bluuebunny/crossref_metadata_2025 huggingface dataset:
Design and Optimization of a Point Absorber for the Mediterranean Sea
Authors: Ghigo Alberto , Sirigu Sergej Antonello , Carapellese Fabio , Bracco Giovanni
Published: October 2022

In the last few years, a wide range of Wave Energy Converter (WEC) have been designed. Among the most interesting technologies for multiple applications, there is the point absorber: if on one hand, these devices guarantee a limited energy production, on the other hand, they ensure good performances, do not require complex installations and have a limited visual and environmental impact. However, a major obstacle to the development of these technologies is the high investment costs, which prevent their development from an industrial point of view.

The purpose of this paper is to present a frequency domain model for a cylindrical point absorber and to perform a holistic optimization that maximizes the extracted power and minimizes device costs. Optimized parameters comprise shape, dimensions, mass properties, ballast and draft.

The optimization is carried out considering different installation sites in the Mediterranean Sea, chosen from the most productive ones, such as the island of Pantelleria along the Sicily channel and Alghero along the north-western coast of Sardinia, to define an optimal point absorber design for offshore applications in the Mediterranean Sea.
Supplemental Material: Eocene magmatism in the Himalaya: Response to lithospheric flexure during early Indian collision?
Authors: Ma Lin , al. et
Published: October 2022

Analytical methods and discussions of post-magmatic processes, with figures and supporting data. 
Supplemental Material: Fluid inclusion evidence for overpressure-induced shale oil accumulation
Authors: Wang Yingqi , Cao Jian , al. et
Published: October 2022

Additional details on geological setting, samples, methods, Figures S1–S3, and Tables S1–S3. 
Supplemental Material: Porphyry copper mineralization triggered by sulfate reduction and alkali metasomatism: Constraints from an experimental investigation
Authors: Li Jianping , Chen Huayong , al. et
Published: October 2022

Supplemental Material
Supplemental Material: Petrochronologic constraints on Paleozoic tectonics in southern New England
Authors: Hillenbrand Ian , al. et
Published: October 2022

Detailed analytical methods, sample descriptions, compositional maps and data, detailed graphic thermobarometric results, and geochronologic data 
Particle Creation: Schwinger + Unruh + Hawking
Authors: Volovik G. E.
Published: October 2022

We discuss the interconnection between the Schwinger pair creation in electric field, Hawking radiation and particle creation in the Unruh effect. All three processes can be described in terms of the entropy and temperature. These thermodynamic like processes can be combined. We consider the combined process of creation of charged and electrically neutral particles in the electric field, which combines the Schwinger and Unruh effects. We also consider the creation of the charged black and white holes in electric field, which combines the Schwinger effect and the black hole entropy. The combined processes obey the sum rules for the entropy and for the inverse temperature. Some contributions to the entropy and to the temperature are negative, which reflects the quantum entanglement between the created objects.
Theoretical Modeling of High Spin to Low Spin Transition and Structural Stability Under Pressure in CaFeO3
Authors: Shorikov A. O.
Published: October 2022

Evolution of magnetic and spectral properties and structure stability of CaFeO3 are investigated in frames of the GGA + U method. It is shown that the GGA + U method is able to reproduce the transition from high spin to low spin under pressure obtained experimentally. At ambient pressure monoclinic structure has lower energy which agrees with experiment. Full structural relaxation shows that orthorhombic structure in unstable above 30 GPa and undergoes a distortion toward monoclinic structure.
Use of linked registry claims data for long term surveillance of devices after endovascular abdominal aortic aneurysm repair: observational surveillance study
Authors: Goodney Philip , Mao Jialin , Columbo Jesse , Suckow Bjoern , Schermerhorn Marc , Malas Mahmoud , Brooke Benjamin , Hoel Andrew , Scali Salvatore , Arya Shipra , Spangler Emily , Alabi Olamide , Beck Adam , Gladders Barbara , Moore Kayla , Zheng Xinyan , Eldrup-Jorgensen Jens , Sedrakyan Art
Published: October 2022

Objective

To evaluate long term outcomes (reintervention and late rupture of abdominal aortic aneurysm) of aortic endografts in real world practice using linked registry claims data.

Design

Observational surveillance study.

Setting

282 centers in the Vascular Quality Initiative Registry linked to United States Medicare claims (2003-18).

Participants

20 489 patients treated with four device types used for endovascular abdominal aortic aneurysm repair (EVAR): 40.6% (n=8310) received the Excluder (Gore), 32.2% (n=6606) the Endurant (Medtronic), 16.0% (n=3281) the Zenith (Cook Medical), and 11.2% (n=2292) the AFX (Endologix). Given modifications to AFX in late 2014, patients who received the AFX device were categorized into two groups: the early AFX group (n=942) and late AFX group (n=1350) and compared with patients who received the other devices, using propensity matched Cox models.

Main outcome measures

Reintervention and rupture of abdominal aortic aneurysm post-EVAR; all patients (100%) had complete follow-up via the registry or claims based outcome assessment, or both.

Results

Median age was 76 years (interquartile range (IQR) 70-82 years), 80.0% (16 386/20 489) of patients were men, and median follow-up was 2.3 years (IQR 0.9-4.1 years). Crude five year reintervention rates were significantly higher for patients who received the early AFX device compared with the other devices: 14.9% (95% confidence interval 13.7% to 16.2%) for Excluder, 19.5% (18.1% to 21.1%) for Endurant, 16.7% (15.0% to 18.6%) for Zenith, and early 27.0% (23.7% to 30.6%) for the early AFX. The risk of reintervention for patients who received the early AFX device was higher compared with the other devices in propensity matched Cox models (hazard ratio 1.61, 95% confidence interval 1.29 to 2.02) and analyses using a surgeon level instrumental variable of >33% AFX grafts used in their practice (1.75, 1.19 to 2.59). The linked registry claims surveillance data identified the increased risk of reintervention with the early AFX device as early as mid-2013, well before the first regulatory warnings were issued in the US in 2017.

Conclusions

The linked registry claims surveillance data identified a device specific risk in long term reintervention after EVAR of abdominal aortic aneurysm. Device manufacturers and regulators can leverage linked data sources to actively monitor long term outcomes in real world practice after cardiovascular interventions.
Text mining occupations from the mental health electronic health record: a natural language processing approach using records from the Clinical Record Interactive Search (CRIS) platform in south London, UK
Authors: Chilman Natasha , Song Xingyi , Roberts Angus , Tolani Esther , Stewart Robert , Chui Zoe , Birnie Karen , Harber-Aschan Lisa , Gazard Billy , Chandran David , Sanyal Jyoti , Hatch Stephani , Kolliakou Anna , Das-Munshi Jayati
Published: October 2022

Objectives

We set out to develop, evaluate and implement a novel application using natural language processing to text mine occupations from the free-text of psychiatric clinical notes.

Design

Development and validation of a natural language processing application using General Architecture for Text Engineering software to extract occupations from de-identified clinical records.

Setting and participants

Electronic health records from a large secondary mental healthcare provider in south London, accessed through the Clinical Record Interactive Search platform. The text mining application was run over the free-text fields in the electronic health records of 341 720 patients (all aged ≥16 years).

Outcomes

Precision and recall estimates of the application performance; occupation retrieval using the application compared with structured fields; most common patient occupations; and analysis of key sociodemographic and clinical indicators for occupation recording.

Results

Using the structured fields alone, only 14% of patients had occupation recorded. By implementing the text mining application in addition to the structured fields, occupations were identified in 57% of patients. The application performed on gold-standard human-annotated clinical text at a precision level of 0.79 and recall level of 0.77. The most common patient occupations recorded were ‘student’ and ‘unemployed’. Patients with more service contact were more likely to have an occupation recorded, as were patients of a male gender, older age and those living in areas of lower deprivation.

Conclusion

This is the first time a natural language processing application has been used to successfully derive patient-level occupations from the free-text of electronic mental health records, performing with good levels of precision and recall, and applied at scale. This may be used to inform clinical studies relating to the broader social determinants of health using electronic health records.
Changes of perceptions and behaviours during the phases of COVID-19 pandemic in German elderly people with neurological disorders: an observational study using telephone interviews
Authors: Zipprich Hannah M , Schönenberg Aline , Teschner Ulrike , Prell Tino
Published: October 2022

Objectives

Describing perceived limitations in everyday life, psychological burden and approval to easing of measures during the COVID-19 phases in elderly people with neurological disorders.

Design

Observational, prospective study

Setting

This is a monocentric study conducted at a university hospital in Germany.

Participants

Overall, 452 elderly people participated in the NeuroGerAdh study (DRKS00016774) and were interviewed by telephone between 18 March and 30 August 2020.

Results

Overall, 307 (67.9%) patients had relevant limitations in daily life due to the measures. These limitations significantly decreased during the pandemic phases. At the beginning of the pandemic, people complained about restricted social contacts and mobility, which were the most common reasons for perceived limitations in daily life. Later, since June 2020, wearing a mouth–nose mask had become the main reason for perceived limitations. In the elastic net regularisation, model higher perceived limitations in daily life were among others associated with younger age and earlier pandemic phases. Higher psychological burden was mainly associated with early pandemic phase, younger age and depression.The perceived psychological burden decreased as the pandemic phases passed, even though the reasons for psychological burden (anxiety or fear of infection, insecurity and concerns) did not remarkably change during the phases. From 16 June 2020, the patients were asked whether they approve the easing of measures. Sixty-seven of 136 patients (49.3%) approved and 55 (40.4%) did not. The common reasons for disapproval were fear of increased risk of infection and irresponsible behaviour of other people.

Conclusion

While limitations in daily life decreased during the study period, anxiety remains a common psychological burden in elderly sick people, and this needs special attention. Accordingly, most people do not approve easing of measures. Special strategies are needed to cope with changing measures during the COVID-19 pandemic.
The UPTAKE study: a cross-sectional survey examining the insights and beliefs of the UK population on COVID-19 vaccine uptake and hesitancy
Authors: Sethi Sonika , Kumar Aditi , Mandal Anandadeep , Shaikh Mohammed , Hall Claire A , Kirk Jeremy M W , Moss Paul , Brookes Matthew J , Basu Supratik
Published: October 2022

Objective

A key challenge towards a successful COVID-19 vaccine uptake is vaccine hesitancy. We examine and provide novel insights on the key drivers and barriers towards COVID-19 vaccine uptake.

Design

This study involved an anonymous cross-sectional online survey circulated across the UK in September 2020. The survey was designed to include several sections to collect demographic data and responses on (1) extent of agreement regarding various statements about COVID-19 and vaccinations, (2) previous vaccination habits (eg, if they had previously declined vaccination) and (3) interest in participation in vaccine trials. Multinominal logistic models examined demographic factors that may impact vaccine uptake. We used principle component analysis and text mining to explore perception related to vaccine uptake.

Setting

The survey was circulated through various media, including posts on social media networks (Facebook, Twitter, LinkedIn and Instagram), national radio, news articles, Clinical Research Network website and newsletter, and through 150 West Midlands general practices via a text messaging service.

Participants

There were a total of 4884 respondents of which 9.44% were black, Asian and minority ethnic (BAME) group. The majority were women (n=3416, 69.9%) and of white ethnicity (n=4127, 84.5%).

Results

Regarding respondents, overall, 3873 (79.3%) were interested in taking approved COVID-19 vaccines, while 677 (13.9%) were unsure, and 334 (6.8%) would not take a vaccine. Participants aged over 70 years old (OR=4.63) and the BAME community (OR=5.48) were more likely to take an approved vaccine. Smokers (OR=0.45) and respondents with no known illness (OR=0.70) were less likely to accept approved vaccines. The study identified 16 key reasons for not accepting approved vaccines, the most common (60%) being the possibility of the COVID-19 vaccine having side effects.

Conclusions

This study provides an insight into focusing on specific populations to reduce vaccine hesitancy. This proves crucial in managing the COVID-19 pandemic.
Impact of social determinants of health on cancer care: a survey of community oncologists
Authors: Zettler Marjorie E , Feinberg Bruce A , Jeune-Smith Yolaine , Gajra Ajeet
Published: October 2022

Objective

Cancer survival rates have improved over the past few decades, yet socioeconomic disparities persist. Social determinants of health (SDOH) have consistently been shown to correlate with health outcomes. The objective of this study was to characterise oncologists’ perceptions of the impact of SDOH on their patients, and their opinions on how these effects could be remediated.

Design

Cross-sectional survey of physicians.

Setting

Web-based survey completed prior to live meetings held between February and April 2020.

Participants

Oncologists/haematologists from across the USA.

Exposure

Clinical practice in a community-based or hospital-based setting.

Main outcome and measure

Physician responses regarding how SDOH affected their patients, which factors represented the most significant barriers to optimal health outcomes and how the impact of SDOH could be mitigated through assistance programmes.

Results

Of the 165 physicians who completed the survey, 93% agreed that SDOH had a significant impact on their patients’ health outcomes. Financial security/lack of insurance and access to transportation were identified most often as the greatest barriers for their patients (83% and 58%, respectively). Eighty-one per cent of physicians indicated that they and their staff had limited time to spend assisting patients with social needs, and 76% reported that assistance programmes were not readily accessible. Government organisations, hospitals, non-profit organisations and commercial payers were selected by 50% or more of oncologists surveyed as who should be responsible for delivering assistance programmes to patients with social needs; 42% indicated that pharmaceutical manufacturers should also be responsible.

Conclusion

Our survey found that most oncologists were aware of the impact of SDOH on their patients but were constrained in their time to assist patients with social needs. The physicians in our study identified a need for more accessible assistance programmes and greater involvement from all stakeholders in addressing SDOH to improve health outcomes.
Protocol for a systematic review on systemic and skin toxicity of important hazardous hair and nail cosmetic ingredients in hairdressers
Authors: Uter Wolfgang , Johansen Jeanne D. , Havmose Martin S. , Kezic Sanja , van der Molen Henk F. , Macan Jelena , Babić Željka , Turk Rajka , Symanzik Cara , John Swen M.
Published: October 2022

Introduction

Hairdressers constitute a major subgroup in the service sector. They are exposed to various substances hazardous for skin, airways or systemically. Accordingly, skin and other occupational diseases are common. The present systematic review will compile and appraise evidence regarding skin, systemic and airways toxicity of an indicative set of specific, important product ingredients. Additionally, evidence concerning hand eczema morbidity among hairdressers will be reviewed.

Methods and analysis

Systematic searches will be performed in two electronic literature databases (Medline, Web of Science–Core Collection), the Cochrane register and two collections of toxicological dossiers (Scientific Committee on Consumer Safety of the European Commission and the MAK Commission of the German Research Council). Additional literature sources will be retrieved using hand search of reference lists of included studies and snowballing methods. We will include studies with all types of quantitative study designs, including results from in vitro and in vivo experiments, chemical analysis, epidemiological findings and clinical results. We will assess the risk of bias within studies amalgamating an abbreviated version of the Mixed Methods Appraisal Tool, basic Cochrane criteria and US Environmental Protection Agency assessment factors for scientific information. As we expect large heterogeneity in methods and outcomes, we will conduct a narrative synthesis of results instead of a meta-analysis, except where quantitative pooling is feasible.

Ethics and dissemination

Ethical approval and patient consent are not required as this is a systematic review based on published studies. The results of this study will be published in international peer-reviewed journals.

PROSPERO registration number

CRD42021238118
Patients’ choice of healthcare providers and predictors of modern healthcare utilisation in Bangladesh: Household Income and Expenditure Survey (HIES) 2016–2017 (BBS)
Authors: Imtiaz Asif , Khan Noor Muhammad , Hasan Emran , Johnson Shanthi , Nessa Hazera Tun
Published: October 2022

Objectives

The number of modern healthcare providers in Bangladesh has increased and they are well equipped with modern medical instruments and infrastructures. Despite this development, patients seeking treatment from alternative healthcare providers are ongoing. Hence, this study aims to determine the underlying predictors of patients’ choosing modern healthcare providers and health facilities for getting treatments.

Setting

Data from the nationally representative Household Income and Expenditure Survey 2016–2017 conducted by the Bangladesh Bureau of Statistics were used.

Participants

34 512 respondents sought treatment for their illnesses from different types of available healthcare providers.

Primary and secondary outcome measure

Patients’ choice of healthcare providers (primary) and predictors of patients’ choice of modern healthcare providers (secondary).

Results

The study found that 40% of the patients visit modern healthcare providers primarily on having symptoms of illness, and the remainder goes to alternative healthcare providers. Patients living in urban areas (adjusted OR (AOR)=1.11, 95% CI 1.05 to 1.17, p<0.01), and if the travel time was between 1 and 2 hours (AOR=1.11, 95% CI 1.00 to 1.22, p<0.05) compared with travel time less than 1 hour, were positively associated to utilisation of modern healthcare facilities for their first consultation. The statistical models show that the predisposing and need factors do not significantly impact patients’ choice of modern healthcare providers.

Conclusions

The distribution of modern healthcare providers should be even across the country to eliminate the rural–urban divide in modern healthcare utilisation. Enhancing the digital provision of modern healthcare services could reduce travel time, omit transportation costs and save waiting time for treatment by the modern healthcare providers. Policymakers can think of introducing a national health insurance programme in Bangladesh as a potential policy instrument.
Audit of data redaction practices in NICE technology appraisals from 1999 to 2019
Authors: Osipenko Leeza
Published: October 2022

Objectives

To assess the extent and type of data redaction in all active technology appraisals (TA) and highly specialised technology (HST) evaluations issued by the National Institute for Health and Care Excellence (NICE) from its conception of the institute to September 2019. To propose policy recommendations for transparency.

Methods

Structured audit to establish extent of data redaction—proportion of appraisals and specific data categories and assess redaction by: indication, appraisal process, manufacturer, type of data—price, adverse events (AEs), clinical (excluding AEs), incremental quality-adjusted life-years. Longitudinal analysis over 20 years.

Results

All TAs with available documentation and active recommendations (n=408) and HSTs (n=10) published from March 2000 to 11 September 2019 have been assessed for data redaction. Overall, 333 TAs (81.6%) have data redaction, 86 (25.8%) of them are heavily redacted. Clinical data (excluding AEs) are redacted in 268 (65.7%) appraisals, AE data in 128 (31.4%), price in 238 (58.3%). In total, 87% of oncology appraisals have redacted data vs 78% of non-oncology appraisals. 91% of single TAs have redacted data vs 59% of multiple TAs. 25% of final guidance documents (e.g. Final Appraisal Determination - FAD) do not report one or more instance of clinical data. Data redaction increased substantially over time, and is currently at its highest level with 100% of TAs having at least some data redaction in 2019/2020, 96% of appraisals in 2018/2019% and 94% of appraisals in 2017/2018. All 10 HST evaluations have redacted data, with 4 of them being heavily redacted.

Conclusions

Documents supporting NICE TA and HST recommendations are significantly redacted, thereby concealing clinical and economic data of importance to patients, clinicians and researchers. Documents remain redacted on the NICE website for years. Policy change is required to ensure transparency of data underpinning NICE’s decisions.
Mode of birth in women with low-lying placenta: protocol for a prospective multicentre 1:3 matched case–control study in Italy (the MODEL-PLACENTA study)
Authors: Ornaghi Sara , Colciago Elisabetta , Vaglio Tessitore Isadora , Abbamondi Alessandra , Antolini Laura , Locatelli Anna , Inversetti Annalisa , Pintucci Armando , Cetin I , Bracco Benedetta , Fabbri Elisa , Sala Valentina , Meroni Mario , Volpe Grazia , Benedetti Sara , Bulfoni Camilla , Marconi Annamaria , Lagrasta Federica , Paolini Cinzia Lucia , Mazza Elisabetta , Candiani Massimo , Valsecchi Luca , Smid Maddalena , Pasi Federica , Pozzoni Mirko , Castoldi Maria , Vignali Michele , Dal Molin Giulia , Guarano Alice , Pellegrino Antonio , Callegari Clelia , Betti Marta , Lazzarin Sara , Prefumo Federico , Zanardini Cristina , Parolin Valentina , Catalano Anna , Barbolini Edoardo , Antonazzo Patrizio , Pignatti Lucrezia , Tintoni Mauro , Spelzini Federico , Martinelli Anna , Facchinetti Fabio , Chiossi G , Vergani Patrizia
Published: October 2022

Introduction

The term placenta praevia defines a placenta that lies over the internal os, whereas the term low-lying placenta identifies a placenta that is partially implanted in the lower uterine segment with the inferior placental edge located at 1–20 mm from the internal cervical os (internal-os-distance). The most appropriate mode of birth in women with low-lying placenta is still controversial, with the majority of them undergoing caesarean section. The current project aims to evaluate the rate of vaginal birth and caesarean section in labour due to bleeding by offering a trial of labour to all women with an internal-os-distance >5 mm as assessed by transvaginal sonography in the late third trimester.

Methods and analysis

The MODEL-PLACENTA is a prospective, multicentre, 1:3 matched case–control study involving 17 Maternity Units across Lombardy and Emilia-Romagna regions, Italy. The study includes women with a placenta located in the lower uterine segment at the second trimester scan. Women with a normally located placenta will be enrolled as controls. A sample size of 30 women with an internal-os-distance >5 mm at the late third trimester scan is needed at each participating Unit. Since the incidence of low-lying placenta decreases from 2% in the second trimester to 0.4% at the end of pregnancy, 150 women should be recruited at each centre at the second trimester scan. A vaginal birth rate ≥60% in women with an internal-os-distance >5 mm will be considered appropriate to start routinely admitting to labour these women.

Ethics and dissemination

Ethical approval for the study was given by the Brianza Ethics Committee (No 3157, 2019). Written informed consent will be obtained from study participants. Results will be disseminated by publication in peer-reviewed journals and presentation in international conferences.

Trial registration number

NCT04827433(pre-results stage)
Anaesthesia protocol evaluation of the videolaryngoscopy with the McGrath MAC and direct laryngoscopy for tracheal intubation in 1000 patients undergoing rapid sequence induction: the randomised multicentre LARA trial study protocol
Authors: Kriege Marc , Lang Philipp , Lang Christoph , Pirlich Nina , Griemert Eva-Verena , Heid Florian , Wittenmeier Eva , Schmidtmann Irene , Schmidbauer W , Jänig Christoph , Jungbecker Johannes , Kunitz Oliver , Strate Maximilian , Schmutz Axel
Published: October 2022

Introduction

Rapid sequence induction of anaesthesia is indicated in patients with an increased risk of pulmonary aspiration. The main objective of the technique is to reduce the critical time period between loss of airway protective reflexes and rapid inflation of the cuff of the endotracheal tube to minimise the chance of aspiration of gastric contents. The COVID-19 pandemic has reinforced the importance of first-pass intubation success to ensure patient and healthcare worker safety. The aim of this study is to compare the first-pass intubation success rate (FPS) using the videolaryngoscopy compared with conventional direct laryngoscopy in surgical patients with a high risk of pulmonary aspiration.

Methods and analysis

The LARA trial is a multicentre, patient-blinded, randomised controlled trial. Consecutive patients requiring tracheal intubation are randomly allocated to either the McGrath MAC videolaryngoscope or direct laryngoscopy using the Macintosh laryngoscope. The expected rate of FPS is 92% in the McGrath group and 82% in the Macintosh group. Each group must include a total of 500 patients to achieve 90% power for detecting a difference at the 5% significance level. Successful intubation with the FPS is the primary endpoint. The secondary endpoints are the time to intubation, the number of intubation attempts, the necessity of airway management alternatives, the visualisation of the glottis using the Cormack and Lehane Score and the Percentage Of Glottic Opening Score and definite adverse events.

Ethics and dissemination

The project is approved by the local ethics committee of the Medical Association of the Rhineland Palatine state (registration number: 2020–15502) and medical ethics committee of the University of Freiburg (registration number: 21–1303). The results of this study will be made available in form of manuscripts for publication and presentations at national and international meetings.

Trial registration

NCT04794764.
Sexual abuse of people with intellectual disabilities in residential settings: a 3-year analysis of incidents reported to the Dutch Health and Youth Care Inspectorate
Authors: Amelink Quirine , Roozen Selini , Leistikow Ian , Weenink Jan-Willem
Published: October 2022

Objectives

To explore characteristics of sexual abuse within residential settings for people with an intellectual disability and to map out measures undertaken and improvement plans made by healthcare organisations after sexual abuse.

Design

Descriptive analysis of reports about sexual violence against persons with an intellectual disability submitted to the Dutch Health and Youth Care Inspectorate by healthcare organisations.

Setting

Residential settings for people with an intellectual disability in The Netherlands.

Selection

186 incident reports submitted to the Inspectorate between January 2017 and December 2019 were included.

Results

125 incident reports concerned sexual abuse by fellow clients and 61 reports concerned sexual abuse by professionals. Client perpetrators were predominantly male whereas almost 30% of the abusing professionals were female. The majority of the perpetrating professionals were unlicensed professionals. Clients who committed sexual abuse were mostly relocated to another residential setting. Most healthcare organisations invested in education and training for employees instead of improving the sexual education programme for clients after an incident of sexual abuse. If there was a strong suspicion of sexual abuse by a professional, resignation followed in most cases. In just two cases, the perpetrating professional was reported to a warning registry.

Conclusions

A small amount of the perpetrating professionals held a licensed profession, which makes it challenging to address this form of sexual abuse through healthcare regulation. It raises the question why warning registries are not engaged more often after alleged sexual abuse. Constantly relocating abusing clients might endanger the (sexual) safety of clients in these new environments. Previous literature suggests that adequate sexual education regarding social skills and sexual behaviour is very effective for the majority of clients who commit sexual abuse. Healthcare organisations could take up a more prominent role in this to ensure safety for their own clients and for clients residing elsewhere.
Understanding variations in reported epidemiology of major lower extremity amputation in the UK: a systematic review
Authors: Meffen Anna , Houghton John S M , Nickinson Andrew T O , Pepper Coral J , Sayers Robert D , Gray Laura J
Published: October 2022

Objective

Estimate the prevalence/incidence/number of major lower extremity amputations (MLEAs) in the UK; identify sources of routinely collected electronic health data used; assess time trends and regional variation; and identify reasons for variation in reported incidence/prevalence of MLEA.

Design

Systematic review and narrative synthesis.

Data sources

Medline, Embase, EMcare, CINAHL, The Cochrane Library, AMED, Scopus and grey literature sources searched from 1 January 2009 to 1 August 2021.

Eligibility criteria for selecting studies

Reports that provided population-based statistics, used routinely collected electronic health data, gave a measure of MLEA in adults in the general population or those with diabetes in the UK or constituent countries were included.

Data extraction and synthesis

Data extraction and quality assessment using the Joanna Briggs Institute Critical Appraisal Instruments were performed by two reviewers independently. Due to considerable differences in study populations and methodology, data pooling was not possible; data were tabulated and narratively synthesised, and study differences were discussed.

Results

Twenty-seven reports were included. Incidence proportion for the general population ranged from 8.2 to 51.1 per 100 000 and from 70 to 291 per 100 000 for the population with diabetes. Evidence for trends over time was mixed, but there was no evidence of increasing incidence. Reports consistently found regional variation in England with incidence higher in the north. No studies reported prevalence. Differences in database use, MLEA definition, calculation methods and multiple procedure inclusion which, together with identified inaccuracies, may account for the variation in incidence.

Conclusions

UK incidence and trends in MLEA remain unclear; estimates vary widely due to differences in methodology and inaccuracies. Reasons for regional variation also remain unexplained and prevalence uninvestigated. International consensus on the definition of MLEA and medical code list is needed. Future research should recommend standards for the reporting of such outcomes and investigate further the potential to use primary care data in MLEA epidemiology.

Systematic review registration

PROSPERO CRD42020165592.
Temporal Dynamic Concept Modeling Network for Explainable Video Event Recognition
Authors: Zhang Weigang , Qi Zhaobo , Wang Shuhui , Su Chi , Su Li , Huang Qingming
Published: October 2022

Recently, with the vigorous development of deep learning and multimedia technology, intelligent urban computing has received more and more extensive attention from academia and industry. Unfortunately, most of the related technologies are black-box paradigms that lack interpretability. Among them, video event recognition is a basic technology. Event contains multiple concepts and their rich interactions, which can assist us to construct explainable event recognition methods. However, the crucial concepts needed to recognize events have various temporal existing patterns, and the relationship between events and the temporal characteristics of concepts has not been fully exploited. This brings great challenges for concept-based event categorization. To address the above issues, we introduce the temporal concept receptive field, which is the length of the temporal window size required to capture key concepts for concept-based event recognition methods. Accordingly, we introduce the temporal dynamic convolution (TDC) to model the temporal concept receptive field dynamically according to different events. Its core idea is to combine the results of multiple convolution layers with the learned coefficients from two complementary perspectives. These convolution layers contain a variety of kernel sizes, which can provide temporal concept receptive fields of different lengths. Similarly, we also propose the cross-domain temporal dynamic convolution (CrTDC) with the help of the rich relationship between different concepts. Different coefficients can help us to capture suitable temporal concept receptive field sizes and highlight crucial concepts to obtain accurate and complete concept representations for event analysis. Based on the TDC and CrTDC, we introduce the temporal dynamic concept modeling network (TDCMN) for explainable video event recognition. We evaluate TDCMN on large-scale and challenging datasets FCVID, ActivityNet, and CCV. Experimental results show that TDCMN significantly improves the event recognition performance of concept-based methods, and the explainability of our method inspires us to construct more explainable models from the perspective of the temporal concept receptive field.
Self-aware Optimization of Adaptation Planning Strategies
Authors: Lesch Veronika , Hadry Marius , Krupitzer Christian , Kounev Samuel
Published: October 2022

In today’s world, circumstances, processes, and requirements for software systems are becoming increasingly complex. To operate properly in such dynamic environments, software systems must adapt to these changes, which has led to the research area of Self-Adaptive Systems (SAS). Platooning is one example of adaptive systems in Intelligent Transportation Systems, which is the ability of vehicles to travel with close inter-vehicle distances. This technology leads to an increase in road throughput and safety, which directly addresses the increased infrastructure needs due to increased traffic on the roads. However, the No-Free-Lunch theorem states that the performance of one adaptation planning strategy is not necessarily transferable to other problems. Moreover, especially in the field of SAS, the selection of the most appropriate strategy depends on the current situation of the system. In this article, we address the problem of self-aware optimization of adaptation planning strategies by designing a framework that includes situation detection, strategy selection, and parameter optimization of the selected strategies. We apply our approach on the case study platooning coordination and evaluate the performance of the proposed framework.
Esophageal wall compliance/stiffness during peristalsis in patients with functional dysphagia and high-amplitude esophageal contractions
Authors: Zifan Ali , Gandu Vignesh , Mittal Ravinder K.
Published: October 2022

We studied healthy asymptomatic subject, patients with functional dysphagia (FD), and patients with high-amplitude esophageal contractions (HAEC). Our data show that in patients with HAEC and functional dysphagia, luminal distension is smaller (low luminal CSA at peak distension), intraluminal pressure is higher, and liquid bolus travels faster through the esophagus as compared with normal subjects. We conclude that patients with functional dysphagia and HAEC have a stiffer distal esophageal wall during bolus transport related to primary peristalsis.
Option Pricing Model Combining Ensemble Learning Methods and Network Learning Structure
Authors: Wang Miao , Zhang Yunfeng , Qin Chao , Liu Peipei , Zhang Qiuyue
Published: October 2022

Option pricing based on data-driven methods is a challenging task that has attracted much attention recently. There are mainly two types of methods that have been widely used, respectively, the neural network method and the ensemble learning method. The option pricing model based on the neural network has high complexity, and a large number of hyper-parameters will be generated during training, resulting in difficult model adjustment. Furthermore, a lot of training data are needed. The option pricing model based on ensemble learning is not ideal for data feature extraction, because each calculation of the ensemble learning method is mainly to reduce the final residual. Therefore, this paper adopts a learning framework that embeds the modular ensemble learning methods into the network learning structure, and an option pricing model based on deep ensemble learning is proposed. The model is mainly composed of two parts: features reorganization based on random forest, used to calculate the importance of features, combined with the original data as training input; the multilayer ensemble data training structure is based on network learning structure and embeds two ensemble learning methods as network modules, and it also designs a stop algorithm to automatically determine the number of layers. This enables the model to retain the effect of data feature extraction and adapt to small and medium data sets without generating many hyper-parameters. Moreover, in order to make the model fully absorb the advantages of the two ensemble learning methods, we adopt cross-training for data. From the experimental results, it can be concluded that compared with the current optimal method, the prediction performance of the proposed model is improved by 36% in the root mean square error (RMSE), which proves the superiority of the proposed model from the quantitative direction.
Acute Adrenal Hemorrhage as the Initial Manifestation of Metastatic Lung Adenocarcinoma: A Cautionary Tale
Authors: Arivazhagan Sowbharnika , Parthiban Guru Prasad , Patterson Christina , Reddy Karthik
Published: October 2022

Adrenal gland metastatic disease is the most commonly occurring malignancy of the adrenal glands. Although metastatic disease is common, adrenal hemorrhage is a rare but potentially fatal manifestation of malignancy. The objectives of this case report are to highlight the unusual presentation of metastatic lung adenocarcinoma as spontaneous adrenal hemorrhage in a 64-year-old female who was otherwise asymptomatic. As well as to support the reasoning that metastatic disease should be considered as a differential in patients with this clinical presentation as this may have altered this fatal outcome.
Survival Outcome of Partial Cystectomy versus Transurethral Bladder Tumor Resection in T1 High-Grade Bladder Cancer Patients: A Propensity Score Matching Study
Authors: Ping Zheng , Zhan Xiangpeng , Chen Tao , Zheng Yunwei , Jiang Ming , Li Yu , Fu Bin
Published: October 2022

Purpose. Partial cystectomy was investigated as a method of bladder preservation with better disease outcomes than transurethral bladder tumor resection in T1 high-grade bladder cancer patients. Method and materials. The national Surveillance, Epidemiology, and End Results database (SEER) (2004–2015) were used to obtain patients diagnosed with T1 high-grade bladder cancer, and finally, 25263 patients were enrolled in our study. The Kaplan–Meier method with the log-rank test was performed to analyze the outcome of overall survival (OS) and cancer-specific survival (CSS) between patients undergoing partial cystectomy (PC), transurethral resection of bladder tumor (TURBT), or radical cystectomy (RC). Moreover, the propensity score matching (PSM) and multivariable Cox proportional hazard model were also utilized in the study. Results. Ultimately, 24635 patients were undergoing TURBT, while 190 and 438 patients were, respectively, assigned to the PC and RC groups. Compared with patients with TURBT, a tendency of a higher proportion of higher older and male patients was observed in the PC group. When matching with RC patients, patients in the PC group were commonly older and had bigger tumor sizes and single tumors (All

P
<
0.05

). After 1 : 1 PSM, 190 patients with TURBT and 160 patients receiving PC were selected. In survival analysis, the patients in the PC group had a higher survival probability of both OS and CSS before and after PSM compared with those in the TURBT group. Meanwhile, no significant differences were observed between the RC and PC groups in OS and CSS analysis. Moreover, multivariable Cox regression showed that PC was a protective factor for overall mortality (ACM) and cancer-specific mortality (CSM) compared with TURBT in T1 high-grade patients (All

P
<
0.05

). Conclusion. Patients undergoing partial cystectomy were shown to have a better outcome compared with those with transurethral bladder tumor resection in T1 high-grade bladder cancer patients. Partial cystectomy could be the more worthwhile choice for bladder preservation in T1 high-grade bladder cancer patients.
Paraneoplastic Pemphigus: A Striking Complication of Undiagnosed Lymphoma
Authors: Adnani Blake O. , O’ Brien Kathleen , Myint Zaw W. , Adler Brandon L.
Published: October 2022

A 49-year-old male with no past medical history presented with acute-onset painful mucosal erosions along with flaccid bullae on his trunk, scalp, and intertriginous areas. The patient initially underwent a skin biopsy which demonstrated suprabasilar acantholysis and lichenoid interface dermatitis. This was followed by a computed tomography scan which identified a large abdominal lymph node. Core needle biopsy of this node demonstrated follicular lymphoma. Lastly, indirect immunofluorescence (IIF) in rat bladder was positive (titer 1 : 10,240). This finding confirmed the diagnosis of paraneoplastic pemphigus (PNP) in the setting of follicular lymphoma. The patient’s cutaneous disease was treated with a combination of intravenous immunoglobulin and methylprednisolone, along with intravenous rituximab, with a resolution of his cutaneous symptoms. His lymphoma was treated with six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R–CHOP), with an interval decrease in his tumor burden. PNP is an autoimmune-mediated mucocutaneous disease associated with underlying neoplasm, most commonly non-Hodgkin lymphoma or chronic lymphocytic leukemia. Affected patients develop variable autoantibodies to antigens on keratinocytes and the basement membrane zone. Severe intractable stomatitis is characteristic, in addition to polymorphous cutaneous eruptions including bullae and erosions. Mortality rates can reach up to 90% due to malignancy, sepsis, or bronchiolitis obliterans, an irreversible and often lethal cause of pulmonary insufficiency. We highlight PNP manifesting in a patient with lymphoma, who responded well to the skin- and malignancy-directed treatments. PNP is an exceedingly rare diagnosis that should be considered in a patient with intractable stomatitis.
Relationship between Biofilm Formation and Antibiotic Resistance and Adherence Genes in Staphylococcus aureus Strains Isolated from Raw Cow Milk in Shahrekord, Iran
Authors: Pajohesh Rasul , Tajbakhsh Elahe , Momtaz Hassan , Rahimi Ebrahim
Published: October 2022

The production of biofilms by S. aureus contributes significantly to treatment failures. The present study aims to establish the relationship between biofilm formation and antibiotic resistance and adhesion genes in Staphylococcus aureus strains isolated from raw cow milk in Shahrekord, Iran. A total of 90 samples of raw cow’s milk were collected. Presumptive S. aureus strains were obtained using Baird-Parker plates after enrichment in tryptone soy broth, and final colonies were selected from brain heart infusion. Additional tests such as coagulase were done, and the identification was confirmed by the detection of the aroA gene. Biofilm producing strains were screened using a spectrophotometry method applied to microplates. Crystal violet staining was used to quantify the formation of biofilm. An antibiotic susceptibility test was performed using the Kirby–Bauer disc diffusion method. PCR was used to detect several biofilm and antibiotics resistance related genes. The chi-square test and Fisher’s exact test were used to establish a statistically significant relationship between biofilm reaction and antibiotic resistance (

p

value <0.05). Results show a moderate (38.88%) recovery rate of S. aureus in milk and 65.71% of the isolates were strong biofilm producers. Antibiotic susceptibility tests show an alarming rate of resistance to beta-lactam antibiotics, especially penicillin (100%), ampicillin (91.42%), and oxacillin (71.42%). This finding correlates with antibiotic resistance gene detection, in which the gene blaZ was most found (71.42%), followed by mecA and Aac-D (42.85%). Detection of biofilm-related genes shows that all the genes targeted were found among S. aureus isolates. Statistical tests show a significant correlation between biofilm production and antibiotic resistance in S. aureus. This study revealed that there is a significant correlation between biofilm production and antibiotic resistance in S. aureus isolated from raw milk. These results highlight the need for regular surveillance of the occurrence of S. aureus strains in milk and milk products in Iran.
Recurrent Cervical Cancer Treated Successfully with Single-Agent PARP-Inhibitor, Olaparib
Authors: Gross Maya , Spencer Ryan J.
Published: October 2022

Recurrent cervical cancer has a grim prognosis with 5-year survival <5%. Current treatment options are limited; standards of care such as palliative chemotherapy and surgical resection often provide a small survival advantage. To date, only one targeted agent has FDA approval for the treatment of recurrent cervical cancer. We present the case of a novel application of olaparib, a poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitor, as single-agent therapy for recurrent metastatic clear cell cervical cancer in a patient with a somatic BRCA2 mutation. The patient had excellent response to therapy with stable disease without evidence of progression until 14 months of therapy, at which time she was switched to an alternative regimen.