bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel three‐phase buck‐boost inverter controlled by an open‐loop assisted closed‐loop hybrid control method
Authors: Yalcin Faruk
Published: January 2021

A novel general purpose three‐phase buck‐boost inverter without need of additional filtering units is presented in this study. The proposed inverter topology is built with moderate numbers of elements in terms of the operation advantages and qualities. The buck‐boost converter‐based structure provides obtaining wide‐range output voltage amplitudes lower or higher than the input voltages. A novel hybrid control method that is open‐loop assisted closed‐loop control is proposed for the inverter operation to improve the response performance on various input and output operation conditions. The wye‐connected modular structure of the proposed inverter topology also enables unbalanced three‐phase operation and single‐phase operation for each phase with independent phase voltages and frequencies. An experimental laboratory setup is built for the proposed three‐phase inverter for 0–50 Hz, 0–100 Vp, and 1.5 kW operation values for real‐time application tests. Simulation tests are also applied for the inverter. The obtained results for both the simulation and the experimental tests show that the presented inverter with the proposed hybrid control method is capable of operating in balanced/unbalanced three‐phase and independent single‐phase modes while producing close to sine wave output voltages under 5% THD levels with wide range desired amplitudes and frequencies on different operating points.
Combination of ivabradine and sacubitril/valsartan in patients with heart failure and reduced ejection fraction
Authors: Lee Ying‐Hsiang , Lin Po‐Lin , Chiou Wei‐Ru , Huang Jin‐Long , Lin Wen‐Yu , Liao Chia‐Te , Chung Fa‐Po , Liang Huai‐Wen , Hsu Chien‐Yi , Chang Hung‐Yu
Published: January 2021

Aims

Ivabradine and sacubitril/valsartan are second‐line therapies for patients with heart failure and reduced ejection fraction (HFrEF) based on guideline recommendations. We aimed to evaluate the synergistic effects of these two medications.

Methods and results

Patients' data were extracted from a multicentre database between 2016 and 2018. Patients were classified into (1) Simultaneous group: simultaneous prescription of ivabradine and sacubitril/valsartan within 6 weeks; (2A) Sequential group, ivabradine‐first: ivabradine was prescribed first, followed by sacubitril/valsartan; and (2B) Sequential group, sacubitril/valsartan‐first: sacubitril/valsartan was prescribed first, followed by ivabradine. A total of 464 patients with HFrEF were enrolled. Cardiovascular death and/or unplanned re‐hospitalizations for HF were less frequent (28.6% vs. 44.8%, P = 0.01), and the improvement of left ventricular ejection fraction (LVEF) was significantly greater in patients from the Simultaneous group than those from the Sequential group (∆LVEF 12.8 ± 12.9% vs. 9.3 ± 12.6%, P = 0.007). Among Sequential subgroups, the ivabradine‐first treatment decreased heart rate and increased systolic blood pressure (SBP) compared with sacubitril/valsartan‐first treatment (∆heart rate −9.1 ± 12.9 b.p.m. vs. 2.6 ± 16.0 b.p.m., P < 0.001; ∆SBP 4.6 ± 16.5 mmHg vs. −4.8 ± 17.2 mmHg, P < 0.001), whereas sacubitril/valsartan‐first treatment showed a higher degree of LVEF improvement (∆LVEF 3.6 ± 7.8% vs. 0.7 ± 7.7%, P = 0.002) than ivabradine‐first treatment. At the end of follow‐up, SBP, LVEF, and left ventricular volume were comparable between two Sequential subgroups.

Conclusions

Among patients with HFrEF, simultaneous rather than sequential treatment with sacubitril/valsartan and ivabradine was a better strategy to reduce adverse events and achieve left ventricular reverse remodelling. Ivabradine treatment had a more significant benefit on improving haemodynamic stability, whereas sacubitril/valsartan treatment showed a more significant effect on improving LVEF.
New developments in biological phosphorus accessibility and recovery approaches from soil and waste streams
Authors: Vučić Vedran , Müller Susann
Published: January 2021

Phosphorus (P) is a non‐renewable resource and is on the European Union's list of critical raw materials. It is predicted that the P consumption peak will occur in the next 10 to 20 years. Therefore, there is an urgent need to find accessible sources in the immediate environment, such as soil, and to use alternative resources of P such as waste streams. While enormous progress has been made in chemical P recovery technologies, most biological technologies for P recovery are still in the developmental stage and are not reaching industrial application. Nevertheless, biological P recovery could offer good solutions as these technologies can return P to the human P cycle in an environmentally friendly way. This mini‐review provides an overview of the latest approaches to make P available in soil and to recover P from plant residues, animal and human waste streams by exploiting the universal trait of P accumulation and P turnover in microorganisms and plants.
Halide perovskites for light emission and artificial photosynthesis: Opportunities, challenges, and perspectives
Authors: Shi Ming , Li Rengui , Li Can
Published: January 2021

Exploring desirable nanomaterials as the new building blocks to construct energy conversion assemblies opens up new ways to utilize renewable sources for energy sustainability. Halide perovskites have already received extraordinary attention from research community due to their unique photophysical properties, making them promising candidates for application in various fields like photovoltaic, photoelectric devices. Specifically, the tunable band structures, superior light harvesting and photoexcited charge properties of halide perovskites endow them the possibilities for light emission and photocatalytic solar‐to‐chemical energy conversion. Herein, we open this review by introducing the fundamentals of halide perovskites, including their chemical composition, crystalline structure, electronic structure, photoelectronic properties, and potential applications. Then, the unique features of halide perovskites such as flexibility (adjustability of composition and structure) and defect tolerance are discussed. After that, we focus on the energy‐related applications of halide perovskites including light emission and artificial photosynthesis, followed by the challenges for halide perovskites in practical application, and finally the development promise of halide perovskites in energy conversion is prospected.

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Forecasting of intermittent demands under the risk of inventory obsolescence
Authors: Sanguri Kamal , Mukherjee Kampan
Published: January 2021

Croston and the other related methods, such as Syntetos‐Boylan approximation (SBA), are the most popular methods recommended in the literature for intermittent demand forecasting. However, these conventional methods are not considered suitable in inventory obsolescence as they do not update their forecast in the periods of zero demand. Therefore, in order to add to the methods suitable for the inventory obsolescence issue, we propose a new method that imparts flexibility to the SBA method. The proposed method updates forecast each period by the use of distinct smoothing constants for interdemand intervals. The method is further examined extensively on a simulated dataset considering gradual and abrupt obsolescence and an empirical dataset from the automotive sector. The study is not limited to assessing the forecasting accuracy but also focuses upon the inventory performance of the considered methods. The study results indicate the effectiveness of the proposed method, particularly under increased risk of obsolescence.
Smart edible films based on mucilage of lallemantia iberica seed incorporated with curcumin for freshness monitoring
Authors: Taghinia Pouya , Abdolshahi Anna , Sedaghati Sahebeh , Shokrollahi Behdad
Published: January 2021

The objective of the present work was first to develop a smart packaging system based on Lallemantia iberica seed gum (LISG)/curcumin and, subsequently, investigate its physicochemical characteristics and biological activity. Finally, the response of LISG/curcumin films against pH change and the spoilage of shrimp were tested. The barrier properties and mechanical performance of the films improved as the curcumin concentration increased. FT‐IR analysis revealed the formation of physical interaction between LISG and curcumin. LISG/curcumin films showed a continuous and steady release of curcumin. The incorporation of curcumin into LISG matrix imparts antioxidant and antibacterial/mold activity to the films. A strong positive correlation was observed between total volatile base nitrogen (TVBN) content of shrimp and a* (redness) during storage time (Pearson correlation = 0.975). Eventually, LISG/curcumin film could be a promising smart packaging system capable of detecting food spoilage.
Cenozoic evolution of Zhangjiakou‐Penglai Fault Zone in the western offshore Bohai Bay Basin: Evidence from 3D seismic data
Authors: Ma Xiao , Liu Jingyan , Lin Changsong , Li Huiyong , Niu Chengmin
Published: January 2021

The Zhangjiakou‐Penglai Fault Zone (ZPFZ) is an NW‐trending strike‐slip fault zone in Eastern China that contains abundant petroleum resources and has induced massive seismic hazards. It is left‐lateral and behaves as a conjugate relationship with the Tan‐Lu Fault Zone (TLFZ). Present studies on the ZPFZ are mainly conducted on its seismology and field exposure features, with subsurface characteristics and evolution history poorly understood. In this study, we investigated the ZPFZ in the western offshore Bohai Bay Basin based on the detailed interpretation of 3D seismic data, specializing in subsurface geometric characters and evolution history. The profile flower structure and plan broom‐like pattern featured the ZPFZ in the study area and indicate its sinistral strike‐slipping. We further investigated and discusssd the Cenozoic evolution history based on evidence in (a) distinguished tectonics in fault releasing and restraining bends, (b) strata thickness map before and after the strike‐slipping, and (c) geometry of composite flower structures. The result suggests the evolution of the ZPFZ mainly comprises three stages: (a) the initial extension from 65 to 38 Ma, (b) the sinistral strike‐slipping in transtension from 38 to 25 Ma, and (3) the sinistral strike‐slipping in transpression from 25 Ma to present. The proposed evolution of the ZPFZ had good consistency with that of the conjugate TLFZ and was closely related to the Cenozoic surrounding plate tectonism, especially the Pacific Plate subduction.
Resection of cerebellar tumours causes widespread and functionally relevant white matter impairments
Authors: Gomes Carlos Alexandre , Steiner Katharina M. , Ludolph Nicolas , Spisak Tamas , Ernst Thomas M. , Mueller Oliver , Göricke Sophia L. , Labrenz Franziska , Ilg Winfried , Axmacher Nikolai , Timmann Dagmar
Published: January 2021

Several diffusion tensor imaging studies reveal that white matter (WM) lesions are common in children suffering from benign cerebellar tumours who are treated with surgery only. The clinical implications of WM alterations that occur as a direct consequence of cerebellar disease have not been thoroughly studied. Here, we analysed structural and diffusion imaging data from cerebellar patients with chronic surgical lesions after resection for benign cerebellar tumours. We aimed to elucidate the impact of focal lesions of the cerebellum on WM integrity across the entire brain, and to investigate whether WM deficits were associated with behavioural impairment in three different motor tasks. Lesion symptom mapping analysis suggested that lesions in critical cerebellar regions were related to deficits in savings during an eyeblink conditioning task, as well as to deficits in motor action timing. Diffusion imaging analysis of cerebellar WM indicated that better behavioural performance was associated with higher fractional anisotropy (FA) in the superior cerebellar peduncle, cerebellum's main outflow path. Moreover, voxel‐wise analysis revealed a global pattern of WM deficits in patients within many cerebral WM tracts critical for motor and non‐motor function. Finally, we observed a positive correlation between FA and savings within cerebello‐thalamo‐cortical pathways in patients but not in controls, showing that saving effects partly depend on extracerebellar areas, and may be recruited for compensation. These results confirm that the cerebellum has extended connections with many cerebral areas involved in motor/cognitive functions, and the observed WM changes likely contribute to long‐term clinical deficits of posterior fossa tumour survivors.
Detection of high‐risk human papillomavirus infection and treatment of high‐grade vaginal intraepithelial neoplasia: A single‐institution study
Authors: Cho Hyun‐Woong , Hong Jin Hwa , Lee Jae Kwan
Published: January 2021

Objective

To identify high‐risk HPV (hrHPV) genotypes associated with high‐grade vaginal intraepithelial neoplasia (VaIN), and evaluate the efficacy of various treatments for high‐grade VaIN.

Methods

A retrospective review of outcomes among women diagnosed with VaIN after vaginal punch biopsy conducted due to an abnormal Papanicolaou smear or positive test for hrHPV at a hospital in Seoul, Korea, from 2013 to 2018. Logistic regression was used to identify variables associated with abnormal pathologic outcomes.

Results

Among 389 women included in the study, 58 were diagnosed with high‐grade VaIN, including VaIN stage 2 (n = 37), VaIN stage 3 (n = 16), carcinoma in situ of the vagina (n = 3), and squamous carcinoma of the vagina (n = 2). In multivariate logistic regression analysis, risk of high‐grade VaIN and cancer was higher among women with abnormal cytology (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.47–2.47), any hrHPV infection (OR, 8.75; 95% CI, 1.14–67.31), HPV16 infection (OR, 5.71; 95% CI, 2.57–12.68), or HPV31 infection (OR, 4.37; 95% CI, 1.45–13.11).

Conclusion

The findings suggest that infection with hrHPV, especially HPV16 and HPV31, is significantly associated with high‐grade VaIN. Regarding treatment modalities, ablative or excisional treatments showed good efficacy against pathologic regression of high‐grade VaIN.
Longitudinal changes in attachment patterns of preterm infants born in a non‐Western country
Authors: Zengin Akkus P , Bahtiyar Saygan B , Ilter Bahadur E , Ozdemir G , Celik H T , Ozmert E N
Published: January 2021

Unexpected early birth of an infant may affect the attachment formation of mother–child dyads. This longitudinal study aimed to explore mother–infant attachment patterns of very preterm (VPT) and preterm (PT) infants compared to their term‐born peers in a non‐Western country. Neurodevelopmental outcomes of infants, maternal anxiety and depressive symptoms, and sociodemographic features were evaluated to explore their effects on attachment. Eighteen VPT, 11 PT, 11 term infants and their mothers participated. Observations of attachment patterns and neurodevelopmental assessments were performed at 18 and 24 months of corrected age. This study identified a change in attachment patterns of VPT infants over time such that VPT infants tended to have less insecure attachment patterns with their mothers at the end of the infancy period. While motor and language development scores were associated with attachment patterns at 18 months, models predicting attachment patterns were no longer significant at 24 months. Therefore, change in VPT infants’ developmental outcomes and attachment patterns over time suggests that preterm birth itself is not necessarily a risk factor for developing insecure attachment patterns; yet, developmental delays may account for insecure attachment patterns. It is suggested that efforts to promote developmental outcomes of preterm infants may improve mother–child attachment.
Toward improved endoscopic surveillance with multidiameter single fiber reflectance spectroscopy in patients with Barrett's esophagus
Authors: Post Anouk L. , de Groof Albert J. , Zhang Xu U. , Swager Anne‐Fré , Fockens Kiki N. , Pouw Roos E. , Weusten Bas L. A. M. , Faber Dirk J. , de Bruin Daniel M. , Bergman Jacques J. G. H. M. , van Leeuwen Ton G. , Sterenborg Henricus J. C. M. , Curvers Wouter L.
Published: January 2021

Patients with Barrett's esophagus are at an increased risk to develop esophageal cancer and, therefore, undergo regular endoscopic surveillance. Early detection of neoplasia enables endoscopic treatment, which improves outcomes. However, early Barrett's neoplasia is easily missed during endoscopic surveillance. This study investigates multidiameter single fiber reflectance spectroscopy (MDSFR) to improve Barrett's surveillance. Based on the concept of field cancerization, it may be possible to identify the presence of a neoplastic lesion from measurements elsewhere in the esophagus or even the oral cavity. In this study, MDSFR measurements are performed on non‐dysplastic Barrett's mucosa, squamous mucosa, oral mucosa, and the neoplastic lesion (if present). Based on logistic regression analysis on the scattering parameters measured by MDSFR, a classifier is developed that can predict the presence of neoplasia elsewhere in the Barrett's segment from measurements on the non‐dysplastic Barrett's mucosa (sensitivity 91%, specificity 71%, AUC = 0.77). Classifiers obtained from logistic regression analysis for the squamous and oral mucosa do not result in an AUC significantly different from 0.5.
The role of surface oxide thickness and structure on the corrosion and nickel elution behavior of nitinol biomedical implants
Authors: Rosenbloom Shari Nathanson , Kumar Parikshith , Lasley Christopher
Published: January 2021

Biocompatibility is an important factor for metallic medical device implants, and corrosion resistance of implantable alloys is one aspect of biocompatibility. Corrosion behavior of nitinol is strongly dependent upon the nature of the surface oxide, which forms during processing. The surface oxide is comprised of a mixture of titanium and nickel oxides, and subsequent thermal exposure (e.g., during shape setting) and surface removal (e.g., electropolishing, mechanical polishing, etching, etc.) influence its structure. Corrosion behavior is often assessed through testing methods such as cyclic potentiodynamic polarization (e.g., ASTM F2129) and nickel ion release. Studies have suggested that a correlation exists between oxide thickness and nickel ion release, with thicker oxides eluting more nickel. It is hypothesized that the composition of the surface oxide, and not only its thickness, influences the corrosion performance of nitinol. To investigate this, nitinol wire samples were processed to produce surface oxides with different structures both in terms of thickness and composition. These samples were tested per ASTM F2129 and nickel ion release testing.
Factors associated with successful mentor matching in an intervention study of youth violence
Authors: Lennon Tyler , Cheng Tina , Lindstrom Johnson Sarah , Jones Vanya , Fein Joel , Manning Ryan Leticia
Published: January 2021

One challenge of conducting intervention studies is ensuring that study participants are exposed to the intervention. For example, in our randomized controlled trial of Take Charge!, a mentor‐implemented and research‐informed violence prevention program that partners with one‐on‐one community‐based mentoring agencies, only 50% of intervention youth with fight‐related injuries were successfully matched with a mentor. We examined the differences between matched (n = 49) and unmatched (n = 49) youth with regard to demographics, time from injury to study enrollment, perceived seriousness of injury, belief that future injury can be avoided, and household chaos. Youth who were successfully matched with a mentor were more likely to perceive the injury as very serious or somewhat serious compared with unmatched youth (95.9% vs. 79.6%, p = .028). All other factors were not significantly associated with successful mentor matching. Future violence prevention interventions should consider youth perceptions as a factor that may influence the completion of desired interventions.
Community psychology's origin and destination: Alternative pathways to the discipline's future
Authors: Lorion Raymond P.
Published: January 2021

A review of the Journal's nearly five decades of publications revealed an early commentary entitled “Common sense Community Psychology” (Thorne, 1974) reflecting on early decisions about the discipline's professional identity and interactions with targeted communities of color and need stimulated this commentary. Considered are ways we distinguished ourselves from our parent, clinical psychology, and its focus on emotional and behavioral disorder treated through psychotherapeutic interventions. Thorne's examination of alternative pathways that the discipline could have followed are considered relative to current challenges confronting communities of color and need.
Impacts of a large invasive mammal on water quality in riparian ecosystems
Authors: Bolds Sara A. , Lockaby B. Graeme , Ditchkoff Stephen S. , Smith Mark D. , VerCauteren Kurt C.
Published: January 2021

Wild pigs (Sus scrofa) are a highly invasive species in many regions of the world and can act as ecosystem engineers in areas where they are established. In riparian ecosystems, wild pigs may affect water quality parameters and introduce fecal bacteria, although previous studies have reported conflicting results. We propose four conditions that we believe are needed for an accurate assessment of wild pig impacts on water quality and address each one in our study. Water samples were collected between May 2018 and June 2019 in riparian watersheds on a privately owned property in Alabama that was densely populated by wild pigs (treatment) and in watersheds at a nearby national forest without an established population. Samples were analyzed for concentrations of water quality parameters, such as anions and cations, dissolved oxygen, total suspended solids, N, dissolved organic C, andEscherichia coliand other fecal coliforms. An additional 38 samples were analyzed using quantitative polymerase chain reaction for swine fecal bacteroidetes. At treatment watersheds, specific conductivity and concentrations of organic N and C, SO42−, and Ca2+were between 2 and 11 times that of reference watersheds.Escherichia colivalues at treatment watersheds were 40 times reference watershed values. DNA from swine fecal bacteroidetes was detected in 70% of treatment samples and 0% of reference samples. Wild pigs are a threat to water quality in riparian areas, and our results indicate that it may be important to control populations upstream of major drinking water sources and recreational areas.
Risk assessment and genetic counseling for hereditary breast and ovarian cancer syndromes—Practice resource of the National Society of Genetic Counselors
Authors: Berliner Janice L. , Cummings Shelly A. , Boldt Burnett Brittany , Ricker Charité N.
Published: January 2021

Cancer risk assessment and genetic counseling for hereditary breast and ovarian cancer (HBOC) are a communication process to inform and prepare patients for genetic test results and the related medical management. An increasing number of healthcare providers are active in the delivery of cancer risk assessment and testing, which can have enormous benefits for enhanced patient care. However, genetics professionals remain key in the multidisciplinary care of at‐risk patients and their families, given their training in facilitating patients’ understanding of the role of genetics in cancer development, the potential psychological, social, and medical implications associated with cancer risk assessment and genetic testing. A collaborative partnership of non‐genetics and genetics experts is the ideal approach to address the growing number of patients at risk for hereditary breast and ovarian cancer. The goal of this practice resource is to provide allied health professionals an understanding of the key components of risk assessment for HBOC as well as the use of risk models and published guidelines for medical management. We also highlight what patient types are appropriate for genetic testing, what are the most appropriate test(s) to consider, and when to refer individuals to a genetics professional. This practice resource is intended to serve as a resource for allied health professionals in determining their approach to delivering comprehensive care for families and individuals facing HBOC. The cancer risk and prevalence figures in this document are based on cisgender women and men; the risks for transgender or non‐binary individuals have not been studied and therefore remain poorly understood.
Measuring the resilience of exploitation systems from agricultural water based on good governance principles (case study: irrigation networks in Khuzestan Province)
Authors: Dahimavi Adel , Akhoond‐Ali Ali Mohammad , Shirvanian Abdoulrasool , Modhej Dalal
Published: January 2021

The sudden changes such as the drought of the 1980s and 1990s as well as the devastating floods of 2018 and 2019 have made water resource management in Khuzestan province a major challenge. Since one of the main ultimate goals of creating an exploitation system and its functions is to increase farmers' resilience to sudden changes, the purpose of this study is to measure the resilience of exploitation systems from agricultural water in irrigation and drainage networks of Khuzestan province. The obtained results are analyzed and compared.
A semi‐automatic solid phase extraction system based on MIL‐101(Cr) foam‐filled syringe for detection of triazines in vegetable oils
Authors: Jiang Yanxiao , Li Xu , Piao Huilan , Qin Zucheng , Li Jingkang , Sun Ying , Wang Xinghua , Ma Pinyi , Song Daqian
Published: January 2021

In this study, several metal‐organic framework‐melamine foam columns were first developed and used as a laboratory‐made semi‐automatic solid phase extraction packed in syringe adsorber for the extraction of six triazine herbicides from vegetable oil samples coupled to high‐performance liquid chromatography‐tandem mass spectrometry. The metal‐organic framework‐foam columns were prepared using a simple approach by embedding the solid particles in melamine foam using polyvinylidene difluoride physical encapsulation. The method was applicable to a wide variety of metal‐organic framework materials, and the incorporated materials retained their unique properties. Key factors that affect the extraction efficiency, including the MIL‐101(Cr) amount, sample flow rate, type and volume of the eluting solvent, and flow rate of eluting solvent, were investigated. Under optimum conditions, the proposed method exhibited low limits of detection (0.017–0.096 ng/mL, S/N = 3) for six triazines. The relative standard deviations calculated for all herbicides ranged from 0.2 to 14.9%. This study demonstrated that the MIL‐101(Cr)‐foam column can be used as a high‐quality adsorption material for the detection of triazines in vegetable oils.
Tracheotomy Outcomes in 64 Ventilated COVID‐19 Patients at a High‐Volume Center in Bronx, NY
Authors: Ahmed Yasmina , Cao Angela , Thal Arielle , Shah Sharan , Kinkhabwala Corin , Liao David , Li Daniel , Parides Michael , Mehta Vikas , Ow Thomas , Smith Richard , Schiff Bradley A.
Published: January 2021

Objectives/Hypothesis

The COVID‐19 pandemic has resulted in a dramatic increase in the number of patients requiring prolonged mechanical ventilation. Few studies have reported COVID‐19 specific tracheotomy outcomes, and the optimal timing and patient selection criteria for tracheotomy remains undetermined. We delineate our outcomes for tracheotomies performed on COVID‐19 patients during the peak of the pandemic at a major epicenter in the United States.

Methods

This is a retrospective observational cohort study. Mortality, ventilation liberation rate, complication rate, and decannulation rate were analyzed.

Results

Sixty‐four patients with COVID‐19 underwent tracheotomy between April 1, 2020 and May 19, 2020 at two tertiary care hospitals in Bronx, New York. The average duration of intubation prior to tracheotomy was 20 days ((interquartile range [IQR] 16.5–26.0). The mortality rate was 33% (n = 21), the ventilation liberation rate was 47% (n = 30), the decannulation rate was 28% (n = 18), and the complication rate was 19% (n = 12). Tracheotomies performed by Otolaryngology were associated with significantly improved survival (P < .05) with 60% of patients alive at the conclusion of the study compared to 9%, 12%, and 19% of patients undergoing tracheotomy performed by Critical Care, General Surgery, and Pulmonology, respectively.

Conclusions

So far, this is the second largest study describing tracheotomy outcomes in COVID‐19 patients in the United States. Our early outcomes demonstrate successful ventilation liberation and decannulation in COVID‐19 patients. Further inquiry is necessary to determine the optimal timing and identification of patient risk factors predictive of improved survival in COVID‐19 patients undergoing tracheotomy.

Level of Evidence

4—retrospective cohort study Laryngoscope, 131:E1797–E1804, 2021
Phase identification for dynamic CT enhancements with generative adversarial network
Authors: Tang Yucheng , Gao Riqiang , Lee Ho Hin , Chen Yunqiang , Gao Dashan , Bermudez Camilo , Bao Shunxing , Huo Yuankai , Savoie Brent V. , Landman Bennett A.
Published: January 2021

Purpose

Dynamic contrast‐enhanced computed tomography (CT) is widely used to provide dynamic tissue contrast for diagnostic investigation and vascular identification. However, the phase information of contrast injection is typically recorded manually by technicians, which introduces missing or mislabeling. Hence, imaging‐based contrast phase identification is appealing, but challenging, due to large variations among different contrast protocols, vascular dynamics, and metabolism, especially for clinically acquired CT scans. The purpose of this study is to perform imaging‐based phase identification for dynamic abdominal CT using a proposed adversarial learning framework across five representative contrast phases.

Methods

A generative adversarial network (GAN) is proposed as a disentangled representation learning model. To explicitly model different contrast phases, a low dimensional common representation and a class specific code are fused in the hidden layer. Then, the low dimensional features are reconstructed following a discriminator and classifier. 36 350 slices of CT scans from 400 subjects are used to evaluate the proposed method with fivefold cross‐validation with splits on subjects. Then, 2216 slices images from 20 independent subjects are employed as independent testing data, which are evaluated using multiclass normalized confusion matrix.

Results

The proposed network significantly improved correspondence (0.93) over VGG, ResNet50, StarGAN, and 3DSE with accuracy scores 0.59, 0.62, 0.72, and 0.90, respectively (P < 0.001 Stuart–Maxwell test for normalized multiclass confusion matrix).

Conclusion

We show that adversarial learning for discriminator can be benefit for capturing contrast information among phases. The proposed discriminator from the disentangled network achieves promising results.
On the conditioning of basis materials and its impact on multimaterial decomposition‐based spectral imaging in photon‐counting CT
Authors: Tang Xiangyang , Ren Yan
Published: January 2021

Purpose

Material‐specific imaging and virtual monochromatic imaging/analysis are the two forms of spectral imaging in CT implemented via either energy‐integration or photon‐counting data acquisition. Aimed at further understanding the fundamentals and providing guidelines on its design and implementation, we quantitatively investigate the conditioning (sufficiency in dimensionality, well‐posedness in basis functions, and matching of K‐edge materials) of basis materials and its impact on the performance of spectral imaging in photon‐counting CT.

Materials and Methods

Initially, singular value decomposition (SVD) is employed to investigate the dimensionality of material space for multimaterial decomposition‐based spectral imaging in photon‐counting CT over the energy range [18 150] keV. Then, the SVD is extended to study the well‐posedness of basis functions, its relationship with the dimensionality of materials to be imaged, and its impact on imaging performance. A number of phantoms are designed to mimic the soft and bony tissues in the head and contrast enhancement materials (iodine and gadolinium). Simulation studies, in which the geometry of photon‐counting CT is similar to a clinical CT, are carried out to evaluate and verify the proposed approach of conditioning analysis and the relationship between the conditioning of basis materials and the performance of spectral imaging in photon‐counting CT.

Results

The preliminary data show that the dimensionality of biological tissues, including both soft and bony tissues, is effectively equal to two. The dimensionality increments with inclusion of K‐edge materials into the materials to be imaged. The well‐posedness of basis functions depends on the correlation between the functions and impacts the noise in material decomposition substantially, but affects the noise in virtual monochromatic imaging/analysis moderately. If a K‐edge material is in the materials to be imaged, the same K‐edge material has to be one of the basis materials, but its concentration does not affect the accuracy of material decomposition significantly. Moreover, inclusion of K‐edge material into the basis material makes the tuning of correlation among the basis functions feasible and thus improves the performance of spectral imaging in photon‐counting CT.

Conclusion

The extension of SVD for systematic analysis of multimaterial decomposition‐based spectral imaging in photon‐counting CT is of innovation and significance. In addition to providing more information on the fundamentals, the approach used in this study and the data obtained so far may provide guidelines on the implementation of spectral imaging in either photon‐counting or energy‐integration CT, as well as other x‐ray‐related imaging modalities such as radiography and tomosynthesis.
Prevalence and risk factors of urinary incontinence among Iranian women
Authors: Daneshpajooh Azar , Naghibzadeh‐Tahami Ahmad , Najafipour Hamid , Mirzaei Mahboubeh
Published: January 2021

Background

Urinary incontinence is a common condition among women. Although it is not a life‐threatening condition, it dramatically influences the quality of life. This study aimed to estimate the prevalence of urinary incontinence and its risk factors among Iranian women in Kerman, Iran.

Methods

This cross‐sectional, population‐based study was conducted on 3100 Iranian women aged 15–80 years in 2017 in Kerman, Iran. The participants were selected via cluster sampling and were invited to complete the questionnaires. Their demographic information and medical history were assessed, the urinary incontinence questionnaire was completed, and the associated risk factors were also recorded. Quantitative variables are reported as mean ± SD, while qualitative and ranked variables are expressed in percentage. All analyses were conducted in Stata version 12 (Stata Corp.).

Results

The mean age of the participants was 46 years, and the overall prevalence of urinary incontinence was estimated to be 63%. The highest and lowest prevalence rates of urinary incontinence were reported in the elderly and the youth, respectively (79% and 41%, respectively). Age, increase of body mass index (BMI), pregnancy, diabetes, anxiety, and depression were the associated risk factors.

Conclusion

We found that the prevalence of urinary incontinence is high in Iran. Therefore, to control this condition and improve women's quality of life, effective plans are needed.
Design and validation of an automated dual‐arm instrumented intravaginal dynamometer
Authors: Czyrnyj Catriona S. , Bérubé Marie‐Ève , Lanteigne Eric , Brennan Ana , Bader Yousef , Lomovtsev Dmitry , Vandermolen Megan , Boucher Samantha , Mitri Layla , McLean Linda
Published: January 2021

Aims

(1) To present the design of a novel intravaginal dynamometer (IVD) capable of measuring vaginal closure force on both the anterior and posterior arms, (2) to use bench testing to validate the force, speed of arm opening, and positional accuracy of load measurement along the IVD arms, and (3) to present in vivo force measurements made with this device, comparing forces measured by the anterior and posterior arms.

Methods

IVD load measurements were validated against an Instron® Universal Tester, arm opening speeds were validated using video analysis, and position‐load accuracy was validated against calibration weights. In vivo IVD data were acquired from female volunteers during passive opening and pelvic floor muscle contraction tasks. Anterior and posterior IVD arm force outcomes were compared.

Results

Forces measured by the IVD and Instron® exhibited a strong linear relationship with excellent model fit. The speed control system was valid when tested under physiological loading conditions, however smaller antero‐posterior opening diameters (25 and 30 mm) exhibited some error. The loading position along the IVD arms had no effect on force outcomes. In vivo data exhibited differences between force outcomes measured at the anterior and posterior aspects of the vagina during active contraction and passive elongation of the pelvic floor muscles.

Conclusions

This IVD design demonstrates valid load measurement and speed control during bench testing. Active and passive forces measured are consistent with the literature. With dual instrumented arms, this device allows for further investigation into the source of measured vaginal closure forces.
Comparing the outcomes of parasacral transcutaneous electrical nerve stimulation for the treatment of lower urinary tract dysfunction in children: A systematic review and meta‐analysis of randomized controlled trials
Authors: O'Sullivan Hugh , Kelly Gabrielle , Toale James , Cascio Salvatore
Published: January 2021

Aims

Despite published evidence in recent decades suggesting improvement in lower urinary tract symptoms (LUTS) with the use of parasacral transcutaneous electrical nerve stimulation (PTENS), no consensus guidelines for therapy exist. This study systematically reviews the literature to assess the effect of PTENS in children with LUTS.

Methods

A database search conducted up to December 2019 included Medline, EMBASE, and the Cochrane Library. From the literature review, 6 randomized controlled studies (234 participants) comparing PTENS and standard treatment (urotherapy/anticholinergics) were considered. From each study, the success rates were available for PTENS and the control group. The ratio of success rates was computed—that is, the risk ratio (RR) and the risk difference (RD).

Results

The overall success rate with PTENS was 1.92 times that of children undergoing standard urotherapy alone (RR: 1.92, 95% confidence interval [CI: 1.02, 3.61]) and 1.56 for those undergoing either urotherapy alone or with pharmacotherapy (anticholinergics; RR: 1.56, 95% CI [1.04, 2.40]). No difference in the success rate was found when PTENS was used in patients failing previous treatment (urotherapy and pharmacological therapy; RR: 0.175, 95% CI [0.02, 1.45]).

Conclusions

Current evidence suggests that PTENS is beneficial in children with LUTS. The chance of success is 1.92 times that of children undergoing standard urotherapy. However, in children who have failed urotherapy and pharmacological therapy, PTENS monotherapy has a limited role and should be an adjunct. Literature shortcomings included small numbers of patients, differing inclusion criteria, and PTENS protocols. A need exists for quality multicenter randomized controlled trials to prove the efficacy of PTENS in children with LUTS.
The muscle twitch profile assessed with motor unit magnetic resonance imaging
Authors: Heskamp Linda , Birkbeck Matthew G. , Whittaker Roger G. , Schofield Ian S. , Blamire Andrew M.
Published: January 2021

Localised signal voids in diffusion‐weighted (DW) images of skeletal muscle have been postulated to occur as a result of muscle fibre contraction and relaxation. We investigated the contrast mechanism of these signal voids using a combination of modelling and experimental measurements by employing DW and phase contrast (PC) imaging sequences. The DW signal and PC signal were simulated for each time point of a theoretical muscle twitch. The model incorporated compaction (simulating actively contracting muscle fibres) and translation (simulating passively moving surrounding fibres). The model suggested that the DW signal depended on contraction time and compaction whereas the PC signal depended on contraction time, compaction and translation. In a retrospective study, we tested this model with subgroup analyses on 10 healthy participants. Electrical nerve stimulation was used to generate muscle twitches in lower leg muscles; the resulting force was measured using an MR‐compatible force transducer. At current levels causing a visible muscle twitch (~13 mA), the width of the first signal drop in the DW signal (mean ± SD: 103 ± 20 ms) was comparable with the force contraction time (93 ± 34 ms; intraclass correlation coefficient [ICC] = 0.717, P = .010). At current levels activating single motor units (~9 mA), the contraction time determined from the DW signal was 75 ± 13 ms and comparable with the PC contraction time (81 ± 15 ms; ICC = 0.925, P = .001). The maximum positive velocity was 0.55 ± 0.26 cm/s and the displacement was 0.20 ± 0.10 mm. Voxel‐wise analysis revealed localised DW changes occurring together with more widespread phase changes. In conclusion, local signal attenuations in DW images following muscle fibre activation are primarily caused by compaction. The PC sequence also detects translating muscle tissue being passively pulled. The magnitude of the changes in DW and PC images depends on the twitch's contractile properties and percentage contraction. DW imaging and PC imaging can therefore measure twitch profiles of skeletal muscle fibres.
Description of a Nutrition Screening and Assessment Tool and Associations with Clinical Outcomes in Preterm Newborns
Authors: Belin Christy Hannah Sanini , Sarmento Roberta Aguiar , Refosco Lília Farret , Bernardi Juliana Rombaldi
Published: January 2021

Background

Preterm newborns have higher nutrition risk and mortality. Nutrition risk screening enables early intervention. This article evaluates a nutrition screening tool in a neonatal intensive care unit (NICU).

Method

Retrospective longitudinal study of preterm newborns (aged <37 weeks) in a NICU in Brazil from May 2018 to January 2019. Weight, length, and head circumference (HC) were analyzed. Nutrition screening was defined by care levels (CLs). Outcomes analyzed were bronchopulmonary dysplasia (BPD), peri‐intraventricular hemorrhage (PIVH), retinopathy of prematurity (ROP), late sepsis, length of stay, mortality, and time receiving enteral and parenteral nutrition.

Results

Data on 110 newborns were studied, with median gestational age 34 (31–35) weeks, mean weight 1914.92 g (±657.7), length 42.2 cm (±4.45), and HC 29.9 cm (±2.97). Most (82.7%) of them were adequate for gestational age. Screening classifications were 41.8% (n = 46) at CL 2, 41.8% (n = 46) at CL 3, and 16.4% (n = 18) at CL 4. CL 3 and CL 4 patients had higher frequencies of BPD (P = .003), ROP (P = .027), and PIVH (P = .006) and longer enteral time (P < .001) and length of stay (P < .001). All mortality occurred in CL 4 patients (P < .001).

Conclusions

CL 3 and CL 4 patients had more BPD, ROP, PIVH, and mortality and longer enteral nutrition. Hospital stay was longer for CL ≥3 than CL 2 patients. Patients classified as CL 3 and CL 4 by the nutrition screening tool may have higher nutrition risk.
Experience of aggressive behaviour of health professionals in home care services and the role of persons with dementia
Authors: Schnelli Angela , Mayer Hanna , Ott Stefan , Zeller Adelheid
Published: January 2021

Aims

To explore the view of health professionals on the form and frequency of aggressive behaviour of clients against health professionals in home care services.

Design

An explorative cross‐sectional survey was conducted.

Methods

We conducted a survey using the Survey of Violence Experienced by Staff German version Revised (SOVES‐G‐R) and the Impact of Patient Aggression on Carers Scale (IMPACS). A convenience sample of 852 healthcare professionals from German‐speaking Switzerland participated. Data collection was conducted between July–October 2019. Data were analysed descriptively using IBM SPSS Statistics.

Results

Of the health professionals, 78.9% (N = 672) experienced aggressive behaviour since they worked in home care services. The most frequent aggressive behaviour was verbal aggression (75.6%, N = 644), while the most common predisposing factor was restriction in cognitive ability (71.3%, N = 67). Fear, burden and impairment of nursing relationship were common consequences of aggressive behaviour.
Feasibility study of using unbalanced embryos as a reference to distinguish euploid carrier from noncarrier embryos by single nucleotide polymorphism array for reciprocal translocations
Authors: Li Rong , Wang Jing , Gu Ailing , Xu Yan , Guo Jing , Pan Jiafu , Zeng Yanhong , Ma Yuanlin , Zhou Canquan , Xu Yanwen
Published: January 2021

Objectives

To study the feasibility of using unbalanced embryos as a reference in distinguishing euploid carrier and noncarrier embryos by single nucleotide polymorphism (SNP) array‐based preimplantation genetic testing (PGT) for reciprocal translocations.

Methods

After comprehensive chromosome screening (CCS), euploid embryos were identified as normal or carriers using a family member as a reference. Next, unbalanced embryos were used as a reference, and the results were compared with the previous ones. Karyotypes of transferred embryos were validated by prenatal diagnosis.

Results

Of 995 embryos from 110 couples, 288 were found to be euploid. Using a family member as a reference, 142 and 144 embryos were tested to be euploid noncarrier and carrier respectively, and the remaining 2 embryos were undetermined. When unbalanced embryos were selected as references, all the results were consistent with the previous ones. A total of 107 embryos were transferred, resulting in 66 clinical pregnancies. Karyotypes of prenatal diagnosis were all in accordance with the results of tested embryos.

Conclusions

SNP array‐based haplotyping is a rapid and effective way to distinguish between euploid carrier and noncarrier embryos. In case no family member is available as a reference, unbalanced embryos can be used for identification of euploid carrier and noncarrier embryos.