bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic review: fetal death reporting and risk in Zika‐affected pregnancies
Authors: Leisher Susannah Hopkins , Balalian Arin A. , Reinebrant Hanna , Shiau Stephanie , Flenady Vicki , Kuhn Louise , Morse Stephen S.
Published: November 2020

Objectives

Zika virus is linked to several adverse pregnancy outcomes. We assessed whether Zika infection during pregnancy is associated with increased risk of foetal death (miscarriage, stillbirth, abortion) and whether there is incomplete reporting of such deaths.

Methods

We searched PubMed, Embase, CINAHL, Web of Science and LILACS for studies reporting Zika‐affected completed pregnancies (ending in foetal death or live birth), excluding studies whose aim required live birth. Studies ‘allowed’ foetal death if their populations were defined to encompass both live births and foetal deaths, regardless of whether deaths were actually found. Two authors independently extracted data and assessed study quality. Foetal death absolute and relative risks in Zika‐affected vs. unaffected pregnancies were calculated.

Results

We found 108 reports including 24 699 completed, Zika‐affected pregnancies. The median absolute risk in 37 studies of completed, Zika‐affected pregnancies was 6.3% (IQR 3.2%, 10.6%) for foetal death and 5.9% (IQR 0%, 29.1%) for non‐fatal adverse outcomes (e.g. microcephaly). More studies allowed non‐fatal adverse outcomes (95%) than foetal death (58%). Of studies which allowed them, 94% found at least one foetal death. In 37% of reports, it was unknown whether foetal deaths were allowed. Only one study had sufficient data to estimate a foetal death relative risk (11.05, 95% CI 3.43, 35.55).

Conclusions

Evidence was insufficient to determine whether foetal death risk is higher in Zika‐affected pregnancies, but suggests quality of foetal death reporting should be improved, including stating whether foetal deaths were found, how many, and at what gestational ages, or justifying their exclusion.
Estimating assistive product need in Cameroon and India: results of population‐based surveys and comparison of self‐report and clinical impairment assessment approaches
Authors: Boggs Dorothy , Kuper Hannah , Mactaggart Islay , Murthy GVS , Oye Joseph , Polack Sarah
Published: November 2020

Objectives

To estimate population need and coverage for distance glasses, hearing aids and wheelchairs in India and Cameroon, and to explore the relationship between assistive product (AP) need measured through self‐report and clinical impairment assessment.

Methods

Population‐based surveys of approximately 4000 people each were conducted in Mahabubnagar district, India and Fundong district, Cameroon. Participants underwent standardised vision, hearing and musculoskeletal impairment assessment to assess need for distance glasses, hearing aids, wheelchairs. Participants with moderate or worse impairment and/or self‐reported difficulties in functioning were also asked about their self‐reported AP need.

Results

6.5% (95% CI 5.4–7.9) in India and 1.9% (95% CI 1.5–2.4) in Cameroon of the population needed at least one of the three APs based on moderate or worse impairments. Total need was highest for distance glasses [3.7% (95% CI 2.8–4.7) India; 0.8% (95% CI 0.5–1.1), Cameroon] and lowest for wheelchairs (0.1% both settings; 95% CI 0.03–0.3 India, 95% CI 0.04–0.3 Cameroon). Coverage for each AP was below 40%, except for distance glasses in India, where it was 87% (95% CI 77.1–93.0). The agreement between self‐report and clinical impairment assessment of AP need was poor. For instance, in India, 60% of people identified through clinical assessment as needing distance glasses did not self‐report a need. Conversely, in India, 75% of people who self‐reported needing distance glasses did not require one based on clinical impairment assessment.

Conclusions

There is high need and low coverage of three APs in two low‐and middle‐income settings. Methodological shortcomings highlight the need for improved survey methods compatible with the international classification of functioning, disability and health to estimate population‐level need for AP and related services to inform advocacy and planning.
Application of Wray–Agarwal Turbulence Model in Flow Simulation of a Centrifugal Pump With Semispiral Suction Chamber
Authors: Ji Leilei , Li Wei , Shi Weidong , Agarwal Ramesh K.
Published: November 2020

The Wray–Agarwal (WA) turbulence model is selected to simulate the internal and external characteristics of a centrifugal pump with semispiral suction chamber; the numerical results are compared with the experimental data and computed results predicted by standard k–ε, renormalization group (RNG) k–ε, and shear stress transport (SST) k–ω turbulence models. The results show that the WA model could be effectively used to compute the energy performance of centrifugal pump under full range of operating conditions and gives higher accuracy than other models. Overall, the WA model shows closer similarity to the experimental data and gives more uniform flow field in the impeller region compared to that predicted by other models. In prediction of internal flow fields of the pump, overall the WA model is more accurate and efficient being a one-equation model. The control of undamped eddy viscosity variable R (= k/ω) in WA model does not allow the overestimation of turbulent kinetic energy and turbulent eddy frequency obtained with other models, which leads to its advantage in accurate prediction of both internal and external flow characteristics of centrifugal pump.
Establishing a Quantitative Endpoint for Transarterial Embolization From Real-Time Pressure Measurements
Authors: Gowda Prateek C. , Chen Victoria X. , Sobral Miguel C. , Bobrow Taylor L. , Romer Tatiana Gelaf , Palepu Anil K. , Guo Joanna Y. , Kim Dohyung J. , Tsai Andrew S. , Chen Steven , Weiss Clifford R. , Durr Nicholas J.
Published: November 2020

Transarterial embolization (TAE) is a standard-of-care treatment for tumors in which embolic particles are locally injected via a catheter to occlude blood flow and induce ischemia in the target tissue. Physicians currently rely on subjective visual cues from fluoroscopy in order to determine the procedural endpoint relative to the injection site. This contributes to highly variable treatment outcomes, including the accumulation of embolic particles in healthy tissue, called off-target embolization. To address this concern, we describe a novel, multilumen catheter that 1) measures real-time pressure upstream of the tumor site during TAE injection; and 2) associates that measurement with the volume of embolic particles injected. Using an in vitro silicon vascular model, we characterize the relationship between blood flow, intravascular pressure, and injection pressure. Furthermore, we identify a predictive pressure curve based on the volume of embolic particles injected. This approach has the potential to standardize and optimize TAE, reducing the likelihood of incomplete or off-target embolization, and improving patient outcomes.
Design of a remote plasma-enhanced chemical vapor deposition system for growth of tin containing group-IV alloys
Authors: Grzybowski Gordon , Ware Morgan E. , Kiefer Arnold , Claflin Bruce
Published: November 2020

Group-IV alloys of Ge and/or Si with Sn are challenging to prepare due to the low solubility of Sn in both of these elements. Herein, we describe a remote plasma-enhanced chemical vapor deposition (RPECVD) system designed to synthesize such group-IV alloys. Thin films of Ge, Ge1−ySiy, Ge1−xSnx, and Ge1−x−ySiySnx were deposited in the range of 280−410 °C on Si (001) substrates utilizing a remote He plasma with downstream injected mixtures of SnCl4, SiH4, and/or GeH4 precursors. The composition and structural properties of these RPECVD films were characterized with x-ray diffraction, transmission electron microscopy, and x-ray photoelectron spectroscopy. They were found to be crystalline, oriented with the substrate, and nearly relaxed due to the formation of an ∼5 nm thick interface layer with a high density of edge dislocations and stacking faults.
The Small RNAs PA2952.1 and PrrH as Regulators of Virulence, Motility, and Iron Metabolism in Pseudomonas aeruginosa
Authors: Coleman Shannon R. , Bains Manjeet , Smith Maren L. , Spicer Victor , Lao Ying , Taylor Patrick K. , Mookherjee Neeloffer , Hancock Robert E. W.
Published: November 2020

Due to the rising incidence of multidrug-resistant (MDR) strains and the difficulty of eliminating
P. aeruginosa
infections, it is important to understand the regulatory mechanisms that allow this bacterium to adapt to and thrive under a variety of conditions. Small RNAs (sRNAs) are one regulatory mechanism that allows bacteria to change the amount of protein synthesized.
The Small Toxic
Salmonella
Protein TimP Targets the Cytoplasmic Membrane and Is Repressed by the Small RNA TimR
Authors: Andresen Liis , Martínez-Burgo Yolanda , Nilsson Zangelin Josefin , Rizvanovic Alisa , Holmqvist Erik
Published: November 2020

Next-generation sequencing (NGS) has enabled the revelation of a vast number of genomes from organisms spanning all domains of life. To reduce complexity when new genome sequences are annotated, open reading frames (ORFs) shorter than 50 codons in length are generally omitted. However, it has recently become evident that this procedure sorts away ORFs encoding small proteins of high biological significance. For instance, tailored small protein identification approaches have shown that bacteria encode numerous small proteins with important physiological functions. As the number of predicted small ORFs increase, it becomes important to characterize the corresponding proteins. In this study, we discovered a conserved but previously overlooked small enterobacterial protein. We show that this protein, which we dubbed TimP, is a potent toxin that inhibits bacterial growth by targeting the cell membrane. Toxicity is relieved by a small regulatory RNA, which binds the toxin mRNA to inhibit toxin synthesis.
Long-Term Modeling of SARS-CoV-2 Infection of
In Vitro
Cultured Polarized Human Airway Epithelium
Authors: Hao Siyuan , Ning Kang , Kuz Cagla Aksu , Vorhies Kai , Yan Ziying , Qiu Jianming
Published: November 2020

The pandemic of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to >35 million confirmed cases and >1 million fatalities worldwide. SARS-CoV-2 mainly replicates in human airway epithelia in COVID-19 patients. In this study, we used
in vitro
cultures of polarized human bronchial airway epithelium to model SARS-CoV-2 replication for a period of 21 to 51 days. We discovered that
in vitro
airway epithelial cultures endure a long-lasting SARS-CoV-2 propagation with recurrent peaks of progeny virus release at an interval of approximately 7 to 10 days. Our study also revealed that SARS-CoV-2 infection causes airway epithelia damage with disruption of tight junction function and loss of cilia. Importantly, SARS-CoV-2 exhibits a polarity of infection in airway epithelium only from the apical membrane; it infects ciliated and goblet cells but not basal and club cells. Furthermore, the productive infection of SARS-CoV-2 requires a high viral load of over 2.5 × 10
5
virions per cm
2
of epithelium. Our study highlights that the proliferation of airway basal cells and regeneration of airway epithelium may contribute to the recurrent infections.
Chemical Profiling Provides Insights into the Metabolic Machinery of Hydrocarbon-Degrading Deep-Sea Microbes
Authors: Moreno-Ulloa Aldo , Sicairos Diaz Victoria , Tejeda-Mora Javier A. , Macias Contreras Marla I. , Castillo Fernando Díaz , Guerrero Abraham , Gonzalez Sanchez Ricardo , Mendoza-Porras Omar , Vazquez Duhalt Rafael , Licea-Navarro Alexei
Published: November 2020

High-throughput technologies and emerging informatics tools have significantly advanced knowledge of hydrocarbon metabolism by marine microbes. However, research into microbes inhabiting deep-sea sediments (>1,000 m) is limited compared to those found in shallow waters. In this study, a nontargeted and nonclassical approach was used to examine the diversity of bacterial taxa and the metabolic profiles of hydrocarbon-degrading deep-sea microbes. In conclusion, this study used metabolomics and chemoinformatics to demonstrate that microbes from deep-sea sediment origin thrive in the presence of toxic and difficult-to-metabolize hydrocarbons. Notably, this study provides evidence of previously unreported metabolites and the global chemical repertoire associated with the metabolism of hydrocarbons by deep-sea microbes.
Public health for paediatricians: Fifteen-minute consultation on
addressing child poverty in clinical practice
Authors: Singh Guddi , Zhu Hannah , Cheung C Ronny
Published: November 2020

Paediatricians and other child health professionals have a key role in
identifying, preventing or mitigating the impacts of poverty on child
health. Approaching a problem as vast and intractable as poverty can seem
daunting. This article will outline how social determinants impact child
health, and provide practical guidance on how to address this problem
through a public health lens. The aim is to give frontline practitioners a
straightforward, evidence-based framework and practical solutions for
tackling child poverty, across three levels: (1) the clinical consultation;
(2) the clinical service for the population of children and young people we
serve and (3) with a broader policy and social view.
SalmonellaTyphi: a rare cause of parotid abscess
Authors: Anandan Yamini , Antony Tessa , Kumari Swati , Alexander Naveen
Published: November 2020

The incidence of extraintestinal infection caused bySalmonellaspp has been increased during the past decade. Here we report a case of a parotid abscess caused bySalmonella entericasubspeciesenterica serotypeTyphi (S. Typhi) in an individual without any significant abnormality of the parotid gland. A 68-year-old man presented to the surgical department with high-grade intermittent fever associated with painful swelling over the right side of the face, extending into the neck. An ultrasound of the neck revealed an abscess of the right parotid gland.S. Typhi was isolated from the pus drained from the parotid gland. The patient was treated with intravenous followed by oral cephalosporin for a period of 7 days. This case gives an insight into one of the rarer aetiological agents causing parotid abscess.
Every loin swelling in an infant is not a renal mass: rare presentation of psoas abscess in an infant
Authors: Venkatesan Dilip Kumar , Chaudhary Himanshi , Verma Sanjay
Published: November 2020

Primary iliopsoas abscess (IPA) in infants is an uncommon condition. It presents as inguinal or thigh swelling with limitation of movements on the affected side. Early detection and timely drainage of the abscess can prevent serious complications related to the dissemination of infection. We report a case of primary IPA due to methicillin-sensitive staphylococcal infection presenting as a left lumbar mass in an immune-competent infant. The abscess was detected in time, drained surgically and treated with cloxacillin for 4 weeks, thereby preventing serious complications.
Glucocorticoid-induced cardiomyopathy: unexpected conclusion
Authors: Sheikh Taha , Shuja Hina , Zaidi Syeda Ramsha , Haque Ayema
Published: November 2020

Glucocorticoid excess is an under-recognised cause of cardiovascular adverse effects. The sources can be either endogenous (Cushing’s syndrome) or exogenous (Anabolic steroid abuse). Cardiovascular complications due to excess glucocorticoid includes hypertension, left ventricular hypertrophy, myocardial infarction, and heart failure. Although anabolic steroid-induced cardiomyopathy is a well-recognised phenomenon, endogenous corticosteroid-induced cardiomyopathy and heart failure are rarely reported sequelae of glucocorticoid excess in the body. We report a glucocorticoid-induced dilated cardiomyopathy in a 26-year-old African–American man with cushingoid features and symptomatic heart failure.
Hyperplastic thyroid nodule masquerading as parathyroid adenoma in a patient with tubercular lymphadenitis induced hypercalcaemia
Authors: Goyal Alpesh , Agarwal Shipra , Goswami Ravinder , Bal Chandrasekhar
Published: November 2020

Serum intact parathyroid hormone (iPTH) levels are high or high normal in patients with parathyroid adenoma. Rarely these patients can have normal or low serum iPTH values. With sandwich immunometric assays, an exceptionally high serum iPTH level can lead to falsely low measurement due to the ‘hook effect’. Here, we describe the case of a 66-year-old female patient with PTH-independent hypercalcaemia which mimicked parathyroid adenoma. A multidisciplinary team approach helped in the diagnosis and management leading to complete recovery.
Post phacoemulsification wound infection byNocardia cyriacigeorgica: a rare acid-fast organism
Authors: Rana Rimpi , Rohilla Ranjana , Bhatia Mohit , Gupta Neeti
Published: November 2020

Tunnel infection is one of the most dreaded infections, post phacoemulsification. Most cases reported till now are caused by Gram-positive and Gram-negative bacteria or fungi and very few cases by the acid-fast organisms. Ocular infections by Nocardia usually have poor prognosis. Here, we report a case of tunnel infection, its management and microbiological identification of cause behind it, that is,Nocardia cyriacigeorgicaa rare acid-fast microorganism.
Persistent viral shedding despite seroconversion in a kidney transplant recipient with severe extrapulmonary COVID-19
Authors: Italiano Jack , Bush Rachel , Acharya Ratna , Upadhyay Kiran
Published: November 2020

Renal transplant (RT) recipients are at increased risk for infectious complications. The clinical course of COVID-19 has been described in several RT recipients with varying clinical outcomes. Most present with pulmonary manifestations, however extrapulmonary presentations are not uncommon. Also, the timing and efficacy of seroconversion in transplant recipients is not well known. This report describes the duration of viral shedding and timing of seroconversion in a young adult RT recipient with COVID-19 who presented with severe diarrhoea and acute kidney injury requiring dialysis. She developed anti‐SARS‐CoV‐2 IgG antibody after 5 weeks despite persistently shedding the virus in the nasopharynx until 6 weeks after symptom onset. Further studies are needed to determine if immunosuppressed patients have prolonged viral shedding and are still contagious despite seroconversion.
Treatment of epithelial ovarian cancer
Authors: Kuroki Lindsay , Guntupalli Saketh R
Published: November 2020

Ovarian cancer is the third most common gynecologic malignancy worldwide but accounts for the highest mortality rate among these cancers. A stepwise approach to assessment, diagnosis, and treatment is vital to appropriate management of this disease process. An integrated approach with gynecologic oncologists as well as medical oncologists, pathologists, and radiologists is of paramount importance to improving outcomes. Surgical cytoreduction to R0 is the mainstay of treatment, followed by adjuvant chemotherapy. Genetic testing for gene mutations that affect treatment is the standard of care for all women with epithelial ovarian cancer. Nearly all women will have a recurrence, and the treatment of recurrent ovarian cancer continues to be nuanced and requires extensive review of up to date modalities that balance efficacy with the patient’s quality of life. Maintenance therapy with poly ADP-ribose polymerase inhibitors, bevacizumab, and/or drugs targeting homologous recombination deficiency is becoming more widely used in the treatment of ovarian cancer, and the advancement of immunotherapy is further revolutionizing treatment targets.
Implementation of the therapeutic use of hydroxyurea for sickle cell disease management in resource-constrained settings: a systematic review of adoption, cost and acceptability
Authors: Ryan Nessa , Dike Lotanna , Ojo Temitope , Vieira Dorice , Nnodu Obiageli , Gyamfi Joyce , Peprah Emmanuel
Published: November 2020

Objectives

Mortality associated with sickle cell disease (SCD) is high in many low- and middle-income countries (LMICs). Hydroxyurea, a medicine to effectively manage SCD, is not widely available in resource-constrained settings. We identified and synthesised the reported implementation outcomes for the therapeutic use of hydroxyurea for SCD in these settings.

Design

Systematic review.

Data sources

PubMed, Embase, Cochrane, Web of Science Plus, Global Health, CINAHL, and PsycINFO were searched February through May 2019 without any restrictions on publication date.

Eligibility criteria

We included empirical studies of hydroxyurea for management of SCD that were carried out in LMICs and reported on implementation outcomes.

Data extraction and synthesis

Two reviewers independently assessed studies for inclusion, carried out data extraction using Proctoret al.’s implementation and health service outcomes, and assessed the risk of bias using ROBINS-I (Risk Of Bias In Non-randomised Studies - of Interventions).

Results

Two cross-sectional surveys (n=2) and one cohort study (n=1) reported implementation of hydroxyurea for SCD management, namely regarding outcomes of adoption (n=3), cost (n=3) and acceptability (n=1). These studies were conducted exclusively among paediatric and adults populations in clinical settings in Nigeria (n=2) or Jamaica (n=1). Adoption is low, as observed through reported provider practices and patient adherence, in part shaped by misinformation and fear of side effects among patients, provider beliefs regarding affordability and organisational challenges with procuring the medicine. There was no difference in the cost of hydroxyurea therapy compared with blood transfusion in the paediatric population in urban Jamaica. Risk of bias was low or moderate across the included studies.

Conclusions

This review rigorously and systematically assessed the evidence on implementation of hydroxyurea in resource-constrained settings such as LMICs. Findings suggest that knowledge regarding implementation is low. To address the know-do gap and guide clinical practice, implementation research is needed. Integrating effective interventions into existing health systems to improve hydroxyurea uptake is essential to reducing SCD-associated mortality.

PROSPERO registration number

CRD42020155953.
What older adults and their caregivers need for making better health-related decisions at home: a participatory mixed methods protocol
Authors: Lai Claudia , Holyoke Paul , Plourde Karine V , Décary Simon , Légaré France
Published: November 2020

Introduction

Shared decision making is an interpersonal process whereby healthcare providers collaborate with and support patients in decision-making. Older adults receiving home care need support with decision-making. We will explore what older adults receiving home care and their caregivers need for making better health-related decisions.

Methods and analysis

This two-phase sequential exploratory mixed methods study will be conducted in a pan-Canadian healthcare organisation, SE Health. First, we will create a participant advisory group to advise us throughout the research process. In phase 1 (qualitative), we will recruit a convenience sample of 15–30 older adults and caregivers receiving home care to participate in open-ended semi-structured interviews. Phase 1 participants will be invited to share what health-related decisions they face at home and what they need for making better decisions. In phase 2 (quantitative), interdisciplinary health and social care providers will be invited to answer a web-based survey to share their views on the decisional needs of older adults and their caregivers. The survey will include questions informed by findings from qualitative interviews in phase 1, and a workbook for assessing decisional needs based on the Ottawa Decision Support Framework. Finally, qualitative and quantitative results will be triangulated (by methods, investigator, theory and source) to develop a comprehensive understanding of decision-making needs from the perspective of older adults, caregivers and health and social care providers. We will use the quality of mixed methods studies in health services research guidelines and the Checklist for Reporting the Results of Internet E-Surveys checklist.

Ethics and dissemination

Ethics approval was obtained from the research ethics boards at Southlake Regional Health Centre and Université Laval. This study will inform the design of decision support interventions. Further dissemination plans include summary briefs for study participants, tailored reports for home care decision makers and policy makers, and peer-reviewed publications.

Trial registration number

NCT04327830.
Improving population health in resident clinics: increasing pneumonia vaccination rates in adults 65 years and older
Authors: McGreevy Sheila , McGowan Caylin , Gillenwater Kristin , Opole Rebecca , Veluri Meena , Stehle Kim , Ramm Bethany , Gibson Cheryl
Published: November 2020

Streptococcus pneumoniaeis a significant bacterial pathogen, especially in the elderly. There are two types of pneumococcal vaccines, one with polysaccharides from the capsule of 23 serotypes (PPSV23) and one with polysaccharides from 13 serotypes that have been conjugated to a protein (PCV13). Both vaccines decrease the incidence of invasive pneumococcal disease and are recommended for all people ≥65 years of age. We found the vaccination rate againstS. pneumoniaein patients ≥65 years of age in our resident physician continuity clinics was 59.85%, which is considerably lower than the vaccination rate of 69.16% in our attending physician clinics. The aim of our study was to double the number of vaccinations given in the resident physician clinics over a 1-month period without compromising workflow or unduly burdening the rooming nurse or resident physicians. For our primary intervention, we assigned a designated nurse with expertise in vaccinations the task of reviewing charts ahead of clinic visits then pending the order for the appropriate pneumococcal vaccine. Our secondary intervention was the education of physicians through pocket cards, verbal encouragement and email reminders. χ² test was conducted to compare the proportion of patients 65 years or older who were vaccinated between the intervention and control groups. The results indicated that the intervention group patients were 2.61 times (95% CI 1.18 to 6.10) more likely to be vaccinated compared with the control group patients (20% vs 8.7%, χ2(1)=5.16, p=0.02, Cramer’s V=0.16). The intervention resulted in more than doubling the number of vaccinations in the intervention group compared with the control group. Moreover, poststudy interviews and surveys indicated our workflow is sustainable and amendable to wider use within the resident physician clinics.
Factors influencing physician responsiveness to nurse-initiated communication: a qualitative study
Authors: Manojlovich Milisa , Harrod Molly , Hofer Timothy , Lafferty Megan , McBratnie Michaella , Krein Sarah L
Published: November 2020

Background

How quickly physicians respond to communications from bedside nurses is important for the delivery of safe inpatient care. Delays in physician responsiveness can impede care or contribute to patient harm. Understanding contributory factors to physician responsiveness can provide insights to promote timely physician response, possibly improving communication to ensure safe patient care. The purpose of this study was to describe the factors contributing to physician responsiveness to text or numeric pages, telephone calls and face-to-face messages delivered by nurses on adult general care units.

Methods

Using a qualitative design, we collected data through observation, shadowing, interviews and focus groups of bedside registered nurses and physicians who worked in four hospitals in the Midwest USA. We analysed the data using inductive content analysis.

Results

A total of 155 physicians and nurses participated. Eighty-six nurses and 32 physicians participated in focus groups or individual interviews; we shadowed 37 physicians and nurses across all sites. Two major inter-related themes emerged, message and non-message related factors. Message-related factors included the medium nurses used to convey messages, physician preference for notification via one communication medium over another and the clarity of the message, all of which could cause confusion and thus a delayed response. Non-message related factors included trust and interpersonal relationships, and different perspectives between nurses and physicians on the same clinical issue that affected perceptions of urgency, and contributed to delays in responsiveness.

Conclusions

Physician responsiveness to communications from bedside nurses depends on a complex combination of factors related to the message itself and non-message related factors. How quickly physicians respond is a multifactorial phenomenon, and strategies to promote a timely response within the context of a given situation must be directed to both groups.
Computed tomography-based triage of extensive baseline infarction: ASPECTS and collaterals versus perfusion imaging for outcome prediction
Authors: McDonough Rosalie , Elsayed Sarah , Faizy Tobias Djamsched , Austein Friederike , Sporns Peter B , Meyer Lukas , Bechstein Matthias , van Horn Noel , Nawka Marie Teresa , Schön Gerhard , Kniep Helge , Hanning Uta , Fiehler Jens , Heit Jeremy J , Broocks Gabriel
Published: November 2020

Background

Patients presenting with large baseline infarctions are often excluded from mechanical thrombectomy (MT) due to uncertainty surrounding its effect on outcome. We hypothesized that computed tomography perfusion (CTP)-based selection may be predictive of functional outcome in low Alberta Stroke Program Early CT Score (ASPECTS) patients.

Methods

This was a double-center, retrospective analysis of patients presenting with ASPECTS≤5 who received multimodal admission CT imaging between May 2015 and June 2020. The predicted ischemic core (pCore) was defined as a reduction in cerebral blood flow (rCBF), while mismatch volume was defined using time to maximum (Tmax). The pCore perfusion mismatch ratio (CPMR) was also calculated. These parameters (pCore, mismatch volume, and CPMR), as well as a combined radiological score consisting of ASPECTS and collateral status (ASCO score), were tested in logistic regression and receiver operating characteristic (ROC) analyses. The primary outcome was favorable modified Rankin Scale (mRS) at discharge (≤3).

Results

A total of 113 patients met the inclusion criteria. The median ischemic core volume was 74.1 mL (IQR 43.8–121.8). The ASCO score was associated with favorable outcome at discharge (aOR 3.7, 95% CI 1.8 to 10.7, P=0.002), while no association was observed for the CTP parameters. A model including the ASCO score also had significantly higher area under the curve (AUC) values compared with the CTP-based model (0.88 vs 0.64, P=0.018).

Conclusions

The ASCO score was superior to the CTP-based model for the prediction of good functional outcome and could represent a quick, practical, and easily implemented method for the selection of low ASPECTS patients most likely benefit from MT.
Long-term survival in patients who had CABG with or without prior coronary artery stenting
Authors: Rai Pratik , Taylor Rebecca , Bittar Mohamad Nidal
Published: November 2020

Objective

To conduct a large-scale, single-centre retrospective cohort study to understand the impact of prior percutaneous coronary intervention (PCI) on long-term survival of patients who then undergo coronary artery bypass graft (CABG).

Methods

Between 1999 and 2017, a total of 11 332 patients underwent CABG at a hospital in the UK. The patients were stratified into those who received PCI (n=1090) or no PCI (n=10 242) prior to CABG. A total of 1058 patients from each group were matched using propensity score matching. Kaplan-Meier estimates were used to assess risk-adjusted survival in patients with prior PCI. Cox proportional hazards (CoxPH) model was then used to assess the effect of prior PCI and other variables in patients undergoing CABG.

Results

The immediate postoperative outcome showed no difference in number of grafts per patients, blood transfusion, hospital stay or 30 days mortality between the groups. There was no significant difference in 5 years (90.8% vs 87.9), 10-year (76.5% vs 74.6%) and 15-year (64.4% vs 64.7%) survival between the non-PCI versus PCI groups. The Cox proportional hazards model further supports the null hypothesis as the PCI variable was found to be non-significant (CoxPH=1.03, p=0.75, CI=0.87–1.22) implying there was no difference in hazard of death for CABG patients with or without previous PCI. However, the model did yield information on the covariates that do affect the hazard of death.

Conclusion

There is no difference in 5-year, 10-year and 15-year survival between patients undergoing CABG with or without prior PCI. However, certain patient, preoperative and intraoperative risk factors were identified with high hazard of death which needs to be investigated further.
Catheter ablation and mortality, stroke and heart failure readmission with atrial fibrillation
Authors: Pallisgaard Jannik Langtved , Lock Hansen Morten , Schjerning Anne-Marie , Johannessen Arne , Gerds Thomas Alexander , Gustafsson Finn , Gislason Gunnar Hilmar , Torp-Pedersen Chriatian , Jacobsen Peter Karl , Kristensen Søren Lund , Koeber Lars , Munch Anders , Schou Morten
Published: November 2020

Background

Recent randomised clinical trials have suggested prognostic benefits of catheter ablation in highly selected patients with atrial fibrillation (AF) and heart failure (HF).

Objectives

This study sought to identify the treatment effect associated with catheter ablation in a broad population of patients with AF and HF.

Methods

Through nationwide administrative registers in Denmark, we estimated the 2-year average treatment effect (ATE) of catheter ablation for AF on a composite endpoint of HF readmission, stroke and all-cause mortality at 1-year and 5-year landmark analyses. The primary cohort was patients with AF before HF, and the second cohort of patients with HF before AF.

Results

A total of 13 756 patients were included with 9904 patients in the primary cohort, and 3852 in the secondary. An ATE (95% CI) reduction of the composite endpoint of 7.0% (4.5% to 9.5%) was observed in the primary cohort and 11.8% (6.0% to 17.6%) in the secondary in the 1-year landmark analysis with a reduction in all-cause mortality of 5.8% (3.7%–7.8%) and 6.3% (0.9%–11.7%), respectively. At the 5-year landmark, catheter ablation was associated with reductions in the composite endpoint and all-cause mortality in the primary (4.7% (2.3% to 7.2%), and 3.6% (1.0% to 6.3%), respectively), but not in the secondary cohort.

Conclusions

Ablation was associated with decreased risk of HF readmission, stroke and all-cause mortality in patients with AF and HF. The effect is most substantial in patients with AF before HF and with catheter ablation after 1 year from the diagnosis of both conditions.
Torsion-induced gravitational $$\theta $$ term and gravitoelectromagnetism
Authors: Chatzistavrakidis Athanasios , Karagiannis Georgios , Schupp Peter
Published: November 2020

Motivated by the analogy between a weak field expansion of general relativity and Maxwell’s laws of electrodynamics, we explore physical consequences of a parity violating $$\theta $$
θ
term in gravitoelectromagnetism. This is distinct from the common gravitational $$\theta $$
θ
term formed as a square of the Riemann tensor. Instead it appears as a product of the gravitoelectric and gravitomagnetic fields in the Lagrangian, similar to the Maxwellian $$\theta $$
θ
term. We show that this sector can arise from a quadratic torsion term in nonlinear gravity. In analogy to the physics of topological insulators, the torsion-induced $$\theta $$
θ
parameter can lead to excess mass density at the interface of regions where $$\theta $$
θ
varies and consequently it generates a correction to Newton’s law of gravity. We discuss also an analogue of the Witten effect for gravitational dyons.
A Generic Approach on How to Formally Specify and Model Check Path Finding Algorithms: Dijkstra, A* and LPA*
Authors: Ogata Kazuhiro
Published: November 2020

The paper describes how to formally specify three path finding algorithms in Maude, a rewriting logic-based programming/specification language, and how to model check if they enjoy desired properties with the Maude LTL model checker. The three algorithms are Dijkstra Shortest Path Finding Algorithm (DA), A* Algorithm and LPA* Algorithm. One desired property is that the algorithms always find the shortest path. To this end, we use a path finding algorithm (BFS) based on breadth-first search. BFS finds all paths from a start node to a goal node and the set of all shortest paths is extracted. We check if the path found by each algorithm is included in the set of all shortest paths for the property. A* is an extension of DA in that for each node [Formula: see text] an estimation [Formula: see text] of the distance to the goal node from [Formula: see text] is used and LPA* is an incremental version of A*. It is known that if [Formula: see text] is admissible, A* always finds the shortest path. We have found a possible relaxed sufficient condition. The relaxed condition is that there exists the shortest path such that for each node [Formula: see text] except for the start node on the path [Formula: see text] plus the cost to [Formula: see text] from the start node is less than the cost of any non-shortest path to the goal from the start. We informally justify the relaxed condition. For LPA*, if the relaxed condition holds in each updated version of a graph concerned including the initial graph, the shortest path is constructed. Based on the three case studies for DA, A* and LPA*, we summarize the formal specification and model checking techniques used as a generic approach to formal specification and model checking of path finding algorithms.
Design and Implementation of Phylotastic, a Service Architecture for Evolutionary Biology
Authors: Tayeen Abu Saleh Md. , Nguyen Thanh Hai , Nguyen Van Duc , Pontelli Enrico
Published: November 2020

Access and reuse of authoritative phylogenetic knowledge have been a longstanding challenges in the evolutionary biology community — leading to a number of research efforts (e.g. focused on interoperation, standardization of formats, and development of minimum reporting requirements). The Phylotastic project was launched to provide an answer to such challenges — as an architectural concept collaboratively designed by evolutionary biologists and computer scientists. This paper describes the first comprehensive implementation of the Phylotastic architecture, based on an open platform for Web services composition. The implementation provides a portal, which composes Web services along a fixed collection of workflows, as well as an interface to allow users to develop novel workflows. The Web services composition is guided by automated planning algorithms and built on a Web services registry and an execution monitoring engine. The platform provides resilience through seamless automated recovery from failed services.
A simple semidistributive lattice
Authors: Freese Ralph , Nation J. B.
Published: November 2020

Under broad finiteness conditions, such as the existence of a greatest or least element, a semidistributive lattice has the two element lattice as a homomorphic image, and so, if it has more than two elements, is not simple. However, the existence of a simple, semidistributive lattice with more than two elements has remained in question. This paper constructs such a lattice.
Varieties of unitary algebras with small growth of codimensions
Authors: de Oliveira M. A. , Vieira A. C.
Published: November 2020

In the last years, the sequence of codimensions of PI-algebras has been studied by several authors and the classification of unitary algebras, up to equivalence, with at most cubic codimension growth was given by Giambruno, La Mattina and Petrogradsky in 2007. In this paper, we establish a new approach by studying the possibilities of specific proper codimensions of a unitary algebra with growth [Formula: see text] in order to present a complete list of varieties generated by unitary algebras with polynomial growth [Formula: see text]. Also, we classify, up to PI-equivalence, the unitary algebras with growth [Formula: see text] whose leading coefficient of the polynomial describing the codimension sequence achieves the largest and the smallest possible value.
Nonlinear Blast Responses of Thin Shell Roof Over Long Span Structures
Authors: Rennie Jake , Kaewunruen Sakdirat , Baniotopoulos Charalampos
Published: November 2020

This paper adopts both explicit and implicit finite element methods in a specialist package LS-DYNA to investigate the nonlinear, dynamic response of a long span shell roof structure when subjected to blast loading. Parametric studies have been carried out on blast loaded laminated glass plates with reference to experimental results obtained by European researchers. A case study that has been chosen is a light rail station in The Netherlands called The Erasmusline. Following the detonation of 15[Formula: see text]kg TNT charge, explicit analysis showed breakage surrounding the rigid supports along the edge beam where modal vibrations are restrained. An implicit analysis has confirmed the resonances in global eigen-frequencies where most blast damage is localized around the roof canopy hence producing cracking and potential glass detachment from the panels without full structural demolition. This insight from this study will inform structural engineers about the potential modes of failure and preventative strategies to minimize further secondary losses of life or assets from a terrorist attack.
Explicit Expressions for Buckling Analysis of Thin-Walled Beams Under Combined Loads with Laterally-Fixed Ends and Application to Stability Analysis of Saw Blades
Authors: Phung Van Binh , Tran Ngoc Doan , Nguyen Viet Duc , Prokopov V. S. , Dang Hoang Minh
Published: November 2020

This paper studies the critical issue of thin-walled beams with laterally fixed ends. The method for defining the formulae of twist moment for the beams subjected to combined loads was elucidated. Based on this, the governing differential equations of the beam were developed. The procedure for determining the critical state of the beam by the energy method was presented. With this procedure, the critical state of the beam concerned under three types of loadings such as axial force [Formula: see text], bending moment [Formula: see text] and distributed load [Formula: see text] (or concentrated load [Formula: see text]) was examined deliberately. The outcomes were presented in explicit closed-form, which can be illustrated in 2D and 3D graphs. Also, the analytical solution obtained was in agreement with the numerical one obtained by the commercial software NX Nastran. Furthermore, the analytical solutions were applied straightforwardly to explore the stability and design optimization of the tooth-blade for the new frame-type saw machine under an eccentric load. The result can also be promisingly used to study problems of thin-walled beams with laterally fixed ends subjected to other types of loads.
Linear Vibration of the Rotary Plate Under Combined Excitations in Subsonic Airflow
Authors: Ma Li , Yao Minghui , Zhang Wei , Cao Dongxing
Published: November 2020

Due to strong nonlinear, unsteady characteristics and the fluid–structure interaction effect, vibration analysis of blades under the excitation of the airflow is still one of the technical difficulties. In this paper, the accurate subsonic aerodynamic force is obtained through numerical simulation, and the aerodynamic coupling model of the rotary blade is established. The distribution of the aerodynamic force of the compressor blade under the unsteady airflow is focused on. The blade is modeled as presetting a presetting pre-twisted rotary cantilever plate. Dynamic frequencies of the plate, calculated by Chebyshev–Ritz method, are compared with frequencies calculated using the finite element method (FEM). Effects of different parameters on natural frequencies of the rotary plate are discussed. Based on von-Karman nonlinear geometric relation and the first-order shear deformation theory, nonlinear dynamic equations of the pre-twisted rotary plate under the combination of the centrifugal force and the aerodynamic are derived by utilizing Hamilton’s principle. Second-order ordinary differential equations are derived by applying the Galerkin method. Analytical solution of the dynamic deformation of the plate is presented and is compared with that produced by FEM. Results indicate the accuracy of the explicit presentation of the aerodynamic of the low-pressure compressor blade. Effects of the rotary speed, the thickness, the pre-twisted angle and the presetting angle on vibration characteristics of the warping blade are studied. Mode shape shift and frequency loci veering are discussed.
Dynamic Study of SIQR-B Fractional-Order Epidemic Model of Cholera with Optimal Control Strategies in Mayo-Tsanaga Department of Cameroon Far North Region
Authors: Nguiwa Tchule , Justin Mibaile , Moussa Djaouda , Betchewe Gambo , Mohamadou Alidou
Published: November 2020

In this paper, we investigated the dynamical behavior of a fractional-order model of the cholera epidemic in Mayo-Tsanaga Department. We extended the model of Lemos-Paião et al. [A. P. Lemos-Paião, C. J. Silva and D. F. M. Torres, J. Comput. Appl. Math. 16, 427 (2016)] by incorporating the contact rate [Formula: see text] by handling cholera death and optimal control strategies such as vaccination [Formula: see text], water sanitation [Formula: see text]. We provide a theoretical study of the model. We derive the basic reproduction number [Formula: see text] which determines the extinction and the persistence of the infection. We show that the disease-free equilibrium is globally asymptotically stable whenever [Formula: see text], while when [Formula: see text], the disease-free equilibrium is unstable and there exists a unique endemic equilibrium point which is locally asymptotically stable on a positively invariant region of the positive orthant. Using the sensitivity analysis, we find that the parameter related to vaccination and therapeutic treatment is more influencing the model. Theoretical results are supported by numerical simulations, which further suggest use of vaccination in endemic area. In case of a lack of necessary funding to fight again cholera, Figure 6 revealed that efforts should focus to keep contamination rate [Formula: see text] (susceptible-to-cholera death) in other to die out the disease.
An Autonomous Cognitive Empathy Model Responsive to Users’ Facial Emotion Expressions
Authors: Bagheri Elahe , Esteban Pablo G. , Cao Hoang-Long , Beir Albert De , Lefeber Dirk , Vanderborght Bram
Published: November 2020

Successful social robot services depend on how robots can interact with users. The effective service can be obtained through smooth, engaged, and humanoid interactions in which robots react properly to a user’s affective state. This article proposes a novel Automatic Cognitive Empathy Model, ACEM, for humanoid robots to achieve longer and more engaged human-robot interactions (HRI) by considering humans’ emotions and replying to them appropriately. The proposed model continuously detects the affective states of a user based on facial expressions and generates desired, either parallel or reactive, empathic behaviors that are already adapted to the user’s personality. Users’ affective states are detected using a stacked autoencoder network that is trained and tested on the RAVDESS dataset.

The overall proposed empathic model is verified throughout an experiment, where different emotions are triggered in participants and then empathic behaviors are applied based on proposed hypothesis. The results confirm the effectiveness of the proposed model in terms of related social and friendship concepts that participants perceived during interaction with the robot.