results

Among MFS, 56% (226/407) of the patients had at least one registration of an ophthalmic diagnosis as inpatient or outpatient during the study period (HR of 8.0 (95% CI 7.0 to 9.2)). Seven out of 11 main groups of diagnoses were affected, including ‘Lens’, ‘Choroid and retina’, ‘Ocular muscles, binocular movement, accommodation and refraction’, ‘Glaucoma’, Visual disturbances and blindness’, ‘Vitreous body and globe’, and ‘Sclera, cornea, iris and ciliary body’. The number of surgical procedures as well as the use of ophthalmic medication in patients with MFS was significantly increased.

Conclusion

This nationwide epidemiological study of ocular morbidity in MFS demonstrates a profound burden and emphasises the need for thorough and experienced ophthalmological surveillance.
Fostering gender equality and reproductive and sexual health among adolescents: results from a quasi-experimental study in Northern Uganda
Authors: Dagadu Nana Apenem , Barker Kathryn M , Okello Sam B T , Kerner Brad , Simon Callie , Nabembezi Dennis , Lundgren Rebecka Inga
Published: March 2022

Objective

To assess the impact of the Gender Roles, Equality and Transformations (GREAT) intervention: a narrative-based, resource-light, life-stage tailored intervention package designed to promote gender-equitable attitudes and behaviours, and improve sexual and reproductive health (SRH) and gender-based violence (GBV) outcomes among adolescents and their communities.

Design

Repeated cross-sectional evaluation study, using propensity score matching combined with difference-in-difference estimation.

Setting

Two postconflict communities in Lira and Amuru districts in Northern Uganda.

Participants

Male and female unmarried adolescents (10–14 years, 15–19 years), married adolescents (15–19 years) and adults (over the age of 19 years) were selected using a stratified, two-stage cluster sample of primary and secondary schools and households (baseline: n=2464, endline: n=2449).

Primary outcome measures

Inequitable gender attitudes and behaviours; GBV; and SRH knowledge and behaviours.

Results

Statistically significant intervention effects were seen across all three outcomes—gender equity, GBV and SRH—among older and newly married adolescents and adults. Among older adolescents, intervention effects include shifts on: inequitable gender attitudes scale score: −4.2 points ((95% CI −7.1 to –1.4), p<0.05); Inequitable household roles scale score: −11.8 ((95% CI −15.6to –7.9), p<0.05); Inequitable attitudes towards GBV scale: −1.9 ((95% CI −5.0 to –0.2), p<0.05); per cent of boys who sexually assaulted a girl in past 3 months: −7.7 ((95% CI −13.1 to –2.3), p<0.05); inequitable SRH attitudes scale: −10.1 ((95% CI −12.9 to –7.3), p<0.05). Among married adolescents, intervention effects include shifts on: Inequitable household roles scale score: −6.5 ((95% CI −10.8 to –2.2), p<0.05); inequitable attitudes towards GBV scale: −4.7 ((95% CI −9.8 to –0.3), p<0.05); per cent who reacted violently to their partner: −15.7 ((95% CI −27.1 to –4.4), p<0.05); inequitable SRH attitudes scale: −12.9 ((95% CI −17.3 to –8.5), p<0.05).

Conclusion

The GREAT intervention model demonstrates the promise of a resource-light, life-stage tailored programme that employs culturally appropriate, participatory and narrative-based techniques to advance gender equity and adolescent health. This type of programming contributes towards reductions in GBV and improved adolescent SRH outcomes.
Big Data Reality Check (BDRC) for public health: to what extent the environmental health and health services research did meet the ‘V’ criteria for big data? A study protocol
Authors: Tang Pui Pui , Tam I Lam , Jia Yongliang , Leung Siu-wai
Published: March 2022

Introduction

Big data technologies have been talked up in the fields of science and medicine. The V-criteria (volume, variety, velocity and veracity, etc) for defining big data have been well-known and even quoted in most research articles; however, big data research into public health is often misrepresented due to certain common misconceptions. Such misrepresentations and misconceptions would mislead study designs, research findings and healthcare decision-making. This study aims to identify the V-eligibility of big data studies and their technologies applied to environmental health and health services research that explicitly claim to be big data studies.

Methods and analysis

Our protocol follows Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Scoping review and/or systematic review will be conducted. The results will be reported using PRISMA for Scoping Reviews (PRISMA-ScR), or PRISMA 2020 and Synthesis Without Meta-analysis guideline. Web of Science, PubMed, Medline and ProQuest Central will be searched for the articles from the database inception to 2021. Two reviewers will independently select eligible studies and extract specified data. The numeric data will be analysed with R statistical software. The text data will be analysed with NVivo wherever applicable.

Ethics and dissemination

This study will review the literature of big data research related to both environmental health and health services. Ethics approval is not required as all data are publicly available and involves confidential personal data. We will disseminate our findings in a peer-reviewed journal.

PROSPERO registration number

CRD42021202306.
Hospital nurse staffing and sepsis protocol compliance and outcomes among patients with sepsis in the USA: a multistate cross-sectional analysis
Authors: Dierkes Andrew M , Aiken Linda H , Sloane Douglas M , Cimiotti Jeannie P , Riman Kathryn A , McHugh Matthew D
Published: March 2022

Objectives

Sepsis is a serious inflammatory response to infection with a high death rate. Timely and effective treatment may improve sepsis outcomes resulting in mandatory sepsis care protocol adherence reporting. How the impact of patient-to-nurse staffing compares to sepsis protocol compliance and patient outcomes is not well understood. This study aimed to determine the association between hospital sepsis protocol compliance, patient-to-nurse staffing ratios and patient outcomes.

Design

A cross-sectional study examining hospital nurse staffing, sepsis protocol compliance and sepsis patient outcomes, using linked data from nurse (2015–2016, 2020) and hospital (2017) surveys, and Centers for Medicare and Medicaid Services Hospital Compare (2017) and corresponding MedPAR patient claims.

Setting

537 hospitals across six US states (California, Florida, Pennsylvania, New York, Illinois and New Jersey).

Participants

252 699 Medicare inpatients with sepsis present on admission.

Measures

The explanatory variables are nurse staffing and SEP-1 compliance. Outcomes are mortality (within 30 and 60 days of index admission), readmissions (within 7, 30, and 60 days of discharge), admission to the intensive care unit (ICU) and lengths of stay (LOS).

Results

Sepsis protocol compliance and nurse staffing vary widely across hospitals. Each additional patient per nurse was associated with increased odds of 30-day and 60-day mortality (9% (OR 1.09, 95% CI 1.05 to 1.13) and 10% (1.10, 95% CI 1.07 to 1.14)), 7-day, 30-day and 60-day readmission (8% (OR 1.08, 95% CI 1.05 to 1.11, p<0.001), 7% (OR 1.07, 95% CI 1.05 to 1.10, p<0.001), 7% (OR 1.07, 95% CI 1.05 to 1.10, p<0.001)), ICU admission (12% (OR 1.12, 95% CI 1.03 to 1.22, p=0.007)) and increased relative risk of longer LOS (10% (OR 1.10, 95% CI 1.08 to 1.12, p<0.001)). Each 10% increase in sepsis protocol compliance was associated with shorter LOS (2% ([OR 0.98, 95% CI 0.97 to 0.99, p<0.001)) only.

Conclusions

Outcomes are more strongly associated with improved nurse staffing than with increased compliance with sepsis protocols.
Clinical and economic impact of extracardiac lesions on coronary CT angiography
Authors: Kelion Andrew , Sabharwal Nikant , Holdsworth David , Dawkins Sam , Peschl Heiko , Sykes Anny , Bashir Yaver
Published: March 2022

Objective

When reporting coronary CT angiography (CCTA), extracardiac structures are routinely assessed, usually on a wide field-of-view (FOV) reconstruction. We performed a retrospective observational cross-sectional study to investigate the impact of incidental extracardiac abnormalities on resource utilisation and treatment, and cost-effectiveness.

Methods

All patients undergoing CCTA at a single institution between January 2012 and March 2020 were identified. The indication for CCTA was chest pain or dyspnoea in >90%. Patients with ≥1 significant extracardiac findings were selected. Clinical follow-up, investigations and treatment were documented, and costs were calculated.

Results

4340 patients underwent CCTA; 717 extracardiac abnormalities were identified in 687 individuals (15.8%; age 62±12 years; male 336, 49%). The abnormality was already known in 162 (23.6%). Lung nodules and cysts were the most common abnormalities (296, 43.1%). Clinical and/or imaging follow-up was pursued in 292 patients (42.5%). Treatment was required by 14 patients (0.3% of the entire population), including lung resection for adenocarcinoma in six (0.1%). All but two abnormalities (both adenocarcinomas) were identifiable on the limited cardiac FOV. The cost of reporting (£20) and follow-up (£33) of extracardiac abnormalities was £53 per patient. The cost per discounted quality-adjusted life year was £23 930, increasing to £46 674 for reporting the wide FOV rather than the cardiac FOV alone.

Conclusions

Extracardiac abnormalities are common on CCTA, but identification and follow-up are costly. The few requiring treatment are usually identifiable without review of the wide FOV. The way in which CCTAs are scrutinised for extracardiac abnormalities in a resource-limited healthcare system should be questioned.
COVID-19 deaths in care homes: primary care management study
Authors: Jones Clifford Wyn , Taylor Liam , Clement-Rees Aimee
Published: March 2022

Objectives

COVID-19 presented a new risk to the care home sector. Primary care adapted their approach to the management of COVID-19 in care homes as the pandemic evolved. Our aim was to evaluate the clinical presentation, management, care planning and clinical decision-making, and after death care of care home residents who died due to COVID-19 in Aneurin Bevan University Health Board in Southeast Wales.

Method

Clinical records of 136 in care homes were reviewed by a General Practitioner reviewer using a standardised template. These were then reviewed by a multidisciplinary panel to identify themes.

Results

Most individuals presented with ‘typical’ COVID-19 symptoms (cough, fever); however, >50 presented with atypical symptoms. 90% had a record of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision, but only 46% had documented advance care planning (ACP), and only 37% had a clearly documented treatment escalation plan.

Conclusion

Care home residents are at risk of sudden clinical deterioration and death. This evaluation demonstrates that although DNACPR is in place for most individuals, holistic planning for end of life (including ACP and clinical care plans covering management of deterioration and escalation of care) is only present for a minority.
Perspectives on recovery from older adult trauma survivors living in rural areas
Authors: Duchin Emma R , Neisinger Lisa , Reed May J , Gause Emma , Sharninghausen Jody , Pham Tam
Published: March 2022

Background

Older patients living in rural areas face unique challenges after trauma that may hinder optimal recovery. This study aims to qualitatively assess postdischarge challenges in this vulnerable population.

Methods

We conducted remote interviews with older trauma survivors in Washington State previously hospitalized in 2019 and residing in rural areas as determined by rural–urban commuting area code. Participants were identified through our institution’s trauma registry and linked with postdischarge data. All eligible participants were contacted. Interview questions focused on needs relating to discharge transition, medical needs, housing, and daily living. Transcribed interviews underwent content analysis to derive a code hierarchy and themes.

Results

We conducted 18 interviews out of 83 survivors queried. Compared with non-participants, interviewees had a higher rate of secondary insurance (61% vs 34%), and fewer had an emergency department visit within 1 year (22% vs 34%). Content analysis yielded four major themes: discharge transitions, loss of control, rural insights, and self-efficacy. Most patients felt prepared for discharge and had social support. Regardless of disposition type, most patients needed therapy sessions after discharge. Geography and transportation issues were among the biggest barriers. Most participants were never offered a telemedicine appointment but would have used it if offered. Subthemes of self-efficacy included financial security, leisure, personal outlook, physical and logistical resources, and participants’ support systems.

Discussion

Older trauma patients from rural areas face unique challenges after discharge. Key strategies to improve patient experience might include more telemedicine appointments and increased awareness of resources in rural communities.

Level of evidence

III.
Spin correlation coefficients in lepton–deuteron elastic scattering and their sensitivity to realistic NN potentials
Authors: Darwish E. M. , Mahmoud Z. M. M. , Al-Thoyaib S. S.
Published: March 2022

Spin correlation coefficients in the elastic scattering of leptons on the deuteron, [Formula: see text], are studied in the one-photon-exchange approximation within the limit of zero lepton mass. Numerical estimations for the spin correlation coefficients caused by a polarized beam and a vector polarized target are given. The estimated spin correlation coefficients are analyzed at various values of beam energy and scattering angle. The sensitivity of the obtained results to the choice of realistic NN potential used for the deuteron wave function is investigated. We found a considerable dependence of the results on the realistic deuteron wave functions at incident beam energies greater than 0.4 GeV and backward scattering angles. The estimated results are of particular interest for encouragement of experimental measurements of lepton–deuteron scattering which aim for accurate calculation of the charge radius of the proton to a high degree of precision. These results may also stimulate new generation of measurements of different physical observables very sensitive to the spin structure of the nucleon and light nuclei.
Possible antimagnetic rotation in 99Pd
Authors: Sihotra S.
Published: March 2022

The reduced electric quadrupole transition rates have been calculated for states of the negative parity band in the [Formula: see text]Pd nucleus using semiclassical particle-rotor model calculations. The calculated transition rates are found to decrease with increasing spin states. The dynamic moment of inertia [Formula: see text] of the states above I = [Formula: see text] are found to be large. The spin ([Formula: see text]) versus frequency ([Formula: see text]) plot obtained from the semiclassical model for the configuration [Formula: see text] ⊗[Formula: see text] is found to agree with the experimental data, which suggests a possible anti magnetic rotational character in the negative parity band.
Anisotropic stellar model in F(T,𝒯 ) gravity under the Karmarkar condition
Authors: Gudekli Ertan , Zubair M. , Kamran M. Junaid , Ahmed Iftikhar
Published: March 2022

In this study, we have explored an anisotropic stellar configuration by applying the Karmarkar condition in the framework of [Formula: see text] [where [Formula: see text] and [Formula: see text] stand for torsion and trace of energy–momentum tensor (EMT)] gravity. We have developed field equations of [Formula: see text] gravity for a spherically symmetric line element and considered a viable [Formula: see text] model, i.e. [Formula: see text] (where [Formula: see text] and [Formula: see text] are arbitrary constants) for meaningful results. Following [S. K. Maurya, B. S. Ratanpal and M. Govender, Ann. Phys. 382 (2017) 36], a spherically symmetric solution of embedding class I has been explored which resulted into a generalized compact stellar model. For the evaluation of unknown parameters, we use the matching conditions at the boundary by taking spherical space-time metric as interior and Schwarzschild space-time solution as exterior space-time metric. The viability of our proposed model is checked by exploring the nature of thermodynamical variables ([Formula: see text], [Formula: see text], [Formula: see text]), anisotropy, energy condition, Tolman–Oppenheimer–Volkov (TOV) forces, Abreu condition, equation of state parameters and adiabatic index taking the observational data of different compact stars like PSR J1416-2230, 4U 1608-52, Cen X-3, EXO 1785-248 and SMC X-1. Our stellar model is found.
Environmental Impact Assessment Analysis in the Kahak’s Wind Farm
Authors: Rasoulinezhad Ehsan
Published: March 2022

The relationship between the environment and green projects has become an important issue since the 1970s. This issue is of particular importance for Iran, which seeks to solve the problem of environmental pollution caused by the consumption of fossil fuels and also seeks to increase the participation of green energy in the economy through the development of green projects. This study aims to investigate the environmental impact of the Kahak wind farm project in the Qazvin province of Iran. In this regard, the opinions of 10 green project experts and the Riam matrix method were used as a flexible and acceptable method in calculating the environmental impact of economic projects in this paper. The results revealed that this wind farm project positively impacts air quality and climate, social welfare, and hydraulic resource. At the same time, patrimony, fauna, and vegetation are affected negatively by this project. As the practical policy implications, the paper recommends strategies to increase private sector participation, combined location of green projects based on feasibility and environmental impacts, and establishment of Regional Green Development Projects (RGDP).
Pedestrian Trajectory Prediction in Heterogeneous Traffic using Facial Keypoints-based Convolutional Encoder-decoder Network
Authors: Xiao Song , Chen Kai , Ren Xiaoxiang , Yuan Haitao
Published: March 2022

Future pedestrian trajectory prediction offers great prospects for many practical applications such as unmanned vehicles, building evacuation design and robotic path planning. Most existing methods focus on social interaction among pedestrians but ignore the fact that heterogeneous traffic objects (cars, dogs, bicycles, motorcycles, etc.) have significant influence on the future trajectory of a subject pedestrian. Also, the walking direction intention of a pedestrian may be referred by his/her facial keypoints. Considering this, this work proposes to predict a pedestrian's future trajectory by jointly using neighboring heterogeneous traffic information and his/her facial keypoints. To fulfill this, an end-to-end
facial keypoints-based convolutional encoder-decoder network (FK-CEN)
is designed, in which the heterogeneous traffic and facial keypoints are input. After training, FK-CEN is evaluated on 5 crowded video sequences collected from the public datasets MOT-16 and MOT-17. Experimental results demonstrate that it outperforms state-of-the-art approaches, in terms of prediction errors.
Nonlinear Phase-Field Modeling of Lithium Dendritic Growth during Electrodeposition
Authors: Jing Hanxu , Xing Hui , Dong Xianglei , Han Yongsheng
Published: March 2022

Lithium batteries have been widely used, but the growth of lithium dendrites does lead to some hazards, such as internal short circuit, thermal runaway and even explosion. In paper, a nonlinear phase field model combined with Butler-Volmer expression was developed to study dendrite growth during electrodeposition. Two types of initial electrode-electrolyte interface are applied in numerical simulations. Results show that the cation concentration enrichment occurs near the dendritic tip due to the electromigration, and the curve of the growth velocity versus time follows a simple power law relation, indicating that the stability of the dendritic array originating from initial electrode-electrolyte interface can be broken with the applied electrical potential increasing. Moreover, we found that applied electric potential gradient can strongly influence the dendritic growth velocity and the dendritic growth during electrodeposition is less relative to the surface tension anisotropy.
Promoting CO2 Release from CO3
2−-Containing Solvents during Water Electrolysis for Direct Air Capture
Authors: Gao Xin , Omosebi Ayokunle , Perrone Roger , Liu Kunlei
Published: March 2022

The pH swings from water electrolysis are leveraged to condition OH−-based facile CO2 capture solvents using an electrochemical flow cell for direct air capture (DAC). Besides demonstrating the DAC using a membrane contactor, promoting CO2 release from a CO3
2− solution at the anode is specifically studied by adjusting the volumetric flow rate, anode chamber volume, residence time, and K2CO3 concentration. Through case-by-case comparisons coupled with modeled results, increasing current, reducing volumetric flow rate, and/or reducing CO3
2− concentration are the effective methods to promote CO2 release from a CO3
2−-containing solvent, whereas enlarging the anode chamber volume poses a minor effect. Moreover, the discrepancies between the experimental and modeled results may be caused by H+ crossover rather than K+ transport through the Nafion membrane during water electrolysis based upon the total alkalinity measurements for the K2CO3 solutions gleaned from the anode. It is believed that such results will provide guidance to design and operate an electrochemical flow cell for electrochemistry-assisted DAC and point source CO2 capture.
Impact of Vitamin C on Gene Expression Profile of Inflammatory and Anti-Inflammatory Cytokines in the Male Partners of Couples with Recurrent Pregnancy Loss
Authors: Fesahat Farzaneh , Norouzi Efat , Seifati Seyed Mohammad , Hamidian Saeideh , Hosseini Akram , Zare Fateme
Published: March 2022

Immune system disorders and increased inflammation in the male reproductive system can lead to fetal risk in the early stages of development and implantation. Antioxidants such as vitamin C can play a protective role against sperm inflammatory reactions. This study aimed to evaluate the effect of vitamin C on the expression of inflammatory and anti-inflammatory cytokine genes in the male partners of couples with recurrent pregnancy loss. In this randomized clinical trial, twenty male partners of couples with RPL were examined for sperm parameters and expression profile of some inflammatory and anti-inflammatory cytokine genes before and after treatment with vitamin C. There was a statistically significant higher rate of normal morphology and sperm concentration in each patient before and after treatment with vitamin C

p
≤
0.05

. The mRNA levels of interleukin 6 and tumor necrosis factor-alpha were significantly decreased in the sperm of patients after treatment with vitamin C compared to before treatment. In contrast, the gene expression levels of interleukin 4 and transforming growth factor-beta showed a significant increase in the sperm of patients after treatment with vitamin C. Oral daily administration of vitamin C may be effective in the fertility potential of male partners of couples with RPL not only through the improvement of the sperm parameters but also by modulating the expression profile of inflammatory and anti-inflammatory genes. Further studies on protein levels are needed to clarify the role of TNF-⍺ and IFN-γ as a prognostic value in evaluating the recurrent abortion risk in infertile male partners. This trial is registered with IRCT20180312039059N1.
Personalized Product Recommendation Model of Automatic Question Answering Robot Based on Deep Learning
Authors: Peng Jie , Xu Jianhui
Published: March 2022

The collaborative filtering algorithm widely used in recommendation systems has problems with the sparsity of scoring data and the cold start of new products. A personalized product recommendation model for automated question-answering robots using deep learning is proposed. First, a personalized attention mechanism at the word level and the comment level is proposed, and the comments and users are individually coded. Then, the bidirectional gated recurrent unit (Bi-GRU) is used to construct the score prediction matrix, and through the dynamic collaborative filtering algorithm to integrate the time characteristics of the user’s interest changes. Finally, the feature codes of the users and products are input into the Bi-GRU model for learning, so as to output the recommendation list of personalized products of the automated question answering robot. Experimental results based on the JD and Tianchi datasets show that the training loss of the proposed model is lower than 45 and 23, respectively. And HR@15 and MRR@15 exceed 48 and 15, respectively, which are better than other comparison models. It can better adapt to the actual needs of automatic question-answering robots.
Dynamic Allocation and Sharing of Millimeter-Wave Spectrum with Indoor Small Cells in Multioperator Environments toward 6G
Authors: Saha Rony Kumer
Published: March 2022

In this article, we propose a two-level dynamic spectrum allocation and sharing (DSAS) technique to address both spectrum liberalization and spectrum flexibility for more progressive spectrum management so as to improve the countrywide spectrum utilization of the 28-GHz millimeter-wave (mmWave). More specifically, to liberalize allocating countrywide spectrum to MNOs, in level 1 (i.e., primary) spectrum allocation (PSA), each mobile network operator (MNO) is assigned with an amount of 28-GHz spectrum corresponding to its number of subscribers for a certain spectrum renewal term, whereas, to exploit spectrum flexibility, in level 2 (i.e., secondary) spectrum sharing (SSS), when no user equipment is present inside the building, the allocated spectrum to an MNO in PSA is allowed to share with small cells of another MNO in a building. We estimate the amount of spectrum for each MNO in both PSA and SSS. We derive system-level average capacity, spectral efficiency (SE), energy efficiency (EE), and cost efficiency (CE) for the proposed DSAS technique, as well as the traditional static licensed spectrum access (SLSA) technique as a baseline. In addition, we discuss the implementation perspectives of DSAS. With numerical and simulation studies on an arbitrary country with four MNOs, we evaluate and then compare the performances of both the proposed DSAS technique and the SLSA technique. It is shown that the DSAS technique can improve both the capacity and the SE by 204.78%, whereas the EE and the CE by 67.19%, over that of the SLSA technique. Finally, we show that, by applying the DSAS technique, the prospective requirements of SE and EE for sixth-generation (6G) networks can be achieved by reusing the 28-GHz spectrum to 64.86% fewer buildings of small cells than that required by the SLSA technique.