bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Soft Tissue Closure on Medication‐Related Osteonecrosis of the Jaw in a Rabbit Model with Tooth Extraction: A Pilot Study
Authors: Yu Ru Qing , Li Jing Wen , Wang Jing Yi , Huo Lei , Zheng Li Wu
Published: December 2021

Objectives. The study investigated the effect of soft tissue closure after tooth extraction on the prevention of medication‐related osteonecrosis of the jaw in a rabbit model. Materials and Methods. Twenty female New Zealand white rabbits were randomly assigned into the experimental group administrated with zoledronic acid (ZA) and control groups treated with saline. Bilateral lower premolar extraction was performed 4 weeks after ZA/saline administration. Immediately after extraction, the wound on the right mandible was closed by suture while the other side was left open. Animals were sacrificed 4 weeks and 8 weeks after tooth extraction. Fluorochrome labeling solutions were injected subcutaneously to evaluate the bone growth rates. The mandibles were harvested and subjected for microcomputed tomography, confocal microscope, and histomorphological examinations. Results. All extraction sites healed well without any signs of infection. Trabecular thickness (Tb.Th) was significantly higher in the ZA‐treated group than in the control group at both week 4 and week 8, while no significant difference was detected in the rest of the assessed parameters. The bone growth rate in mandibles showed gradual reduction in the ZA‐treated group. Histological analysis showed that at week 8, the animals in the ZA‐treated group had significantly higher incidence of osteonecrosis than that in the control group, while no significance was revealed between the sutured and nonsutured side. Conclusions. ZA treatment significantly reduces bone growth rates but does not reveal a significant effect on bone mineral density and bone microarchitecture. Soft tissue closure of the extraction socket does not reduce the incidence of ONJ in the ZA‐treated rabbit model.
Single-Photon Emission Computed Tomography Image-Assisted Diagnosis of Thyroid Diseases under Convolutional Network Neural Algorithm
Authors: Chen Shaobo , Pi Yinzhen , Gong Haiyan , Wang Huaijun , Liu Shu
Published: December 2021

The aim of this study was to investigate the value of single-photon emission computed tomography (SPECT) based on the convolutional neural network (CNN) algorithm in thyroid diseases. Thirty-five patients with thyroid disease from the hospital were selected as the observation group, and another 35 healthy volunteers were selected as the control group. The constructed model of SPECT based on the CNN algorithm was compared with the backpropagation neural network (BPNN) algorithm, which was then applied to the SPECT of 35 patients with thyroid disease. It turned out that as the number of iterations increased, the parameter training of CNN was gradually sufficient, the network model was continuously optimized, and the accuracy gradually increased. From the data results, the Dice value of the proposed CNN algorithm was higher than that of the BPNN algorithm and the segmentation effect was relatively good. The visual index of the thyroid/neck of the observation group (2.68 ± 1.32) was remarkably inferior to that of the control group (12.347.54) (

P
<
0.05

). The visual index of the thyroid/submandibular gland in the observation group (1.02 ± 0.41) was remarkably inferior to that of the control group (8.89 ± 4.86) (

P
<
0.05

). The visual index of the thyroid/parotid gland in the observation group (1.04 ± 0.58) was remarkably inferior to that of the control group (8.53 ± 4.25) (

P
<
0.05

). In addition, 99mTcO4-SPECT had a sensitivity of 95.2%, a specificity of 90.3%, and an accuracy of 91.5% in the diagnosis of thyroid diseases. The area under the curve of the receiver operating characteristic curve for 99mTcO4-SPECT diagnosis of thyroid disease is 0.958, and the 95% confidence interval is 0.834∼1. In summary, the SPECT based on the CNN algorithm proposed in this study has a good segmentation effect and can accurately locate the anatomical information of thyroid diseases, which can replace the traditional diagnostic methods for the diagnosis of thyroid diseases.
Application of Data Mining in the Evaluation of Enterprise Lean Management Effect
Authors: Yang Jinpeng , Liu Ying
Published: December 2021

In order to improve the effect of enterprise lean management, this study proposes a lean data mining algorithm based on the characteristics of lean data in enterprise management. This study connects data mining and lean production to study the data of enterprise management operation, proposes an intelligent data processing model suitable for modern enterprise management, and constructs the model function module in combination with the enterprise operation management process. Moreover, this study constructs an evaluation system for the effect of enterprise lean management based on data mining. The system provides a human-computer interaction interface, and operators can use various functions and services provided by the system through a visual interface. Through experimental research, it can be known that the enterprise lean effect evaluation system based on data mining proposed in this study can play an important role in enterprise lean management.
Iranian Pediatric COVID-19 Epidemiology and Clinical Characteristics
Authors: Armin Shahnaz , Mirkarimi Mohammadreza , Pourmoghaddas Zahra , Tariverdi Marjan , Jafrasteh Azadeh , Marhamati Noushin , Shirvani Armin , Karimi Abdollah , Rafiei Tabatabaei Sedigheh , Mansour Ghanaei Roxana , Fahimzad SeyedAlireza , Shirvani Fariba , Hoseini-Alfatemi Seyedeh Mahsan
Published: December 2021

Background. Despite the worldwide spread of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), information about the epidemiological and clinical patterns of this infection is still largely unknown in children. In addition, the prevalence of this disease is still very high in some parts of the world, including Iran. Thus, this study aims to evaluate the epidemiological features, laboratory and imaging findings, and the type of treatments in children with novel coronavirus 2019 (COVID-19). Method. This study is conducted from March 2020–March 2021 by using the medical records of hospitalized confirmed COVID-19 children younger than 18 years in five cities of Iran: Tehran, Ahwaz, Isfahan, Bandar-Abbas, and Khorramabad. In addition to demographic and epidemiological data, we also studied clinical signs and treatments. Results. In total 278 confirmed COVID-19 children, the average age was 5.3 years, and 59.4%were boys. A total of 37.8% had an underlying disease, in which the most common was a malignancy. The most common symptoms were fever and cough. In this group of pediatrics, some abnormal laboratory findings have been seen. GGO (Ground-Glass Opacity) had been diagnosed in 58.6% of children. 3.6% needed oxygen therapy with ventilators, and 83.09% had received antibiotic treatments with the majority of ceftriaxone. Also, 10% had got steroids. In this study, the mortality rate was 4.3%. Conclusion. In this study, most of the children who died had an underlying disease, so timely care and action is important in them. Most children admitted to our study received antibiotics and were prescribed antivirals and steroids for a smaller number. Also, a small number of children received oxygen therapy, most of whom were in the age group of 1 to 5 years.
Significant Physical and Exercise‐Related Variables for Exercise‐Centred Lifestyle: Big Data Analysis for Gynaecological Cancer Patients
Authors: Yang Eun Joo , Jee Hyunseok
Published: December 2021

This study investigated the characteristics of gynaecological cancers and is aimed at identifying significant risk variables using the National Health Insurance Sharing Service database to develop practical interventions for affected patients. Data regarding patients with uterine and ovarian cancer from the National Health Insurance Sharing Service database were collected and analysed using Student’s t‐test, logistic regression, and receiver operating characteristic curve analyses. Student’s t‐test analyses revealed that age, body mass index, blood pressure, and waist variables differed significantly among patients with uterine cancer. Gamma‐glutamyl transpeptidase levels were higher in patients with ovarian cancer than in patients with uterine cancer. Physical fitness function tests reflected the status of patients with cancer. Moreover, physical disability was associated with an increased incidence of ovarian cancer. Intensive exercise for 20 min more than 1 time per week must be avoided to prevent uterine cancer. Receiver operating characteristic curve analyses showed that the optimal cutoff value for one‐leg standing time, a prognostic and preventive factor in ovarian cancer, was 9.50 s (sensitivity, 94.9%; specificity, 96.9%). Controlling significant variables for each gynaecological cancer type in an individualised and optimised manner is recommended, including by maintenance of an adjusted exercise‐centred lifestyle.
Assessment of Cavitation Erosion in a Water-Jet Pump Based on the Erosive Power Method
Authors: Qiu Ning , Zhu Han , Long Yun , Zhong Jinqing , Zhu Rongsheng , Wu Suhuan
Published: December 2021

Cavitation affects the performance of water-jet pumps. Cavitation erosion will appear on the surface of the blade under long-duration cavitation conditions. The cavitation evolution under specific working conditions was simulated and analyzed. The erosive power method based on the theory of macroscopic cavitation was used to predict cavitation erosion. The result shows that the head of the water-jet pump calculated using the DCM-SST turbulence model is 12.48 m. The simulation error of the rated head is 3.8%. The cavitation structure of tip leakage vortex was better captured. With the decrease of the net positive suction head, the position where the severe cavitation appears in the impeller domain gradually moves from the tip to the root. The erosion region obtained by the cavitation simulation based on the erosive power method is similar to the practical erosion profile in engineering. As the net positive suction head decreases, the erodible area becomes larger, and the erosion intensity increases.
Study of Suspension Parameters Matching to Enhance Vehicle Ride Comfort on Bump Road
Authors: Gao Jin , Qi Xiaoping
Published: December 2021

In this study, the parameters of the MacPherson front suspension and the E‐type multilink rear suspension are matched to enhance the vehicle ride comfort on bump road. Vehicle vibration and suspension stiffness are analyzed theoretically. In the simulation study, the influence of the front and rear wheels on the vehicle vibration is considered, so the time‐domain curves of the front and rear seat rail accelerations are processed by adding windows with two different window functions. The resulting ΔRmsLocal and ΔRmsGlobal are used as evaluation indexes of the vehicle ride comfort. The sensitivity analysis yields the magnitude of the influence of the suspension parameters on the evaluation indexes. In addition, the trends of ΔRmsLocal and ΔRmsGlobal with bushing stiffness at different vehicle speeds are discussed. The results show that longitudinal ΔRmsLocal and ΔRmsGlobal of the seat rails are influenced by the bushings mostly, while the vertical ΔRmsLocal and ΔRmsGlobal of the seat rails are influenced by the spring and shock absorber mostly. The trends of ΔRmsLocal and ΔRmsGlobal with bushing stiffness are influenced by the speed of the vehicle. Finally, the vehicle ride comfort is enhanced after optimization and matching of the suspension parameters by NSGA‐II optimization algorithm.
Optimization of Historic Building Survey Technology under Artificial Intelligence Wireless Network Technology Environment
Authors: Tan Wei , Fen Ye , Yuan Qi
Published: December 2021

In order to optimize the technology of the building, the damage identification of the building structure is studied. Firstly, back propagation neural network (BPNN) and information fusion technology are used to build neural network models. Secondly, the established model is trained. Finally, the displacement mode, natural frequency, Modal Assurance Criterion (MAC), and three kinds of information fusion with only one characteristic information are used as input data to analyse the results of BPNN identification damage. The results show that when the natural frequency is used as the sensitive feature of damage, the accuracy is the highest. The difference between the network output value and the expected value is the smallest, the network output is the most stable, and the network recognition effect is the best. The network output of a mixture of two damage depths is compared with the output of a single damage depth. The data of the network training set composed of the feature data with damage depth of 20 mm and 5 mm has higher accuracy and more accurate damage recognition. This research provides a reference for the optimization of building survey technology and has certain practical value.
A Machine Learning Approach to Assess Differential Item Functioning in Psychometric Questionnaires Using the Elastic Net Regularized Ordinal Logistic Regression in Small Sample Size Groups
Authors: Ebrahimi Vahid , Bagheri Zahra , Shayan Zahra , Jafari Peyman
Published: December 2021

Assessing differential item functioning (DIF) using the ordinal logistic regression (OLR) model highly depends on the asymptotic sampling distribution of the maximum likelihood (ML) estimators. The ML estimation method, which is often used to estimate the parameters of the OLR model for DIF detection, may be substantially biased with small samples. This study is aimed at proposing a new application of the elastic net regularized OLR model, as a special type of machine learning method, for assessing DIF between two groups with small samples. Accordingly, a simulation study was conducted to compare the powers and type I error rates of the regularized and nonregularized OLR models in detecting DIF under various conditions including moderate and severe magnitudes of DIF (DIF = 0.4 and 0.8), sample size (N), sample size ratio (R), scale length (I), and weighting parameter (w). The simulation results revealed that for I = 5 and regardless of R, the elastic net regularized OLR model with w = 0.1, as compared with the nonregularized OLR model, increased the power of detecting moderate uniform DIF (DIF = 0.4) approximately 35% and 21% for N = 100 and 150, respectively. Moreover, for I = 10 and severe uniform DIF (DIF = 0.8), the average power of the elastic net regularized OLR model with 0.03 ≤ w ≤ 0.06, as compared with the nonregularized OLR model, increased approximately 29.3% and 11.2% for N = 100 and 150, respectively. In these cases, the type I error rates of the regularized and nonregularized OLR models were below or close to the nominal level of 0.05. In general, this simulation study showed that the elastic net regularized OLR model outperformed the nonregularized OLR model especially in extremely small sample size groups. Furthermore, the present research provided a guideline and some recommendations for researchers who conduct DIF studies with small sample sizes.
Drive System Design for Small Autonomous Electric Vehicle: Topology Optimization and Simulation
Authors: Wu Zhongming , Zhu Mufangzhou , Guo Yu , Sun Li , Gu Yuchen
Published: December 2021

High driving efficiency remains challenging in autonomous electric vehicles, especially in small electric vehicle subtype. Here, we reported investigation of the structure and requirements of the drive system for those vehicles, while the motor‐drive axle combined integrated driving scheme has been chosen. In the study, the power matching of drive motor as well as transmission ratio has been calculated based on the performance of the small electric vehicles, and the total gear ratio of 8.124 was determined. For better comprehensive performance and efficiency, the two‐stage retarder has been designed, in which elements including high‐speed shaft, low‐speed shaft, gears, and differential have been examined to ensure their proof strength when the motor outputs reached the maximum torque. Notably, by utilizing topology optimization, Gear 4, the transmission unit with the heaviest weight percentage has been modified in a lightweight way, achieving a 41% reduction of the mass in emulation analysis and turned up to the target of optimization eventually.
Mobility Analysis of Persons with Disabilities
Authors: Počuč Miodrag , Mirović Valentina , Mitrović Simić Jelena , Karamasa Caglar
Published: December 2021

This study presents the results of the research on travel behaviour for persons with different types of disabilities. Persons with disabilities are a group of participants with specific traffic requirements often not included in traffic research and consequently adequate planning of urban transport. To obtain the data, a home interview was conducted on a representative sample. The paper presents the main results of the research and indicates the specificity of the requirements of this group of users. The results are compared with the results of the same research conducted for the development of the Smart Plan of Novi Sad and the results of similar research abroad. The main goal is to obtain a qualitative and quantitative database of the requirements of this group of users as a basis for creating sustainable urban mobility plans.
Influence of Process Parameter on Carbon Nanotube Field Effect Transistor Using Response Surface Methodology
Authors: SundaramK Mohana , Prakash P. , Angalaeswari S. , Deepa T. , Natrayan L. , Paramasivam Prabhu
Published: December 2021

Carbon nanotube field-effect transistor (CNTFET) is a good option to replace silicon for low power consumption application. Recent research shows that CN-FET thermal and electrical properties alter with length, diameter, and gate parameters. Optimization of CNTFET design parameters helps control some of the factors. Double gate and cylindrical gate layouts are introduced to overcome these facts. Carbon nanotubes have an intercapacitance between them that increases as their diameter increases. Total capacitance and inductance of CNTFETs increase with nanotube count. In order to reduce the voltage drop between semiconducting and metallic terminals, the diameter and pitch must be raised. This study employs response surface methodology and ANOVA technique that were used to optimize CNTFET process parameters. Thickness, voltage, delay, and power were all considered. The most affecting parameter was investigated.
Wireless Image Transmission Interference Signal Recognition System Based on Deep Learning
Authors: Guo Zhijun , Liu Shuai
Published: December 2021

In the process of wireless image transmission, there are a large number of interference signals, but the traditional interference signal recognition system is limited by various modulation modes, it is difficult to accurately identify the target signal, and the reliability of the system needs to be further improved. In order to solve this problem, a wireless image transmission interference signal recognition system based on deep learning is designed in this paper. In the hardware part, STM32F107VT and SI4463 are used to form a wireless controller to control the execution of each instruction. In the software part, aiming at the time‐domain characteristics of the interference signal, the feature vector of the interference signal is extracted. With the support of GAP‐CNN model, the interference signal is recognized through the training and learning of feature vector. The experimental results show that the packet loss rate of the designed system is less than 0.5%, the recognition performance is good, and the reliability of the system is improved.
Exploration of PPP Investment and Financing Model for Infrastructure: A Case Study of the Beijing-Tianjin-Hebei Region
Authors: Chi Xiuxiang , Liu Liguo
Published: December 2021

With the overall weakening of the macroeconomic situation, the investment growth in Beijing-Tianjin-Hebei continued to slow down. This article focuses on the reform and innovation of investment and financing models in the vertical and horizontal collaborative construction of Beijing-Tianjin-Hebei infrastructure. Under the framework of the PPP model, this article discusses how to design a market-oriented platform of infrastructure investment and financing model, introduce and use private capital, build remote capital access and exit mechanism, measure the government’s financial capacity and financial risks in the PPP model, set up PPP institutions, and improve relevant laws and regulations to make the infrastructure construction and operation more efficient, thus promoting the coordinated development of infrastructure construction in the Beijing-Tianjin-Hebei region.
Research on Preparation and Performance of Clay‐Based Shield Tunnel Nonsintered Bricks
Authors: Chen Sibin , Jiang Hao , Xing Huitang , Wang Jing , Huang Yongliang , Wei Guangbin , Zhang Yijie , Hou Dongshuai
Published: December 2021

With the rapid development of rail transit in China, the number and scale of underground engineering construction have increased significantly, and a large amount of shield muck has been generated, which has brought great challenges to the urban environment. The reuse of shield muck has become an important research direction in underground engineering construction. In this paper, a nonsintered brick is prepared with shield muck soil as the matrix. The influence of different doping amounts of lime, fly ash, cement, and polyvinyl alcohol on porosity, density, water absorption, saturation coefficient, compressive strength, and other properties was explored to realize the resource utilization of shield dregs and at the same time obtain excellent performance nonsintered bricks. Through research, it is found that when the lime doping amount is 10% and the cement doping amount is 5%, with the increase of the fly ash doping amount, the overall compressive strength increases significantly, and the maximum compressive strength can reach 13.69 MPa. Although the doping of trace amounts of polyvinyl alcohol reduces the compressive strength, it can significantly reduce the compressive strength and mass loss rate after 15 freeze‐thaw cycles.
Characters of Explicit Solutions for a Semidiscrete Integrable Coupled Equation
Authors: Zhao Qiulan , Yang Qianqian , Qu Xiangwen
Published: December 2021

A semidiscrete integrable coupled system is obtained by embedding a free function into the discrete zero-curvature equation. Then, explicit solutions of the first two nontrivial equations in this system are derived directly by the Darboux transformation method. Finally, in order to compare the solutions before and after coupling intuitively, their structure figures are presented and analyzed.
FDA Approval Summary: Margetuximab plus Chemotherapy for Advanced or Metastatic HER2-Positive Breast Cancer
Authors: Royce Melanie , Osgood Christy L. , Amatya Anup K. , Fiero Mallorie H. , Chang C.J. George , Ricks Tiffany K. , Shetty Krithika A. , Kraft Jeffrey , Qiu Junshan , Song Pengfei , Charlab Rosane , Yu Jingyu , King Kathryn E. , Rastogi Anshu , Janelsins Brian , Weinberg Wendy C. , Clouse Kathleen , Borders-Hemphill Vicky , Brown Lindsey , Gomez-Broughton Candace , Li Zhong , Nguyen Thuy Thanh , Qiu Zhihao , Ly Anh-Thy , Chang Suyoung , Gao Tingting , Tu Chi-Ming , King-Kallimanis Bellinda , Pierce William F. , Chiang Kelly , Lee Clara , Goldberg Kirsten B. , Leighton John K. , Tang Shenghui , Pazdur Richard , Beaver Julia A. , Amiri-Kordestani Laleh
Published: December 2021

On December 16, 2020, the FDA granted regular approval to margetuximab-cmkb (MARGENZA), in combination with chemotherapy, for the treatment of adult patients with HER2-positive (HER2+) metastatic breast cancer who have received two or more prior anti-HER2 regimens, at least one of which was for metastatic disease. Approval was based on data from SOPHIA, a multicenter, randomized, open-label, active controlled study comparing margetuximab with trastuzumab, in combination with chemotherapy. The primary efficacy endpoint was progression-free survival (PFS) by blinded independent central review. SOPHIA demonstrated a 0.9-month difference in median PFS between the two treatment arms [5.8 vs. 4.9 months, respectively; stratified HR, 0.76 (95% confidence interval: 0.59–0.98; P = 0.0334)]. Overall survival (OS) was immature at the data cut-off date of September 10, 2019. Infusion-related reactions (IRR) are an important safety signal associated with margetuximab plus chemotherapy. In SOPHIA, 13% of patients treated with margetuximab plus chemotherapy reported IRRs, of which 1.5% were grade 3. The most commonly reported adverse drug reactions (>10%) with margetuximab in combination with chemotherapy were fatigue/asthenia, nausea, diarrhea, vomiting, constipation, headache, pyrexia, alopecia, abdominal pain, peripheral neuropathy, arthralgia/myalgia, cough, decreased appetite, dyspnea, IRR, palmar-plantar erythrodysesthesia, and extremity pain. Overall, the favorable risk-benefit profile for margetuximab when added to chemotherapy supported its approval for the intended indication.
Baker’s Cyst with Knee Osteoarthritis: Clinical and Therapeutic Implications
Authors: Abate Michele , Di Carlo Luigi , Di Iorio Angelo , Salini Vincenzo
Published: December 2021

Objective: Several symptoms are common to knee osteoarthritis and Baker’s cyst. To what extent each condition contributes to the patient’s discomfort is still a matter of debate. The aim of the present study was twofold: first, to compare the burden of symptoms in patients with isolated knee osteoarthritis and patients with knee osteoarthritis associated with Baker’s cyst; second, to assess the outcomes after conservative treatments. Subject and Methods: Patients suffering from monolateral idiopathic knee osteoarthritis were enrolled. Demographic, anthropometric and clinical data (KOOS scale) were collected. Ultrasound evaluation was performed according to standard protocols. On the basis of the clinical presentation different therapeutic options were used (fluid withdrawal, hyaluronic acid and/or steroids injections). Results: One-hundred and thirty patients were included in the study (97 with isolated knee osteoarthritis, 33 with knee osteoarthritis and Baker’s cyst). In basal conditions, lower scores in KOOS sub-scales were observed in patients with knee osteoarthritis associated with Baker’s cyst and in patients with effusion compared with patients without effusion. At 3 months after therapy significant higher scores were observed in both groups. At 6 months the scores were unchanged in the patients without Baker’s cyst, but worsened in those with Baker’s cyst. Conclusions: The study shows that Baker’s cysts associated with knee osteoarthritis contribute to the burden of symptoms. The conservative treatment of both conditions allows significant improvements, but in the medium term (6 months) the efficacy of the therapy declines in patients with knee osteoarthritis associated with Baker’s cyst.
Are Differences in Dysphagia Assessment, Oral Care Provision, or Nasogastric Tube Insertion Associated with Stroke-Associated Pneumonia? A Nationwide Survey Linked to National Stroke Registry Data
Authors: Eltringham Sabrina A. , Bray Benjamin D. , Smith Craig J. , Pownall Sue , Sage Karen
Published: December 2021

Introduction: Stroke-associated pneumonia (SAP) is a common complication associated with poor outcomes. Early dysphagia screening and specialist assessment is associated with a reduced risk of SAP. Evidence about oral care and nasogastric tube (NGT) placement is equivocal. This study aimed to expose variations in dysphagia management practices and explore their associations with SAP. Participants and Methods: Speech pathologists from 166 stroke units in England and Wales were surveyed about dysphagia assessment and management, oral care, and NGT placement. Survey data were then linked to the Sentinel Stroke National Audit Programme (SSNAP), the national register of stroke. Univariable and multivariable linear regression models were fitted to estimate the association between dysphagia management practices and SAP incidence. Results: 113 hospitals completed the survey (68%). Variation was evident in dysphagia screening protocols (DSPs), oral care, and NGT practice while specialist swallow assessment data patterns were more consistent. Multivariable analysis showed no evidence of an association in incidence of SAP when using a water-only hospital DSP compared to a multiconsistency DSP (B −0.688, 95% CI: −2.912 to 1.536), when using written swallow assessment guidelines compared to not using written guidelines (B 0.671, 95% CI: −1.567 to 2.908), when teams inserted NGTs overnight compared to teams which did not (B −0.505, 95% CI: −2.759 to 1.749), and when teams had a written oral care protocol compared to those which did not (B −1.339, 95% CI: −3.551 to 0.873). Discussion and Conclusion: Variation exists in dysphagia screening and management, but there was no evidence of an association between clinical practice patterns and incidence of SAP. Further research with larger sample sizes is needed to examine association with SAP.
Impact of Bladder Wall Thickness on the Outcomes of Antimuscarinic Treatment in Women with Overactive Bladder
Authors: Azab Sherif Salah , El Sayed Omar , El Kafoury Mona
Published: December 2021

Aim: This study aimed to evaluate the effect of bladder wall thickness (BWT) (using transabdominal ultrasound) on the outcomes of antimuscarinic treatment in women with overactive bladder. Methods: A total of 102 female patients with symptoms of OAB were recruited. All patients completed the Overactive Bladder version 8 (OAB-V8) (Arabic validation) and the International Consultation of Incontinence Questionnaire (ICIQ-SF). Patients completed the urodynamic study (UDS) including uroflowmetry and PVR and measures of BWT by transabdominal ultrasound. The patients were classified into 2 major groups: G1 (patients with BWT <5 mm) and G2 (patients with BWT ≥5 mm). The patients were re-evaluated after 3-month medication with solifenacin 10-mg oral tablet. Results: At baseline, the results of OAB-V8 and ICIQ-SF were significantly higher in G2 than G1 (p < 0.001). Regarding UDS, volume at 1st desire to void, volume at strong desire to void, and MBC were significantly higher in group 1 compared to group 2 (p = 0.001). Intravesical pressure at strong desire and patients’ number of DO were significantly increased in G2 (p < 0.05 and p = 0.001, respectively). After treatment, there was an improvement in both groups regarding OAB-V8, ICIQ-SF, bladder volume at 1st desire to void, bladder volume at strong desire to void, bladder volume at DO, MBC, intravesical pressure at strong desire, and the patients’ number with DO (decreased), and these improvements were statistically significant in group 1 compared to group 2 (p < 0.05). Conclusion: BWT showed a significant association with both OAB symptom scores and UDS parameters. The decrease in BWT is associated with a significantly higher response to solifenacin therapy regarding the UDS results.
Pesquisas em Filologia e Língua Portuguesa: Vol. 2
Authors: Gil Beatriz Daruj , Cardoso Elis de Almeida , Módolo Marcelo , Campos Maria Inês Batista , Fachin Phablo Roberto Marchis
Published: December 2021

s capítulos deste volume consistem em resultados de pesquisas desenvolvidas por pós-graduandos do Programa de Filologia e Língua Portuguesa da Faculdade de Filosofia, Letras e Ciências Humanas da Universidade de São Paulo (FFLCH-USP). Inserem-se em três linhas do Programa, a saber: Filologia do Português, Linguística Textual e Teorias do Discurso no Português e História e Historiografia do Português. Nessas três linhas, desenvolvem-se, respectivamente, i) pesquisas sobre o texto escrito, literário e não-literário, que o descrevem e o editam, identificando a forma que seja base fidedigna para estudos filológicos e para a constituição de corpora em língua portuguesa, impressos e digitais; ii) pesquisas que se dedicam à investigação dos processos de constituição de textos orais e escritos, bem como de discursos de variadas esferas sociais em língua portuguesa; iii) pesquisas diacrônicas ou históricas da língua portuguesa, sob diferentes níveis de análise, assim como os estudos de história das ideias linguísticas, referentes ao português. A despeito de serem trabalhos conduzidos em perspectivas variadas, reúnem-se em torno do estudo da língua portuguesa, objeto ao qual inúmeros pesquisadores vêm se dedicando ao longo dos 50 anos de existência do Programa. Para dar maior divulgação a esse conjunto de estudos, o Programa promove, desde 2018, o Colóquio de Pesquisa Discente (CoPeD), evento bienal no qual estudantes compartilham suas pesquisas, são avaliados por pesquisadores externos ao programa e têm a oportunidade de publicar seus trabalhos em obras como esta. Os 17 capítulos deste volume são resultado dos trabalhos apresentados no II CoPeD, realizado em dezembro de 2020, e abordam questões filológicas variadas, propostas de classificações de gêneros textuais e estudos historiográficos.
Abstract 11295: Out-of-Hospital Cardiac Arrest Characteristics According to Arrest Location in Urban, Suburban, and Rural Areas of Denmark
Authors: Gregers Mads Christian Tofte , Andelius Linn , Hansen Carolina Malta , Møller Sidsel Gamborg , Torp-Pedersen Christian , Kjoelbye Julie , Folke Fredrik
Published: December 2021

Introduction:
Cardiopulmonary resuscitation (CPR) and early defibrillation are two of the most important factors for survival after out-of-hospital cardiac arrest (OHCA). However, little is known whether bystander interventions and survival are impaired in rural areas compared to more urbanized areas in Denmark. We hypothesized that bystander interventions and survival are lower in rural areas compared to urbanized areas.

Methods:
We included all non-EMS witnessed OHCAs with known GPS-location in Denmark (January 1, 2016 to December 31, 2019) and geocoded them according to county. All counties in Denmark were classified either as urban, suburban, or rural according to the degree of urbanization tool defined by the European Statistical Agency.

Results:
A total of 16,670 OHCAs were included, of which 4,555 (27%), 5,457 (33%), and 6,658 (40%) arrests occurred in urban, suburban, and rural areas respectively. The median age (73 vs. 74 vs. 73 years, p=0.003), ambulance response time (6 vs. 7 vs. 8 minutes, p<0.0001), and proportion of arrests occurring in residential areas (77 vs. 79 vs. 78%, p=0.05) differed significantly between degrees of urbanization (from high to low). Fewer OHCAs received bystander CPR in urban and suburban areas compared to rural (76 vs. 77 vs. 79%, p=0.0002). The proportion of patients defibrillated by bystanders remained equal across urbanization. However, return of spontaneous circulation (ROSC) (27 vs. 27 vs. 24%, p<0.0001) and 30-day survival was lower in rural areas (15 vs. 14 vs. 12, p<0.0001) (Figure 1).

Conclusion:
Degree of urbanization was associated with increased rates of bystander CPR in rural areas. Despite this, ROSC and 30-day survival were higher in urban and suburban areas compared to rural areas which could not be explained by cardiac arrest characteristics.
Abstract 11901: CPR Quality During the COVID-19 Pandemic - More Evidence of Collateral Damage During Out-of-Hospital Cardiac Arrest
Authors: Ball Jocasta , Nehme Ziad , Villani Melanie , Smith Karen L
Published: December 2021

Introduction:
Many regions around the world have reported declining survival rates from out-of-hospital cardiac arrest (OHCA) during the COVID-19 pandemic. This has been attributed to COVID-19 infection and overwhelmed healthcare services in some regions and imposed social restrictions in others. However, the effect of the pandemic period on CPR quality, which has the potential to impact outcomes, has not yet been described.

Methods:
A retrospective observational study was performed using data collected in an established OHCA registry in Victoria, Australia. During a pre-pandemic period (11 February 2019-31 January 2020) and the COVID-19 pandemic period (1 February 2020-31 January 2021), 1,111 and 1,349 cases with attempted resuscitation had complete CPR quality data, respectively. The proportion of cases where CPR targets (chest compression fraction [CCF]≥90%, compression depth 5-10cm, compression rate 100-120 per minute, pre-shock pauses <6 seconds, post-shock pauses <5 seconds) were met was compared between the pre-pandemic and pandemic periods. Logistic regression was performed to identify the independent effect of the COVID-19 pandemic on achieving CPR targets.

Results:
The proportion of arrests where CCF≥90% significantly decreased during the pandemic (57% vs 74% in the pre-pandemic period, p<0.001) as did the proportion with pre-shock pauses <6 seconds (54% vs 62%, p=0.019) and post-shock pauses <5 seconds (68% vs 82%, p<0.001). However, the proportion within target compression rate significantly increased during the pandemic (64% vs 56%, p<0.001). Following multivariable adjustment, the COVID-19 pandemic period was independently associated with a decrease in the odds of achieving a CCF≥90% (adjusted odds ratio [AOR] 0.47 [95% CI 0.40, 0.56]), a decrease in the odds of achieving pre-shock pauses<6 seconds (AOR 0.71 [95% CI 0.52, 0.96]), and a decrease in the odds of achieving post-shock pauses<5 seconds (AOR 0.49 [95% CI 0.34, 0.71]).

Conclusion:
CPR quality was impacted during the COVID-19 pandemic period which may have contributed to a decrease in OHCA survival previously identified. These findings reinforce the importance of maintaining effective resuscitation practices despite changes to clinical context.
Abstract 11974: Impact of Routine ECPR Service on Availability of Donor Organs
Authors: Smalcova Jana , Rusinova Katerina , Ortega-Deballon Iván , Pokorna Eva , Franek Ondrej , Knor Jiri , Kavalkova Petra , Balik Martin , Rob Daniel , Pudil Jan , Huptych Michal , Smid Ondrej , Belohlavek Jan
Published: December 2021

Introduction:
In refractory cardiac arrest, extracorporeal cardiopulmonary resuscitation (ECPR) may increase the chance of survival. However, in brain death or donation after cardiac death scenario, ECPR may also become an important organ donor source.

Hypothesis:
We hypothesized that 1/ the implementation of ECPR into the daily routine of a high volume cardiac arrest centre might increase the availability of organ donors, and 2/ ECPR might assure the same long-term function of donated organs as non-ECPR care.

Methods:
We retrospectively evaluated pre-ECPR (2007-2011) and ECPR (2012-2020) periods in terms of donors recruited from the out-of-hospital and in-hospital cardiac arrest population. We assessed the number of donors referred, the number of organs harvested and their one- and five-year survival.

Results:
In the pre-ECPR period, 11 donors were referred, of which 7 were accepted. During the ECPR period, the number of donors increased to 80, of which 42 were accepted. The number of donated organs in respective periods were 18 and 119, corresponding to 3,6 vs 13,2 (p =0.033) organs per year harvested. One-year survival of transplanted organs was 94.4% vs 100%, and five-year survival was 94.4% vs 87,5%, in relevant periods. Survival of organs obtained from donors after CPR and ECPR at one year (98.9% vs 100%) and five years (90,2% vs 88.9%) was the same. Graft failure was not the cause of death in any single case.

Conclusions:
Establishing a high volume cardiac arrest/ECPR centre may lead to a higher number of potential and subsequently accepted organ donors. The length of survival of donated organs is high and comparable between ECPR vs non-ECPR cardiac arrest donors.
Abstract 13114: Effectiveness of a Novel Decision Aid for Surrogate Decision Makers of Comatose Survivors of Cardiac Arrest: A Pilot Study of the “Tool to EMPOwer Surrogate Decision Makers” (TEMPO)
Authors: Perman Sarah M , Shelton Shelby , Siry-Bove Bonnie , Mayer Katherine , Matlock Dan D , Haukoos Jason S , Abella Benjamin , Daugherty Stacie , Havranek Edward
Published: December 2021

Introduction:
Surrogate decision makers (SDMs) represent critical stakeholders in decision making for comatose survivors of cardiac arrest, yet these individuals are often unprepared for decision making and unfamiliar with the complexity of post-cardiac arrest care. To that end, we created a decision aid for SDMs intended to inform and support evidence-based decision making for comatose survivors of cardiac arrest.

Methods:
We conducted a pilot trial to measure real world effectiveness of the Tool to EMPOwer (TEMPO) Surrogate Decision Makers, by measuring knowledge and acceptability. Individuals were enrolled who self-identified as the SDM for a comatose survivor of OHCA admitted to an academic tertiary care hospital. Participants completed a pre-intervention survey prior to the provision of TEMPO, and a post-intervention survey approximately 24 hours after exposure to the intervention. Pre-survey questions included SDM demographics and an 8-question knowledge survey. Post-intervention surveys included the same knowledge questions, the Ottawa Acceptability of Decision Aid tool, and questions to measure if SDMs shared TEMPO with others. This study was approved by the Colorado Multiple Institutional Review Board and registered at Clinicaltrials.gov (NCT03908346).

Results:
Twenty SDMs were enrolled between 9/1/2020 and 6/7/2021. One subject did not complete the post-intervention survey therefore 19 subject responses were analyzed for the purpose of this report. Participants were 85.0% Female, 47.4 +/- 14.8 years, and 45.0% were the spouse of the patient. In the 8-question knowledge survey, results improved from 57.2% correct to 90.8% correct after exposure to TEMPO (p<0.001). Using the Ottawa Acceptability Tool, 89.5% of participants stated TEMPO was useful in decision-making and 94.7% reported that TEMPO made their decision “easier”. Most (79.0%) participants reported they shared the DA with another family/friend in-person, while some (52.6%) reported they shared content with another person by telephone.

Conclusion:
Initial pilot data on the efficacy of the Tool to EMPOwer Surrogate Decision Makers of comatose survivors of cardiac arrest shows significant promise in improving knowledge and supporting decision-making.
Abstract 13226: Epinephrine versus Norepinephrine in Cardiac Arrest Patients With Postresuscitation Shock
Authors: Bougouin Wulfran , Slimani Kaci , Renaudier Marie , Binois Yannick , Paul Marine , Dumas Florence , Lamhaut Lionel , Loeb Thomas , Ortuno Sofia , Deye Nicolas , Voicu Sebastian , BEGANTON Frankie , jost daniel , Mekontso-Dessap Armand , Marijon Eloi , JOUVEN Xavier , Aissaoui Nadia , Cariou Alain
Published: December 2021

Backgound:
Whether epinephrine or norepinephrine is preferable as the continuous intravenous vasopressor used to treat postresuscitation shock is unclear.

Objectives:
To compare outcomes of patients with postresuscitation shock after out-of-hospital cardiac arrest according to whether the continuous intravenous vasopressor used was epinephrine or norepinephrine.

Methods:
We conducted an observational multicenter study of consecutive patients managed in 2011-2018 for postresuscitation shock. The primary outcome was all-cause hospital mortality, and secondary outcomes were cardiovascular hospital mortality and unfavorable neurological outcome (Cerebral Performance Category 3 to 5). A multivariate regression analysis and a propensity score analysis were performed, as well as several sensitivity analyses.

Results:
Of the 766 patients included in five hospitals, 285 (37%) received epinephrine and 481 (63%) norepinephrine. All-cause hospital mortality was significantly higher in the epinephrine group (OR 2.6; 95%CI, 1.4-4.7;
P
=0.002). Cardiovascular hospital mortality was also higher with epinephrine (aOR 5.5; 95%CI 3.0-10.3;
P
<0.001), as was the proportion of patients with CPC of 3 to 5 at hospital discharge. Sensitivity analyses produced consistent results. The analysis involving adjustment on a propensity score to control for confounders showed similar findings (aOR 2.1; 95%CI 1.1-4.0;
P
=0.02).

Conclusions:
Among patients with postresuscitation shock after out-of-hospital cardiac arrest, use of epinephrine was associated with higher all-cause and cardiovascular-specific mortality, compared with norepinephrine infusion. A randomized controlled trial comparing the two vasopressors in this population is warranted.
Associations Between Time After Stroke and Exercise Training Outcomes: A Meta‐Regression Analysis
Authors: Marzolini Susan , Wu Che‐Yuan , Hussein Rowaida , Xiong Lisa Y. , Kangatharan Suban , Peni Ardit , Cooper Christopher R. , Lau Kylie S.K. , Nzodjou Mahdoum Ghislaine , Pakosh Maureen , Zaban Stephanie A. , Nguyen Michelle M. , Banihashemi Mohammad Amin , Swardfager Walter
Published: December 2021

Background

Knowledge gaps exist regarding the effect of time elapsed after stroke on the effectiveness of exercise training interventions, offering incomplete guidance to clinicians.

Methods and Results

To determine the associations between time after stroke and 6‐minute walk distance, 10‐meter walk time, cardiorespiratory fitness and balance (Berg Balance Scale score [BBS]) in exercise training interventions, relevant studies in post‐stroke populations were identified by systematic review. Time after stroke as continuous or dichotomized (≤3 months versus >3 months, and ≤6 months versus >6 months) variables and weighted mean differences in postintervention outcomes were examined in meta‐regression analyses adjusted for study baseline mean values (pre‐post comparisons) or baseline mean values and baseline control‐intervention differences (controlled comparisons). Secondary models were adjusted additionally for mean age, sex, and aerobic exercise intensity, dose, and modality. We included 148 studies. Earlier exercise training initiation was associated with larger pre‐post differences in mobility; studies initiated ≤3 months versus >3 months after stroke were associated with larger differences (weighted mean differences [95% confidence interval]) in 6‐minute walk distance (36.3 meters; 95% CI, 14.2–58.5), comfortable 10‐meter walk time (0.13 m/s; 95% CI, 0.06–0.19) and fast 10‐meter walk time (0.16 m/s; 95% CI, 0.03–0.3), in fully adjusted models. Initiation ≤3 months versus >3 months was not associated with cardiorespiratory fitness but was associated with a higher but not clinically important Berg Balance Scale score difference (2.9 points; 95% CI, 0.41–5.5). In exercise training versus control studies, initiation ≤3 months was associated with a greater difference in only postintervention 6‐minute walk distance (baseline‐adjusted 27.3 meters; 95% CI, 6.1–48.5; fully adjusted, 24.9 meters; 95% CI, 0.82–49.1; a similar association was seen for ≤6 months versus >6 months after stroke (fully adjusted, 26.6 meters; 95% CI, 2.6–50.6).

Conclusions

There may be a clinically meaningful benefit to mobility outcomes when exercise is initiated within 3 months and up to 6 months after stroke.
Beyond Overcoming: A Woman Writer’s Articulation of Pain in Socialist China
Authors: Licandro Daniela
Published: December 2021

Feminist inquiries into the status of women in Mao-era China have shed light on the challenges women experienced in their double role as producers and reproducers in the nascent socialist state. Less is known about how women lived up to expectations of (re)productivity while struggling with illness. Drawing on gender studies, literary studies, history, and the history of medicine, this article examines articulations of pain in the diaries that writer Yang Mo (1914-95) kept between 1945 and 1982, and published in 1985, to explore intersections among normative configurations of pain, gender politics, and identity construction in socialist China. Yang’s diaries show that the narrative of pain is fundamentally shaped by cultural and political discourses of “overcoming” physical and ideological shortcomings – discourses that the party-state upheld to transform the Chinese people into physically-fit, ideologically-correct socialist citizens. Within this context, this study focuses on Yang’s embodied experience to reveal both the empowering potential of these discourses and their inherent limits.