bluuebunny/crossref_metadata_2025 huggingface dataset:
Consolidation of employability in Nepal: A reflective look
Authors: Sharma Amrita
Published: February 2023

Employability is a construct that includes soft and hard skills to prepare a person to gain employment, progress in it and sustain a career. The employability discourse, in the context of linking education with skills development, has gained increased attention globally. However, engagement with this agenda differs across countries, as it depends on the social, political and economic contexts. Hence it is essential to examine the different aspects of employability, its historical development and strategic interventions to improve it. With this in mind, existing models, policies, frameworks, interventions, reforms and practices in selected countries were analyzed. This analysis was then interwoven with Social Cognitive Career Theory to present a model of employability in Nepal. The model links the family, academic institutions and industries/employers, which are dedicated directly or indirectly to enhancing employability among people. Collaboration and coordination among academic institutions and industries yield various benefits to people entering the job market; importantly, these benefits help students who rarely have opportunities to develop their employability skills in their family environment.
Thermal imaging of the wheel-rail interface
Authors: Firlik Bartosz , Staśkiewicz Tomasz , Słowiński Marcin
Published: February 2023

The paper presents the use of a new method of imaging of the wheel-rail interface wear adopting thermal imaging techniques. Based on the heat generated at the point of contact, coming from the friction and strain of the mating materials, it is possible to identify the type and location of the wheel-rail interface. This work presents the usability of the method with reference to the typical conditions of operation of light rail vehicles (small-radius curves – from 22 m, wheel diameter around 0.6 m, lower standard of track maintenance than in the case of regular railways, use of shallow-grooved frogs, etc.). Thermal imaging presents a big potential in terms of monitoring the wheel-rail interaction and can also be used to identify flange climbing, rolling noise generation or longitudinal creepage during traction or braking.
A Prosociality Paradox: How Miscalibrated Social Cognition Creates a Misplaced Barrier to Prosocial Action
Authors: Epley Nicholas , Kumar Amit , Dungan James , Echelbarger Margaret
Published: February 2023

Behaving prosocially can increase well-being among both those performing a prosocial act and those receiving it, and yet people may experience some reluctance to engage in direct prosocial actions. We review emerging evidence suggesting that miscalibrated social cognition may create a psychological barrier that keeps people from behaving as prosocially as would be optimal for both their own and others’ well-being. Across a variety of interpersonal behaviors, those performing prosocial actions tend to underestimate how positively their recipients will respond. These miscalibrated expectations stem partly from a divergence in perspectives, such that prosocial actors attend relatively more to the competence of their actions, whereas recipients attend relatively more to the warmth conveyed. Failing to fully appreciate the positive impact of prosociality on others may keep people from behaving more prosocially in their daily lives, to the detriment of both their own and others’ well-being.
The Characteristics of magnetic resonance imaging and immunohistochemical findings in de-differentiated liposarcoma
Authors: Yoshida Keisuke , Nakamura Tomoki , Nakamura Koichi , Matsuyama Yumi , Hagi Tomohito , Asanuma Kunihiro , Sudo Akihiro
Published: February 2023

Purpose

Radiological imaging in Dedifferentiated liposarcoma (DDLPS) often shows the coexistence of fatty and non-fatty solid components; however, it has been shown that when fatty components were not identified on magnetic resonance imaging (MRI), the diagnosis of DDLPS would not have been diagnosed if immunohistochemical (IHC) staining had not been performed. The aim of this study was to investigate the pattern of MRI and relationship between MRI and IHC findings in DDLPS.

Methods

We retrospectively reviewed the cases of 25 patients with DDLPS. To identify the MRI spectrum of DDLPS, tumors were classified into the following four categories based on MRI findings: I = a well-defined fatty mass and juxtaposed well-defined non-fatty mass, II = a non-fatty component within a predominantly fatty mass, III = a focal fatty component within a large non-fatty mass, and IV = a non-fatty mass with atypical MRI findings. IHC staining for CDK4, MDM2, and p16 were evaluated.

Results

Category IV tumor was the most common tumor in this population. Of the 22 patients who underwent IHC staining, MDM2, CDK4, and p16 were positive in 21, 20, and 19 patients, respectively. MDM2 was positive in all 11 patients with category IV tumors; CDK4 and p 16 were positive in 10 and eight patients, respectively. There was no difference of survival between the patients with category I, II and III and category IV.

Conclusions

DDLPS without fatty components on MRI scans was mostly found. We recommend IHC staining to screen for DDLPS even if the tumors in STS cases have a non-fatty component.
From “What Works” to “Why it Works” – From a Humean to an Aristotelian Understanding of Causality
Authors: Jess Kari , Petersén Anna Charlotta
Published: February 2023

Purpose: Authors of this theoretical article are questioning Hume's view on causality by arguing for Aristotle’s pluralistic view as an alternative strategy for social work research and practice. Methods: Aristotle's notion of causality is applied to discuss its relevance, and then tested on a real case, thereby illustrating how it can contribute to explain why something works. Results: Different types of causes can reveal characteristics that are preconditional for professional's and service user's mutual roles in enhancing outcomes. They can further reveal the architecture of the intervention; the underlying processes for actions to reach a desired goal. Discussion: To deliver knowledge of relevance in social work, one needs to explain the results of an intervention through causal analysis as well as understanding the content and processes of it. Aristotle's forms of causality make it possible to take the contextual historicism of social phenomenon into consideration and give knowledge beyond effects.
Theoretical modeling and analysis of a quasi-zero-stiffness vibration isolator equipped with extensible and axially magnetized negative stiffness modules
Authors: Yuan Junjie , Jin Guoyong , Ye Tiangui , Chen Yukun , Bai Jinlin
Published: February 2023

Quasi-zero-stiffness (QZS) isolation systems have demonstrated good performance in low-frequency vibration isolation fields. However, the existing QZS isolation systems with traditional negative stiffness elements cannot support high payloads under miniaturization and simplification. To give some beneficial insights into high loading capacity, optimized structure, and good vibration isolation performance, a novel axially magnetized negative stiffness module (MNSM) is proposed based on the concepts of modularity and expansibility. Concretely, an axially magnetized negative stiffness unit (MNSU) is designed as the fundamental building block of MNSM, and the proposed MNSM can be composed of different axially magnetized negative stiffness units (MNSUs) for diversified requirements. To effectively investigate the characteristics of the MNSU, a computationally high efficient equivalent surface current method is developed. As a result, two types of MNSUs with optimized parameters are achieved, and their design procedures are presented respectively. To verify the benefits of the MNSMs, the designed QZS isolator is theoretically modeled and solved with the average method and then verified through the Runge–Kutta method. Through analyzing the isolation systems with MNSMs under different nonlinearities and dynamic parameters, the results indicate that the proposed MNSMs can endow the QZS vibration isolator with a lower resonant frequency, a wider isolation frequency range, and a smaller transmissibility. Additionally, it is also demonstrated that there is an inverse relationship between the complexity of the MNSM structure and the sensitivity of the isolation system.
Bandwidth widening for sound absorption of a flexible microperforated panel backed by a multi-frequency panel-type resonator
Authors: Yeang Wai Yeen , Halim Dunant
Published: February 2023

A microperforated panel (MPP) often suffers from a limited absorption bandwidth and poor sound absorption in the low frequency range. The present study aimed to propose an MPP-panel-type resonator (PR) compound structure that can simultaneously widen the half-absorption bandwidth and improve the poor absorption at the low frequency range. A vibroacoustic model is developed and compared to finite element simulations to demonstrate its accuracy. The vibration characteristics of the compound structure and the surface impedance are analyzed to reveal the mechanism forming the absorption characteristics of an MPP-PR structure. It is found that backing an MPP with a panel-type resonator (PR) creates a low frequency absorption peak but followed by an absorption valley that decreases the absorption bandwidth. The analysis showed that the phase difference between velocity of air particles in perforation and the PR panel velocity dictates the absorption characteristics associated with the PR resonance. A multi-resonators panel-type resonator (MPR) is found that the absorption valley associated with the host panel resonance splits into multiple smaller amplitude absorption dips improving absorption performance. The proposed MPP-MPR compound structure demonstrated a relatively wider half-absorption bandwidth with improved low frequency absorption.
Correlation transmissibility damage indicator for deterioration performance analysis of hydropower generator unit
Authors: Tong Kaixuan , Mao Hanying , Wu Ruixuan , Zhong Jiankang , Mao Hanling , Huang Zhenfeng , Li Xinxin
Published: February 2023

The condition monitoring system of the hydropower generator unit (HGU) contains a vast amount of monitoring data related to equipment performance. It is challenging to reveal the HGU performance change law from these data. This paper constructed a correlation transmissibility damage indicator (CTDI) to analyze HGU degradation performance based on the transmissibility function (TF). Unlike traditional TF damage indicators, CTDI can use different types of monitoring data to obtain system TF to increase TF combination and improve detection sensitivity. The analysis is performed using actual monitoring data from a hydropower plant in Guangxi, China. Firstly, a new frequency concept is defined based on the characteristics of HGU obtaining data every 10 minutes. Then, the HGU is considered a system and divided into three subsystems according to the sensor installation locations of the monitoring system. The damage indicator is used to analyze the system and its subsystems at the time scales of day, week, and month to locate and quantify the damage of HGU. The final results of this analysis show that the method can accurately detect and locate faults, applies to different operating conditions, and reveals the HGU performance deterioration pattern, which is of great significance for HGU maintenance.
Im/Probabilities of Post/Authorship and Academic Writing Otherwise in Postfoundational Inquiry
Authors: Taylor Carol A. , Benozzo Angelo
Published: February 2023

This article explores questions of im/probability of/as post/authorship in postfoundational inquiry. Inspired by Deleuzian philosophy, the article instantiates post/authorship and academic writing otherwise as a means to interrogate, critique, and undo the representationalist modes of normative authorship. Through a series of playful im/probabilities, the article suggests and enacts a writerly mode of post/authorship that reframes notions of authorial intentionality and origination.

Reviewer 2: “… your contribution … needs to be more clearly stated at the outset”.

In paying attention to writerly invention as inquiry without method, the article’s provocation is, “What might happen if/when we go rogue and become post/authorship imposters instead of authors?”
Exponential stability for a porous thermoelastic system of type II
Authors: Zhang Hualei
Published: February 2023

In this paper, we study the stability of a porous thermoelastic system of type II. When a global viscous dissipation is imposed on the elastic wave equation or two local viscous dissipations are imposed on the elastic wave equation and the wave equation of the volume fraction, respectively, we show that the system is exponentially stable by the frequency domain method.
Henle fiber layer hemorrhage as the first manifestation of factor V Leiden homozygous mutation
Authors: Flores-Márquez Ana , Moreno-Gutiérrez Juan Ángel , García-Marcet Susana , García-Martín Fernando , Gismero-Moreno Saturnino , Rocha-de-Lossada Carlos
Published: February 2023

Purpose

To report a case of a Henle fiber layer hemorrhage as the initial manifestation of Factor V Leiden disease.

Methods

Case report and literature review.

Results

A healthy 19-year-old patient presented with a spontaneous Henle fiber layer (HFL) hemorrhage. The genetic analysis showed a previously unknown homozygous Factor V Leiden Mutation. No specific treatment was given due to the patient's good visual acuity and favorable prognosis, but the diagnosis of a Factor V Leiden mutation enabled a correct therapeutic management to be followed by the patient.

Conclusion

Advances in eye imaging allow to detect ocular findings that may lead to an early diagnosis and treatment. To the best of our knowledge, this is the first case of a HFL hemorrhage as the initial manifestation of Factor V Leiden disease. Further research is needed to identify the pathways linking these findings.
Treatment of long-term catheter-related bloodstream infections with short-course Daptomycin lock and systemic therapy associated with Taurolidine-lock: A multicenter experience
Authors: Vassallo Matteo , Denis Eric , Manni Sabrina , Lotte Laurene , Fauque Philippe , Sindt Audrey
Published: February 2023

Purpose:

Few studies describe the efficacy of antibiotic lock therapy (ALT) in long-term catheter-related bloodstream (CRBSI) infections. We applied local protocols combining Daptomycin (DPT) and Taurolidine ALT, associated with systemic antibiotic treatment (SAT), for conservative management of coagulase-negative Staphylococci (CoNS) CRBSI.

Methods:

Patients admitted for CoNS-associated CRBSI and treated with DPT and Taurolidine as ALT were retrospectively analyzed. Success was defined as catheter retention 30 days after ending treatment. Catheter removal within 30 days was considered as failure.

Results:

From April 2018 to September 2021, 22 subjects with CoNS-associated-CRBSI were included (95% with cancer, mean age 64 years, 59% male). Staphylococcus epidermidis was isolated in 82% of cases. Mean duration of DPT was 3.9 and 3 days as ALT and SAT, respectively. SAT also included Rifampin for 3 days. Taurolidine ALT was started on day 4 and was combined with oral SAT, that is, either Linezolid or Tedizolid. Mean duration of Taurolidine was 10.5 days, while total antibiotic treatment lasted 13.5 days. Clinical success and failure rates were 95% and 5%, respectively.

Discussion:

Short course DPT as ALT, combined with SAT and Taurolidine ALT, allowed high rates of conservative management of catheters in case of CoNS-associated-CRBSI.
A study on surface microgrooves in cavitation test of 6061 aluminum alloy
Authors: Wang Shuo , Cheng Feng , Wu Fujia , Peng Xiaoxing , Cao Yantao
Published: February 2023

Microgrooves of different widths and microgrooves structures with varying widths were engraved on the surface of 6061 aluminum alloy using fiber laser marking equipment. In order to investigate the influence of the width of microgrooves on its cavitation behavior, cavitation tests on the microgroove structure were performed using an ultrasonic vibration apparatus. The hardness, the surface roughness, and the microscopic morphology of the samples were examined with a digital microhardness tester, a digital three-dimensional video microscope, and a scanning electron microscope, respectively. The results demonstrated that, increasing microgroove size was conducive to inhibition of cavitation erosion while decreasing microgroove size had an opposite effect. The surface microgrooves group elongated the incubation period of aluminum alloy in the cavitation tests, and noticeably increased the cavitation resistance of the aluminum alloy. It was also concluded that, the microgrooves group could transform microjets aiming at the alloy surface to the inside of microgrooves, and absorbed the impacted energy from microjets, leading to a remarkable anticavitation effect.
Blurred lines between electoral and parliamentary representation: The use of constituency staff among Members of the European Parliament
Authors: Hermansen Silje Synnøve Lyder , Pegan Andreja
Published: February 2023

Parliamentarians receive public funding to employ local staff in the constituency. Local staff help members of parliament to execute their representative duties, but can also become an electoral asset. Drawing on theories of personal vote-seeking we study local staff as an example of constituency service. Modelling within-individual changes in local staff size among 1174 Members of the European Parliament (MEPs), we find that the number of local staff increases before both European and national elections, and more so in candidate-centred than party-centred systems. Despite a single European Parliament (EP) staff system, EU citizens are represented differently depending on where they elect their members and the electoral system that applies. Attempts to mend the EU’s democratic deficit by strengthening MEPs’ contacts with citizens through local staff potentially means that European public money is used to fund EP incumbents’ electoral campaigns. We discuss the implications of our findings for the democratic functioning of the European multi-level system.
Deprescribing initiative of NSAIDs (DIN): Pharmacist-led interventions for pain management in a federal correctional setting
Authors: Dawson Keith G. , Mok Vanessa , Wong Jason G.M. , Bhalla Alka
Published: February 2023

Background:

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for management of pain and inflammation. However, these medications are associated with adverse outcomes such as dyspepsia and acute myocardial infarction, especially with long-term uses.

Objective:

We sought to determine the effect of a pharmacist-led deprescribing intervention on oral NSAID use among patients in federal custody.

Methods:

Clinical pharmacists from Correctional Services Canada (CSC) conducted a prospective case series of adult patients with chronic noncancer pain who were on long-term NSAIDs (defined as >90 days supply in the past 120 days) in 3 CSC institutions in British Columbia, Canada. CSC clinical pharmacists met with patients to perform medication reviews and identify drug-related problems, with a focus on analgesic therapy. Pharmacist-led interventions were implemented in consultation with the primary care team to address these drug-related problems. Patient progress was monitored weekly for 3 months. Function, quality of life and pain severity scores (modified SPAASMS, Patient-Specific Functional Scale [PSFS] and visual analog scale [VAS] scores) were compared at baseline, 6 weeks and 3 months postintervention. Patient satisfaction survey results were also collected at 3 months.

Results:

A total of 53 patients received clinical pharmacist interventions. Modified SPAASMS, PSFS and VAS scores were collected at baseline, 6 weeks and 3 months from 38 patients (some were lost to follow-up when released back into the community). All 38 patients demonstrated clinically significant improvements to all 3 pain scales at 3 months (mean SPAASMS scores decreased by 7 points, mean PSFS scores increased by 2 points, mean VAS scores decreased by 2 points). Twenty-four of 31 patients who completed the patient satisfaction survey agreed that their overall health and well-being improved because of the visit they received from the pharmacist.

Conclusion:

Clinical pharmacist-led interventions in CSC have shown to reduce oral NSAID use as well as contribute positively to patient pain scores.
Alkaloids and Iridoids From the Aerial Parts of Rauvolfia cambodiana Pierre ex Pit. and Their Acetylcholinesterase Inhibitory Activity
Authors: Tung Ninh Khac Thanh , Mai Nguyen Chi , Yen Duong Thi Hai , Tai Bui Huu , Ban Ninh Khac , Kang Jong Seong , Van Kiem Phan
Published: February 2023

Objective: Rauvolfia cambodiana has been used as a Vietnamese folk medicine to treat high blood pressure and for sedation and memory loss diseases. However, to date, there have been few studies on the chemical constituents and biological activity of this medicinal plant. This study aimed to find the chemical constituents of R cambodiana and evaluate their enhancement memory properties. Methods: The aerial parts of R cambodiana were powdered and ultrasonically extracted with methanol. The methanol extract was suspended in water and successively partitioned with dichloromethane and ethyl acetate to give dichloromethane, ethyl acetate, and water-soluble extracts. Each extract was fractionated and purified by column and HPLC chromatographic methods. The chemical structures of the isolated compounds were elucidated by analysis of HRESIMS, 1D and 2D NMR spectra, and experimental and TD-DFT calculated ECD spectra. The enhancement memory property of the compounds was evaluated by their in vitro acetylcholinesterase inhibitory activity. Results: Five alkaloids (1-5) and 2 iridoids (6 and 7), including one new one named rauvolcambonine (1), and 6 known compounds, perakine (2), ajmaline (3), 10-hydroxy-16- epi-affinine (4), sitsirikine (5), loganic acid (6), and secoxyloganin (7) were isolated and identified from the aerial parts of R cambodiana. Compounds 4 and 5 significantly showed acetylcholinesterase inhibitory effects in vitro with IC50 values of 30.1 ± 1.4 µM and 65.5 ± 3.3 µM, respectively. The other compounds inhibited acetylcholinesterase with IC50 values ranging from 111.0 ± 6.0 µM to 197.6 ± 19.8 µM. Conclusion: One new (1) and 3 other compounds (2, 4-7) were recorded from R cambodiana for the first time. The NMR spectroscopic data of compound 4 are reported herein for the first time. Our study preliminarily revealed that the vobasenal framework type alkaloids could be active ingredients of Rauvolfia species and responsibility for the enhancement memory property of these plants.
Populism and Critical Incidents in Journalism: Has Bolsonaro Disrupted the Mainstream Press in Brazil?
Authors: Marques Francisco Paulo Jamil
Published: February 2023

Despite the increasing number of studies examining the conflicts between the media and populist leaders, understanding how such clashes prompt shifts in journalism norms and practices remains to be thoroughly explored. Based on a literature review and the discussion of an extensive array of examples characterizing the Brazilian media setting, this article provides a qualitative assessment of how Jair Bolsonaro's rhetoric and actions have triggered a “critical incident” in our mainstream journalism. We consider four dimensions currently experiencing transformations: the media's (1) institutional responses and campaigns, (2) production of the news, (3) production of editorials, and (4) how media professionals have reacted to populist attacks. There is evidence that journalism has increasingly become a central topic in news texts. We have also cataloged changes in news production routines (e.g., the editors’ hesitancy to send reporters to cover some political events), the use of editorials to reinforce metajournalistic discourses, and shifts in how professionals make sense of their work. Our findings contribute to the broader literature by investigating how traditional borders and values of journalism are renegotiated during institutional crises. In addition, our analytical framework can be applied to other media settings experiencing similar tensions and help underpin the construction of empirical variables to understand meaningful changes in the field. Lastly, this study considers the possible effects that change in norms, routines, and practices can have on the democratic roles of journalism.
Acceptability of wearable devices for measuring mobility remotely: Observations from the Mobilise-D technical validation study
Authors: Keogh Alison , Alcock Lisa , Brown Philip , Buckley Ellen , Brozgol Marina , Gazit Eran , Hansen Clint , Scott Kirsty , Schwickert Lars , Becker Clemens , Hausdorff Jeffrey M. , Maetzler Walter , Rochester Lynn , Sharrack Basil , Vogiatzis Ioannis , Yarnall Alison , Mazzà Claudia , Caulfield Brian
Published: February 2023

Background

This study aimed to explore the acceptability of a wearable device for remotely measuring mobility in the Mobilise-D technical validation study (TVS), and to explore the acceptability of using digital tools to monitor health.

Methods

Participants ( N = 106) in the TVS wore a waist-worn device (McRoberts Dynaport MM + ) for one week. Following this, acceptability of the device was measured using two questionnaires: The Comfort Rating Scale (CRS) and a previously validated questionnaire. A subset of participants ( n = 36) also completed semi-structured interviews to further determine device acceptability and to explore their opinions of the use of digital tools to monitor their health. Questionnaire results were analysed descriptively and interviews using a content analysis.

Results

The device was considered both comfortable (median CRS (IQR; min-max) = 0.0 (0.0; 0–20) on a scale from 0–20 where lower scores signify better comfort) and acceptable (5.0 (0.5; 3.0–5.0) on a scale from 1–5 where higher scores signify better acceptability). Interviews showed it was easy to use, did not interfere with daily activities, and was comfortable. The following themes emerged from participants’ as being important to digital technology: altered expectations for themselves, the use of technology, trust, and communication with healthcare professionals.

Conclusions

Digital tools may bridge existing communication gaps between patients and clinicians and participants are open to this. This work indicates that waist-worn devices are supported, but further work with patient advisors should be undertaken to understand some of the key issues highlighted. This will form part of the ongoing work of the Mobilise-D consortium.
Factors Associated With Airline Cabin Crews’ Influenza Vaccination Intention in the Workplace-based Setting
Authors: Kim Layoung , Kim Gwang Suk , Lee Kyung Hee , Kim Jungha
Published: February 2023

Background:

Yearly influenza vaccination is the best way to prevent influenza. Workplace vaccination program for airline cabin crews is an important countermeasure in the management of infectious diseases. Understanding the influenza vaccination behavior of cabin crews is essential to establishing strategies to promote vaccine uptake. This study aimed to examine factors associated with airline cabin crews’ influenza vaccination intention in a workplace-based setting. We applied the theory of planned behavior (TPB) to explain the vaccination behavior of employees.

Methods:

A cross-sectional study was performed in April 2021. Participants self-reported the structured questionnaires that consisted of TPB variables, and reasons for influenza vaccination/nonvaccination in 2020. A total of 253 crew members participated, and 242 were included in the analysis.

Findings:

The influenza vaccination rate was 70.7% in 2020, and vaccination intention was 5.92 of 7 points in 2021. Multiple linear regression showed that influenza vaccination intention was associated with subjective norms (β = .394, p < .001), positive attitude (β = .145, p = .007), perceived behavioral control (β = .170, p = .004), actual behavioral control (β = .145, p = .010), and the previous year’s vaccination (β = .163, p < .001). The model accounted for 57% of the variance in influenza vaccination intention ( F = 40.959, p < .001).

Conclusions/Application to Practice:

Our findings indicate that TPB is useful in explaining employees’ influenza vaccination intention and influencing factors. Focusing on positive messages that emphasize the social effects of vaccination and providing free vaccination on specific dates are potential strategies to increase intention. It can be applied to help design on-site workplace vaccination programs for essential frontline workers.
Predictors of Bronchopulmonary Dysplasia in Infants With Birth Weight Less Than 1500 g
Authors: Maytasari Galuh Martin , Haksari Ekawaty Lutfia , Prawirohartono Endy Paryanto
Published: February 2023

Bronchopulmonary dysplasia (BPD) is a complication of preterm and low birth weight infants. The incidence of BPD has not decreased over the past 20 years. Complications of BPD include rehospitalization, chronic lung disease, cardiovascular disease, and impaired growth and development which will affect the patient's quality of life. There are unfortunately limited data available regarding BPD in Indonesia. This study is expected to be a reference in taking preventive measures to reduce mortality and morbidity in preterm and low birth infants. This study aims to determine predictors of BPD in infants with birth weight less than 1500 g. We conducted a retrospective cohort study that included 116 infants with birth weight <1500 g. Twenty-two (19%) infants had BPD with the highest proportion (63.6%) in the 28 to 31 weeks of gestational age. Multivariate analysis showed mechanical ventilation in more than first 2 days of life ( P = .008; HR = 7.7), hematocrit <39% ( P = .001; HR = 12), and hemodynamically significant patent ductus arteriosus (hsPDA; P = .041; HR = 3.5) were significant predictors of BPD in infants with birth weight <1500 g.
Impact of remote vital sign monitoring on health outcomes in acute respiratory infection and exacerbation of chronic respiratory conditions: systematic review and meta-analysis
Authors: Creavin Samuel Thomas , Garg Megha , Hay Alastair D.
Published: February 2023

Background

Our aim was to investigate the effectiveness of virtual wards on health outcomes in patients with acute respiratory infection.

Methods

We searched four electronic databases from January 2000 to March 2021 for randomised controlled trials (RCTs). We included studies in people with acute respiratory illness or an acute exacerbation of a chronic respiratory illness, where a patient or carer measured vital signs (oximetry, blood pressure, pulse) for initial diagnosis and/or asynchronous monitoring, in a person living in private housing or a care home. We performed random-effects meta-analysis for mortality.

Results

We reviewed 5834 abstracts and 107 full texts. Nine RCTs were judged to be relevant for inclusion, in which sample sizes ranged from 37 to 389 (total n=1627) and mean ages ranged between 61 and 77 years. Five were judged to be at low risk of bias. Five RCTs had fewer hospital admissions in the intervention (monitoring) group, out of which two studies reported a significant difference. Two studies reported more admissions in the intervention group, with one reporting a significant difference. We were unable to perform a meta-analysis on healthcare utilisation and hospitalisation data due to lack of outcome definition in the primary studies and variable outcome measurements. We judged two studies to be at low risk of bias. The pooled summary risk ratio for mortality was 0.90 (95% CI 0.55–1.48).

Conclusion

The limited literature for remote monitoring of vital signs in acute respiratory illness provides weak evidence that these interventions have a variable impact on hospitalisations and healthcare utilisation, and may reduce mortality.
Clinical impact of routine sleep assessment by peripheral arterial tonometry in patients with COPD
Authors: Hansson Daniel , Andersson Anders , Vanfleteren Lowie E.G.W. , Andelid Kristina , Zou Ding , Hedner Jan , Grote Ludger
Published: February 2023

Background

Coexisting obstructive sleep apnoea (OSA) in patients with COPD, defined as overlap syndrome (OVS), is prevalent and underdiagnosed. Routine assessment of OSA is not common practice in COPD care. Our study assessed the clinical impact of sleep assessment by peripheral arterial tonometry (PAT) in COPD patients.

Methods

105 COPD patients (mean age 68.1±9 years, body mass index (BMI) 28.3±6.0 kg·m−2, 44% males, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I to IV in 2%, 40%, 42% and 16%, respectively) underwent assessment at an outpatient COPD clinic including anthropometrics, arterial blood gas (ABG) and spirometry in this clinical cohort study. PAT-based sleep studies were performed. Predictors of OVS and ABG were determined. Rapid eye movement (REM) sleep-related OSA (REM-OSA) was analysed in OVS.

Results

49 COPD patients (47%) suffered from moderate to severe OSA (OVS group, mean apnoea–hypopnoea index 30.8±18 events·h−1, REM-oxygen desaturation index (REM-ODI) 26.9±17 events·h−1). OVS was more prevalent in males compared to females (59% and 37%, p=0.029, respectively). Age (70.1±8versus66.3±10 years), BMI (30.0±6versus26.4±7 kg·m−2) and hypertension prevalence (71%versus45%) were elevated (all p<0.03, respectively), while deep sleep (12.7±7% and 15.4±6%, p=0.029) and mean overnight oxygenation (90.6±3% and 92.3±2%, p=0.003) were lower in OVS compared to COPD alone. REM-ODI was independently associated with daytime arterial carbon dioxide tension (PaCO2) (β=0.022, p<0.001). REM-OSA was associated with an elevated prevalence of atrial fibrillation compared to no REM-OSA (25% and 3%, p=0.022).

Conclusions

OVS was highly prevalent, specifically in obese males. REM-related OSA showed strong association with elevated daytimePaCO2and prevalent cardiovascular disease. PAT was feasible for sleep assessment in COPD.
Awake prone position in COVID-19 acute respiratory failure: a randomised crossover study using electrical impedance tomography
Authors: Brunelle Thomas , Prud'homme Eloi , Alphonsine Jean-Emmanuel , Baumstarck Karine , Sanz Celine , Salmi Saida , Peres Noemie , Forel Jean-Marie , Papazian Laurent , Hraiech Sami , Roch Antoine , Guervilly Christophe
Published: February 2023

Background

The goal of this study was to determine whether an awake prone position (aPP) reduces the global inhomogeneity (GI) index of ventilation measured by electrical impedance tomography (EIT) in COVID-19 patients with acute respiratory failure (ARF).

Methods

This prospective crossover study included COVID-19 patients with COVID-19 and ARF defined by arterial oxygen tension:inspiratory oxygen fraction (PaO2:FIO2) of 100–300 mmHg. After baseline evaluation and 30-min EIT recording in the supine position (SP), patients were randomised into one of two sequences: SP-aPP or aPP-SP. At the end of each 2-h step, oxygenation, respiratory rate, Borg scale and 30-min EIT were recorded.

Results

10 patients were randomised in each group. The GI index did not change in the SP-aPP group (baseline 74±20%, end of SP 78±23% and end of aPP 72±20%, p=0.85) or in the aPP-SP group (baseline 59±14%, end of aPP 59±15% and end of SP 54±13%, p=0.67). In the whole cohort,PaO2:FIO2increased from 133±44 mmHg at baseline to 183±66 mmHg in aPP (p=0.003) and decreased to 129±49 mmHg in SP (p=0.03).

Conclusion

In spontaneously breathing nonintubated COVID-19 patients with ARF, aPP was not associated with a decrease of lung ventilation inhomogeneity assessed by EIT, despite an improvement in oxygenation.
Validation of the HULL Score clinical prediction rule for unsuspected pulmonary embolism in ambulatory cancer patients
Authors: Haque Farzana , Ryde Jessamine , Broughton Laura , Huang Chao , Sethi Sifut , Stephens Andrew , Pillai Annet , Mirza Shagufta , Brown Victoria , Avery Ged , Bozas Georgios , Maraveyas Anthony
Published: February 2023

Background

Clinical prediction rules (CPRs) developed to predict adverse outcomes of suspected pulmonary embolism (PE) and facilitate outpatient management have limitations in discriminating outcomes for ambulatory cancer patients with unsuspected PE (UPE). The HULL Score CPR uses a 5‑point scoring system incorporating performance status and self-reported new or recently evolving symptoms at UPE diagnosis. It stratifies patients into low, intermediate and high risk for proximate mortality. This study aimed to validate the HULL Score CPR in ambulatory cancer patients with UPE.

Patients and methods

282 consecutive patients managed under the UPE-acute oncology service in Hull University Teaching Hospitals NHS Trust were included from January 2015 to March 2020. The primary end-point was all-cause mortality, and outcome measures were proximate mortality for the three risk categories of the HULL Score CPR.

Results

30-day, 90-day and 180-day mortality rates for the whole cohort were 3.4% (n=7), 21.1% (n=43) and 39.2% (n=80), respectively. The HULL Score CPR stratified patients into low-risk (n=100, 35.5%), intermediate-risk (n=95, 33.7%) and high-risk (n=81, 28.7%) categories. Correlation of the risk categories with 30-day mortality (area under the curve (AUC) 0.717, 95% CI 0.522–0.912), 90-day mortality (AUC 0.772, 95% CI 0.707–0.838), 180-day mortality (AUC 0.751, 95% CI 0.692–0.809) and overall survival (AUC 0.749, 95% CI 0.686–0.811) was consistent with the derivation cohort.

Conclusion

This study validates the capacity of the HULL Score CPR to stratify proximate mortality risk in ambulatory cancer patients with UPE. The score uses immediately available clinical parameters and is easy to integrate into an acute outpatient oncology setting.
Monocyte count is associated with the severity of human adenovirus pneumonia in hospitalized children aged less than 6 years
Authors: Hu Rong , Luo Xiaorong , Tang Guilan , Ding Yiyi
Published: February 2023

Background

Human Adenovirus (HAdV) pneumonia is common in young children and infants. Overall, 7–8% of all viral respiratory illnesses among children for less than 5 years are induced by HAdVs. Unfortunately little is known about the role of monocyte count in the disease severity.

Methods

Data were gathered from 595 children (age < 6 years) who were diagnosed with HAdV infection at the 1st People's Hospital (Changde City, China) between January 2019 and December 2019. There were 181 cases of severe adenovirus pneumonia.

Results

The correlation between the patients' monocyte count and the severity of HAdV pneumonia was estimated by performing a multiple linear regression analysis. The results showed a negative association (OR: 0.53, 95% CI 0.31 to 0.89, P < 0.05). We further built Generalized Additive Models (GAMs) and demonstrated that the monocyte count had a non-linear association with severe HAdV pneumonia. The inflection point of monocyte count detected in the two-stage linear regression model was 1.5. On the left side of this point, the monocyte count was negatively interrelated (OR: 0.26, 95% CI 0.13 to 0.52, P < 0.001), while on the opposite side, there was a positive association (OR: 7.48, 95% CI 1.30 to 43.08, P < 0.05).

Conclusions

Based on the results of this investigation, we established a link between monocyte count and the severity of HAdV pneumonia. Monocyte count is negatively associated with severe HAdV pneumonia. The inflection point of monocyte count detected in the two-stage linear regression model was 1.5 × 109/L.
What internal medicine attendings talk about at morning report: a multicenter study
Authors: Redinger Jeffrey W. , Heppe Daniel B. , Albert Tyler J. , Cornia Paul B. , Gordon Kirsha S. , Arundel Cherinne , Bradley Joel M. , Caputo Laura M. , Chun Jonathan W. , Cyr Jessica E. , Ehlers Erik T. , Guidry Michelle M. , Jagannath Anand D. , Kwan Brian K. , Laudate James D. , Mitchell Christine A. , Smeraglio Andrea C. , Sweigart Joseph R. , Tuck Matthew G. , Gunderson Craig G.
Published: February 2023

Background

Morning report is a core educational activity in internal medicine resident education. Attending physicians regularly participate in morning report and influence the learning environment, though no previous study has described the contribution of attending physicians to this conference. This study aims to describe attending comments at internal medicine morning reports.

Methods

We conducted a prospective, observational study of morning reports conducted at 13 internal medicine residency programs between September 1, 2020, and March 30, 2021. Each attending comment was described including its duration, whether the comment was teaching or non-teaching, teaching topic, and field of practice of the commenter. We also recorded morning report-related variables including number of learners, report format, program director participation, and whether report was scripted (facilitator has advance knowledge of the case). A regression model was developed to describe variables associated with the number of attending comments per report.

Results

There were 2,344 attending comments during 250 conferences. The median number of attendings present was 3 (IQR, 2–5). The number of comments per report ranged across different sites from 3.9 to 16.8 with a mean of 9.4 comments/report (SD, 7.4). 66% of comments were shorter than one minute in duration and 73% were categorized as teaching by observers. The most common subjects of teaching comments were differential diagnosis, management, and testing. Report duration, number of general internists, unscripted reports, and in-person format were associated with significantly increased number of attending comments.

Conclusions

Attending comments in morning report were generally brief, focused on clinical teaching, and covered a wide range of topics. There were substantial differences between programs in terms of the number of comments and their duration which likely affects the local learning environment. Morning report stakeholders that are interested in increasing attending involvement in morning report should consider employing in-person and unscripted reports. Additional studies are needed to explore best practice models of attending participation in morning report.
A novel inverse membrane bioreactor for efficient bioconversion from methane gas to liquid methanol using a microbial gas-phase reaction
Authors: Chen Yan-Yu , Ishikawa Masahito , Hori Katsutoshi
Published: February 2023

Background

Methane (CH4), as one of the major energy sources, easily escapes from the supply chain into the atmosphere, because it exists in a gaseous state under ambient conditions. Compared to carbon dioxide (CO2), CH4is 25 times more potent at trapping radiation; thus, the emission of CH4to the atmosphere causes severe global warming and climate change. To mitigate CH4emissions and utilize them effectively, the direct biological conversion of CH4into liquid fuels, such as methanol (CH3OH), using methanotrophs is a promising strategy. However, supplying biocatalysts in an aqueous medium with CH4involves high energy consumption due to vigorous agitation and/or bubbling, which is a serious concern in methanotrophic processes, because the aqueous phase causes a very large barrier to the delivery of slightly soluble gases.

Results

An inverse membrane bioreactor (IMBR), which combines the advantages of gas-phase bioreactors and membrane bioreactors, was designed and constructed for the bioconversion of CH4into CH3OH in this study. In contrast to the conventional membrane bioreactor with bacterial cells that are immersed in an aqueous phase, the filtered cells were placed to face a gas phase in the IMBR to supply CH4directly from the gas phase to bacterial cells.Methylococcus capsulatus(Bath), a representative methanotroph, was used to demonstrate the bioconversion of CH4to CH3OH in the IMBR. Cyclopropanol was supplied from the aqueous phase as a selective inhibitor of methanol dehydrogenase, preventing further CH3OH oxidation. Sodium formate was added as an electron donor to generate NADH, which is necessary for CH3OH production. After optimizing the inlet concentration of CH4, the mass of cells, the cyclopropanol concentration, and the gas flow rate, continuous CH3OH production can be achieved over 72 h with productivity at 0.88 mmol L−1 h−1in the IMBR, achieving a longer operation period and higher productivity than those using other types of membrane bioreactors reported in the literature.

Conclusions

The IMBR can facilitate the development of gas-to-liquid (GTL) technologies via microbial processes, allowing highly efficient mass transfer of substrates from the gas phase to microbial cells in the gas phase and having the supplement of soluble chemicals convenient.
Description of Sarcocystis platyrhynchosi n. sp. (Apicomplexa: Sarcocystidae) from domestic ducks Anas platyrhynchos (Anseriformes: Anatidae) in China
Authors: Hu Junjie , Zhang Mingzhu , Wu Zhipeng , Zeng Hongxia , Tao Jianping
Published: February 2023

Background

Limited data are currently available on protozoan parasites of the genus Sarcocystis that infect their avian hosts within the order Anseriformes (waterfowl). To date, no Sarcocystis species has been recorded in ducks in China.

Methods

Leg muscles were sampled from 26 domestic ducks (Anas platyrhynchos) in China in 2021. Morphological characteristics of sarcocysts detected in the muscle tissue were described using light microscopy (LM) and transmission electron microscopy (TEM). Genomic DNA was extracted from single sarcocysts obtained from different ducks, and three genetic markers, 18S ribosomal DNA (18S rDNA), 28S ribosomal DNA (28S rDNA) and mitochondrial (mt) cytochrome oxidase subunit 1 (cox1), were amplified and cloned for sequence analyses.

Results

Sarcocysts were observed by LM in only three of the 28 samples (10.7%). These sarcocysts had a thick cyst wall with numerous brush-like villar protrusions (vps) of 3.8–4.3 μm in length (n = 30) on the cyst surface. TEM observation showed that the sarcocysts had lanceolated vps. Each vps narrowed in the stalk and contained a bundle of microtubules that extended into the ground substance. Comparisons of the new sequences with those deposited in GenBank showed that the most similar sequences were those of Sarcocystishalieti in the great cormorant Phalacrocorax carbo and European starling Sturnus vulgaris, and Sarcocystis calchasi in the domestic pigeon (Columba livia) at the 18S rDNA (99.1% identity); Sarcocystiswenzeli from the domestic chicken Gallus gallus at the 28S rDNA (95.9–96.0% identity); and Sarcocystis speeri from the opossum at the mtcox1 (98.2% identity). The new 18S rDNA, 28S rDNA and mitochondrial cox1 sequences shared up to 99.0%, 95.6% and 97.7% identity, respectively, with those of Sarcocystis spp. obtained from Anseriformes avian hosts. Phylogenetic analysis inferred from the sequences of the three genetic markers placed the organism within a group of Sarcocystis spp. obtained from avian or carnivorous intermediate hosts and avian, marsupial or carnivorous definitive hosts. Based on the morphological observation and molecular analyses, the organism found in the Chinese domestic ducks was regarded as a new species and named Sarcocystis platyrhynchosi n. sp.

Conclusions

Based on morphology and sequence analyses, the microcysts diagnosed in the domestic ducks examined in this study were named as a new species. This is the first record of Sarcocystis spp. from waterfowl in China. Sarcocysts of similar morphology occur frequently in different Anseriformes birds, and the relationships among these species need to be further clarified in future studies using more molecular markers.

Graphical Abstract