bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of Infantile Hemangiomas and Retinopathy of Prematurity: Analysis of the Multicenter KID
Authors: Dankhara Nilesh , Kalikkot Thekkeveedu Renjithkumar , Patel Jaimin , Desai Jagdish
Published: January 2022

Introduction: Retinopathy of prematurity (ROP) and infantile hemangiomas (IHs) both have similar proposed pathophysiological mechanisms. IH is more common in preterm than term infants. Hypoxia-induced mediators like vascular endothelial growth factor have been found elevated in children with hemangiomas. The aim of our study was to determine if there is an association between ROP and IH in preterm infants and to investigate racial/ethnic and gender differences of ROP and IHs in this cohort. Methods: We accessed the national multicenter Kids’ Inpatient Database (KID) Healthcare Cost and Utilization Project (HCUP) including admissions at age ≤28 days. Eligible infants were identified by using ICD-9 codes of ROP and IH in infants with gestational age (GA) ≤32 weeks and/or birth weight ≤1,500 g during the years 2003, 2006, 2009, and 2012. A weight-based analysis was performed using SAS Enterprise Guide 7.1 for complex sample design. Results: In the cohort of 1,068,502 eligible infants, the prevalence of IH was 4.7 per 1,000 preterm admissions (<32 weeks). ROP prevalence was 16% for GA ≤26 weeks, 12.5% for GA 27–30 weeks, and 2.7% for GA 31–32 weeks. IH was significantly higher in infants with ROP; this relationship was consistent among all stages of ROP. Regression analysis showed that females are at increased risk of IH with ROP compared to males (adjusted odds ratio [aOR]: 2.00 [1.85–2.56]). White non-Hispanic premature infants had an increased risk of IH with concomitant ROP compared to both African American (aOR: 3.9 [2.63–4.76]) and Hispanic (aOR: 1.2 [1.14–1.38]) infants. However, African American infants had an increased risk of ROP compared to white non-Hispanic infants (aOR: 1.16 [1.07–1.14]). These genders and racial/ethnic disparities were consistent among GA categories. Conclusions: To our knowledge, this is the largest cohort based on a national multicenter database comparing an association between ROP and IH. A strong association between ROP and IH may suggest similar risk factors and/or pathophysiology. A further role of genetic factors could explain racial/ethnic differences in both conditions despite similar pathogenesis. These findings may open up new bases of research for management and prevention strategies.
Superiority of Simplified Acute Physiologic Score II Compared with Acute Physiologic and Chronic Health Evaluation II and Sequential Organ Failure Assessment Scores for Predicting 48-Hour Mortality in Patients Receiving Continuous Kidney Replacement Therapy
Authors: Jung Hee-Yeon , Jeon Yena , Jeon Soojee , Lim Jeong-Hoon , Kim Yong-Lim
Published: January 2022

Background: Predicting early mortality is important in patients undergoing continuous kidney replacement therapy (CKRT), especially in the first 48 h. This study aimed to determine the predictive performance of the Simplified Acute Physiologic Score (SAPS) II, the Acute Physiologic and Chronic Health Evaluation (APACHE) II, and the Sequential Organ Failure Assessment (SOFA) scores for early mortality in patients receiving CKRT. Methods: Data from patients with acute kidney injury receiving CKRT were consecutively and retrospectively obtained at a tertiary medical center between August 2017 and March 2021. The outcomes included 48-h and 7-day mortality. The scoring systems were evaluated via discrimination at the time of CKRT initiation (using area under the receiver operating characteristics curve [AUROC]) and calibration (via Hosmer-Lemeshow goodness-of-fit C statistics). Results: Among eligible 652 patients, 95 (14.6%) and 212 (32.5%) died within 48 h and within 7 days, respectively. The AUROC for SAPS II (0.71, 95% confidence interval [CI]: 0.65–0.77, p = 0.016 vs. APACHE II score, p = 0.044 vs. SOFA score) was significantly higher than that of the APACHE II (0.66, 95% CI: 0.60–0.72) and SOFA scores (0.66, 95% CI: 0.60–0.72) for 48-h mortality. However, no significant differences in the AUROCs for SAPS II, APACHE II, and SOFA scores for 7-day mortality were observed. The calibration of the SAPS II for 48-h and 7-day mortality was adequate (p = 0.507 and p = 0.141, respectively). Conclusions: The predictive performance of SAPS II for mortality within the first 48 h was superior to that of the APACHE II and SOFA scores in patients with acute kidney injury receiving CKRT.
Non-Invasive Fetal K Status Prediction: 7 Years of Experience
Authors: Rieneck Klaus , Clausen Frederik Banch , Bergholt Thomas , Nørgaard Lone Nikoline , Dziegiel Morten Hanefeld
Published: January 2022

Introduction: In the Kell blood group system, the K and k antigens are the clinically most important ones. Maternal anti-K IgG antibodies can lead to the demise of a K-positive fetus in early pregnancy. Intervention can save the fetus. Prenatal K status prediction of the fetus in early pregnancy is desirable and gives a good basis for pregnancy risk management. We present the results from 7 years of clinical experience in predicting fetal K status as well as some theoretical considerations relevant for design of the assay and evaluation of results. Methods: Blood was collected from 43 women, all immunized against K, at a mean gestational age of 18 weeks (range 10–38). A total of 56 consecutive samples were tested. The KEL*01.01/KEL*02 single nucleotide variant that determines K status was amplified from maternal plasma DNA by PCR without allele specificity. The PCR product was sequenced by NGS technology, and the number of sequenced KEL*01.01 and KEL*02 reads were counted. Prediction of the fetal K status was based on this count and was compared with the serologically determined K status of the newborns. Results: All fetal K predictions were in accordance with postnatal serology where available (n = 34), using our current data analysis. Conclusion: We have developed an NGS-based method for the non-invasive prediction of fetal K status. This approach requires special considerations in terms of primer design, stringent preanalytical sample handling, and careful analytical procedures. We analyzed samples starting at GA 10 weeks and demonstrated the correct prediction of fetal K status. This assay enables timely clinical intervention in pregnancies at risk of hemolytic disease of the fetus and newborn caused by maternal anti-K IgG antibodies.
Hybrid dynamic chunk ensemble model for multi-class data streams
Authors: Khandekar Varsha Sachin , Shrinath Pravin
Published: January 2022

In the analysis more specifically in the classification of continuous data stream using machine learning algorithms joint occurrence of concept drift and imbalanced issue becomes more provocative. Also, imbalance issue is again more challenging when the data stream is multi-class with minority class and that is too with data-difficulty factors. Incremental learning with ensemble models found more promising in handling theses issues. But most of the approaches are for two-class data streams which can’t be utilized for multiclass data streams. In this paper we have designed hybrid dynamic chunk ensemble model (HDCEM) for the classification of multi-class insect-data stream for handling imbalance and concept drift issue. To deal with imbalance issue we have proposed effective split bagging algorithm which has achieved better performance on minority class recall and F-measure on arriving dynamic chunks of data from multi-class data stream. HDCEM model can adapt to abrupt and gradual drift because it has combined features of both online and chunk-based learning together. It has achieved average 78% minority class recall in abrupt insect data stream and 71% in gradual drift insect stream.
Energy harvesting maximization by integration of distributed generation based on economic benefits
Authors: Boghdady Tarek A. , Nasser Samar G. A. , Zahab Essam El-Din Aboul
Published: January 2022

The purpose of distributed generation systems (DGS) is to enhance the distribution system (DS) performance to be better known with its benefits in the power sector as installing distributed generation (DG) units into the DS can introduce economic, environmental and technical benefits. Those benefits can be obtained if the DG units' site and size is properly determined. The aim of this paper is studying and reviewing the effect of connecting DG units in the DS on transmission efficiency, reactive power loss and voltage deviation in addition to the economical point of view and considering the interest and inflation rate. Whale optimization algorithm (WOA) is introduced to find the best solution to the distributed generation penetration problem in the DS. The result of WOA is compared with the genetic algorithm (GA), particle swarm optimization (PSO), and grey wolf optimizer (GWO). The proposed solutions methodologies have been tested using MATLAB software on IEEE 33 standard bus system.
Estimation of the transformer parameters from nameplate data using turbulent flow of water optimization technique
Authors: Hassan Amir Yassin , Said Mokhtar , Salem Saber Mohamed Saleh
Published: January 2022

The mismatch between the transformer and its model leads to deviation of the results during the study of the different abnormal phenomena. This paper presents an optimization technique using transformer nameplate data to minimize the difference in the estimation of the parameters between the model and the actual transformer data. The turbulent flow of water through a narrow path (TFWO) in a circular form technique is used for the optimization of the transformer parameters. The optimization algorithms are used in extracting the parameters of the different rating of transformers, this technique needs an objective function for performing the optimization process. Minimizing the sum of square error (SSE) is the objective function of the optimizer technique. The SSE function includes the summation of the square error for the primary current and secondary current and voltage referring to the primary. The proposed optimization transformer parameters evaluation based on the nameplate data is accurate and fulfilled compared with the other methods.
Third harmonic current minimization using third harmonic blocking transformer
Authors: Bhat Vishnuprasada Vittal , Pius Pinto
Published: January 2022

Zero sequence blocking transformers (ZSBTs) are used to suppress third harmonic currents in 3-phase systems. Three-phase systems where single-phase loading is present, there is every chance that the load is not balanced. If there is zero-sequence current due to unequal load current, then the ZSBT will impose high impedance and the supply voltage at the load end will be varied which is not desired. This paper presents Third harmonic blocking transformer (THBT) which suppresses only higher harmonic zero sequences. The constructional features using all windings in single-core and construction using three single-phase transformers explained. The paper discusses the constructional features, full details of circuit usage, design considerations, and simulation results for different supply and load conditions. A comparison of THBT with ZSBT is made with simulation results by considering four different cases.
Low power architecture of logic gates using adiabatic techniques
Authors: Sanadhya Minakshi , Sharma Devendra Kumar
Published: January 2022

The growing significance of portable systems to limit power consumption in ultra-large-scale-integration chips of very high density, has recently led to rapid and inventive progresses in low-power design. The most effective technique is adiabatic logic circuit design in energy-efficient hardware. This paper presents two adiabatic approaches for the design of low power circuits, modified positive feedback adiabatic logic (modified PFAL) and the other is direct current diode based positive feedback adiabatic logic (DC-DB PFAL). Logic gates are the preliminary components in any digital circuit design. By improving the performance of basic gates, one can improvise the whole system performance. In this paper proposed circuit design of the low power architecture of OR/NOR, AND/NAND, and XOR/XNOR gates are presented using the said approaches and their results are analyzed for powerdissipation, delay, power-delay-product and rise time and compared with the other adiabatic techniques along with the conventional complementary metal oxide semiconductor (CMOS) designs reported in the literature. It has been found that the designs with DC-DB PFAL technique outperform with the percentage improvement of 65% for NOR gate and 7% for NAND gate and 34% for XNOR gate over the modified PFAL techniques at 10 MHz respectively.
Particle swarm optimization based interval type 2 fuzzy logic control for motor rotor position control of artificial heart pump
Authors: Raheem Raghda Saad , Hassan Mohammed Y. , Kdahim Saleem Khalefa
Published: January 2022

Artificial heart pump (AHP) is employed to replace the native damaged heart and perform its functions. Bearingless brushless DC (BBLDC) motors are used for the implementation of the AHP. BBLDC motor is a highly nonlinear model with uncertainties and its mathematical model is hard to be found accurately. In this paper, BBLDC motor is simulated. Proportional plus integral (PI) controller is proposed to control the rotor suspension current. Furthermore, a type 2 proportional plus integral plus derivative-like fuzzy logic controller (T2 PID-Like FLC) is proposed to control the motor rotor (x, y) positions. Particle swarm optimization (PSO) technique is employed to find the best controller scaling factors and to optimize the controller inputs membership functions distribution within its universe of discourse. Simulation results showed enhancement in levitating the rotor to the required position, when using T2 PID-like FLC as compared with using type 1 PID-like fuzzy logic controller. The enhancement is measured using integral of absolute error (IAE) as a cost function to achieve 64.18% and 81.81% in the x and y axes respectively. The Performance of the motor is enhanced by 20%, which decreases the rotor oscillation and increases the ability to withstand the system disturbances and nonlinearity
Classify arrhythmia by using 2D spectral images and deep neural network
Authors: Vu Tran Anh , Huy Hoang Quang , Khanh Pham Duy , Huyen Nguyen Thi Minh , Uyen Trinh Thi Thu , Huong Pham Thi Viet
Published: January 2022

Electrocardiogram (ECG) is the most common method for monitoring the working of the heart. ECG signal is the basis to determine normal or abnormal rhythm, thereby helping to accurately diagnose cardiovascular diseases. Therefore, an automatic algorithm to detect and diagnose abnormal heart rhythms is essential. There are many methods of classifying arrhythmias using machine learning algorithms such as k-nearest neighbors (KNN), support vector machines (SVM), based on the features extracted from the record of ECG signal. Actually, deep learning algorithms are evolving and highly effective in image analysis and processing. In this research, a dense neural network model is proposed to classify normal and abnormal beats. Input ECG signal presenting a time series is converted into 2-D spectral image by applying wavelet transform. Our research is evaluated based on using the Massachusetts Institute of Technology-Beth Israel Hospital (MIT-BIH) arrhythmia database. The accuracy of the classification algorithm we employ is 99.8%, demonstrating the model's validity when compared to other reports' findings. This is the foundation for our algorithm to prove it can be utilized as an efficient model for categorizing arrhythmia using ECG signals.
Internet of things and multi-class deep feature-fusion based classification of tomato leaf disease
Authors: Mahakud Rina , Pattanayak Binod Kumar , Pati Bibudhendu
Published: January 2022

A deep transfer learning (deep-TL) classification model has been proposed to diagnose tomato leaf disease. The main challenge of inaccurate classification of a convolution neural network (CNN) model was the availability of the small-sized dataset. This model deals with the challenges like availability of small-sized and imbalanced datasets. The proposed Alex support vector machine (SVM) fused hybrid classification (ASFHC) model is based on fully fusion technology that avoids overfitting to classify the type of disease in tomato leaves. The proposed model achieves the best performance in terms of accuracy by data augmentation of the training data. It uses a pre-trained network for feature extraction with the modification of architecture by concatenating two layers FC6 and FC7 (fully connected layer), plus a linear SVM classifier for classification of the disease. The uniqueness of the research is although the dataset is not balanced, the performance of the model has achieved the maximum. Compared with VGG 16 and VGG 19, the proposed model (ASFHC) has been evaluated using different measuring parameters, indicating remarkable computation time for implementation in the internet of things (IoT) domain. The overall accuracy attained by the model is 99.62%.
Impact of Pretransplant Malignancy on Heart Transplantation Outcomes: Contemporary United Network for Organ Sharing Analysis Amidst Evolving Cancer Therapies
Authors: Batra Jaya , DeFilippis Ersilia M. , Golob Stephanie , Clerkin Kevin , Topkara Veli K. , Habal Marlena V. , Restaino Susan , Griffin Jan , Hi Lee Sun , Latif Farhana , Farr Maryjane A. , Sayer Gabriel , Raikelkar Jayant , Uriel Nir
Published: January 2022

Background:

An aging population and improved cancer survivorship have increased the number of individuals with treated malignancy who develop advanced heart failure. The benefits of heart transplantation (HT) in patients with a pretransplant malignancy (PTM) must be balanced against risks of posttransplant malignancy in the setting of immunosuppression.

Methods:

Adult patients in the United Network for Organ Sharing registry who received HT between January 1, 2010, and December 31, 2020 were included. Trends, patient characteristics, and posttransplant outcomes in HT recipients with PTM were evaluated.

Results:

From 2000 to 2020, the proportion of HT recipients with PTM increased from 3.2% to 8.2%. From 2010 to 2020, 2113 (7.7%) of 27 344 HT recipients had PTM. PTM was associated with higher rates of 1-year mortality after HT (11.9% versus 9.2%; adjusted hazard ratio, 1.25 [95% CI, 1.09–1.44],
P
=0.001), driven by increased mortality in patients with hematologic PTM (adjusted hazard ratio, 2.00 [95% CI, 1.61–2.48];
P
<0.001). For recipients who survived the first year, 5-year survival was similar between patients with and without PTM. Rates of malignancy at 5-years posttransplant were higher in the PTM group (20.4% versus 13.1%; adjusted hazard ratio, 1.57 [95% CI, 1.38–1.79],
P
<0.001).

Conclusions:

Prevalence of PTM in HT recipients nearly tripled over the past 2 decades. Patients with hematologic PTM were at increased risk of early mortality after HT. Patients with PTM were also at higher risk for posttransplant malignancy. Guidelines that reflect contemporary oncological care are needed to inform care of this heterogenous and expanding group of individuals.
Atrial Fibrillation and Dementia: A Report From the AF-SCREEN International Collaboration
Authors: Rivard Léna , Friberg Leif , Conen David , Healey Jeffrey S. , Berge Trygve , Boriani Giuseppe , Brandes Axel , Calkins Hugh , Camm A. John , Yee Chen Lin , Lluis Clua Espuny Josep , Collins Ronan , Connolly Stuart , Dagres Nikolaos , Elkind Mitchell S.V. , Engdahl Johan , Field Thalia S. , Gersh Bernard J. , Glotzer Taya V. , Hankey Graeme J. , Harbison Joseph A. , Georg Haeusler Karl , Hills Mellanie T. , Johnson Linda S.B. , Joung Boyoung , Khairy Paul , Kirchhof Paulus , Krieger Derk , Lip Gregory Y.H. , Løchen Maja-Lisa , Madhavan Malini , Mairesse Georges H. , Montaner Joan , Ntaios George , Quinn Terence J. , Rienstra Michiel , Rosenqvist Mårten , Sandhu Roopinder K. , Smyth Breda , Schnabel Renate B. , Stavrakis Stavros , Themistoclakis Sakis , Van Gelder Isabelle C. , Wang Ji-Guang , Freedman Ben
Published: January 2022

Growing evidence suggests a consistent association between atrial fibrillation (AF) and cognitive impairment and dementia that is independent of clinical stroke. This report from the AF-SCREEN International Collaboration summarizes the evidence linking AF to cognitive impairment and dementia. It provides guidance on the investigation and management of dementia in patients with AF on the basis of best available evidence. The document also addresses suspected pathophysiologic mechanisms and identifies knowledge gaps for future research. Whereas AF and dementia share numerous risk factors, the association appears to be independent of these variables. Nevertheless, the evidence remains inconclusive regarding a direct causal effect. Several pathophysiologic mechanisms have been proposed, some of which are potentially amenable to early intervention, including cerebral microinfarction, AF-related cerebral hypoperfusion, inflammation, microhemorrhage, brain atrophy, and systemic atherosclerotic vascular disease. The mitigating role of oral anticoagulation in specific subgroups (eg, low stroke risk, short duration or silent AF, after successful AF ablation, or atrial cardiopathy) and the effect of rhythm versus rate control strategies remain unknown. Likewise, screening for AF (in cognitively normal or cognitively impaired patients) and screening for cognitive impairment in patients with AF are debated. The pathophysiology of dementia and therapeutic strategies to reduce cognitive impairment warrant further investigation in individuals with AF. Cognition should be evaluated in future AF studies and integrated with patient-specific outcome priorities and patient preferences. Further large-scale prospective studies and randomized trials are needed to establish whether AF is a risk factor for cognitive impairment, to investigate strategies to prevent dementia, and to determine whether screening for unknown AF followed by targeted therapy might prevent or reduce cognitive impairment and dementia.
Recent Hadley Circulation Strengthening: A Trend or Multidecadal Variability?
Authors: Zaplotnik Žiga , Pikovnik Matic , Boljka Lina
Published: January 2022

This study explores the possible drivers of the recent Hadley circulation strengthening in the modern reanalyses. Predominantly, two recent generations of reanalyses provided by the European Centre for Medium-Range Weather Forecasts are used: the fifth-generation atmospheric reanalysis (ERA5) and the interim reanalysis (ERA-Interim). Some results are also evaluated against other long-term reanalyses. To assess the origins of the Hadley cell (HC) strength variability, we employ the Kuo–Eliassen (KE) equation. ERA5 shows that both HCs were strengthening prior to the 2000s, but they have been weakening or remained steady afterward. Most of the long-term variability in the strength of the HCs is explained by the meridional gradient of diabatic (latent) heating, which is related to precipitation gradients. However, the strengthening of both HCs in ERA5 is larger than the strengthening expected from the observed zonal-mean precipitation gradient [estimated from the Global Precipitation Climatology Project (GPCP)]. This suggests that the HC strength trends in the recent decades in ERA5 can be explained partly as an artifact of the misrepresentation of latent heating and partly through (physical) long-term variability. To show that the latter is true, we analyze ERA5 preliminary data for the 1950–78 period, other long-term (e.g., twentieth century) reanalyses, and sea surface temperature observational data. This reveals that the changes in the HC strength can be a consequence of the Atlantic multidecadal oscillation (AMO) and related diabatic and frictional processes, which in turn drive the global HC variability. This work has implications for further understanding of the long-term variability of the Hadley circulation.
East Asian Rainbands and Associated Circulation over the Tibetan Plateau Region
Authors: Liu Jiabin , Fung Inez Y. , Chiang John C. H.
Published: January 2022

Rainbands that migrate northward from spring to summer are persistent features of the East Asian summer monsoon. This study employs a machine learning algorithm to identify individual East Asian rainbands from May to August in the 6-hourly ERA-Interim reanalysis product and captures rainband events during these months for the period 1979–2018. The median duration of rainband events at any location in East Asia is 12 h, and the centroids of these rainbands move northward continuously from approximately 28°N in late May to approximately 33°N in July, instead of making jumps between quasi-stationary periods. Whereas the length and overall area of the rainbands grow monotonically from May to June, the intensity of the rainfall within the rainband dips slightly in early June before it peaks in late June. We find that extratropical northerly winds on all pressure levels over East China are the most important anomalous flow accompanying the rainband events. The anomalous northerlies augment climatological background northerlies in bringing low moist static energy air and thus generate the front associated with the rainband. Persistent lower-tropospheric southerly winds bring in moisture that feeds the rainband and are enhanced a few days prior to rainband events, but they are not directly tied to the actual rainband formation. The background northerlies could originate as part of the Rossby waves resulting from the jet stream interaction with the Tibetan Plateau. The ageostrophic circulation in the jet entrance region peaks in May and weakens in June and July and does not prove to be critical to the formation of the rainbands.
Use of a Reflectivity Operator Based on Double-Moment Thompson Microphysics for Direct Assimilation of Radar Reflectivity in GSI-Based Hybrid En3DVar
Authors: Liu Chengsi , Li Huiqi , Xue Ming , Jung Youngsun , Park Jun , Chen Lianglyu , Kong Rong , Tong Chong-Chi
Published: January 2022

The assimilation of reflectivity (Z) within 3DVar or hybrid ensemble-3DVar (En3DVar) requires the adjoint of the Z observation operator. With the 3DVar or En3DVar method, previous studies often use Z operators consistent with a single-moment microphysics scheme even when the forecast model uses a double-moment scheme. As such, only the mixing ratios of hydrometeors are directly updated by the data assimilation (DA) system, leading to inconsistency between the analyzed microphysics state variables and the microphysics scheme in the prediction model. In this study, we formulated a Z operator consistent with the double-moment Thompson microphysics used in the numerical integrations; in the operator the snow and graupel reflectivity components are simplified using functions fitted to T-matrix simulation results. This operator and its adjoint are implemented within the GSI hybrid En3DVar DA system to enable direct assimilation of Z with a consistent operator. The impacts of this new operator on convective storm analysis through DA cycles, and on the ensuing 3-h forecasts are first examined in detail for a tornado outbreak case of 16 May 2017 in Texas and Oklahoma, and then for five additional thunderstorm cases. Forecast reflectivity, hourly precipitation, and updraft helicity tracks are subjectively evaluated, while neighborhood ETSs and performance diagrams are examined for reflectivity and/or precipitation. Compared to experiments using a Z operator consistent with a single-moment microphysics scheme, the Z operator consistent with double-moment Thompson microphysics used in the forecast model produces better forecasts of reflectivity, hourly precipitation, and updraft helicity tracks with smaller biases, and the improvement is somewhat larger for a higher Z threshold.
The impact of the parental division of paid labour on depressive symptoms: The moderating role of social policies
Authors: Baranowska-Rataj Anna
Published: January 2022

This study examines the association between the parental division of paid labour and depressive symptoms in a comparative perspective. It investigates how this relationship varies across couples in countries with different social policies using data from European Social Survey, and multilevel models with cross-level interactions between the parental division of paid labour and macro-level indicators of social policies.

The results indicate that dual-earner couples report fewer depressive symptoms than parents in other types of families. This relative advantage of dual-earner couples varies across policy contexts. The benefits of a dual-earner model over a male breadwinner model are larger in countries where childcare services are easily available and do not disappear in countries with generous financial support from the state. Additional analyses reveal how these relationships differ across gender.
Fewer Levels of Dedicated Trauma Care Leads to Better Outcomes
Authors: Thacker Christopher , Nealon Kathleen , Torres Denise , Leonard Dianne , Young Katelyn , Rapp Megan
Published: January 2022

Background

Dedicated trauma intensive care units (ICUs) staffed by surgical intensivists lead to better patient outcomes. Increased length of stay (LOS) leads to worse outcomes. Little research has focused on the effect of dedicated trauma medical-surgical units or ICU/medicalsurgical systems. In 2018, our Level 1 trauma center transitioned from 3 non-dedicated levels of care (ICU/stepdown unit/medical-surgical) to 2 dedicated levels of care (ICU/medical-surgical). Our objective was to look at patient outcomes pre- and post-intervention.

Methods

Retrospective analysis of trauma registry data was performed on patients (age ≥18) admitted to the trauma service at a Level 1 rural trauma center over 46-months. In the pre-intervention group, step down and medical-surgical patients were combined as “Non-ICU” for analysis. Standard statistical analysis was performed.

Results

Analysis included 6103 patients. The group demographics were similar, except pre-intervention patients had higher ISS and fewer comorbidities. Emergency department LOS decreased from 30 versus 13.9% ( P < .0001) and 15.9 versus 5.8% ( P < .0001) for greater than 3 and 6 hours, respectively. Median LOS decreased for all patients ( P < .0001). Mortality dropped from 9.0 versus 5.5% ( P = .0009) for ICU and 1.7 versus 0.26% ( P = .0013) for non-ICU patients. Overall patient mortality was level at 3.7%. Inpatient complications dropped from 9.9 versus 8.5% ( P = .07). Unplanned ICU readmissions were unchanged ( P = .4169). For patients with 3+ comorbidities, overall LOS dropped by 2 days ( P < .0001) and home discharge increased from 42.8 versus 51% ( P < .0001).

Conclusion

Implementation of 2 levels of dedicated care has decreased ED and hospital LOS for all trauma patients without increasing mortality or complications. Patients with extensive comorbidities saw the most improvements.
Occupations and Sickness-Related Absences during the COVID-19 Pandemic
Authors: Lyttelton Thomas , Zang Emma
Published: January 2022

Pandemic frontline occupations consist of disproportionately low socioeconomic status and racial minority workers. Documenting occupational health disparities is therefore crucial for understanding COVID-19-related health inequalities in the United States. This study uses Current Population Survey microdata to estimate occupational differences in sickness-related absences (SAs) from work in March through June 2020 and their contribution to educational, racial-ethnic, and nativity health disparities. We find that there has been an unprecedented rise in SAs concentrated in transportation, food-related, and personal care and service occupations. SA rates were 6 times higher in these occupations than in non-health-care professions. The greatest increases were in occupations that are unsuitable for remote work, require workers to work close to others, pay low wages, and rarely provide health insurance. Workers in these occupations are disproportionately Black, Hispanic, indigenous, and immigrants. Occupation contributes 41% of the total of Black/white differences and 54% of educational differences in SAs.
Sharing is Caring: A Realist Evaluation of a Social Support Group for Individuals Who Have Been Bereaved by Suicide
Authors: Adshead Claire , Runacres Jessica
Published: January 2022

Aim

To understand the experiences and perceived impact on the wellbeing of individuals attending a suicide bereavement social support group.

Design

A qualitative study guided by a realist evaluation framework.

Methods

Data were collected from May–July 2020 using online semistructured individual interviews with participants ( N = 6), from the North West of England recruited from a suicide bereavement support group's social media. Data were analysed using thematic analysis informed by the realist framework.

Results

Effective social support includes the prioritisation of building meaningful connections with like-minded individuals, providing a safe space for authentic self-expression aiding personal relationship maintenance. Contextual factors included: Societal and cultural stigma of suicide, self-stigma and gender norms. Mechanisms influencing support seeking include: Not wanting to burden loved ones due to judgement, and a lack of understanding.

Impact

Policymakers can reduce demand on healthcare systems by developing tailored support groups to suit individual needs.
Moving beyond the gifted label in gifted education: An equity perspective
Authors: Dixson Dante D.
Published: January 2022

This manuscript focuses on the various ways that the gifted label hinders the field of gifted and talented education (GATE) from progressing into a more inclusive and equitable field. Specifically, this manuscript outlines how (a) the social status that the gifted label confers is problematic for achieving equity within GATE, (b) how the gifted label impedes the ability of GATE programs to meet the real-time advanced academic needs of a more diverse group of students, and (c) how the gifted label encourages the perspective that gifted ability is general in nature (as opposed to domain-specific), which results in many students from underrepresented groups getting fewer opportunities to receive advanced academic services.
A genome-wide association study for varicose veins
Authors: Lee Meng-Lin , Liang Chao , Chuang Cheng-Hsun , Lee Pei-Shyuan , Chen Thay-Hsiung , Sun Shen , Liao Kuang-Wen , Huang Hsien-Da
Published: January 2022

Background

The aim was to compare the genetic information of varicose vein patients with that of a healthy population attempting to identify certain significant genetic associations.

Method

Patients’ clinical characteristics and demographics were collected, and their genetic samples were examined. The results were compared to the genetic information of one thousand sex-matched healthy controls from Taiwan Biobank database. The Clinical-Etiology-Anatomy-Pathophysiology classification was applied for further subgroup analysis.

Results

After comparison of genetic information of ninety-six patients to that of healthy controls, two significant single nucleotide polymorphisms (SNPs) were identified. One was in DPYSL2 gene, and the other was in VSTM2L gene. A further comparison between C2-3 patient subgroup and C4-6 subgroup identified another four significant SNPs, which were located in ZNF664-FAM101A, PHF2, ACOT11, and TOM1L1 genes.

Conclusion

Our preliminary result identified six significant SNPs located in six different genes. All of them and their genetic products may warrant further investigations.
Evaluation of the Efficacy of Vancomycin-Soaked Autograft to Eliminate Staphylococcus aureus Contamination After Anterior Cruciate Ligament Reconstruction: Based on an Infected Rat Model
Authors: Tong Kai , Wei Jian , Li Zhenyu , Wang Hui , Wen Yinxian , Chen Liaobin
Published: January 2022

Background:

Vancomycin-soaked autograft application in anterior cruciate ligament reconstruction (ACLR) significantly reduces postoperative infection rates. However, the optimal vancomycin concentrations and time of vancomycin presoaking of autografts for preventing infection are still unknown.

Purpose:

To evaluate the efficacy of vancomycin-soaked autografts in preventing infection in rats with ACLR.

Study Design:

Controlled laboratory study.

Methods:

A total of 102 tendons of Wistar rats were harvested under sterile conditions from fresh cadaveric legs. Contamination with 2.0 × 104 colony forming units per milliliter of Staphylococcus aureus and soaking in different vancomycin concentrations for different soaking times was performed in vitro. In vivo, after being contaminated with S. aureus and soaked with optimal vancomycin solution treatment and sterile saline, the grafts were implanted in rat knees to finish ACLR surgery. At 2, 4, and 12 weeks after surgery, samples were harvested to observe signs of infection and tendon-bone incorporation via general postoperative conditions, serum inflammatory markers, microbiological counting, knee radiographs, micro–computed tomography, histologic staining, scanning electron microscopy, and biomechanical testing.

Results:

Bacterial contamination was eliminated when at least 5 or 10 mg/mL of vancomycin was applied for 30 minutes in vitro. Rats in the vancomycin-soaked graft group (5 mg/mL of vancomycin for 30 minutes) showed no significant signs of infection and fewer positive cultures than did those without presoaking. The vancomycin-soaked graft group had reduced serum inflammatory markers, tissue scores, inflammatory reactions in the joint tissue, and radiographic evidence of periarticular osseous destruction compared with the control group. At postoperative week 12, the vancomycin-soaked graft group showed good outcomes in tendon-bone incorporation via micro–computed tomography, histologic staining, and biomechanical testing.

Conclusion:

In a rat model of infection after ACLR, presoaking grafts in a 5-mg/mL vancomycin solution for 30 minutes could effectively prevent S. aureus contamination without affecting tendon-bone incorporation and knee function.

Clinical Relevance:

The present study could provide a specific solution for the use of vancomycin in the prevention of infection after ACLR clinically.
Biomechanical Assessment of Knee Laxity After a Novel Posterolateral Corner Reconstruction Technique
Authors: Vivacqua Thiago , Vakili Samira , Willing Ryan , Moatshe Gilbert , Degen Ryan , Getgood Alan M.
Published: January 2022

Background:

Different techniques to restore knee stability after posterolateral corner (PLC) injury have been described. The original anatomic PLC reconstruction uses 2 separate allografts to reconstruct the PLC. Access to allograft tissue continues to be a significant limitation of this technique, which led to the development of a modified anatomic approach utilizing a single autologous semitendinosus graft fixed on the tibia with an adjustable suspensory loop to enable differential tensioning of the PLC components.

Purpose/Hypothesis:

The purpose of this study was to compare the modified anatomic technique with the original anatomic reconstruction in terms of varus and external rotatory laxity in a cadaveric biomechanical model. The hypothesis was that both techniques would restore varus and external rotatory laxity after a simulated complete PLC injury.

Study Design:

Controlled laboratory study.

Methods:

Eight pairs of fresh-frozen cadaveric knee specimens were tested to compare the 2 techniques. Varus and external tibial rotation laxity of the knee were measured while applying 10-N·m varus and 5-N·m external rotatory torques at 0°, 30°, 60°, and 90° of flexion. These measurements were tested under 3 conditions: (1) intact fibular collateral ligament, popliteal tendon, and popliteofibular ligament; (2) complete transection of the fibular collateral ligament, popliteal tendon, and popliteofibular ligament; (3) after PLC reconstruction with either the modified (n = 8) or the original (n = 8) technique.

Results:

After PLC reconstruction, varus laxity was restored with no statistically significant differences from the intact condition after both reconstruction techniques. Similar outcomes were observed for external rotation in extension; however, in terms of the external rotation limit with respect to the intact joint, significant reductions of mean ± SD 4.1°± 6.3° ( P = .036) and 5.1°± 6.6° ( P = .016) were recorded with the modified technique at 60° and 90° of flexion, respectively. No significant effect was observed on the neutral flexion kinematics from 0° to 90° of flexion, and no significant differences were observed between reconstructions ( P = .222).

Conclusion:

Both PLC reconstruction techniques restored the normal native varus as compared with the intact knee. Although the modified technique constrained end-range external rotation at 60° and 90° of flexion, no differences were noted with neutral flexion kinematics. Care should be taken when tensioning in the modified technique so that the tibia is in a neutral position to avoid overconstraining the knee.

Clinical Relevance:

The modified technique may prove useful in situations where there are limited graft options, particularly where allografts are not available or are restricted.
Climax as Work: Heteronormativity, Gender Labor, and the Gender Gap in Orgasms
Authors: Andrejek Nicole , Fetner Tina , Heath Melanie
Published: January 2022

Gender scholars have addressed a variety of gender gaps between men and women, including a gender gap in orgasms. In this mixed-methods study of heterosexual Canadians, we examine how men and women engage in gender labor that limits women’s orgasms relative to men. With representative survey data, we test existing hypotheses that sexual behaviors and relationship contexts contribute to the gender gap in orgasms. We confirm previous research that sexual practices focusing on clitoral stimulation are associated with women’s orgasms. With in-depth interview data from a subsample of 40 survey participants, we extend this research to show that both men and women engage in gender labor to explain and justify the gender gap in orgasms. Relying on an essentialist view of gender, a narrow understanding of what counts as sex, and moralistic language that recalls the sexual double standard, our participants craft a narrative of women’s orgasms as work and men’s orgasms as natural. The work to produce this gendered narrative of sexuality mirrors the gender labor that takes place in the bedroom, where both women and men engage in sexual behaviors that emphasize men’s pleasure to a greater extent than women’s.
Measuring Violence: A Computational Analysis of Violence and Propagation of Image Tweets From Political Protest
Authors: Rossi Luca , Neumayer Christina , Henrichsen Jesper , Beck Lucas K.
Published: January 2022

This research quantitatively investigates the impact of violence on the propagation of images in social media in the context of political protest. Using a computational approach, we measure the relative violence of a large set of images shared on Twitter during the protests against the G20 summit in Frankfurt am Main in 2017. This allows us to investigate if more violent content is shared more times and faster than less violent content on Twitter, and if different online communities can be characterized by the level of violence of the visual content they share. The results show that the level of violence in an image tweet does not correlate with the number of retweets and mentions it receives that the time to retweet is marginally lower for image tweets containing a high level of violence and that the level of violence in image tweets differs between communities.
Learning about climate politics during COP 21: Explaining a diminishing knowledge gap
Authors: De Silva-Schmidt Fenja , Brüggemann Michael , Hoppe Imke , Arlt Dorothee
Published: January 2022

A basic understanding of climate politics is necessary for citizens to assess their government’s policies. Media use is supposed to enable learning, while widening knowledge gaps. We analyze whether such a gap opened up in times of intense media coverage during the 2015 climate conference in Paris and explain learning through hierarchical regression analyses, drawing on a 3-month panel survey ( n = 1121) in Germany. We find a diminishing knowledge gap: people with low previous knowledge catch up on the better informed, but overall knowledge remained low and learning was limited. This suggests a ceiling effect: possibly journalistic media did not provide enough new information for the well-informed. Closing knowledge gaps may also be explained by the media system with public television and regional newspapers reaching broad segments of the population. Higher knowledge was predicted less by media use than by education, concern, and being male.
Reimagining relationality for reproductive care: Understanding obstetric violence as “separation”
Authors: van der Waal Rodante , van Nistelrooij Inge
Published: January 2022

Nursing Ethics has published several pleas for care ethics and/or relationality as the most promising ethical foundation for midwifery philosophy and practice. In this article, we stand by these calls, contributing to them with the identification of the structural form of violence that a care ethical relational approach to reproductive care is up against: that of “maternal separation”. Confronted with reproductive and obstetric violence globally, we show that a hegemonic racialized, instrumentalized, and individualized conception of pregnancy is responsible for a severance of relationalities that are essential to safe reproductive care: (1) the relation between the person and their child or reproductive capabilities; and (2) the relation between the pregnant person and their community of care. We pinpoint a separation of the maternal relation in at least two discursive domains, namely, the juridical-political and the ethical-existential. Consequently, we plea for a radical re-imagination of maternal relationality, envisioning what care ethical midwifery, including abortion care, could be.
A beginner’s guide to academic integrity and legal referencing using the AGLC
Authors: Mackay Anita , Ojelabi Lola Akin
Published: January 2022

This article is for beginning law students (both undergraduate and graduate). It aims to provide them with an accessible guide to academic integrity requirements (including the implications of academic misconduct for admission to legal practice), legal referencing and the Australian Guide to Legal Citation (AGLC) rules they encounter early in their studies.
Advancing Entrepreneurship Theory Through Replication: A Case Study on Contemporary Methodological Challenges, Future Best Practices, and an Entreaty for Communality
Authors: Crawford G. Christopher , Skorodziyevskiy Vitaliy , Frid Casey J. , Nelson Thomas E. , Booyavi Zahra , Hechavarria Diana M. , Li Xuanye , Reynolds Paul D. , Teymourian Ehsan
Published: January 2022

Given that replication studies are important for theory building, theory testing, knowledge accumulation, and domain legitimacy, we attempted to replicate 19 seminal studies of new venture emergence that used PSED-type data; only six attempts were successful. Our humbling experience highlights how changes at the author, journal, and institutional levels—indeed, a communal effort—can encourage, facilitate, and expedite replication studies. We provide entrepreneurship scholars with ten best practices for conducting replication studies, as well as recommendations to other stakeholders to steer away from the replication “crisis” plaguing other research domains. As they say, it takes a village.