bluuebunny/crossref_metadata_2025 huggingface dataset:
Sb2O3‐modified lead zirconate titanate piezoelectric ceramics with enhancing piezoelectricity and low loss
Authors: Fei Xuan , Lin Xiujuan , Wang Chao , Li Wenlong , Yu Feng , Yang Changhong , Huang Shifeng
Published: September 2022

Lead zirconate titanate (PZT)–based piezoelectric ceramics as important functional materials are widely used in many electromechanical devices. The piezoelectric coefficient and mechanical quality factor are vital property parameters for piezoelectric applications. However, the piezoelectric coefficient is inversely proportional to the mechanical quality factor, resulting in a strong limitation among wide applications. Herein, piezoelectric ceramics composed of (xSb2O3, 0.3‐wt% MnCO3)‐doped (Pb0.92Sr0.08)(Zr0.533Ti0.443Nb0.024)O3 ((xSb, Mn)‐PSZTN) were prepared by a conventional solid‐state process. The excellent piezoelectric properties d33 = 554 pC/N, kp = 0.645, and high mechanical quality factor Qm = 540 were simultaneously obtained at x = 0.1 ceramic in the morphotropic phase boundary region. The enhancement of piezoelectric properties was mainly due to the contribution of irreversible domain wall motion. In particular, the regulation of different defect chemical reactions on the properties showed that Sb2O3 could play the role of both donor and acceptor dopant. This work demonstrated that (0.1Sb, Mn)‐PSZTN ceramic was a good candidate material for high‐power piezoelectric devices.
Transfer of Phi6 bacteriophage between human skin and surfaces common to consumer-facing environments
Authors: Baker Christopher A. , Hamilton Allyson N. , Chandran Sahaana , Poncet Aurelie M. , Gibson Kristen E.
Published: September 2022

Aims

This study aimed to determine the extent of Phi6 (Φ6) transfer between skin and surfaces relevant to consumer-facing environments based on inoculum matrix, surface type and contact time.

Methods and Results

Φ6 transfer rates were determined from skin-to-fomite and fomite-to-skin influenced by inoculum matrix (artificial saliva and tripartite), surface type (aluminium, plastic, stainless steel, touchscreen, vinyl and wood) and contact time (5 and 10 s). Significant differences in estimated means were observed based on surface type (both transfer directions), inoculum matrix (skin-to-fomite) and contact time (both transfer directions). During a sequential transfer experiment from fomite-to-skin, the maximum number of consecutive transfer events observed was 3.33 ± 1.19, 2.33 ± 1.20 and 1.67 ± 1.21 for plastic, touchscreen and vinyl, respectively.

Conclusions

Contact time significantly impacted Φ6 transfer rates, which may be attributed to skin absorption dynamics. Surface type should be considered for assessing Φ6 transfer rates.

Significance and Impact of the Study

Although the persistence of Φ6 on fomites has been characterized, limited data are available regarding the transfer of Φ6 among skin and fomites. Determining Φ6 transfer rates for surfaces in consumer-facing environments based on these factors is needed to better inform future virus transmission mitigation strategies.
Assessing lithological uncertainty in dikes: Simulating construction history and its implications for flood safety assessment
Authors: van Woerkom Teun , van Beek Rens , Middelkoop Hans , Bierkens Marc F. P.
Published: September 2022

Dikes often have a long history of reinforcement, with each reinforcement adding new material resulting in a heterogeneous dike. As data on the dike internal heterogeneity is sparse, it is generally overlooked in the stability assessment of dikes. We present an object‐based and process‐based model simulating dike construction history on archeological dike cross, yielding similar patterns of heterogeneity as observed in real dikes, and apply it in a dike safety assessment. Model predictions improve when being based on more accurate statistics of dike buildup, or when being conditioned to ground truth data. When incorporated in a dike stability assessment, multiple model runs can be coupled to hydrological simulations and dike slope stability calculations, resulting in a probabilistic stability assessment considering internal dike heterogeneity. While high‐resolution observations are still sparse, good model accuracies can be reached by combining regional information on dike buildup with local point observations and this model provides a parsimonious basis to include information of internal dike heterogeneity in safety assessments.
Potential associations between alterations in gut microbiome and obesity‐related traits after the bariatric surgery
Authors: Özdemir Aslıhan , Yozgat Ahmet , Işgın‐Atıcı Kübra , Avcı Enver , Yıldız Barış D. , Gündoğdu Aycan , Nalbantoğlu Ufuk , Turhan Turan , Doğruman‐Al Funda , Büyüktuncer Zehra
Published: September 2022

Background

This study aimed to examine the effects of both obesity and bariatric surgery on gut microbiome, dietary intake, as well as metabolic and inflammatory parameters.

Methods

All participants (15 with morbid obesity who had bariatric surgery, 8 with morbid obesity and 11 non‐obese) were followed up for a 6‐month period with interviews at baseline (M0), at the end of 3 (M3) and 6 months (M6). Dietary assessment was done, and blood and faecal samples were collected.

Results

Dietary energy and nutrient intakes as well as serum glucose levels, total cholesterol, low‐density lipoprotein (LDL)‐cholesterol and high sensitivity C‐reactive protein (hs‐CRP) levels decreased after surgery (p < 0.05, for each). Participants with morbid obesity had higher levels of Firmicutes and lower levels of Bacteroidetes at M0 compared to non‐obese participants. The abundances of Bacteroidetes increased (p = 0.02), whereas that of Firmicutes decreased (p > 0.05) after the surgery, leading to a significant decrease in Firmicutes/Bacteroidetes ratio (p = 0.01). At sub‐phylum level, the abundances of Lactobacillus and Bifidobacterium decreased, whereas those of Akkermansia increased after the surgery (p < 0.01, for each). Although participants who were morbidly obese had a distinct profile according to ß‐diversity indices at M0, it became similar with the profile of non‐obese participants (p > 0.05) at M3 and M6. Similarly, α‐diversity indices were lower in subjects with morbid obesity at M0, but became similar to levels in non‐obese controls at M6.

Conclusion

This study confirmed that bariatric surgery has substantial impacts on gut microbiome's composition and diversity, as well as anthropometrical measurements and biochemical parameters, which were associated with the alterations in dietary intake patterns.
Using an interactive nutrition technology platform to predict malnutrition risk
Authors: Fisher Erin , Luscombe Georgina , Schmidt David , Brown Leanne , Duncanson Kerith
Published: September 2022

Background

The Nutrition Dashboard is an interactive nutrition technology platform that displays food provision and intake data used to categorise the nutrition risk of hospitalised individuals. The present study aimed to investigate the Nutrition Dashboard's ability to identify malnutrition compared with a validated malnutrition screening tool (MST).

Methods

A retrospective observational study at a 99‐bed hospital was conducted using medical record and food intake data presented via the Nutrition Dashboard. Inter‐Rater Reliability of food intake estimation between hospital catering staff and a dietitian reported good agreement across 912 food items (κ = 0.69, 95% confidence interval = 0.65–0.72, p < 0.001). Default nutritional adequacy thresholds of 4500 kJ and 50 g protein were applied for Nutrition Dashboard categorisation of supply and intake. Generalised estimating equation regression models explored the association between the Nutrition Dashboard risk categories and the MST, with and without controlling for patient demographic characteristics.

Results

Analyses from 216 individuals (1783 hospital‐stay days) found that those in the highest risk Nutrition Dashboard category were 1.93 times more likely to have a MST score indicating risk compared to the lowest Nutrition Dashboard category (unadjusted odds ratio = 1.93, 95% confidence interval = 1.17–3.19, p < 0.01). When patient weight was added to the model, lower weight became the only significant predictor of MST ≥ 2 (p < 0.01)

Conclusions

The present study indicates a role for nutrition intake technology in malnutrition screening. Further adaptions that address the complexities of applying this technology could improve the use of the Nutrition Dashboard to support identification of malnutrition.
Association between receipt of nutritional counselling during antenatal care visits and anaemia: A cross‐sectional study
Authors: Taddese Eden , Alemu Dawit G. , Haider Mohammad R. , Haile Zelalem T.
Published: September 2022

Background

Anaemia during pregnancy is associated with premature births, low birth weight and increased susceptibility to infection. Almost one‐quarter (24.34%) of Ethiopian pregnant women suffer from anaemia. Nutritional counselling during antenatal care (ANC) visits may encourage pregnant women to take a more iron‐rich diet and prevent anaemia. The present study examines the association between nutritional counselling during ANC and anaemia among Ethiopian women.

Methods

This cross‐sectional study uses the 2016 Ethiopia Demographic and Health Survey (EDHS) data (n = 4, 384). The outcome of interest was anaemia, measured objectively by blood haemoglobin level. The main independent variable was the receipt of nutritional counselling during ANC visits. Univariate, bivariate and multivariable analyses were performed using SAS, version 9.4 (SAS Institute Inc.).

Results

Overall, 25.8% of the participants were anaemic and 65.7% received nutritional counselling during ANC visits. Compared with women who received nutritional counselling during ANC visits, a significantly higher proportion of women who did not receive nutritional counselling were anaemic (23.1% vs. 30.8%; p < 0.001). In the multivariable model, compared with women who received nutritional counselling during their ANC visits, the odds of being anaemic were higher among women who did not receive nutritional counselling during their ANC visits adjusted odds ratio = 1.34 (95% confidence interval = 1.07–1.67; p = 0.010).

Conclusions

In a representative sample of Ethiopian women, exposure to nutritional counselling during ANC visits is associated with a lower likelihood of anaemia, independent of potential confounders. Focused ANC counselling that includes nutritional counselling programs during ANC visits can be an effective strategy to prevent and control anaemia.
Four decades of experience with carcinoid heart disease: An analysis of 84 patients
Authors: Levy Sonja , Korse Catherina E. , de Groot Andre C. A. , Meijer Ronald C. A. , Tesselaar Margot E. T. , Valk Gerlof D.
Published: September 2022

Carcinoid heart disease (CHD) is a serious cardiac condition which is caused by elevated serotonin in the systemic circulation, secreted by neuroendocrine tumours (NET). It mostly affects the right‐sided heart valves, where it causes fibrotic disturbances and is associated with worse survival. In this study, we describe a large cohort of patients with CHD and provide an insight into their survival over the past decades. All consecutive patients with a serotonin producing NET and CHD referred to the Netherlands Cancer Institute that presented with CHD or developed CHD during their follow up time were included from 1984 until 2021. Patients were divided into three time periods: 1984–2000, 2000–2010 and 2010–2018. Median N‐terminal pro B‐type natriuretic protein (NT‐proBNP) and serum serotonin levels were stratified according to tricuspid regurgitation severity. Kaplan–Meier curves and log rank test were used for visualisation of survival. Cox regression was used for identification of the characteristics associated with disease specific mortality (DSM). A total of 84 patients with CHD were included of whom 49 (58.3%) were male. Median age at NET diagnosis was 62.3 (range 23.9–81.7) years, and median time to development of CHD was 1.1 (range 0–24.2) years. NT‐proBNP was significantly higher when more severe tricuspid regurgitation (TR) was present (p = .027). Median survival from CHD diagnosis for 1984–2000, 2000–2010 and 2010–2018 were 1.3 (confidence interval [CI]: 0.9–1.6), 1.9 (CI: 1.2–2.6) and 3.9 (CI: 1.7–6.2) years (p = .025). Valve replacement surgery (VSR) occurred more frequent in later time periods. VSR (hazard ratio [HR] 0.33,p = .005) and NT‐proBNP (HR 1.003, 1.00–1.005,p = .036) were significantly associated with DSM. The prognosis of patients with CHD has improved over the past decades, possibly caused by more VSR. NT‐proBNP is a valuable biomarker in patients with CHD. Clinical practice should be aimed at timely diagnosis and intervention of CHD.
Testing for changes in rate of evolution and position of the climatic niche of clades
Authors: Castiglione Silvia , Mondanaro Alessandro , Di Febbraro Mirko , Melchionna Marina , Serio Carmela , Girardi Giorgia , Belfiore Arianna Morena , Raia Pasquale
Published: September 2022

There is solid recognition that phylogenetic effects must be acknowledged to appreciate climatic niche variability among species clades properly. Yet, most currently available methods either work at the intra‐specific level (hence they ignore phylogeny) or rely on the Brownian motion model of evolution to estimate phylogenetic effects on climatic niche variation. The Brownian motion model may be inappropriate to describe niche evolution in several cases, and even a significant phylogenetic signal in climatic variables does not indicate that the effect of shared ancestry was relevant to niche evolution.

We introduce a new phylogenetic comparative method which describes significant changes in the width and position of the climatic niche at the inter‐specific (clade) level, while making no a priori assumption about how niche evolution took place.

We devised the R function phylo.niche.shift to estimate whether the climatic niches of individual clades in the tree are either wider or narrower than expected, and whether the niche occupies unexpected climates. We tested phylo.niche.shift on realistic virtual species' distribution patterns applied to a phylogeny of 365 extant primate species.

We demonstrate via simulations that the new method is fast and accurate under widely different climatic niche evolution scenarios. phylo.niche.shift showed that the capuchin monkeys and langurs occupy much wider, and prosimian much narrower, climatic niche space than expected by their phylogenetic positions.

phylo.niche.shift may help to improve research on niche evolution by allowing researchers to test specific hypotheses on the factors affecting clades' realised niche width and position, and the potential effects of climate change on species' distributions.
Evolving beyond antiracism: Reflections on the experience of developing a cultural safety curriculum in a tertiary education setting
Authors: Hall Kerry , Vervoort Stacey , Del Fabbro Letitia , Rowe Minniss Fiona , Saunders Vicki , Martin Karen , Bialocerkowski Andrea , Milligan Eleanor , Syron Melanie , West Roianne
Published: September 2022

There is an inextricable link between cultural and clinical safety. In Australia high‐profile Aboriginal deaths in custody, publicised institutional racism in health services and the international Black Lives Matter movement have cemented momentum to ensure culturally safe care. However, racism within health professionals and health professional students remains a barrier to increasing the number of Aboriginal and Torres Strait Islander Health professionals. The Australian Health Practitioner Regulation Agency's Aboriginal and Torres Strait Islander Health Strategy's objective to ‘eliminate racism from the health system’, and the recent adoption of the Aboriginal and Torres Strait Islander peoples led cultural safety definition, has instigated systems level reflections on decolonising practice. This article explores cultural safety as the conceptual antithesis to racism, examining its origins, and contemporary evolution led by Aboriginal and Torres Strait Islander peoples in Australia, including its development in curriculum innovation. The application of cultural safety is explored using in‐depth reflection, and the crucial development of integrating critical consciousness theory, as a precursor to culturally safe practice, is discussed. Novel approaches to university curriculum development are needed to facilitate culturally safe and decolonised learning and working environments, including the key considerations of non‐Indigenous allyship and collaborative curriculum innovations and initiatives.
Beyond transformational leadership in nursing: A qualitative study on rebel nurse leadership‐as‐practice
Authors: Kok Eline de , Weggelaar Anne M. , Reede Corijna , Schoonhoven Lisette , Lalleman Pieterbas
Published: September 2022

Most nurse leadership studies have concentrated on a classical, heroic, and hierarchical view of leadership. However, critical leadership studies have argued the need for more insight into leadership in daily nursing practices. Nurses must align their professional standards and opinions on quality of care with those of other professionals, management, and patients. They want to achieve better outcomes for their patients but also feel disciplined and controlled. To deal with this, nurses challenge the status quo by showing rebel nurse leadership. In this paper, we describe 47 nurses’ experiences with rebel nurse leadership from a leadership‐as‐practice perspective. In eight focus groups, nurses from two hospitals and one long‐term care organization shared their experiences of rebel nurse leadership practices. They illustrated the differences between “bad” and “good” rebels. Knowledge, work experience, and patient‐driven motivation were considered necessary for “good” rebel leadership. The participants also explained that continuous social influencing is important while exploring and challenging the boundaries set by colleagues and management. Credibility, trust, autonomy, freedom, and preserving relationships determined whether rebel nurses acted visibly or invisibly. Ultimately, this study refines the concept of rebel nurse leadership, gives a better understanding of how this occurs in nursing practice, and give insights into the challenges faced when studying nursing leadership practices.
Identifying the optimal blood pressure for cerebral autoregulation in infants after cardiac surgery by monitoring cerebrovascular reactivity—A pilot study
Authors: Zipfel Julian , Wikidal Berit , Schwaneberg Bernadett , Schuhmann Martin U. , Magunia Harry , Hofbeck Michael , Schlensak Christian , Schmid Simon , Neunhoeffer Felix
Published: September 2022

Background

Advances in the treatment of pediatric congenital heart disease have increased survival rates. Despite efforts to prevent neurological injury, many patients suffer from impaired neurodevelopmental outcomes. Compromised cerebral autoregulation can increase the risk of brain injury following pediatric cardiac surgery with cardiopulmonary bypass. Monitoring autoregulation and maintaining adequate cerebral blood flow can help prevent neurological injury.

Aims

Our objective was to evaluate autoregulation parameters and to define the optimal blood pressure as well as the lower and upper blood pressure limits of autoregulation.

Methods

Autoregulation was monitored prospectively in 36 infants after cardiopulmonary bypass surgery for congenital heart defects between January and December 2019. Autoregulation indices were calculated by correlating invasive arterial blood pressure, cortical oxygen saturation, and relative tissue hemoglobin levels with near‐infrared spectroscopy parameters.

Results

The mean patient age was 4.1 ± 2.8 months, and the mean patient weight was 5.2 ± 1.8 kg. Optimal mean arterial pressure could be identified in 88.9% of patients via the hemoglobin volume index and in 91.7% of patients via the cerebral oxygenation index, and a lower limit of autoregulation could be found in 66.7% and 63.9% of patients, respectively. No significant changes in autoregulation indices at the beginning or end of the monitoring period were observed. In 76.5% ± 11.1% and 83.8% ± 9.9% of the 8 and 16 h monitoring times, respectively, the mean blood pressure was inside the range of intact autoregulation (below in 21.5% ± 25.4% and 11.3% ± 16.5% and above in 8.7% ± 10.4% and 6.0% ± 11.0%, respectively). The mean optimal blood pressure was 57.4 ± 8.7 mmHg and 58.2 ± 7.9 mmHg and the mean lower limit of autoregulation was 48.8 ± 8.3 mmHg and 45.5 ± 6.7 mmHg when generated via the hemoglobin volume index and cerebral oxygenation index, respectively.

Conclusions

Postoperative noninvasive autoregulation monitoring after cardiac surgery in children can be reliably and safely performed using the hemoglobin volume index and cerebral oxygenation index and provides robust data. This monitoring can be used to identify individual hemodynamic targets to optimize autoregulation, which differs from those recommended in the literature. Further evaluation of this subject is needed.
Back to the roots: Understanding banana below‐ground interactions is crucial for effective management of Fusarium wilt
Authors: Were Evans , Viljoen Altus , Rasche Frank
Published: September 2022

Global banana production is affected by Fusarium wilt, a devastating disease caused by the soilborne root‐infecting fungus, Fusarium oxysporum f. sp. cubense (Foc). Fusarium wilt is notoriously difficult to manage because infection arises through complex below‐ground interactions between Foc, the plant, and the soil microbiome in the root–soil interface, defined as the rhizosphere. Interactions in the rhizosphere play a pivotal role in processes associated with pathogen development and plant health. Modulation of these processes through manipulation and management of the banana rhizosphere provides an auspicious prospect for management of Fusarium wilt. Yet, a fundamental understanding of interactions in the banana rhizosphere is still lacking. The objective of this review is to discuss the state‐of‐the‐art of the relatively scant data available on banana below‐ground interactions in relation to Fusarium wilt and, as a result, to highlight key research gaps. Specifically, we seek to understand (a) the biology of Foc and its interaction with banana; (b) the ecology of Foc, including the role of root‐exuded metabolites in rhizosphere interactions; and (c) soil management practices and how they modulate Fusarium wilt. A better understanding of molecular and ecological factors influencing banana below‐ground interactions has implications for the development of targeted interventions in the management of Fusarium wilt through manipulation of the banana rhizosphere.
Informative and semantic language features of people with dementia displayed during reminiscence therapy
Authors: Park Kyongok , Moon SeolHwa
Published: September 2022

Background

Communication is essential for people with dementia (PWD) to independently perform activities of daily living. While cognitive training could improve communication abilities in PWD, there is limited evidence of the effect of reminiscence therapy (RT) on communication. Therefore, this study examines this effect, focusing on language features.

Method

This study used data from randomised controlled trials applying RT to women with dementia registered in a day‐care center. RT using digital material or storytelling was conducted with PWD for 4 weeks. Outcome measures included general characteristics and communicative ability, such as the number of correct information units (CIUs, a measure of informativeness in discourse), the Holden Communication Scale (HCS) score, and verbal engagement. Repeated‐measures multivariate analysis of variance and the paired t‐test were performed to confirm the effect of RT on communicative ability.

Results

There was a significant change over time in the ratio of CIUs (F = 4.35, P = 0.016). In the first 2 weeks of the intervention, there were significant differences in the ratio of CIUs (t = −3.00, P = 0.005), total HCS score (t = 2.28, P = 0.028), and conversation score (HCS subdomain) (t = 2.44, P = 0.019) between two measurement time points (T0, T1), while the number of syllables did not significantly change (t = −1.60, P = 0.117).

Conclusions

Informative/semantic linguistic ability was significantly increased in PWD, while the amount of discourse did not change after RT. This result may be helpful to improve effective communication with PWD and train healthcare staff working with PWD.
Seed‐ versus transplant‐based eelgrass (Zostera marina L.) restoration success in a temperate marine lake
Authors: Cronau Rens J. T. , de Fouw Jimmy , van Katwijk Marieke M. , Bouma Tjeerd J. , Heusinkveld Jannes H. T. , Hoeijmakers Dieuwke , Lamers Leon P. M. , van der Heide Tjisse
Published: September 2022

Despite active seagrass restoration gaining traction as a tool to halt and reverse worldwide seagrass losses, overall success remains limited. Restoration strategies, through seeding or transplantation, face different environmental bottlenecks that limit success. Choosing the most appropriate strategy of the two for a specific location, however, is hampered by lack of direct practical comparisons between strategies within a single system. To investigate potential life stage dependent bottlenecks, we compared seed‐based and transplant‐based restoration of Zostera marina in the subtidal saltwater Lake Grevelingen. Our results demonstrate that seedling recruitment was negatively impacted by bioturbation from the lugworm Arenicola marina and sediment movement due to hydrodynamic exposure. Transplant‐based restoration was clearly more successful but surprisingly best predicted by leaf gluing by the ragworm Platynereis dumerilii. This previously undescribed interaction caused seagrass leaves to clump and reduce effective photosynthetic surface and leaf movement. We suggest that the observed behavior of these worms may result from a lack of foodweb interactions, illustrating the importance of  trophic control for seagrass restoration. Thus, in addition to recognizing life stage dependent environmental bottlenecks for restoration strategy selection, seagrass restoration may also require the active recovery of their associated food webs.
‘It's a lonely old world’: Developing a multidimensional understanding of loneliness in farming
Authors: Wheeler Rebecca , Lobley Matt , McCann Jude , Phillimore Alex
Published: September 2022

This article develops a multidimensional understanding of loneliness in farming communities, based on qualitative research with the UK farming community. It presents a conceptual model of loneliness in farming and uses evidence from workshops and interviews with farmers, farm family members and farm support practitioners to explore the various ways in which loneliness is manifested and experienced within the specific context of farming environments, cultures and identities. A range of farming‐specific factors commonly contribute to experiences of loneliness within this community, and we argue that these can be conceptualised as relating to three varying, but interlinking, dimensions of loneliness: social, emotional and cultural. We also discuss the role that certain elements of farming culture and identity play in shaping the ways in which loneliness is experienced and managed. Finally, we consider some of the implications of our findings and suggest priorities for action from a range of stakeholders including the government, the public, farm support organisations and the farming community themselves. Understanding the complexities and nuances of loneliness within farming is important in order to mitigate the issue and help address wider mental health problems within this population.
Clinical and healthcare burden of disease associated with cytomegalovirus in allogeneic hematopoietic stem cell transplantation – A retrospective single‐center study
Authors: Ranti Juha , Perkonoja Katariina , Kauko Tommi , Korhonen Riku
Published: September 2022

Background

CMV infection is a common complication in allogeneic hematopoietic stem cell transplantation (HSCT). We investigated the association of clinically significant CMV (CS‐CMV) infection with clinical outcomes and healthcare resource utilization in allogeneic HSCT patients in Finland.

Methods

This retrospective study included adult patients who received their first allogeneic HSCT between January 1, 2013, and December 31, 2018, at the Turku University Hospital. Data were collected from the hospital data lake. Clinical and healthcare outcomes were investigated at one year and mortality up to three years.

Results

The study included 251 patients. CMV seroprevalence was 69.7%. CS‐CMV infection occurred in 59.0% of the patients, and of those, 14.2% had ≥2 infections. The median time to CS‐CMV infection was 34.5 days (Q1–Q3, 27.0–45.0). Recipient and donor seropositivity, and lymphoproliferative diseases were associated with higher, and HLA identical sibling donors with lower CS‐CMV infection risk. CS‐CMV infection was not associated with mortality in three years of follow‐up. One hundred thirty‐three (89.8%) and 75 (72.8%) patients with and without CS‐CMV infection, respectively, were readmitted to the hospital. Patients with CS‐CMV infection had more hospital readmissions (incidence rate ratio [IRR] 1.38, 95% confidence interval [CI] 1.10–1.73, p = .005) and patients with one CS‐CMV infection (IRR 1.48, 95% CI 1.12–1.94, p = .005) or ≥2 infections had longer length of hospital stay (IRR 2.71, 95% CI 1.76‐4.35, p < .001).

Conclusion

CMV seroprevalence is relatively high among Finnish allogeneic HSCT patients. CS‐CMV infection was common and associated with a higher readmission rate and longer length of hospital stay.

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Ex vivo and in vivo evaluation of a modified interrupted Lembert pattern for small intestinal anastomoses in horses
Authors: Seitz‐Cherner Emma , Bauck Anje G. , Denagamage Thomas , Freeman David E.
Published: September 2022

Objective

To compare single‐layer anastomoses (modified continuous Lembert [mod‐CL] and modified‐interrupted Lembert [mod‐IL]) and a 2‐layer simple continuous anastomosis (2 L; seromuscular and mucosal) for jejunojejunal anastomoses in equine cadavers and to compare ex vivo to in vivo time to complete the anastomosis and stoma size with a mod‐IL pattern.

Study design

Measurements in jejunum from cadaver and anesthetized horses.

Animals

Ten live horses and 18 equine cadavers.

Methods

Time to complete anastomosis, bursting pressures (BP), leakage sites, and anastomotic index (size ratio of anastomotic lumen to control lumen) were recorded. Time to completion and lumen size were compared between in vivo and ex vivo mod‐IL patterns.

Results

The mod‐CL pattern was fastest (8.44 ± 1.30 min, p < .05), and the 2 L pattern was slower (17.07 ± 2.0 min) than the mod‐CL and mod‐IL (p < .05). The anastomotic index exceeded 100 and did not differ between patterns. Segments reached higher bursting pressures when anastomosed with mod‐IL (145.94 ± 24.18 mm Hg) than mod‐CL (p < .05). In vivo closure was approximately 8 minutes slower than ex vivo, and with a smaller anastomotic index.

Conclusions

All anastomoses increased lumen size over control segments ex vivo. Lumen size after placement of a mod‐IL was greater ex vivo than in vivo, and completion was slower in vivo than ex vivo. [Corrections added on 26 Dec 2022, after online publication: added “ex vivo” to the first line of Conclusions in the Abstract.]

Clinical significance

Slower and smaller anastomoses should be anticipated in vivo compared to ex vivo results. Anastomoses with a mod‐IL pattern appear clinically advantageous, producing a comparable lumen size in less time than 2 L.
Assessing evidence of a potential Salmonella transmission across the poultry food chain
Authors: Cargnel Mickaël , Filippitzi Maria‐Eleni , Van Cauteren Dieter , Mattheus Wesley , Botteldoorn Nadine , Cambier Ludivine , Welby Sarah
Published: September 2022

Enhanced Salmonella surveillance programmes in poultry were implemented in all European Member States, with minimum prevalence targets for a list of targeted serotypes to safeguard food and public health. Based on the Belgian Salmonella surveillance programme and focusing on poultry, the overarching aim of this study was to highlight possible Salmonella transmissions across the food chain (FC). For this purpose, firstly, the prevalence patterns of Salmonella (targeted and the most prevalent non‐targeted) serotypes along the FC were described over time. Secondly, the effectiveness of the control measures against vertical transmission (breeders to 1‐day‐old broiler and layer chicks) was indirectly assessed by looking into the odds of targeted serotypes detection. Thirdly, it was appraised if Salmonella prevalence can significantly increase during broilers and layers production. In addition, it was tested if being tested negative at the end of production in broilers when tested positive at the entrance is serotype dependent (targeted vs. non‐targeted serotypes). Results showed that, firstly, the prevalence patterns of the listed serotypes were inconstant over time and across the FC. Secondly, the odds of Salmonella targeted serotype detection in 1‐day‐old broiler and in 1‐day‐old layer flocks were lower than in breeder flocks while, thirdly, infection during broiler and layer production can lead to significant increase in positivity in subsequent samples. Finally, being infected by a targeted or by non‐targeted serotype at the entrance of the flock poorly reflects the Salmonella status at the end of production. Note that this study did not make a distinction between the different sources of contamination and the effects of sampling methods and isolation methods should be subject to further investigation.
Impact of Prejudice on Caregivers of People with Mental Illness in Uasin Gishu County, Kenya
Authors: Ombok Caroline. A. , Kareithi Joram , Wandere Donald
Published: September 2022

Negative beliefs and preconceived opinions on mental illness, which are not based on reason or actual experience, play a significant role in determining treatment and health-seeking behaviour by caregivers of people with mental illness. This paper assesses the influence of prejudice on caregivers of people with mental illness in Uasin Gishu County. The study was anchored on the health-seeking behavior theory and targeted 480 respondents drawn from Uasin Gishu County. This was achieved through purposive sampling. Data from the caregivers was collected using a structured questionnaire and focus group discussions, while data from health care providers was collected using an interview schedule. Data from the questionnaire was analyzed using descriptive and inferential statistics, while data from the focus group discussions and interviews used themes. The study revealed that prejudice (b=-0.332, þ<0.05), had negative and significant influences on health-seeking behavior of caregivers. The study concluded that prejudice was an element of the cultural construction of mental illness that negatively influenced health-seeking behavior among caregivers of people with mental illness. It is recommended that future studies should seek to use data collection approaches that integrate feelings and emotions of the people who have mental illness in addition to widening the geographical scope of the study.
Effect of pulmonary rehabilitation on functional capacity in individuals treated for pulmonary tuberculosis: a systematic review protocol
Authors: da Silva Thiago Santos , Arêas Guilherme Peixoto Tinoco , da Cruz Diná de Almeida Lopes Monteiro
Published: September 2022

Objective:

The aim of this review is to synthesize the available evidence on the effectiveness of pulmonary rehabilitation on the functional capacity of people who have finished drug treatment for pulmonary tuberculosis.

Introduction:

Pulmonary rehabilitation is a treatment option for physical functional problems that persist after pharmacological treatment for tuberculosis; however, the results of primary studies on the subject are inconclusive.

Inclusion criteria:

This review will consider for inclusion studies carried out with adults (≥18 years old) who have completed pharmacological treatment for tuberculosis. Outcomes of interest will include functional capacity, quality of life, lung function, respiratory and skeletal muscle strength, subjective perception exertion, and dyspnea.

Methods:

Searches for published and unpublished studies will be carried out on MEDLINE (via PubMed), LILACS, PEDro, CINAHL, Web of Science, Embase, Science Direct, Scopus, Cochrane Library (CENTRAL), Sport Medicine and Education Index, Rehabilitation and Sports Medicine Source, and SPORTDiscus. The results of the review will be reported according to PRISMA guidelines. There will be no language or time limitations. Two independent reviewers will select and critically appraise the selected studies and extract the data using standardized instruments. The certainty of evidence will be reported according to GRADE. Where appropriate, studies will be subjected to meta-analysis. Effect sizes will be expressed in odds ratios (for dichotomous data) or in standardized mean difference (for continuous data) and its 95% CI.

Systematic review registration number:

PROSPERO CRD42021254719.
Optimizing the Porohyperelastic Response of a Layered Compliance Matched Vascular Graft to Promote Luminal Self-Cleaning
Authors: Behrangzade Ali , Simon Bruce R. , Wagner William R. , Geest Jonathan P. Vande
Published: September 2022

Thrombosis and intimal hyperplasia have remained the major failure mechanisms of small-diameter vascular grafts used in bypass procedures. While most efforts to reduce thrombogenicity have used a biochemical surface modification approach, the use of local mechanical phenomena to aid in this goal has received somewhat less attention. In this work, the mechanical, fluid transport, and geometrical properties of a layered and porous vascular graft are optimized within a porohyperelastic finite element framework to maximize self-cleaning via luminal reversal fluid velocity (into the lumen). This is expected to repel platelets as well as inhibit the formation of and/or destabilize adsorbed protein layers thereby reducing thrombogenic potential. A particle swarm optimization algorithm was utilized to maximize luminal reversal fluid velocity while also compliance matching our graft to a target artery (rat aorta). The maximum achievable luminal reversal fluid velocity was approximately 246 μm/s without simultaneously optimizing for host compliance. Simultaneous optimization of reversal flow and compliance resulted in a luminal reversal fluid velocity of 59 μm/s. Results indicate that a thick highly permeable compressible inner layer and a thin low permeability incompressible outer layer promote intraluminal reversal fluid velocity. Future research is needed to determine the feasibility of fabricating such a layered and optimized graft and verify its ability to improve hemocompatibility.
Musculoskeletal Gait Simulation to Investigate Biomechanical Effect of Knee Brace
Authors: Yap Yi Ting , Gouwanda Darwin , Gopalai Alpha A. , Chong Yu Zheng
Published: September 2022

Musculoskeletal modeling and simulation have been an emerging trend in human gait analysis. It allows the user to isolate certain biomechanical conditions and elucidate the dynamics of joints and muscles. This study used an open-source musculoskeletal modeling and simulation tool, opensim to investigate the biomechanical effect of knee brace. It collected gait data from thirty-eight participants and examined the gait spatio-temporal parameters, joint angles, and joint moments. Static optimization was performed to estimate the lower extremity muscle force. Statistical analysis was conducted to identify the difference between normal and braced gaits. The results demonstrated the feasibility of this method to investigate the interaction and coordination of lower extremity joints and muscles. The knee brace constrained the range of the motion of the knee during walking. It also changed the walking speed, step length, and stance-to-swing ratio. Several significant differences were found in the joint moments and muscle forces of the rectus femoris, gastrocnemius, soleus and tibialis anterior. Musculoskeletal modeling and simulation tool offers a less invasive and practical alternative to analyze human motion. It also provides a means to investigate the effect of medical devices such as knee brace, which can be potentially beneficial for the future design and development of such devices and for the derivation of future rehabilitation treatment to improve patient's gait.
Immersion Cooling of Suspended and Coated Nano-Phosphor Particles for Extending the Limits of Optical Extraction of Light Emitting Diodes
Authors: Tamdogan Enes
Published: September 2022

GaN LEDs are usually encapsulated with a cured phosphor-epoxy mixture for the light conversions from blue to white light. However, during this conversion, significant self-heating problems may occur due to insufficient cooling capabilities against the increasing power demand. Moreover, possible fracture and ultimate device failures were intersected with large displacements inside the LED package with these self-heating problems. Thus, including phosphor in a high brightness LED package is complex. Therefore, three coating technologies were investigated for an LED package's higher lifetime and ultimate optical output. Those are phosphor dispersed inside the liquid coolant as particles, remote phosphor-coated under the dome, and remote phosphor-coated under the dome with immersion cooling with dielectric liquid coolant. Their results were compared with the commonly used over chip coating application chosen as the baseline case in the current study. Furthermore, computational models and experimental studies were performed for proposed coating configurations. The chosen baseline case has shown higher junction temperatures, lower conversion efficiency, and undesirable color shifts at critical temperatures. As the first proposed technique, dispersed phosphor particles inside the dielectric liquid coolant have resulted with almost similar conversion efficiency but with a lower thermal enhancement on the LED junction than the baseline case. The second technique, remote phosphor system has resulted in better junction temperatures and 23% higher optical extraction than the baseline case. On the other hand, the remote phosphor with immersion cooling has shown the lowest junction temperature levels and extended the lumen extraction limits of white LEDs above 53% as the third proposed technique.
Auditory spatial analysis in reverberant multi-talker environments with congruent and incongruent audio-visual room information
Authors: Ahrens Axel , Lund Kasper Duemose
Published: September 2022

In a multi-talker situation, listeners have the challenge of identifying a target speech source out of a mixture of interfering background noises. In the current study, it was investigated how listeners analyze audio-visual scenes with varying complexity in terms of number of talkers and reverberation. The visual information of the room was either congruent with the acoustic room or incongruent. The listeners' task was to locate an ongoing speech source in a mixture of other speech sources. The three-dimensional audio-visual scenarios were presented using a loudspeaker array and virtual reality glasses. It was shown that room reverberation, as well as the number of talkers in a scene, influence the ability to analyze an auditory scene in terms of accuracy and response time. Incongruent visual information of the room did not affect this ability. When few talkers were presented simultaneously, listeners were able to detect a target talker quickly and accurately even in adverse room acoustical conditions. Reverberation started to affect the response time when four or more talkers were presented. The number of talkers became a significant factor for five or more simultaneous talkers.
A simple model for elastic wave propagation in hard sphere-filled random composites
Authors: Ru C. Q.
Published: September 2022

A simple model is proposed to study wave propagation in hard sphere-reinforced elastic random composites. Compared to existing related models, the proposed model is featured by a modified form of classical elastodynamic equations in which the inertia term is substituted by the acceleration field of the mass centre of a representative unit cell, supplied with a derived simple differential relation between the displacement field of the composite and the displacement field of the mass centre of a representative unit cell. The present model enjoys conceptual and mathematical simplicity although it is restricted to hard sphere-filled elastic composites in which the elastic moduli of embedded spheres are much (at least 4–5 times) stiffer than those of a softer matrix. Explicit formulas are derived for the attenuation coefficient and the effective phase velocity of plane longitudinal P-waves and transverse S-waves. The efficiency and reasonable accuracy of the present model are demonstrated by reasonably good agreement between the predicted results and some established known data. The proposed model could offer a potential general method to study various three-dimensional dynamic problems of hard sphere-filled elastic random composites.
A Comparison of Wrist- Versus Hip-Worn ActiGraph Sensors for Assessing Physical Activity in Adults: A Systematic Review
Authors: Gall Nolan , Sun Ruopeng , Smuck Matthew
Published: September 2022

Introduction: Wrist-worn accelerometer has gained popularity recently in commercial and research use for physical activity tracking. Yet, no consensus exists for standardized wrist-worn data processing, and physical activity data derived from wrist-worn accelerometer cannot be directly compared with data derived from the historically used hip-worn accelerometer. In this work, through a systematic review, we aim to identify and analyze discrepancies between wrist-worn versus hip-worn ActiGraph accelerometers in measuring adult physical activity. Methods: A systematic review was conducted on studies involving free-living data comparison between hip- and wrist-worn ActiGraph accelerometers among adult users. We assessed the population, study protocols, data processing criteria (axis, epoch, wear-time correction, etc.), and outcome measures (step count, sedentary activity time, moderate-to-vigorous physical activity, etc.). Step count and activity count discrepancy were analyzed using meta-analysis, while meta-analysis was not attempted for others due to heterogeneous data processing criteria among the studies. Results: We screened 235 studies with 19 studies qualifying for inclusion in the systematic review. Through meta-analysis, the wrist-worn sensor recorded, on average, 3,537 steps/day more than the hip-worn sensor. Regarding sedentary activity time and moderate-to-vigorous physical activity estimation, the wrist sensor consistently overestimates moderate-to-vigorous physical activity time while underestimating sedentary activity time, with discrepancies ranging from a dozen minutes to several hours. Discussions: Our findings quantified the substantial discrepancies between wrist and hip sensors. It calls attention to the need for a cautious approach to interpreting data from different wear locations. These results may also serve as a reference for data comparisons among studies using different sensor locations.