bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of prescriptions for completeness in a tertiary care teaching hospital
Authors: Srinivasa Jyothsnya , Swamy Shubhatara
Published: November 2020

Background: Prescribing errors are major problems among medication errors. Prescribing errors include mistakes or inaccuracies when choosing and ordering treatments, such as wrong doses or illegible prescriptions. Most of these errors result in no harm or have low to moderate harm however, some result in severe harm or death. There are economic consequences attributed to prescribing errors.Methods: The aim of the study was to analyse the prescriptions for completeness. The prospective observational study was conducted in outpatient department of different specialities in a tertiary care teaching hospital. Prescriptions with atleast one antibiotic, was collected through duplicate copies from the prescribing doctors. The data obtained from prescriptions were analysed and the conclusions were drawn using descriptive analysis.Results: A total of 1516 prescriptions with 3957 drugs were prescribed, out of which 1697 were antibiotics. Average number of drugs per prescription was 2.6 and average number of antibiotics per prescription was 1.1. Patient’s name, age, and gender were mentioned in 99%, 87.8%, and 96% of prescriptions respectively. Generic drug names were used in 0.7% of prescriptions. Out of 1681 antibiotics prescribed in 1574 had appropriate dosage form.Conclusions: The present study highlights the problem of incomplete prescriptions and extensive use of brand names. Intervention strategies focused on education and training, introduction of strict feedback control and monitoring systems are highly effective in reducing prescription errors.
The Application of Ju'alah in Islamic Finance: The Malaysian Perspective
Authors: Mar Iman Abdul Hamid bin , Hj. Muhammad Mohammad Tahir Sabit
Published: November 2020

This paper is a foundation study on the concept of animal unit waqf (AUW). It is the first of its kind, based on local circumstances where there exists a need to encourage small farmers’ participation in animal husbandry in poverty-stricken and lack-of-employment states in Malaysia, through the concept of waqf. Understandably, poor members of the community who wish to raise animals as a source of living do not find an affordable means of beginning a herd. Livestock waqf could be offered as an approach to resolving this issue. Based on the concept of social entrepreneurship, this paper explores the mechanism of livestock waqf, in particular the bahīmatul an’ām, that could be introduced to the farming community in Malaysia.
Lecturer Identities and Perceptions of CPD for Supporting Learning and Teaching in FE and HE in the UK
Authors: Buckley Charles , Husband Gary
Published: November 2020

This paper draws together the findings of two separate studies that were focused on the professional learning of lecturers working in the post compulsory education sector. The studies were conducted independently in separate locations and institutions in the United Kingdom and focused in different sectors of post compulsory education (further and higher). Each study aimed to discover the ongoing professional learning needs of lecturers some years after initial training had been completed. Through conducting semi structured interviews, each researcher gained a situational understanding from the perspective of the respondent lecturers through a lens of their experience and agency. This paper acts an extending study as the researchers bring together their independent results and findings in a further analysis. Focusing on understanding the similarities and differences in experiences, the paper reports several additional findings based on this cross analysis. Further to the pedagogical developments and support for undertaking teaching practice, this research reports that in both communities of further and higher education lecturers, their initial teaching qualifications and related experiences had a more profound and longitudinal impact on their professional identity and practices than they had previously considered. Organisationally, these finding prove to be interesting as it demonstrates that initial training and induction support networks and courses of study, have a longer lasting impact on individuals and consequently, the cultural and social aspects of associated organisations. By looking at the both combined studies, it was possible to broaden the sample size and ascertain whether observed phenomenon were present in a cross sectoral capacity.
A Competitive Analysis of East African Cement Companies using the High Performance Organisation Framework
Authors: Osano Evans Makini , de Waal André
Published: November 2020

Sub-standard infrastructure is one of the most significant challenges for economic development in East Africa. Specifically, the availability of affordable, locally produced cement is critical to infrastructural and economic development and job creation in the region. Thus, it is critical for cement companies to achieve better operational and financial results so they can satisfy the need for higher-quality cement for infrastructure projects and to deal with increasing environmental issues. In this article we evaluate, using de Waal’s high performance organisations (HPO) framework, the quality of three cement companies in Kenya and Tanzania to identify improvements these companies can make to their internal organisation and operations so they can achieve better financial and operational results. The research results indicate that whilst all three companies were yet to achieve HPO status, the best performing company with the highest HPO score also had the best financial performance over the past 10 years. The research also resulted in a series of recommendations on the basis of the weaknesses identified in the cement companies.
Stylistique et poétique de l’extrême : analyse de l’oeuvre poétique "Galerie infernale" de Jean-Marie-Adiaffi
Authors: Koffi Fulbert
Published: November 2020

Galerie infernale est, à bien des égards, une œuvre subversive par rapport aux normes langagières et éthiques. Cette transgression se perçoit à divers niveaux du langage : lexique, combinaison syntaxique et syntagmatique, logique du sens et de la pensée. Ce langage de rupture est mis au service d’une pensée elle-même en rupture avec les valeurs éthiques communément admises en société. Tout se passe comme si le poète décidait de franchir les limites de l’humainement acceptable et de scruter les territoires de l’extrême langagier et éthique, comme pour révéler la finitude et l’échec du langage, avec sa morale tout aussi désuète, le but du jeu étant de proposer d’autres possibles à une société en dérive en dépit de ses normes.
A kis apollólepke (Parnassius mnemosyne (LINNAEUS, 1758)) nektárnövényfajok közti választása
Authors: Vajna Flóra , Szigeti Viktor , Harnos Andrea , Kis János
Published: November 2020

A lepkék jó modelljei lehetnek a táplálékforrás-választás tanulmányozásának, mert a kifejlett egyedek válogatnak a nektárforrás-kínálatból és képesek alkalmazkodni időben változó táplálékforrásaikhoz. Célunk a kis apollólepke (Parnassius mnemosyne (LINNAEUS, 1758)) nektárnövényfajválasztását befolyásoló virágtulajdonságok megismerése volt. A vizsgált populációk egyedeit jelölésvisszalátás módszerrel mintavételeztük 5, majd 2 éven keresztül két egymáshoz közeli réten a Visegrádi-hegységben. A virággyakoriságot bejárásos módszerrel becsültük. A virágtulajdonságokat a Biolflor adatbázisból gyűjtöttük. Az évenkénti viráglátogatási arány változott a növényfajok között. Nagy változatosságot találtunk az elérhető növények tulajdonságaiban és a virágkínálatban az egyes évek és a két rét között. A lepkék választását a virágok gyakorisága, színe és típusa, valamint a rovarbeporzás szerepe befolyásolta az egyik, míg csupán a virággyakoriság és a virágszín a másik réten. A növények beporzóik választását befolyásoló tulajdonságai egymástól valószínűleg nem függetlenek. A viráglátogatási mintázat mindkét élőhelyen arra utal, hogy a kis apollólepkék választanak elérhető forrásaik közül. A két rét populációi közötti különbség azt sugallja, hogy a választás környezetfüggő. Valószínű, hogy az energiabefektetés-arányosan kinyerhető legtöbb és/vagy legjobb nektárt nyújtó fajokat látogatják a leggyakrabban. Ahhoz, hogy egy élőhely megfelelő legyen egy adott lepkefaj számára, elsődleges szempont a lárvális tápnövény jelenléte, ám az imágók táplálékát biztosító nektárnövények kellő mennyiségű előfordulása is nélkülözhetetlen lehet.
Literature Review: Healthy Home as The New Normal for Covid19 Prevention
Authors: Ramadhani Fairuz Haniyah
Published: November 2020

Introduction: The SARS-CoV-2 virus has 2 pathways of spread which are direct (through droplets) and indirect (through the surface of objects affected by droplets or through air). Therefore, social distancing by staying in home is one of the key to prevent the spread of Covid19. However, the transmission of SARS-CoV-2 is increasingly common in family level. The risk of family members getting infected is higher because they begin to move outside the house during new normal. Accordingly, a good home environment is needed to improve its residents’ health. This study aims to determine the benefits of implementing healthy home as the new normal in preventing the spread of Covid19 at family level. Discussion: This study was a literature review using literature research as the data source. The literature used were in the form of research journals and articles on Covid19 and healthy home. The data used were research studies conducted from January 2016 to June 2020. There was 9 articles, about benefit healthy home on SARS-CoV-2 transmission, that selected in this study. Healthy home was the idea of homes that have fulfilled the health standards with adequate sanitation. Healthy home was purposively built to make the residents feel comfortable and stay healthy at all times. The components of healthy home were: good ventilation; natural lighting of the house; occupancy density; residents’ behavior; and waste management. Conclusion: The application of healthy home principle had many benefits for its residents and was closely related to Covid19 prevention.
Analysis of The MA AL-QODIRI VIII’S UKS Program Implementation Based on System Approach
Authors: Lestari Ayu Fitri
Published: November 2020

Latar Belakang: Pembinaan dan pengembangan Usaha Kesehatan Sekolah (UKS) merupakan salah satu upaya pemeliharaan dan peningkatan kesehatan yang ditujukan kepada peserta didik (usia sekolah). Hasil pengamatan yang dilakukan oleh Tim Pembina UKS Pusat ternyata masih cukup banyak sekolah yang belum melaksanakan UKS secara baik dan benar. Oleh karena itu, penulis melakukan penelitian dengan menganalisis pelaksanaan program UKS di sekolah. Tujuan: Tujuan penelitian ini yaitu untuk mendeskripsikan pelaksanaan program UKS di MA Al-Qodiri VIII Kelir, Metode: Kecamatan Kalipuro, Kabupaten Banyuwangi berdasarkan pendekatan sistem. Pengambilan data dilakukan dengan metode observasi dan wawancara mendalam. Wawancara mendalam dilakukan kepada empat informan, yaitu Guru Pembina UKS, dua orang Kader Kesehatan Remaja, dan pemegang Program UKS di Puskesmas setempat. Penelitian ini menggunakan desain deskriptif kualitatif.  Hasil: Hasil penelitian menunjukkan bahwa pelaksanaan Program UKS di MA-Al-Qodiri menurut komponen pendekatan sistem berupa input, proses dan outputnya masih dalam kategori cukup. Lebih dari 50% indikator keberhasilan dalam Program UKS di MA Al-Qodiri sudah terlaksana atau terpenuhi. Diantaranya indicator sumber daya manusia, sarana, kebijakan, perencanaan, pelaksanaan, dan pengawasan. Masih terdapat banyak beberapa kekurangan dalam pelaksanaan program UKS di masing-masing komponen menurut pendekatan sistem, begitu pula pada sub komponennya. Kesimpulan: Oleh karena itu, perlu ada beberapa perbaikan dalam pelaksanaan Program UKS yang diusulkan dan dilaksanakan sesuai dengan analisis permasalahan yang dilakukan.
Stacking Effects on Anthraquinone/DNA Charge-Transfer Electronically Excited States
Authors: Cárdenas Gustavo , Nogueira Juan J.
Published: November 2020

The design of more efficient photosensitizers is a matter of great importance in the field of cancer treatment by means of photodynamic therapy. One of the main processes involved in the activation of apoptosis in cancer cells is the oxidative stress on DNA once a photosensitizer is excited by light. As a consequence, it is a matter of great relevance to investigate in detail the binding modes of the chromophore with DNA, and the nature of the electronically excited states that participate in the induction of DNA damage, for example, charge-transfer states. In this work, we investigate the electronic structure of the anthraquinone photosensitizer intercalated into a double-stranded poly(dG-dC) decamer model of DNA. First, the different geometric configurations are analyzed by means of classical molecular dynamics simulations. Then, the excited states for the most relevant poses of anthraquinone inside the binding pocket are computed by an electrostatic-embedding quantum mechanics/molecular mechanics approach, where anthraquinone and one of the nearby guanine residues are described quantum mechanically to take into account intermolecular charge-transfer states. The excited states are characterized as monomer, exciton, excimer and charge-transfer states based on the analysis of the transition density matrix, and each of these contributions to the total density of states and absorption spectrum is discussed in terms of the stacking interactions. These results are relevant as they represent the footing for future studies on the reactivity of anthraquinone derivatives with DNA and give insights on possible geometrical configurations that potentially favor the oxidative stress of DNA.
Integration Study, Analysis and Design of a Flexible Antenna in OLED Light for WiMAX Wireless Communication Systems
Authors: Sekkal Soukaina , Canale Laurent , El Gharbi Mariam , Asselman Adel
Published: November 2020

In this work, a new flexible antenna integrated with OLED light sources is presented for WiMAX wireless communication systems. The proposed antenna was placed on a 100% polyester base with a thickness of 1.5 mm and achieved a high gain. We evaluated and tested its performance, including reflection coefficient, radiation pattern and gain. The flexible and simple patch antenna has been designed to operate at 3.5 GHz for WiMAX wireless communication systems with a gain value of 5.38 dB. This article proves the applicability of the proposed material for the integration of flexible antennas in OLEDs while maintaining gain performance similar to conventional flat antennas.
An Integrated Multi-Disciplinary Modeling and Simulation Approach to History Matching and Forecasting Shale Wells - An Eagle Ford Case Study
Authors: Aslam Usman , Bordas Rafel
Published: November 2020

In the current business environment, oil and gas operators in unconventional plays are continually pushed to reduce risk and increase profitability. Recent advances in horizontal drilling, hydraulic fracturing, and completion design in shale wells have helped reduce costs. However, accurate reserve estimation and production forecasting remain the greatest unknowns impacting the bottom line. The use of advanced subsurface models is gaining momentum to address this challenge. Typical techniques currently used to build and history match these models are based on simplified assumptions and ignore uncertainty in the subsurface characterization. This paper presents an integrated multi-disciplinary shale modeling, simulation, and history matching approach. It incorporates uncertainty from different modeling domains, leading to the generation of improved predictive shale models.

The proposed approach leverages micro-seismic data to create a more realistic representation of the Stimulated Reservoir Volume (SRV). Micro-seismic event locations, magnitude, and fracture plane characteristics are used to construct a Discrete Fracture Network (DFN) required for petrophysical modeling. A forward model comprising DFN modeling, an application to generate relative permeability curves, and a reservoir simulator is set up using a common platform integrator. These applications are run in tandem to generate an ensemble of history matched shale models that capture the range of uncertainties in fracture attributes, relative permeability, and other important dynamic parameters. Production data is assimilated into the shale model using Bayesian statistics and state-of-the-art supervised machine learning techniques.

Our approach is demonstrated using data acquired from three hydraulically fracked wells drilled in the Eagle Ford shale oil window. The use of Bayesian statistics and machine learning techniques led to the identification of multiple shale models calibrated to the production data. Fracture attributes, saturation endpoints, relative permeability curvature, matrix porosity, and initial water saturation were found to significantly affect the history match. A comparison of prior and posterior ensembles showed a significant reduction in uncertainty in predicted production.

The proposed technique ensures that important, previously neglected subsurface uncertainties and their dependencies are captured and used as input to the simulation model. Improved SRV delineation using micro-seismic data and property modeling using DFN, combined with the ability to capture uncertainty through an integrated multi-disciplinary approach, deliver predictive shale models that enable future decisions to be made with a high degree of confidence.
Hydration Products and Mechanical Properties Investigations of Nanofiber Additives in Cement Wellbore Environments
Authors: McElroy Phillip D. , Emadi Hossein , Watson Marshall C. , Heinze Lloyd
Published: November 2020

Complete zonal isolation along with wellbore integrity is paramount to oil field development which ensures environmental safety and favorable well economics. However, the complexity of wells today increases the wellbore architecture's susceptibility to unavoidable stress events. This research focuses on utilizing aluminum oxide nanofibers (ANF's) in oil well cements. ANF's are a relatively new type of composite nanomaterial that has the potential to provide significant mechanical performance.

A Scanning Electron Microscope (SEM) was used to study the morphology of ANF's. Nanofibers were ultrasonicated in water and characterized quantitatively by ultraviolet–visible spectrophotometry (UV-Vis) and qualitatively by transmission electron microscope (TEM) images. The results show ANF's have high dispersibility. Cement class "H" formulations containing different percentages of ANF's by weight of cement (BWOC) were mixed and cured with various additives for 24 hours at 76.7 °C with 24.13 MPa. Uniaxial compressive strength (UCS) tests were performed which suggested the inclusion of ANF's increases the UCS when compared to cement samples without ANF's. Although, high concentrations of ANF's results in nanofiber agglomeration which weakens the mechanical properties of the cement samples. The elastic properties of the cement samples were measured under cyclic confining pressures. All cement samples experienced low inelastic deformation during confining pressure cycling. Samples containing 0.1% ANF's BWOC possessed the lowest Modulus of Elasticity (MOE) and the highest Poisson's Ratio. This increases the cement sheath's chances of resisting deformation due to casing contraction/expansion. An X-ray diffraction (XRD) analysis was conducted to determine the hydration products. All cement formulation experienced the same XRD pattern with only variations in the diffraction peaks. Cement samples containing ANF's contained increased amounts of calcium silicate hydrate (C-S-H) gel due to the nucleation effect and the formation of tobermorite.
Machine Learning Assisted Closed-Loop Reservoir Management using Echo State Network
Authors: Deng Lichi , Pan Yuewei
Published: November 2020

Closed-loop reservoir management (CLRM) consists of continuous application of history matching and optimization of model-predictive control to maximize production or reservoir net present value in any given period. Traditional field-scale implementation of CLRM by using a large number of reservoir models, in particular when uncertainty is accounted for, is computationally impractical. This presented machine-learning assisted workflow uses the Echo State Network (ESN) coupled with an empirical water fractional flow relationship as a proxy to replace time-consuming simulations and improve the computational efficiency of the CLRM. The ESN, under the paradigm of reservoir computing, provides a specific architecture and supervised learning principle for recurrent neural networks (RNN). ESNs, with randomly generated and invariant input weights and recurrent weights, greatly minimize the computational load and solve potential problems during typical backpropagation through time in traditional RNNs while it still obtains the benefits of RNNs to memorize temporal dependencies. Also, the linear readout layer makes the training much faster by using analytical Ridge Regression. Field level well control and production response data are fed into the workflow to obtain a trained ESN and fitted fractional flow relationship, which will represent/reproduce the dynamics of the reservoir under various well control scenarios. Further production optimization is directly applied on the matched models to maximize reservoir net present value. Optimized well control scenario is applied and further observation is obtained to update the models. History matching and production optimization are performed again in a closed-loop fashion. The aforementioned advantages make ESN a very powerful tool for CLRM with both history matching and production optimization quickly accomplished and make near-real-time CLRM possible. In the research, two case studies will be presented to prove the effectiveness of the proposed workflow.
Distribution and Abundance of Double-crested Cormorants Nesting in the Interior of California, 2009–2012
Authors: Shuford W. David , Molina Kathy C. , Kelly John P. , Condeso T. Emiko , Cooper Daniel S. , Jongsomjit Dennis
Published: November 2020

As part of an 11-state inventory, we censused the Double-crested Cormorant (Phalacrocorax auritus) in the interior of California from 2009 to 2012, using a combination of aerial, ground, and boat surveys. An estimated 8791 pairs breeding in the interior of the state in 2009–2012 exceeded the 7170 pairs estimated in 1998–1999. In both periods, cormorants were breeding in 9 of 11 ecoregions, but three-fourths were at one site—Mullet Island at the Salton Sea in the Sonoran Desert ecoregion (abandoned in 2014). The ecoregions with the next highest proportions were the Sacramento Valley, San Joaquin Valley, and Modoc Plateau. The apparent increase in numbers and colony sites since 1999—consistent with the pattern through much of western North America—reflects the (short-lived) increase in numbers at the Salton Sea, an increasing number of colonies and breeding pairs in the Central Valley, and slightly better coverage on the recent surveys. Because of practical survey constraints and limited data to date, evidence of change in numbers of Doublecrested Cormorants breeding in the interior of California between 1998–1999 and 2009–2012 is inconclusive. Plans for monitoring will need to take into account the effects of substantial annual variation in numbers, which may be associated with large fluctuations in cormorants’ prey base, short-term cycles of drought and flood, shifts of nesting cormorants into or out of the interior of California, and the expectation of greater environmental fluctuations with continuing climate change. The factors most likely to limit the number of cormorants breeding in the interior of the state are habitat loss or alteration (particularly from reallocation of water for human needs), disease, human disturbance, and the long-term effects of climate change.
Clinical features and outcomes of hospitalized COVID-19 patients in a low burden region.
Authors: Mylona Eleni , Margellou Evangelia , Kranidioti Eleftheria , Vlachakos Vasilios , Sypsa Vana , Sakka Vissaria , Balis Evangelos , Kalomenidis Ioannis
Published: November 2020

Data on the clinical features and outcomes of COVID-19 patients from countries with low disease burden are rare. Greece, however, presented a low burden of COVID-19 disease during the first pandemic outbreak. This is a retrospective study of COVID-19 hospitalized patients in Greece. Clinical data were extracted from medical records using univariable and multivariable logistic regression analysis to assess the factors associated with ICU admission and in-hospital death. Eighty five patients were included in this study, 49 (57.7%) male with median (25th-75th) age 60 (49-72) years old. Sixty-one (72%) of them had at least one comorbidity with hypertension being the most common (45,6%). More than half (56%) had severe or critical disease, 20% required ICU care (14% received invasive ventilation) and 10.7% died. Solid tumor (p=0.021) and NEWS score (p=0.048), thrombocytopenia (p=0.036) or involvement of all lung fields in chest x-ray (p=0.002) on admission were independent risk factors of ICU admission. Immunosuppression (p=0.032) and thrombocytopenia (p=0.049) were independent predictors of death. Hospitalized COVID-19 patients in a European country with a low burden of the disease, in which hospital capacities had not been overwhelmed, had lower mortality rate compared to those reported patients hospitalized in regions with a high burden of the disease.
Loneliness and Depression in College Students During the COVID-19 Pandemic: Boredom and Repetitive Negative Thinking as Mediators
Authors: Hager Nathan M. , Judah Matt R. , Milam Alicia L.
Published: November 2020

The COVID-19 pandemic triggered increased rates of depression, especially among college students. Due to social distancing guidelines, loneliness has been suspected as a prominent factor in depression during the pandemic. Research is needed to identify possible mechanisms through which loneliness conveys risk for pandemic-era depression. Two potential mechanisms are boredom and repetitive negative thinking (RNT). This study examined cross-sectional associations between depression, loneliness, boredom, and RNT in a sample of college students (N =199) in April 2020 immediately following campus closure. Results showed a serial indirect effect of loneliness on depression through boredom then RNT. Moreover, specific indirect effects of loneliness on depression were found through boredom and RNT, individually. These data align with cognitive-behavioral theory and identify boredom and RNT as possible mechanisms of the association between loneliness and depression in college students. As such, boredom and RNT might be suitable treatment targets for depression during the COVID-19 pandemic.
Geographic Disparities In Access To Cancer Clinical Trials In India
Authors: Chakraborty Santam , Mallick Indranil , Luu Hung N , Bhattacharyya Tapesh , Moses Arunsingh , Achari Rimpa Basu , Chatterjee Sanjoy
Published: November 2020

Introduction The current study was aimed at quantifying the disparity in geographic access to cancer clinical trials in India. Methods We collated data of cancer clinical trials from the clinical trial registry of India (CTRI) and data on state-wise cancer incidence from the Global Burden of Disease Study. The total sample size for each clinical trial was divided by the trial duration to get the sample size per year. This was then divided by the number of states in which accrual was planned to get the sample size per year per state (SSY). For interventional trials investigating a therapy, the SSY was divided by the number of incident cancers in the state to get the SSY per 1,000 incident cancer cases. The SSY data was then mapped to visualise the geographical disparity.Results We identified 181 ongoing studies, of whom 132 were interventional studies. There was a substantial inter-state disparity - with a median SSY of 1.55 per 1000 incident cancer cases (range 0.00 - 296.81 per 1,000 incident cases) for therapeutic interventional studies. Disparities were starker when cancer site-wise SSY was considered. Even in the state with the highest SSY, only 29.7 % of the newly diagnosed cancer cases have an available slot in a therapeutic cancer clinical trial. Disparities in access were also apparent between academic (range: 0.21 - 226.60) and industry-sponsored trials (range: 0.17 - 70.21).Conclusion There are significant geographic disparities in access to cancer clinical trials in India. Future investigations should evaluate the reasons and mitigation approaches for such disparities.
Short-term effectiveness of precise safety decompression via double percutaneous lumbar foraminoplasty and percutaneous endoscopic lumbar decompression for lateral lumbar spinal canal stenosis: a prospective cohort study
Authors: Wang Yu , Deng Mingyan , Wu Hao , Wu Ye , Guo Chuan , Zhang Dongfeng , Kong Qingquan
Published: November 2020

Purpose This prospective cohort study reports on a new technique, namely precise safety decompression via double percutaneous lumbar foraminoplasty (DPLF) and percutaneous endoscopic lumbar decompression (PELD) for lateral lumbar spinal canal (LLSC) stenosis, and its short-term clinical outcomes.Methods The study analyzed 69 patients with single-level LLSC stenosis simultaneously occurring in both zones 1 and 2 (defined as retrodiscal space and upper bony lateral recess respectively by new LLSC classification) who underwent DPLF–PELD from November 2018 to April 2019. Clinical outcomes were evaluated according to preoperative, three months postoperatively, and last follow-up, via leg pain/low back pain (LBP) visual analog scale (VAS) scores, Oswestry disability index (ODI) scores, and the Macnab criteria. The postoperative MRI and CT were used to confirm the complete decompression, and flexion-extension x-rays at the last follow-up were used to observe lumbar stability.Results All patients successfully underwent DPLF–PELD, and the stenosis was completely decompressed, confirmed by postoperative MRI and CT. The mean follow-up duration was 13 months (range: 8–17 months). The mean preoperative leg pain VAS score is 7.05 ± 1.04 (range 5–9), which decreased to 1.03 ± 0.79(range: 0–3) at three months postoperatively and to 0.75 ± 0.63 (range: 0–2) by the last follow-up visit(p < 0.05). The mean preoperative ODI was 69.8 ± 9.05 (range: 52–85), which decreased to 20.3 ± 5.52 (range: 10–35) at the third month postoperatively and to 19.6 ± 5.21 (range: 10–34) by the final follow-up visit(p < 0.05). The satisfactory (excellent or good) results were 94.2%. There was one patient with aggravated symptoms, which were relieved after an open surgery. Two patients had a dural tear, and two patients suffered postoperative LBP. No recurrence or segmental instability was observed at the final follow-up.Conclusion DPLF–PELD could be a good alternative for the treatment of LLSC stenosis patients whose stenosis occurred in both zones 1 and 2.Trial registration Chinese Clinical Trial Registry (ChiCTR1800019551). Registered 18 November 2018.
Estimating the potential reduction in future sickness absence from optimizing group-level psychosocial work characteristics: a prospective, multicenter cohort study in German industrial settings
Authors: Fischer Joachim E , Genser Bernd , Nauroth Peter , Litaker David , Mauss Daniel
Published: November 2020

Background: Absence from work due to sickness impairs organizational productivity and performance. Even in organizations with perfect work conditions, some inevitable baseline sickness absence exists amongst working populations. The excess sickness absence observed above this baseline rate has become the focus of traditional health promotion efforts, addressing preventable physical illness, health behavior and mental health at the personal level. However, a health and safety approach following the TOP-rule would consider work-group psychosocial work characteristics as a potential risk factor amenable to organizational measures. To date, there is a scarcity of studies relating psychosocial work characteristics to possible reduction of excess sickness-absence rates.Methods: We aimed to estimate the potentially avoidable excess fraction of absence attributable to work-group psychosocial characteristics. We considered work-group averaged perception of psychosocial work characteristics as a proxy to the methodologically elusive objective assessment of organizational characteristics. Participants were recruited from multiple sites of a German automotive manufacturer with individuals nested within work groups. We predicted 12-month follow-up work-group sickness absence rates using data from a baseline comprehensive health examination assessing work characteristics, health behavior, and biomedical risk factors. We considered the quartile of work-groups yielding favorable psychosocial work characteristics as a realistic existing benchmark. Using the population attributable fraction method we estimated the potentially amenable sickness absence from improving work-group psychosocial characteristics. Results: Data from 3992 eligible participants from 29 work groups were analyzed (39 percent participation rate, average age 41.4 years (SD = 10.3 years), 89.9% males and 49% manual workers.). Work-group absence rates at follow up varied from 2.1% to 8.9% (mean 5.1%, 11.7 missed days). A prediction model of seven psychosocial work characteristics at the work group level explained 70 percent of the variance of future absence rates. The estimated reduction from improving psychosocial work characteristics to the benchmark level amounted to 32% of all sickness absence, compared to a 31% reduction from eliminating health behavioral and medical risk factors to the benchmark target. Conclusions: Psychosocial characteristics at the work-group level account for a relevant proportion of all sickness absence. Health promotion interventions should therefore address psychosocial characteristics at the work group level.
Health variations among breast-cancer patients from different disease states: Evidence from China
Authors: Yang Qing , Yu Xuexin , Zhang Wei
Published: November 2020

Background: This study aimed to obtain health utility parameters among Chinese breast cancer patients in different disease states for subsequent health economics model. In addition, we aimed to explore the feasibility of establishing a breast cancer health utility mapping model in China.Methods: Multiple patient-reported health attributes were assessed, including quality of life, which was measured by the Functional Assessment of Cancer Therapy-Breast (FACT-B) instrument; health utility and self-rated health, which were measured by the EuroQol-5 Dimension-5 Level (EQ-5D-5L) questionnaire. Multivariate regression models, including a linear regression model, an ordinal logistic regression model and a Tobit model, were employed to analyze health differences among 446 breast cancer patients. Subgroup analyses were performed to examine differences in multiple dimensions of health derived from the FACT-B and EQ-5D-5L instruments. A mapping function was used to estimate health utility from quality of life. Rank correlation analyses were employed to examine the correlation between estimated and observed health utility values.Results: A total of 446 breast cancer patients with different disease states were analyzed. The health utility values of breast cancer patients in the P state (without cancer recurrence and metastasis), R state (with cancer recurrence within a year), S state (with primary and recurrent breast cancer for the second year and above), and M state (metastatic cancer) were 0.81 (SD±0.23), 0.90 (SD±0.12), 0.78 (SD±0.31), and 0.74 (SD±0.27), respectively. There were positive correlations between all scores, including every domain of the FACT-B instrument (p<0.001). Results from multivariate analysis suggested that patients in the R and M states had lower scores for overall quality of life (R, β = -9.45, p< 0.01; M, β = -6.72, p<0.05). Patients in the M state had lower health utility values than patients in the P state (β = -0.11, p< 0.05). Estimated health utility values, which were derived from quality of life by using a mapping function, were significantly correlated with directly measured health utility values (p<0.001).Conclusions: We obtained the health utility and health-related quality of life (HRQoL) scores of Chinese breast cancer patients in different disease states. Mapping health utility values from quality of life using four disease states could be feasible in health economic modelling, but the mapping function may need further revision.
Opioid use disorder in pregnancy: Leveraging provider perceptions to inform comprehensive treatment
Authors: Titus-Glover Doris , Shaya Fadia T , Welsh Christopher , Qato Danya M , Shah Savyasachi , Gressler Laura E , Vivrette Rebecca
Published: November 2020

Background: Medication-assisted treatment is recommended for pregnant women with opioid use disorder (OUD), yet only 50% receive the treatment. Knowledge deficit, limited access to prescribing providers, and complex delivery models are known barriers to treatment. Strategies for improvement of medication-assisted treatment during pregnancy require multi-disciplinary provider input. The objective of this study is to explore provider perceptions and factors critical to medication-assisted treatment delivery for pregnant women with OUD. Methods: A qualitative research approach was used to gather data from individual provider and group semi-structured interviews. Providers (n=12) responded to questions in several domains related to perceptions of medication-assisted treatment, treatment delivery, access to resources, and challenges/barriers. Data were collected, transcribed, coded (by consensus) and emerging themes were analyzed using grounded theory methodology. Results: Emerging themes in this pilot study, revealed persistent provider knowledge/training gaps, inadequate service coordination, inconsistent treatment guidelines, stigmatization, and lack of resources such as housing and transportation. Providers found medication-assisted treatment offered pregnant women with OUD, a “lifeline.” Conclusions: In this pilot study, we conclude that, MAT variances can be improved by leveraging healthcare provider perceptions, direct experiences and recommendations towards a team-based, patient-centered integrated approach.
Distraction by a cognitive task has a higher impact on electrophysiological measures compared with conditioned pain modulation
Authors: Do A. T. Lisa , Enax-Krumova Elena , Özgül Özüm , Eitner Lynn B. , Heba Stefanie , Tegenthoff Martin , Maier Christoph , Höffken Oliver
Published: November 2020

Background Conditioned pain modulation (CPM) evaluates the effect of a painful conditioning stimulus (CS) on a painful test stimulus (TS). Using painful cutaneous electrical stimulation (PCES) as TS and painful cold water as CS, the pain relief was paralleled by a decrease in evoked potentials (PCES-EPs). We now aimed to compare the effect of CPM with cognitive distraction on PCES-induced pain and PCES-EP amplitudes. Methods PCES was performed using surface electrodes inducing a painful sensation of 60 (NRS 0-100) on one hand. In a crossover design healthy subjects (included: n=38, analyzed: n=23) immersed the contralateral hand into 10°C cold water (CS) for CPM evaluation and performed the 1-back task for cognitive distraction. Before and during the CS and 1-back task, respectively, subjects rated the pain intensity of PCES and simultaneously cortical evoked potentials were recorded. Results Both CPM and cognitive distraction significantly reduced PCES-EP amplitudes (CPM: 27.6±12.0μV to 20.2±9.5μV, cognitive distraction: 30.3±14.2µV to 13.6±5.2μV, p<0.001) and PCES-induced pain (on a 0–100 numerical rating scale: CPM: 58±4 to 41.1±12.3, cognitive distraction: 58.3±4.4 to 38.0±13.0, p<0.001), though the changes in pain intensity and PCES-amplitude did not correlate. The changes of the PCES-EP amplitudes during cognitive distraction were more pronounced than during CPM (p=0.001).Conclusions CPM and cognitive distraction reduced the PCES-induced pain to a similar extent. The more pronounced decrease of PCES-EP amplitudes after distraction by a cognitive task implies that both conditions might not represent the general pain modulatory capacity of individuals, but may underlie different neuronal mechanisms with the final common pathway of perceived pain reduction.
Complete genome analysis of a virulent Vibrio scophthalmi strain VSc190401 isolated from diseased marine fish half-smooth tongue sole, Cynoglossus semilaevis 
Authors: zhang zheng , Yu Yong-xiang , Wang Yin-geng , Liu Xiao , Wang Lifang , Zhang Hao , Liao Mei-jie , Li Bin
Published: November 2020

Background: Vibrio scophthalmi is an opportunistic bacterial pathogen, which is widely distributed in the marine environment. Earlier studies have suggested that it is a normal microorganism in the turbot gut. However, recent studies have confirmed that this bacterial strain can cause diseases in many different marine animals. Therefore, it is necessary to investigate its whole genome for better understanding its physiological and pathogenic mechanisms.Results: In the present study, we obtained a pathogenic strain of V. scophthalmi from diseased half-smooth tongue sole (Cynoglossus semilaevis) and sequenced its whole genome. Its genome contained two circular chromosomes and two plasmids with a total size of 3,541,838 bp, which harbored 3,185 coding genes. Among these genes, 2,648, 2,298, and 1,915 genes could be found through annotation information in COG, Blast2GO, and KEGG databases, respectively. Moreover, 10 genomic islands were predicted to exist in the chromosome I through IslandViewer online system. Comparison analysis in VFDB and PHI databases showed that this strain had 334 potential virulence-related genes and 518 pathogen-host interaction-related genes. Although it contained genes related to four secretion systems of T1SS, T2SS, T4SS, and T6SS, there was only one complete T2SS secretion system. Based on CARD database blast results, 180 drug resistance genes belonging to 27 antibiotic resistance categories were found in the whole genome of such strain. However, there were many differences between the phenotype and genotype of drug resistance. Conclusions: Based on the whole genome analysis, the pathogenic V. scophthalmi strain contained many types of genes related to pathogenicity and drug resistance. Moreover, it showed inconsistency between phenotype and genotype on drug resistance. These results suggested that the physiological mechanism seemed to be complex.
High-flow Nasal Cannula therapy: A feasible treatment for vulnerable older COVID-19 patients on the wards
Authors: Steenkiste Job van , Herwerden Michael C. van , Weller Dolf , Bout Christiaan J. van den , Ruiter Rikje , Hollander Jan G. den , Moussaoui Rachida el , Verhoeven Gert T. , Noord Charlotte van , Dorpel Marinus van den
Published: November 2020

Background: In the midst of the COVID-19 crisis, many frail elderly adults were admitted to our hospital with COVID-19. Some faced severe respiratory failure but were not eligible for invasive mechanical ventilation, due to frailty, functional status, comorbidity or wish of the patient. Our main objective was to investigate whether High-flow nasal cannula (HFNC) treatment on the wards could be an effective alternative treatment for these patients.Methods: A retrospective cohort study amongst COVID-19 adult patients with respiratory failure defined as persisting hypoxemia despite maximum conventional oxygen administration requiring invasive mechanical ventilation in the Intensive Care Unit (ICU) but being treated with HFNC as they were non-eligible due to frailty or wish of the patient.Results: The study included 32 patients between March 9th and May 1st, 2020. The median age was 79.0 years (74.5-83.0) with a median of three comorbidities (3-4) and a median Clinical Frailty Score of 4 out of 9 (3-6). The median SpO2/FiO2 Ratio was 157.5 indicating moderate ARDS. Overall survival rate in the HFNC cohort was 25%. Age (80.5 (78.0-84.3) vs 69.5 (65.5-74.3) p=0.0040) and hypertension (92% vs 25%, p=0.0008) were correlated with mortality.Conclusion: This study suggests that HFNC could be an effective last resort respiratory management strategy for respiratory failure in vulnerable elderly COVID-19 patients who failed on conventional high dose oxygen supply and are not eligible for invasive mechanical ventilation.
Study of 10kW molten carbonate fuel cell power generation system and its performance test
Authors: Lu Chengzhuang , Zhang Ruiyun , Li Hao , Cheng Jian , Xu Shisen , Yang Guanjun , Huang Hua
Published: November 2020

High-temperature fuel cells are a power technology that can improve the efficiency of electricity generation and achieve near-zero emissions of carbon dioxide. The present work explores the performance of the 10kW high-temperature molten carbonate fuel cell (MCFC). The key materials of the molten carbonate fuel cell single cell were characterized and analyzed by X-ray diffraction(XRD) and scanning electron microscope (SEM). The results show that the pore size of key electrode material was 6.5 μm and the matrix material is α-LiAlO2.The open circuit voltage of the single cell is 1.23 V in experiment. The current density is greater than 100 mA / cm^2 when the operating voltage is 0.7 V. The 10 kW fuel cell stack was constitutive of 80 pieces single fuel cells with area of 2000 cm2. The open circuit voltage of the stack reaches above 85 V. The fuel cell stack power and current density can reach 11.7 kW and 104.5 mA/cm^2 when the operating voltage is 56 V. The influence and long-term stable operation of the stack were also analyzed and discussed. The successful operation of 10kW high temperature fuel cell promotes the scale of domestic fuel cell and provides the research basis of fuel cell capacity enhancement and distributed generation in the next step.
Lower Diagnostic Costs Associated with Early Deployment of Capsule Endoscopy in Non-Hematemesis Gastrointestinal Bleeding: a Cost-Utilization Analysis
Authors: Jawaid Salmaan , Maranda Louise , Cave David
Published: November 2020

Introduction: Often, the diagnostic workup of patients presenting with non-hematemesis gastrointestinal bleeding (NHGIB) is inconclusive. Consequently, the diagnostic evaluation may incur unnecessary health care costs and diagnostic times. The use of a cost decision-analytical model of the current diagnostic management strategy applied to patients presenting with NHGIB may reveal alternative strategies for the evaluation of NHGIB.Methods: Cost decision-analytical model that retrospectively follows the diagnostic course of 231 consecutive patients presenting with NHGIB to the emergency department (ED) of a tertiary medical center. We measured the effect (cost and relative times) of selecting a specific procedure, plus the effect of pursuing secondary procedures after non-diagnostic primary procedures. Results: A primary VCE had a diagnostic rate of 68% vs. 45% and 48% for a primary EGD and COLO, respectively. Combining the diagnostic rates for each primary procedure with the cost of performing subsequent procedures (after non-diagnostic primary procedures), demonstrates the primary use of VCE (n=9) results in a total cost of $12,146 vs. $12,746 and $13,162 for a primary EGD (n=47) and COLO (n=33), respectively. Similarly, the use of VCE as a primary diagnostic procedure in NHGIB patients admitted to the floor would take 74 unit hours to reach a diagnosis compared to 104 and 131 for EGD and COLO, respectively. Conclusion: Our model suggests initial use of VCE for the diagnosis of acute NHGIB, may reduce time to diagnosis and management costs.