bluuebunny/crossref_metadata_2025 huggingface dataset:
An automated respiratory data pipeline for waveform characteristic analysis
Authors: Lusk Savannah , Ward Christopher S. , Chang Andersen , Twitchell‐Heyne Avery , Fattig Shaun , Allen Genevera , Jankowsky Joanna L. , Ray Russell S.
Published: October 2023

Comprehensive and accurate analysis of respiratory and metabolic data is crucial to modelling congenital, pathogenic and degenerative diseases converging on autonomic control failure. A lack of tools for high‐throughput analysis of respiratory datasets remains a major challenge. We present Breathe Easy, a novel open‐source pipeline for processing raw recordings and associated metadata into operative outcomes, publication‐worthy graphs and robust statistical analyses including QQ and residual plots for assumption queries and data transformations. This pipeline uses a facile graphical user interface for uploading data files, setting waveform feature thresholds and defining experimental variables. Breathe Easy was validated against manual selection by experts, which represents the current standard in the field. We demonstrate Breathe Easy's utility by examining a 2‐year longitudinal study of an Alzheimer's disease mouse model to assess contributions of forebrain pathology in disordered breathing. Whole body plethysmography has become an important experimental outcome measure for a variety of diseases with primary and secondary respiratory indications. Respiratory dysfunction, while not an initial symptom in many of these disorders, often drives disability or death in patient outcomes. Breathe Easy provides an open‐source respiratory analysis tool for all respiratory datasets and represents a necessary improvement upon current analytical methods in the field.

image

Key points

Respiratory dysfunction is a common endpoint for disability and mortality in many disorders throughout life.

Whole body plethysmography in rodents represents a high face‐value method for measuring respiratory outcomes in rodent models of these diseases and disorders.

Analysis of key respiratory variables remains hindered by manual annotation and analysis that leads to low throughput results that often exclude a majority of the recorded data.

Here we present a software suite, Breathe Easy, that automates the process of data selection from raw recordings derived from plethysmography experiments and the analysis of these data into operative outcomes and publication‐worthy graphs with statistics.

We validate Breathe Easy with a terabyte‐scale Alzheimer's dataset that examines the effects of forebrain pathology on respiratory function over 2 years of degeneration.
Natural Convective Nanofluid Flows Immersed in Oscillating Magnetic Fields Simulated by a Sub-Continuous Lattice Boltzmann Model
Authors: Sui Pengxiang , Su Yan , Sun Liyong
Published: September 2023

Natural convective nanofluid flows immersed in oscillating magnetic fields are simulated with a sub-continuous nondimensional lattice Boltzmann model. The effective electrical conductivity model is built including coupled effects of nanoparticle concentrations and two Knudsen numbers. Effects of directions, frequencies, and strength amplitudes of the magnetic fields are studied in wide ranges of Hartmann numbers (0.1≤Haf,L≤600) and Rayleigh numbers (103≤Raf,L≤107). To achieve higher values of cycle averaged Nusselt numbers Nu¯̂f,L, optimal magnetic directions are along or opposite from the gravity directions. Effects of the magnetic frequency f˜B are negligible, in the conduction dominating lower Rayleigh number regime of Raf,L<104. In the convection dominating regime, Nu¯̂f,L increase with Raf,L in orders of Raf,L0.48 and Raf,L0.45 for vertical and horizontal magnetic directions, respectively, and maximum values of Nu¯̂f,L appear at the optimal magnetic frequency of f˜B=1/5cs*MaL(L/UL) for all magnetic directions. With Raf,L as high as 106, the oscillating amplitudes of the transient wall mean Nusselt numbers Nu¯f,L increase with increasing Haf,L, but the cycle averaged Nusselt numbers Nu¯̂f,L decrease from 9.35 to 1.42 with increasing Haf,L in the transient regime of 5≤Haf,L≤500. Meanwhile, heat transfer patterns transit back from convection to conduction dominating patterns with increasing Haf,L, as illustrated by transient streamlines and isotherms.
Analysis of Failure Forms of Bevel Gear, Shaft, and Bearing Structure System Considering Multi-Mode Damage Accumulation
Authors: Han Xudong , Hong Jie , Chen Cheng , Chen Xueqi
Published: September 2023

During the working process, the structural system, including bevel gear, shaft, and bearing, located in the front journal of the high pressure compressor of the aeroengine rotor is affected by various loads such as assembly load, centrifugal load, temperature load, and meshing excitation, and it leads to different modes of interface damage, for example, wear, slip, and fatigue. With the increase number of working cycles, different interface damage modes affect each other and damage gradually accumulates, which leads to the degradation of the mechanical properties of each component. Finally, the function of the weakest component is lost, resulting in the failure of the structural system. Consequently, the comprehensive influence of multiple failure forms caused by interface damage at different positions results in the failure of the structural system, where the damage position and the failure position are different, and the final failure form is uncertain. In this paper, a damage accumulation mechanical model considering multimode damage interaction is established for bevel gear, shaft and bearing structure system. And the damage-failure mechanical process of the structural system and its key influencing factors under complex environment loads are studied. The results showed that the failure forms of the structural system were closely related to the assembly and load characteristic parameters of the components. Therefore, considering the randomness of the initial assembly state and environment loads, the damage accumulation mechanical process and the final failure forms of the structural system have significant uncertainty.
Rigid Mode Vibration Control for 250 HP Air Compressor System With Integrated Hybrid Air-Foil Magnetic Thrust Bearing (i-HFMTB)
Authors: Ha Yunseok , Kim Jungwan , Jeong Keonwoo , Lee Yongbok
Published: September 2023

This study aims to verify the effectiveness of the 250 HP class compressor system to which the integrated hybrid air-foil magnetic thrust bearing (i-HFMTB) proposed in (Ha et al., 2023, “Integrated Hybrid Air Foil-Magnetic Thrust Bearing (i-HFMTB) Part I: Preliminary Experimental Test for Rotordynamic Parameter Identification and Behavior With PD Control,” ASME Paper No. GT2023-102860) [1] is applied, and the vibration and instability problems of air-foil journal bearing (AFJB) occurring in the rigid mode are controlled by i-HFMTB. The compressor rotor is supported by two AFJB (journal diameter = 60 mm) and an i-HFMTB, and the length and mass of the rotor are 550 mm and 15.24 kg, respectively. i-HFMTB has a structure in which air-foil thrust bearing (AFTB) pads are inserted into eight slotted active magnetic thrust bearings (AMTB), and PD control (proportional gain: 4000; differential gain: 10) is applied. The operating area was identified through AFJB’s dynamic coefficients and rotordynamic analysis. As a result, in the experiment with the 250 HP compressor system supported only by two AFJB, sub- and super-synchronous vibrations were generated owing to the AFJB’s insufficient load capacity and damping in the rigid mode (7000 rpm) region, and this instability did not disappear even upon increasing the speed to 15,000 rpm. However, when i-HFMTB was turned on in rigid mode, it was confirmed that the sub- and super-synchronous vibrations were significantly reduced. The thrust collar tilt angle was calculated through orbit trajectory analysis of the impeller and cooling side, and it was confirmed that the tilt angle of the thrust collar was reduced during i-HFMTB operation.
Nonlinear Normal Modes of Vibrating Mechanical Systems: 10 Years of Progress
Authors: Mikhlin Yu , Avramov K.
Published: September 2023

This paper contains a review of the theory and applications of nonlinear normal modes, which have been developed during last decade. This review has more than 200 references. It is a continuation of two previous review papers by the same authors. The following theoretical issues of nonlinear normal modes are treated: basic concepts and definitions; application of the normal form theory for nonlinear modes construction; nonlinear modes in finite degrees-of-freedom systems; resonances and bifurcations; reduced-order modeling; nonlinear modes in stochastic dynamical systems; numerical methods; identification of mechanical systems using nonlinear modes. The following applied issues of this theory are treated in this review: experimental measurement of nonlinear modes; nonlinear modes in continuous systems; engineering applications (aerospace engineering, power engineering, piecewise-linear systems and structures with dry friction); nonlinear modes in nanostructures and physical systems; targeted energy transfer and absorption problem.
Thermodynamic Analysis and Performance Assessment of a Novel Solar-Based Multigeneration System for Electricity, Cooling, Heating, and Freshwater Production
Authors: Siddiqui Mohd Asjad
Published: October 2023

This study offers a comprehensive assessment of the thermodynamic performance of a novel solar-based multigeneration system, which caters to the energy needs of a sustainable community by producing electricity, cooling, heating, and freshwater. The solar-based multigeneration system is comprised of four main components: the thermal subsystem of the parabolic trough collector (PTC) employing CO2 as a heat transfer fluid, a single-effect absorption refrigeration cycle (ARC), a supercritical CO2 (S-CO2) cycle, and an adsorption desalination (AD) cycle with heat recovery employing aluminum fumarate metal–organic framework (MOF) adsorbent material. A comprehensive parametric study was performed on the proposed solar-based multigeneration system by varying key parameters to evaluate its performance. It is found that the thermal and exergy efficiencies of a PTC were evaluated to be 68.35% and 29.88%, respectively, at a fixed inlet temperature of 225 °C and solar irradiation of 850 W/m2 and also a slight reduction in the ARC cycle when examining the variation in the thermal and exergetic COPs for the generator temperature. Additionally, the thermal and exergy efficiencies of electricity, cooling, and heating were determined to be 20.41% and 21.93%, 41.34% and 3.51%, and 7.14% and 3.07%, respectively, at the operating condition. The maximum specific daily water production (SDWP) value of 12.91 m3/ton/day and a gain output ratio (GOR) of 0.64 were obtained under steady operating conditions in the AD cycle.
The Influence of Cage Pocket Lubrication on the Simulation of Deep Groove Ball Bearing Cage Motion
Authors: Russell Thomas , Sadeghi Farshid , Kang Young Sup , Mazzitelli Isidoro
Published: October 2023

A six degrees-of-freedom dynamic bearing model (DBM) was modified to include a novel cage pocket lubrication model. The motion of the cage was determined using the finite difference method to solve for the pressure generation and resultant forces inside of each cage pocket at each time-step of the dynamic model. The computational domain of the finite difference model was designed to reflect the specific cage pocket geometry of four common cage designs. Additionally, a bearing cage friction test rig was utilized to characterize the lubrication state inside of each cage. Experiments were performed that reveal the relationship between cage shape, ball speed, and relative ball—cage position. Specifically, information on the occurrence of kinematic starvation, the speed-dependent evacuation of oil from a cage pocket, was collected for use as an input condition to the dynamic bearing model. An inverse distance weighting scheme was utilized to predict starvation parameters for a general ball position inside of the cage pocket. Results from the dynamic simulation reveal new knowledge on the effect of cage geometry and lubrication on dynamic behavior. The inclusion of lubrication effects inside of the cage pocket reduces the median contact force between the balls and cage pocket and improves the stability of the predicted cage motion.
Ion track formation and porosity in InSb induced by swift heavy ion irradiation
Authors: Alwadi Taleb , Notthoff Christian , Dutt Shankar , Wierbik Jessica , Afrin Nahid , Kiy Alexander , Kluth Patrick
Published: October 2023

Ion track formation, irradiation-induced damage (amorphization), and the formation of porosity in InSb after 185 MeV 197Au swift heavy ion irradiation are studied as a function of ion fluence and irradiation angle. Rutherford backscattering spectrometry in channeling geometry reveals an ion track radius of about 16 nm for irradiation normal to the surface and 21 nm for off-normal irradiation at 30° and 60°. Cross-sectional scanning electron microscopy shows significant porosity that increases when irradiation was performed off-normal to the surface. Off-normal irradiation shows a preferential orientation of the pores at about 45° relative to the surface normal. Moreover, when subjected to identical conditions, InSb samples demonstrate notably higher swelling compared to GaSb bulk samples.
Analysis of under-ice ambient noise characteristics of Gakkel Ridge in the Arctic
Authors: Sheng Xueli , Mu Mengfei , Zhang Yuxiang , Li Bingrui , Dou Yinke
Published: October 2023

This paper presents an analysis of the under-ice acoustic data and environmental parameters measured over a three-month period from August 31 to November 28, 2021, within the area of the Gakkel Ridge in the Arctic. After “spikes” caused by micro-level events are removed, the distribution of the retained under-ice noise related to macro-level events can be described satisfactorily by a Gaussian distribution, as verified by Q–Q plots and kurtosis/skewness analysis. We use sliding window analysis to deal with the features of under-ice ambient noise and model the data by Gaussian interpolation. This shows that the ambient noise level over the low-frequency range (10–100 Hz) is comparatively flat at about 60 dB; with the frequency increases from 100 to 2560 Hz, the ANL decreased to about 40 dB. We then introduce canonical correlation analysis (CCA) to analyze the potential relation between environmental forcing and the under-ice noise level. The results of CCA indicate that the seawater parameters (including temperature, salinity, and sound velocity) close to the ice–water interface have the greatest influence on the under-ice noise level among all environmental parameters recorded in the air, sea-ice, and seawater. Additionally, the under-ice noise level forced by the environment does not exhibit any particular frequency dependence.
Call rate of oyster toadfish (Opsanus tau) is affected by aggregate sound level but not by specific vessel passages
Authors: Colbert Benjamin R. , Popper A. N. , Bailey Helen
Published: October 2023

Anthropogenic sound is a prevalent environmental stressor that can have significant impacts on aquatic species, including fishes. In this study, the effects of anthropogenic sound on the vocalization behavior of oyster toadfish (Opasnus tau) at multiple time scales was investigated using passive acoustic monitoring. The effects of specific vessel passages were investigated by comparing vocalization rates immediately after a vessel passage with that of control periods using a generalized linear model. The effects of increased ambient sound levels as a result of aggregate exposure within hourly periods over a month were also analyzed using generalized additive models. To place the response to vessel sounds within an ecologically appropriate context, the effect of environmental variables on call density was compared to that of increasing ambient sound levels. It was found that the immediate effect of vessel passage was not a significant predictor for toadfish vocalization rate. However, analyzed over a longer time period, increased vessel-generated sound lowered call rate and there was a greater effect size from vessel sound than any environmental variable. This demonstrates the importance of evaluating responses to anthropogenic sound, including chronic sounds, on multiple time scales when assessing potential impacts.
Stress exhausts T cells
Authors: Baek Amy E.
Published: October 2023

Catecholamines associated with stress promote T cell exhaustion through the β
1
-adrenergic receptor.
Standardization of an antiviral pipeline for human norovirus in human intestinal enteroids demonstrates nitazoxanide has no to weak antiviral activity
Authors: Lewis Miranda A. , Cortés-Penfield Nicolás W. , Ettayebi Khalil , Patil Ketki , Kaur Gurpreet , Neill Frederick H. , Atmar Robert L. , Ramani Sasirekha , Estes Mary K.
Published: October 2023

Human noroviruses (HuNoVs) are the leading cause of acute gastroenteritis. In immunocompetent hosts, symptoms usually resolve within 3 days; however, in immunocompromised persons, HuNoV infection can become persistent, debilitating, and sometimes life-threatening. There are no licensed therapeutics for HuNoV due to a near half-century delay in its cultivation. Treatment for chronic HuNoV infection in immunosuppressed patients anecdotally includes nitazoxanide, a broad-spectrum antimicrobial licensed for treatment of parasite-induced gastroenteritis. Despite its off-label use for chronic HuNoV infection, nitazoxanide has not been clearly demonstrated to be an effective treatment. In this study, we standardized a pipeline for antiviral testing using multiple human small intestinal enteroid lines representing different intestinal segments and evaluated whether nitazoxanide inhibits replication of five HuNoV strains
in vitro
. Nitazoxanide did not exhibit high selective antiviral activity against any HuNoV strain tested, indicating it is not an effective antiviral for HuNoV infection. Human intestinal enteroids are further demonstrated as a model to serve as a preclinical platform to test antivirals against HuNoVs to treat gastrointestinal disease.

Abstr
Evaluation of Fourier transform-infrared spectroscopy (FT-IR) as a control measure for nosocomial outbreak investigations
Authors: Uribe Gabriela , Salipante Stephen J. , Curtis Lauren , Lieberman Joshua A. , Kurosawa Kyoko , Cookson Brad T. , Hoogestraat Daniel , Stewart Mary K. , Olmstead Tessa , Bourassa Lori
Published: October 2023

Whole-genome sequencing (WGS) provides greater resolution than other molecular epidemiology strategies and is emerging as a new gold standard approach for microbial strain typing. The Bruker IR Biotyper is designed as a screening tool to identify bacterial isolates that require WGS to establish accurate relationships, but its performance and utility in nosocomial outbreak investigations have not been thoroughly investigated. Here, we evaluated the IR Biotyper by retrospectively examining isolates tested by WGS during investigations of potential nosocomial transmission events or outbreaks. Ninety-eight clinical isolates from 14 different outbreak investigations were examined: three collections of
Acinetobacter baumannii
(
n
= 2,
n
= 9,
n
= 5 isolates in each collection), one of
Escherichia coli
(
n
= 16), two of
Pseudomonas aeruginosa
(
n
= 2 and
n
= 5), two of
Serratia marcescens
(
n
= 9 and
n
= 7), five of
Staphylococcus aureus
(
n
= 8,
n
= 4,
n
= 3,
n
= 3,
n
= 17), and one of
Stenotrophomonas maltophilia
(
n
= 8). Linear regression demonstrated a weak, positive correlation between the number of pairwise genome-wide single-nucleotide polymorphisms (SNPs) and IR Biotyper spectral distance values for Gram-positive (
r
= 0.43,
P
≤ 0.0001), Gram-negative (
r
= 0.1554,
P
= 0.0639), and all organisms combined (
r
= 0.342,
P
≤ 0.0001). Overall, the IR Biotyper had a positive predictive value (PPV) of 55.81% for identifying strains that were closely related by genomic identity, but a negative predictive value (NPV) of 86.79% for identifying unrelated isolates. When experimentally adjusted cut-offs were applied to
A. baumannii, P. aeruginosa
, and
E. coli,
the PPV was 62% for identifying strains that were closely related and the NPV was 100% for identifying unrelated isolates. Implementation of the IR Biotyper as a screening tool in this cohort would have reduced the number of Gram-negative isolates requiring further WGS analysis by 50% and would reduce the number of
S. aureus
isolates needing WGS resolution by 48%.
Extragenic suppression of an HSV-1 UL34 nuclear egress mutant reveals role for pUS9 as an inhibitor of epithelial cell-to-cell spread
Authors: Twigg Carly A. I. , Haugo-Crooks Alison , Roller Richard J.
Published: October 2023

The herpes simplex virus pUL34 component of the nuclear egress complex functions in both nuclear egress and cell-to-cell spread. A R158A/R161A double substitution in pUL34 has been shown to strongly inhibit both nuclear egress and spread. Selection for extragenic suppressors of UL34
R158A/R161A
on the background of a virus that expresses monomeric red fluorescent protein-tagged pUL35 yielded two viruses , SUP7 and SUP9, that both replicated and spread much better than the parental virus. The two viruses carried both unique and common genetic changes. The most striking unique genetic change was a large rearrangement of the US region of SUP7 resulting in duplication of ICP22 and deletion of part of US3 and all of US9-12. The two common genetic changes were a frame shift that eliminated expression of pUL35, and mutations that either eliminated or diminished expression of pUS9. The mutations in pUL35 significantly improved replication but had only a small effect on spread. We observed that mutations that diminish or eliminate detectable pUS9 expression significantly improved spread on Vero cells of viruses that were impaired in the spread function of either pUL34 or pUL51, but did not enhance spread of an otherwise wild-type virus. A similar enhancement was observed on U2OS, but not HaCaT cells, suggesting that the spread-inhibitory function of pUS9 differs between cell lines.

IMPORTANCE

Herpesviruses are able to disseminate in infected hosts despite development of a strong immune response. Their ability to do this relies on a specialized process called cell-to-cell spread in which newly assembled virus particles are trafficked to plasma membrane surfaces that abut adjacent uninfected cells. The mechanism of cell-to-cell spread is obscure, and little is known about whether or how it is regulated in different cells. We show here that a viral protein with a well-characterized role in promoting spread from neurons has an opposite, inhibitory role in other cells.
Carbapenem resistance in extensively drug-resistant
Salmonella enterica
serovar Agona and AmpC β-lactamase-producing
S.
Infantis
Authors: Hsu Ping-Chun , Wang You-Wun , Chen Bo-Han , Hong Yu-Ping , Teng Ru-Hsiou , Liu Po-Yu , Chiou Chien-Shun
Published: October 2023

We report that carbapenem resistance developed in an extensively drug-resistant
Salmonella enterica
serovar Agona strain during antimicrobial therapy and in an AmpC β-lactamase-producing
S
. Infantis strain. Whole-genome sequence analysis indicated that carbapenem resistance in the
S
. Agona strain was associated with the insertion of a 160-kb IS15DI composite transposon in
ompC_378
, which encodes a porin consisting of 378 amino acids, along with a 397-bp deletion in the
ompD
. The transposon harbored 12 resistance genes including
bla
CTX-M-55
and an efflux pump regulatory gene,
ramAp
. Carbapenem resistance in the
bla
CMY-2
-carrying
S
. Infantis strain was linked to the insertion of a 22,905-bp segment located 10 bp upstream of the
ompC_378
coding sequence, as well as a 254-bp deletion in
ompD
. Our findings indicate that the loss of both
ompC_378
and
ompD
is necessary for carbapenem resistance in extended-spectrum β-lactamase and AmpC β-lactamase-producing
Salmonella
strains.

IMPORTANCE

Carbapenem resistance arising from the loss of porins is commonly observed in extended-spectrum β-lactamase (ESBL) and AmpC β-lactamase-producing strains of certain
Enterobacteriaceae
genera, including
Klebsiella pneumoniae
,
Escherichia coli
, and
Pseudomonas aeruginosa
. However, this resistance mechanism is rarely reported in the
Salmonella
genus. To address this knowledge gap, our study offers genetic evidence demonstrating that the loss of two specific porins (OmpC_378 and OmpD) is crucial for the development of carbapenem resistance in
Salmonella
ESBL and AmpC β-lactamase-producing strains. Furthermore, our findings reveal that most
Salmonella
serovars carry seven porin parathologs, with OmpC_378 and OmpD being the key porins involved in the development of carbapenem resistance in
Salmonella
strains.
Myths and facts about functional neurological disorders: a cross-sectional study of knowledge and awareness among medical students and healthcare professionals in Iraq
Authors: Al-Sibahee Essam M , Hashim Ahmed , Al-Badri Sajjad , Al-Fatlawi Nabeel
Published: September 2023

Background

Functional neurological disorder (FND) is a complex condition with neurological symptoms but no clear structural or biochemical explanation. Myths and misconceptions about FND can lead to misdiagnosis and inappropriate treatment. This study aimed to assess knowledge and common myths about FND among medical students and practitioners.

Methods

Data were collected from 324 participants using a structured questionnaire. The questionnaire included demographics, general information about FND and myths about FND. Data were analysed using non-parametric tests and Spearman’s r for correlations.

Results

The majority of participants were clinical-years medical students (65.1%) and female (59.6%). Overall, knowledge about FND was limited, with a mean score of 42.3% of correct answers. Common myths included the belief that FND is a psychological disorder and that patients feign symptoms. Knowledge scores differed significantly among different grades/experience levels, with postgraduate practitioners having the highest scores. There was a positive correlation between knowledge scores and confidence in managing FND.

Conclusion

This study highlights the prevalence of myths and misconceptions about FND among medical students and practitioners, emphasising the need for accurate education to improve diagnosis and management. Healthcare professionals should take a biopsychosocial approach to FND, considering the complex interplay between biological, psychological and social factors. Efforts to increase awareness and reduce stigma associated with FND are crucial for promoting better care. Targeted educational interventions may be beneficial to improve the understanding and management of FND among medical professionals.
Hip fractures in the older adult: orthopaedic and geriatric shared care model in Southland, New Zealand—a 5-year follow-up study
Authors: Morris Holly , Cameron Claire , Vanderboor Christina , Nguyen Anh , Londahl Monica , Harng Chong Yih , Navarre Pierre
Published: October 2023

Background

Neck of femur fractures are common with associated high morbidity and mortality rates. National standards include provision of orthogeriatric care to any patient with a hip fracture. This study assessed the outcomes at 5 years following implementation of a collaborative orthogeriatric service at Southland Hospital in 2012.

Methods

Retrospective data were collected for patients aged 65 years and older admitted with a fragility hip fracture. Data were collated for 2011 (preimplementation) and 2017 (postimplementation). Demographic data and American Society of Anesthesiologists (ASA) scores were recorded to ensure comparability of the patient groups. Length of stay, postoperative complications and 30-day and 1-year mortality were assessed.

Results

74 admissions with mean age at surgery of 84.2 years in 2011 and 107 admissions with mean age of 82.6 years in 2017. There was a higher proportion of ASA 2 and ASA 3 patients in 2017 compared with 2011 (p=0.036). The median length of stay in the orthopaedic ward was unchanged in the two cohorts but there was a shorter median length of stay by 6.5 days and mean length of stay by 11 days in 2017 in the rehabilitation ward (p<0.001 for both median and mean). Through logistic regression controlling for age, sex and ASA score, there was a reduction in the odds of having a complication by 12% (p<0.001). The study was too small to undertake statistical testing to calculate significant difference in overall 30-day and 1-year mortality between the groups.

Conclusion

The orthogeriatric service has reduced the frequency of complications and length of stay on the rehabilitation ward 5 years following implementation.
Improving fragility hip fracture care through data: a multicentre experience from a country with an emerging economy during the COVID-19 pandemic
Authors: Tabu Irewin A , Araneta Karla Teresa S , Alpuerto Bernardino B , Delgado Giorgio D , Lai Joseph Garvy L , San Juan Jose Antonio G , Ho, Alexander , Reyes Ma. Ramona B , De Vera Jose , Syquia Jose Fernando C , Manalastas Rene Edgardo C , Tablante Adrian Joseph C , Brabante Allan Michael T , Dimayuga Cesar Cipriano D , Pacheco Deejay M , Baclig Phillipe Y , Co Andrew Steven T , Yap John Alfred D
Published: October 2023

Introduction

In low-to-middle-income countries (LMIC), the orthogeriatric model of care is still in its early stages of development. This study describes the initial results of the first online fragility hip fracture database to be setup in the Philippines using a modified minimum common dataset to generate outcomes data based on current hospital practices.

Methods

A multicentre prospective cohort study among 12 Philippine hospitals was conducted from June 2020 to February 2021. Thirty-day mortality, morbidity and mobility were measured. Significant factors associated with mortality were determined.

Results

158 elderly patients with fragility hip fractures were included in the study. Nine patients (5.7%) were confirmed or suspected to have COVID-19 infection. Median time of injury to admission was at least 3 days (IQR: 1.0–13.7). Overall, 80% of patients underwent surgical intervention with a median time from admission to surgery of at least 5 days (IQR: 2.5–13.6). Thirty-day mortality and morbidity rates for acute fragility fractures were 3.7%. Factors significantly associated with early mortality were poor prefracture mobility, COVID-19 infection, radiograph of the abnormal chest and conservative treatment. Non-surgical patients had no functional mobility or were wheelchair users and had a significantly higher morbidity rate than surgically treated patients (13.6% vs 1.8%; p=0.031).

Conclusion

Despite treatment delays unique to an LMIC, short-term outcomes remain favourable for non-COVID-19 fragility hip fracture patients treated with surgery. Prompt admission and multidisciplinary care for elderly hip fracture patients while maintaining protective measures for COVID-19 infection control are recommended. The quality of data collected illustrates how this online database can provide a framework for a sustainable audit or registry as well as provide a platform for the introduction of orthogeriatric concepts at a multiregional scale.
Primary care teams’ reported actions to improve medication safety: a qualitative study with insights in high reliability organising
Authors: Young Richard A , Gurses Ayse P , Fulda Kimberly G , Espinoza Anna , Daniel Kathryn M , Hendrix Zachary N , Sutcliffe Kathleen M , Xiao Yan
Published: September 2023

Background

Our aim was to understand actions by primary care teams to improve medication safety.

Methods

This was a qualitative study using one-on-one, semistructured interviews with the questions guided by concepts from collaborative care and systems engineering models, and with references to the care of older adults. We interviewed 21 primary care physicians and their team members at four primary care sites serving patients with mostly low socioeconomic status in Southwest US during 2019–2020. We used thematic analysis with a combination of inductive and deductive coding. First, codes capturing safety actions were incrementally developed and revised iteratively by a team of multidisciplinary analysts using the inductive approach. Themes that emerged from the coded safety actions taken by primary care professionals to improve medication safety were then mapped to key principles from the high reliability organisation framework using a deductive approach.

Results

Primary care teams described their actions in medication safety mainly in making standard-of-care medical decisions, patient-shared decision-making, educating patients and their caregivers, providing asynchronous care separate from office visits and providing clinical infrastructure. Most of the actions required customisation at the individual level, such as limiting the supply of certain medications prescribed and simplifying medication regimens in certain patients. Primary care teams enacted high reliability organisation principles by anticipating and mitigating risks and taking actions to build resilience in patient work systems. The primary care teams’ actions reflected their safety organising efforts as responses to many other agents in multiple settings that they could not control nor easily coordinate.

Conclusions

Primary care teams take many actions to shape medication safety outcomes in community settings, and these actions demonstrated that primary care teams are a reservoir of resilience for medication safety in the overall healthcare system. To improve medication safety, primary care work systems require different strategies than those often used in more self-contained systems such as hospital inpatient or surgical services.
Are there differences in the relationship between respiratory rate and oxygen saturation between patients with COVID-19 and those without COVID-19? Insights from a cohort-based correlational study
Authors: Laredo Mikael , Vandiedonck Claire , Miró Òscar , González del Castillo Juan , Alquézar-Arbé Aitor , Jacob Javier , Piñera Pascual , Mégarbane Bruno
Published: October 2023

Background

Physicians have observed patients with COVID-19 without respiratory distress despite marked hypoxaemia and extensive radiographic abnormalities, a controversial phenomenon called ‘silent hypoxaemia’. We aimed to compare the relationship between RR and peripheral oxygen saturation (SpO2) in patients with COVID-19 versus patients without COVID-19 when breathing air on admission.

Methods

We conducted a retrospective multicentre ED cohort correlational study.

We used the Spanish Investigators on Emergency Situations TeAm network cohort of patients with COVID-19 admitted to 61 Spanish EDs between March and April 2020. The non-COVID-19 cohort included patients with lower respiratory tract bacterial infections admitted between January 2016 and April 2018.

We built a multivariable linear model to investigate the independent predictive factors related to RR and a logistic multivariate regression model to analyse the presence of ‘silent hypoxaemia’.

Results

We included 1094 patients with COVID-19 and 477 patients without COVID-19. On admission, RR was lower (20±7 vs 24±8/min, p<0.0001), while SpO2higher (95±5% vs 90±7%, p<0.0001) in patients with COVID-19 versus patients without COVID-19. RR was negatively associated with SpO2(RR decreasing with increasing age, beta=−0.37, 95% CI (−0.43; −0.31), p<0.0001), positively associated with age (RR increasing with increasing age, beta=0.05, 95% CI (0.03; 0.07), p<0.0001) and negatively associated with COVID-19 status (RR lower in patients with COVID-19, beta=−1.90, 95% CI (−2.65; −1.15), p<0.0001). The negative RR/SpO2correlation differed between patients with COVID-19 aged <80 and ≥80 years old (p=0.04). Patients with COVID-19 aged ≥80 years old had lower RR than patients without COVID-19 aged ≥80 years old at SpO2values <95% (22±7 vs 24±8/min, p=0.004). ‘Silent hypoxaemia’ defined as RR <20/min with SpO2<95% was observed in 162 (14.8%) patients with COVID-19 and in 79 (16.6%) patients without COVID-19 (p=0.4). ‘Silent hypoxaemia’ was associated with age ≥80 years (OR=1.01 (1.01; 1.03), p<0.0001) but not with gender, comorbidities and COVID-19 status.

Conclusion

The RR/SpO2relationship before oxygen administration does not differ between patients with COVID-19 and those without COVID-19, except in elderly patients.
Population frailty trends by education and income levels over a period of 30 years: findings from Swedish registry data
Authors: Wennberg Alexandra , Tao Yining , Ek Stina , Modig Karin
Published: October 2023

Background

Frailty is an age-related health condition affecting an estimated 18% of older adults in Europe and past evidence has shown a relationship between socioeconomic factors and frailty. We examined population frailty trends and the association between frailty and 5-year mortality by education tertiles and income quartiles at ages 75, 85 and 95 in Swedish registry data.

Methods

All Swedish residents born in 1895–1945 and in the Total Population Register from 1990 to 2020 were included. Frailty was assessed with the Hospital Frailty Risk Score (HFRS), which sums 109 weighted International Classification of Diseases (ICD codes), collected from the National Patient Register.

Results

Regardless of education and income, frailty increased over time, though the association between frailty and 5-year mortality remained stable. Particularly in earlier birth cohorts, although the highest education and income levels had the highest mean HFRS scores, the lowest education and income levels accounted for greater proportions among the frail. These trends varied slightly by sex and age. Men and women had similar levels of frailty, but frailty was more strongly associated with mortality among men.

Conclusion

Over time, education and income levels were more equally represented among the frail population in more recent years. More equitable distribution over time may suggest improvement in health disparities, though more work is needed. The overall increase in frailty and unchanged association with mortality indicates that additional research is needed to better understand how to best support the growing ageing population. This would then support the long-term viability of the healthcare system.
One-year direct and indirect costs of ischaemic stroke in China
Authors: Lv Wei , Wang Anxin , Wang Qianyi , Wang Ruimin , Xu Qin , Wu Shuqing , Han Yi , Jiang Yong , Lin Jinxi , Jing Jing , Li Hao , Wang Yongjun , Meng Xia
Published: October 2023

Background

This is the first real-world study to estimate the direct costs and indirect costs of first-ever ischaemic stroke with 1-year follow-up in China, based on a nationally representative sample.

Methods

Patients were chosen from 20 geographically diverse sites from the nationally representative database China National Stroke Registry-III (CNSR-III). The inclusion criteria were surviving patients who were hospitalised with first-ever ischaemic stroke from February 2017 to February 2018 (the index event); aged 18–80 during the index event; no history of other stroke types. The primary endpoints were direct medical costs, direct non-medical costs, indirect costs and total cost (ie, the sum of all cost components). Patient characteristics and clinical data were extracted from CNSR-III. Stroke-related in-hospital direct medical costs were collected from hospital electronic medical records. The patient survey collected data related to out-of-hospital direct medical costs, direct non-medical costs and indirect costs. The secondary objective was to explore clinical factors associated with cost outcomes through univariate analysis and multiple regression.

Results

The study enrolled 520 patients. The total cost was 57 567.48 CNY, with 26 612.67 CNY direct medical costs, 2 787.56 CNY direct non-medical costs and 28 167.25 CNY indirect costs. Univariate analysis showed that longer lengths of stay during the index event, higher National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale scores were associated with higher costs in all categories. Conversely, EuroQol 5 Dimension utility scores were associated with decreased costs except direct non-medical costs. Multiple regressions showed that higher admission NIHSS scores were independently associated with higher direct medical costs, indirect costs and total cost. Higher 3-month utilities were associated with lower total cost.

Conclusion

This real-world study showed substantial 1-year economic burden following first-ever ischaemic stroke in China, and that indirect costs are a non-negligible driver of costs.
Non-existence of spontaneous symmetry breakdown of time-translation symmetry on general quantum systems: Any macroscopic order parameter moves not!
Authors: Moriya Hajime
Published: September 2023

The Kubo–Martin–Schwinger (KMS) condition is a well-founded general definition of equilibrium states on quantum systems. The time invariance property of equilibrium states is one of its basic consequences. From the time invariance of any equilibrium state it follows that the spontaneous breakdown of time-translation symmetry is impossible. Moreover, triviality of the temporal long-range order is derived from the KMS condition. Therefore, the manifestation of genuine quantum time crystals is impossible as long as the standard notion of spontaneous symmetry breakdown is considered.
Kittel’s molecular zipper model on Cayley trees
Authors: Rozikov U. A.
Published: September 2023

Kittel’s 1D model represents a natural DNA with two strands as a (molecular) zipper, which may be separated as the temperature is varied. We define multidimensional version of this model on a Cayley tree and study the set of Gibbs measures. We reduce description of Gibbs measures to solving of a nonlinear functional equation, with unknown functions (called boundary laws) defined on vertices of the Cayley tree. Each boundary law defines a Gibbs measure. We give a general formula of free energy depending on the boundary law. Moreover, we find some concrete boundary laws and corresponding Gibbs measures. Explicit critical temperature for occurrence of a phase transition (non-uniqueness of Gibbs measures) is obtained.
Cascading failures in interdependent networks with reinforced crucial nodes and dependency groups
Authors: Li Qian , Yu Hongtao , Li Shaomei , Liu Shuxin
Published: September 2023

Previous studies of group percolation models in interdependent networks with reinforced nodes have rarely addressed the effects of the degree of reinforced nodes and the heterogeneity of group size distribution. In this paper, a cascading failure model in interdependent networks with reinforced crucial nodes and dependency groups is investigated numerically and analytically. For each group, we assume that if all the nodes in a group fail on one network, a node on another network that depends on that group will fail. We find that rich percolation transitions can be classified into three types: discontinuous, continuous, and hybrid phase transitions, which depend on the density of reinforced crucial nodes, the group size, and the heterogeneity of group size distribution. Importantly, our proposed crucial reinforced method has higher reinforcement efficiency than the random reinforced method. More significantly, we develop a general theoretical framework to calculate the percolation transition points and the shift point of percolation types. Simulation results show that the robustness of interdependent networks can be improved by increasing the density of reinforced crucial nodes, the group size, and the heterogeneity of group size distribution. Our theoretical results can well agree with numerical simulations. These findings might develop a new perspective for designing more resilient interdependent infrastructure networks.
On gap matching for lane-changing vehicles: Coordinated strategies to improve traffic flow at weave bottlenecks
Authors: Wu Wenjing , Deng Chunchun , Zhan Yongbin , Jia Hongfei
Published: September 2023

The weaving section on the freeway will be an active bottleneck due to vehicles’ mandatory or discretionary lane-changing (LC) conflicts. In the early stages of the development of intelligent connected transportation, destination information collection of weaving vehicles is possible, which provides an opportunity to improve performance in weaving traffic. In this paper, a simulation system with coordinated strategies embedded to satisfy the LC needs is presented under the weaving traffic flow. First, an algorithm is proposed to evaluate the balance between the demand for LC vehicles and the available gaps provided in weaving traffic, which can be adjusted by variable speed limit (VSL) and ramp metering strategies. Second, to validate the proposed algorithm, a typical weave section with a merge and a diverge connected through a single auxiliary lane is researched, and a simulation platform based on cellular automata has been developed. The optimal control strategies are obtained by model predictive control (MPC) and taking the minimum travel time as an objective. Third, the advantages of coordinated control strategies are studied and discussed in traffic efficiency improvement and the success of LC proportions under different combinations of weaving ratios and large vehicle traffic mix.
Diffusion Convolution Neural Network-Based Multiview Gesture Recognition for Athletes in Dynamic Scenes
Authors: Wang Qingyun , Li Hua
Published: September 2023

This paper focuses on deep vision sensing-assisted gesture recognition for athletes in dynamic scenes. Although many research attention had been devoted to this field in recent years, most of existing works failed to fully take characteristics of dynamic scenes into consideration. To deal with this challenge, this paper proposes a diffusion convolution neural network-based multiview gesture recognition approach in dynamic scenes. For one thing, the dynamic spatiotemporal slice position selection based on the body mask heatmap is adopted to calculate positions of horizontal and vertical slices. Thus, the dynamic selection of slice positions in two directions can be realized, and then the extraction of bi-directional spatiotemporal slice images can be completed. For another, action sequences through the 3D residual neural network are learned, and the spatiotemporal information among frames are mined through recurrent networks. Through their combination, a multi-view gesture recognition approach for athletes is constructed. In the experiments, two standard datasets UCF101 and HMDB51 are utilized to establish simulation environment. The proposed method can reach the accuracy beyond 95% on the two datasets. Compared with several typical recognition methods, the proposed method shows higher accuracy.
A Modular Mathematical Modeling Method for Smart Design and Manufacturing of Automobile Driving Axles
Authors: Xu Wenbo , Ma Xiaojie , Jin Yi
Published: September 2023

The automobile driving axles contain many types of transmission gears, as well as complex dimensional constraints among them. This makes it a cumbersome work for design of the whole vehicle. To improve design efficiency and reduce consumption of expert labors, it is necessary to search digital design for manufacturing optimization of automobile driving axles. As a result, this paper proposes a modular mathematical modeling method to realize smart design and manufacturing of automobile driving axles. First, with use of modular segmentation, design process of automobile driving axles can be abstracted as mathematical expressions according to their basic functions. Through solution of the developed model objective, main performance indexes of automobile driving axles under various utilization conditions can be automatically output by computers. In addition, to further analyze and optimize noise-vibration-harshness performance of designed schemes, computers-aided engineering-based simulation technology is utilized to make modal analysis and vibration noise analysis toward designed automobile driving axles. Such comprehensive evaluation works can contribute to determination of better design schemes for manufacturing optimization.