bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a perinatal care quality improvement package on patient satisfaction: a secondary outcome analysis of a cluster-randomised controlled trial
Authors: Brunell Olivia , Chaulagain Dipak , KC Ashish , Bergström Anna , Målqvist Mats
Published: June 2022

Objective

To investigate the effect of a quality improvement (QI) package on patient satisfaction of perinatal care.

Design

Secondary analysis of a stepped-wedge cluster-randomised controlled trial. Participating hospitals were randomised by size into four different wedges.

Setting

12 secondary-level public hospitals in Nepal.

Participants

Women who gave birth in the hospitals at a gestational age of ≥22 weeks, with fetal heart sound at admission. Adverse outcomes were excluded. One hospital was excluded due to data incompleteness and four low-volume hospitals due to large heterogeneity. The final analysis included 54 919 women.

Intervention

Hospital management was engaged and facilitators were recruited from within hospitals. Available perinatal care was assessed in each hospital, followed by a bottle-neck analysis workshop. A 3-day training in essential newborn care was carried out for health workers involved in perinatal care, and a set of QI tools were introduced to be used in everyday practice (skill-checks, self-assessment checklists, scoreboards and weekly Plan–Do–Study–Act meetings). Refresher training after 6 months.

Outcome measure

Women’s satisfaction with care during childbirth (a prespecified secondary outcome).

Results

The likelihood of women being overall satisfied with care during childbirth increased after the intervention (adjusted OR (aOR): 1.66, 95% CI: 1.59 to 1.73). However, the proportions of overall satisfaction were low (control 58%, intervention 62%). Women were more likely to be satisfied with education and information from health workers after intervention (aOR: 1.34, 95% CI: 1.29 to 1.40) and to have been treated with dignity and respect (aOR: 1.81, 95% CI: 1.52 to 2.16). The likelihood of having experienced abuse during the hospital stay decreased (aOR: 0.42, 95% CI: 0.34 to 0.51) and of being satisfied with the level of privacy increased (aOR: 1.14, 95% CI: 1.09 to 1.18).

Conclusions

Improvements in patient satisfaction were indicated after the introduction of a QI-package on perinatal care. We recommend further studies on which aspects of care are most important to improve women’s satisfaction of perinatal care in hospitals in Nepal.

Trial registration number

ISRCTN30829654.
Factors affecting the implementation of guideline-based prophylactic antiemetic therapy for chemotherapy-induced nausea and vomiting in Japan: a protocol for a hospital-based qualitative study
Authors: Yaguchi-Saito Akiko , Kaji Yuki , Matsuoka Ayumu , Okuyama Ayako , Fujimori Maiko , Saito Junko , Odawara Miyuki , Otsuki Aki , Uchitomi Yosuke , Zenda Sadamoto , Shimazu Taichi
Published: June 2022

Introduction

Chemotherapy-induced nausea and vomiting (CINV) decrease patients’ quality of life and negatively impact treatment outcomes. Although standard prophylactic antiemetic therapy for acute CINV recommended by guidelines is effective, poor guideline implementation is a worldwide problem. In Japan, prophylactic antiemetic therapy is relatively well implemented for chemotherapy associated with high emetogenic risk, while implementation gaps are observed for that with low emetogenic risk.

Although most reports on factors influencing appropriate antiemetic prescription focus on physicians’ attitudes and behaviours, a more comprehensive exploration is needed since chemotherapy is expected to involve pharmacists, nurses and eventually hospital directors. The purpose of this qualitative study is to comprehensively explore the factors that influence the implementation of appropriate prophylactic antiemetic procedures at cancer care hospitals in Japan.

Methods and analysis

This study is a hospital-based qualitative study using semistructured individual interviews. The target population will be hospital directors, and chiefs (including proxies) of departments of oncology and/or chemotherapy, pharmacy and nursing, working in the hospitals, selected by purposive sampling. We will obtain information on antiemetics in chemotherapy regimens, antiemetic routine use and awareness of guidelines using prequestionnaires. Interviews will then be conducted online using an interview guide. The Consolidated Framework for Implementation Research will be used to collect and analyse the interview data. We will also create new codes inductively, as required. In addition, we will refer to the aggregate results of the Quality Indicator survey to determine the implementation of recommended antiemetic prescriptions for each hospital and discuss the relationship with influencing factors.

Ethics and dissemination

This study has been approved by the National Cancer Centre Ethics Approval Committee (approval number: 2020-305). The study findings will be disseminated via peer-reviewed journal publications and presentations to academics, policy-makers, and clinicians at scientific conferences.
Evidence mapping and overview of systematic reviews of the effects of acupuncture therapies
Authors: Lu Liming , Zhang Yuqing , Ge Shuqi , Wen Hao , Tang Xiaorong , Zeng Jing chun , Wang Lai , Zeng Zhao , Rada Gabriel , Ávila Camila , Vergara Camilo , Chen Rouhao , Dong Yu , Wei Xiaojing , Luo Wen , Wang Lin , Guyatt Gordon , Tang Chun-Zhi , Xu Neng-Gui
Published: June 2022

Objective

To provide a route map regarding systematic reviews (SRs) of acupuncture therapies that will meet two goals: (1) to identify areas in which more or better evidence is required and (2) to identify acupuncture applications that, although proven effective, remain underused in practice, and thus warrant more effective knowledge dissemination.

Eligibility criteria

We included SRs that conducted meta-analyses (MAs) of randomised controlled trials (RCTs) for this overview.

Information sources

We searched for SRs without language restrictions from January 2015 to November 2020 in four Chinese electronic databases and Epistemonikos database. And we also searched for newly published RCTs that were eligible for selected best SRs in PubMed, Medline, Cochrane Central Register of Controlled Trials, Embase and four Chinese electronic databases from its lasted search dates to November 2020.

Synthesis of results

We reanalysed the selected MAs if new primary studies were added. We used random-effect model to calculate the overall effect.

Results

Our search identified 120 SRs published in the last 5 years addressing acupuncture therapies across 12 therapeutic areas and 77 diseases and conditions. The SRs included 205 outcomes and involved 138 995 participants from 1402 RCTs. We constructed 77 evidence matrices, including 120 SRs and their included RCTs in the Epistemonikos database. Seventy-seven SRs represented the effect estimate of acupuncture therapies. Finally, we system summarised the areas of possible underutilisation of acupuncture therapies (high or moderate certainty evidence of large or moderate effects), and the areas of warranting additional investigation of acupuncture therapies (low or very low certainty evidence of moderate or large effects).

Conclusion

The evidence maps and overview of SRs on acupuncture therapies identified both therapies with substantial benefits that may require more assertive evidence dissemination and promising acupuncture therapies that require further investigation.
Lidocaine Infusion for the Management of Postoperative Pain and Delirium (LIMPP): protocol for a randomised control trial
Authors: Buren Marc Alan , Theologis Alekos , Zuraek Ariadne , Behrends Matthias , Clark Aaron J , Leung Jacqueline M
Published: June 2022

Introduction

Postoperative delirium is a frequent adverse event following elective non-cardiac surgery. The occurrence of delirium increases the risk of functional impairment, placement to facilities other than home after discharge, cognitive impairment at discharge, as well as in-hospital and possibly long-term mortality. Unfortunately, there is a dearth of effective strategies to minimise the risk from modifiable risk factors, including postoperative pain control and the analgesic regimen. Use of potent opioids, currently the backbone of postoperative pain control, alters cognition and has been associated with an increased risk of postoperative delirium. Literature supports the intraoperative use of lidocaine infusions to decrease postoperative opioid requirements, however, whether the use of postoperative lidocaine infusions is associated with lower opioid requirements and subsequently a reduction in postoperative delirium has not been investigated.

Methods and analysis

The Lidocaine Infusion for the Management of Postoperative Pain and Delirium trial is a randomised, double-blinded study of a postoperative 48-hour infusion of lidocaine at 1.33 mg/kg/hour versus placebo in older patients undergoing major reconstructive spinal surgery at the University of California, San Francisco. Our primary outcome is incident delirium measured daily by the Confusion Assessment Method in the first three postoperative days. Secondary outcomes include delirium severity, changes in cognition, pain scores, opioid use, incidence of opioid related side effects and functional benefits including time to discharge and improved recovery from surgery. Lidocaine safety will be assessed with daily screening questionnaires and lidocaine plasma levels.

Ethics and dissemination

This study protocol has been approved by the ethics board at the University of California, San Francisco. The results of this study will be published in a peer-review journal and presented at national conferences as poster or oral presentations. Participants wishing to know the results of this study will be contacted directly on data publication.

Trial registration number

NCT05010148.
Trajectories of asthma symptom presenting as wheezing and their associations with family environmental factors among children in Australia: evidence from a national birth cohort study
Authors: Shahunja K M , Sly Peter D , Chisti Md Jobayer , Mamun Abdullah
Published: June 2022

Objectives

Asthma is one of the greatest health burdens, yet contributors to asthma symptom trajectories are understudied in Australian children. We aimed to assess the trajectories of asthma symptom and their associations with several family environmental factors during the childhood period in Australia.

Design

Secondary analysis from a cross-sequential cohort study.

Setting

Nationwide representative data from the ‘Longitudinal Study of Australian Children (LSAC)’.

Participants

Participants from the LSAC birth cohort.

Outcome measures

Asthma symptom trajectory groups.

Methods

Asthma symptom presenting as wheezing, family environmental factors and sociodemographic data (2004–2018) were obtained from the LSAC. Group-based trajectory modelling was applied to identify asthma symptom trajectories and multivariable logistic regression models were used to assess the associations between these and environmental factors.

Results

Of 5107 children in the LSAC cohort, 3846 were included in our final analysis. We identified three distinct asthma symptom trajectories from age 0/1 year to 14/15 years: ‘low/no’ (69%), ‘transient high’ (17%) and ‘persistent high’ (14%). Compared with the ‘low/no’ group, children exposed to ‘moderate and declining’ (relative risk ratio (RRR): 2.22, 95% CI 1.94 to 2.54; RRR: 1.26, 95% CI 1.08 to 1.46) and ‘high and persistent’ prevalence of maternal smoking (RRR: 1.41, 95% CI 1.23 to 1.60; RRR: 1.26, 95% CI 1.10 to 1.44) were at increased risk of being classified into the ‘transient high’ and ‘persistent high’ trajectories of asthma symptom. Persistently bad external dwelling conditions (RRR: 1.27, 95% CI 1.07 to 1.51) were associated with ‘transient high’ trajectory while ‘moderate and increasing’ conditions of cluttered homes (RRR: 1.37, 95% CI 1.20 to 1.56) were associated with ‘persistent high’ trajectory of asthma symptom. Exposure to tobacco smoke inside the house also increased the risk of being in the ‘persistent high’ trajectory group (RRR: 1.30, 95% CI 1.12 to 1.50).

Conclusion

Poor home environment increased the risk of asthma symptom during childhood. Improving home environment and reducing exposure to tobacco smoke may facilitate a favourable asthma symptom trajectory during childhood.
Reactive arthritis incidence in a community cohort following a large waterborne campylobacteriosis outbreak in Havelock North, New Zealand
Authors: Walker Tiffany A , Grainger Rebecca , Quirke Terence , Roos Rebekah , Sherwood Jill , Mackereth Graham , Kiedrzynski Tomasz , Eyre Rachel , Paine Shevaun , Wood Tim , Jagroop Anita , Baker Michael G , Jones Nicholas
Published: June 2022

Objectives

In August 2016, Campylobacter spp contaminated an untreated reticulated water supply resulting in a large-scale gastroenteritis outbreak affecting an estimated 8320 people. We aimed to determine the incidence of probable reactive arthritis (ReA) cases in individuals with culture-confirmed campylobacteriosis (CC), self-reported probable campylobacteriosis (PC) and those reporting no diarrhoea (ND).

Design

We conducted a retrospective cohort study to identify incidence of probable ReA cases. We identified cases with new ReA symptoms using an adapted acute ReA (AReA) telephone questionnaire. Those reporting ≥1 symptom underwent a telephone interview with the study rheumatologist. Probable ReA was defined as spontaneous onset of pain suggestive of inflammatory arthritis in ≥1 previously asymptomatic joint for ≥3 days occurring ≤12 weeks after outbreak onset.

Setting

Population-based epidemiological study in Havelock North, New Zealand.

Participants

We enrolled notified CC cases with gastroenteritis symptom onsets 5 August 2016–6 September 2016 and conducted a telephone survey of households supplied by the contaminated water source to enrol PC and ND cases.

Results

One hundred and six (47.3%) CC, 47 (32.6%) PC and 113 (34.3%) ND cases completed the AReA telephone questionnaire. Of those reporting ≥1 new ReA symptom, 45 (75.0%) CC, 13 (68.4%) PC and 14 (82.4%) ND cases completed the rheumatologist telephone interview. Nineteen CC, 4 PC and 2 ND cases developed probable ReA, resulting in minimum incidences of 8.5%, 2.8% and 0.6% and maximum incidences of 23.9%, 12.4% and 2.15%.

Discussion

We describe high probable ReA incidences among gastroenteritis case types during a very large Campylobacter gastroenteritis outbreak using a resource-efficient method that is feasible to employ in future outbreaks.
Physical functioning outcome measures in the lumbar spinal surgery population and measurement properties of the physical outcome measures: protocol for a systematic review
Authors: Kowalski Katie L , Lukacs Michael J , Mistry Jai , Goodman Maren , Rushton Alison B
Published: June 2022

Introduction

Low back pain can lead to substantial decline in physical functioning. For disabling pain not responsive to conservative management, surgical intervention can enhance physical functioning. Measurements of physical functioning include patient-reported outcome measures and physical outcome measures using evaluations of impairments, performance on a standardised task or activity in a natural environment. Selecting outcome measures with adequate measurement properties is fundamental to evaluating effectiveness of interventions. The purpose of this systematic review is to identify outcome measures (patient reported and physical) used to evaluate physical functioning (stage 1) and assess the measurement properties of physical outcome measures of physical functioning (stage 2) in the lumbar spinal surgery population.

Methods and analysis

This protocol aligns with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Using a two-staged approach, searches will be performed in MEDLINE, EMBASE, Health and Psychosocial Instruments, CINAHL, Web of Science, Scopus, PEDro and the grey literature from inception until 15 December 2021. Stage 1 will identify studies evaluating physical functioning with patient-reported or physical outcome measures in the lumbar spinal surgery population. Stage 2 will search for studies evaluating measurement properties (validity, reliability, responsiveness) of the physical outcome measures identified in stage 1 in the lumbar spinal surgery population. Two independent reviewers will evaluate studies for inclusion, extract data, assess risk of bias (COSMIN risk of bias tool and checklist) and quality of evidence (modified Grading of Recommendations Assessment, Development and Evaluation approach). Results for each measurement property per physical outcome measure will be quantitatively pooled if there is adequate clinical and methodological homogeneity or qualitatively synthesised if there is high heterogeneity in studies.

Ethics and dissemination

Ethics approval is not required. Results will be disseminated through peer-reviewed journal publication and conference presentation.

PROSPERO registration number

CRD42021293880.
Multicentre, prospective, randomised controlled trial to evaluate hexaminolevulinate photodynamic therapy (Cevira) as a novel treatment in patients with high-grade squamous intraepithelial lesion: APRICITY phase 3 study protocol
Authors: Chen Fei , Novák Zoltán , Dannecker Christian , Mokráš Ctirad , Sui Long , Zhang Youzhong , You Zhixue , Han Ling , Lang Jinghe , Hillemanns Peter
Published: June 2022

Introduction

High-risk human papilloma virus (HPV)-associated cervical cancer is the fourth most common cancer in women worldwide. Current treatments of high-grade squamous intraepithelial lesion (HSIL) of the cervix are based on invasive surgical interventions, compromising cervical competence and functionality. APRICITY is a multicentre, prospective, double-blind, randomised controlled phase 3 study further evaluating the efficacy and safety of Cevira, an integrated drug-delivery and light-delivery device for hexaminolevulinate photodynamic therapy, which shows promise as a novel, non-invasive outpatient therapy for women with HSIL.

Methods and analysis

Patients with biopsy-confirmed HSIL histology are invited to participate in the study planned to be conducted at 47 sites in China and 25 sites in Ukraine, Russia and the European Union. The aim is to include at least 384 patients, which will be randomised to either Cevira or placebo group (2:1). All patients will be assessed 3 months after first treatment and a second treatment will be administered in patients who are HPV positive or have at least low-grade squamous intraepithelial lesion. Primary endpoint is the proportion of the responders 6 months after first treatment. Secondary efficacy and safety endpoints will be assessed at 6 months, and data for secondary performance endpoints of the Cevira device will be collected at 3 months and 6 months, in case second treatment was administered. All patients in the Cevira group will be enrolled in an open, long-term extension study for 6 months to collect additional efficacy and safety data (study extension endpoints).

Ethics and dissemination

The study was approved by the ethics committee of the Peking Union Medical College Hospital and Hannover Medical University, Germany. Findings will be disseminated through peer review publications and conference presentations.

Trial registration number

NCT04484415; clinicaltrials.gov.
Characteristics of nursing homes and early preventive measures associated with risk of infection from COVID-19 in Lazio region, Italy: a retrospective case–control study
Authors: Orlando Stefano , Mazhari Tuba , Abbondanzieri Alessio , Cerone Gennaro , Ciccacci Fausto , Liotta Giuseppe , Mancinelli Sandro , Marazzi Maria Cristina , Palombi Leonardo
Published: June 2022

Objectives

To understand which organisational–structural characteristics of nursing homes—also referred to as long-term care facilities (LTCFs)—and the preventative measures adopted in response to the pandemic are associated with the risk of a COVID-19 outbreak.

Setting

LTCFs in Lazio region in Italy.

Design

The study adopts a case–control design.

Participants

We included 141 facilities and 100 provided information for the study. Cases were defined as facilities reporting a COVID-19 outbreak (two or more cases) in March–December 2020; controls were defined as LTCFs reporting one case or zero. The exposures include the structural–organisational characteristics of the LTCFs as reported by the facilities, preventative measures employed and relevant external factors.

Results

Twenty facilities reported an outbreak of COVID-19. In binary logistic regression models, facilities with more than 15 beds were five times more likely to experience an outbreak than facilities with less than 15 beds OR=5.60 (CI 1.61 to 25.12; p value 0.002); admitting new residents to facilities was associated with a substantially higher risk of an outbreak: 6.46 (CI 1.58 to 27.58, p value 0.004). In a multivariable analysis, facility size was the only variable that was significantly associated with a COVID-19 outbreak OR= 5.37 (CI 1.58 to 22.8; p value 0.012) for larger facilities (>15 beds) versus smaller (<15 beds). Other characteristics and measures were not associated with an outbreak.

Conclusion

There was evidence of a higher risk of COVID-19 in larger facilities and when new patients were admitted during the pandemic. All other structural–organisational characteristics and preventative measures were not associated with an outbreak. This finding calls into question existing policies, especially where there is a risk of harm to residents. One such example is the restriction of visitor access to facilities, resulting in the social isolation of residents.
Cardiovascular risk factors and markers of myocardial injury and inflammation in people living with HIV in Nairobi, Kenya: a pilot cross-sectional study
Authors: Ahmed Hassan Adan , Mohamed Jeilan , Akuku Isaiah G , Lee Kuan Ken , Alam Shirjel R , Perel Pablo , Shah Jasmit , Ali Mohammed K , Eskander Sherry , Chung Michael H , Shah Anoop SV
Published: June 2022

Objectives

To determine the prevalence of cardiovascular disease (CVD) risk factors and explore associations with high-sensitivity cardiac troponin I (hscTnI) and high-sensitivity C-reactive protein (hsCRP) in people living with HIV (PLHIV) in Kenya.

Design

Pilot cross-sectional study.

Setting

Data were collected from community HIV clinics across two sites in Nairobi, Kenya, from July 2019 to May 2020.

Participants

Convenience sample of 200 PLHIV (≥30 years with no prior history of CVD).

Outcome measures

Prevalence of cardiovascular risk factors and its association with hsTnI and hsCRP levels.

Results

Across 200 PLHIV (median age 46 years, IQR 38–53; 61% women), the prevalence of hypercholesterolaemia (total cholesterol >6.1 mmol/L) and hypertension were 19% (n=30/199) and 30% (n=60/200), respectively. Smoking and diabetes prevalence was 3% (n=5/200) and 4% (n=7/200). HscTnI was below the limit of quantification (<2.5 ng/L) in 65% (n=109/169). High (>3 mg/L), intermediate (1–3 mg/L) and low (<1 mg/L) hsCRP levels were found in 38% (n=75/198), 33% (n=65/198) and 29% (n=58/198), respectively. Framingham laboratory-based risk scores classified 83% of PLHIV at low risk with 12% and 5% at intermediate and high risk, respectively. Older age (adjusted OR (aOR) per year increase 1.05, 95% CI 1.01 to 1.08) and systolic blood pressure (140–159 mm Hg (aOR 2.96; 95% CI 1.09 to 7.90) and >160 mm Hg (aOR 4.68, 95% CI 1.55 to 14) compared with <140 mm Hg) were associated with hscTnI levels. No associations were observed between hsCRP and CVD risk factors.

Conclusion

The majority of PLHIV—using traditional risk estimation systems—have a low estimated CVD risk likely reflecting a younger aged population predominantly consisting of women. Hypertension and hypercholesterolaemia were common while smoking and diabetes rates remained low. While hscTnI values were associated with increasing age and raised blood pressure, no associations between hsCRP levels and traditional cardiovascular risk factors were observed.
Non-pharmacological interventions for the prevention of type 2 diabetes in low-income and middle-income countries: a systematic review of randomised controlled trials
Authors: Sarker Anupam , Das Rina , Ether Saraban , Shariful Islam Md , Saif-Ur-Rahman K M
Published: June 2022

Objective

Diabetes poses serious health threats and economic burdens to patients, especially in low-income and middle-income countries (LMICs). This systematic review searches for non-pharmacological interventions for the prevention of type-2 diabetes mellitus (T2DM) among patients who are non-diabetic and pre-diabetic from LMICs.

Settings

LMICs.

Participants

Adult population aged over 18 years without having diabetes.

Primary and secondary outcomes

Primary outcome is to measure the change in the incidence of T2DM. The secondary outcome is to measure changes in glycated haemoglobin (HbA1c) level, weight/body mass index (BMI), fasting glucose level and 2-hour glucose from baseline of the included randomised controlled trials.

Methods

This review has been conducted following the standard systematic review guidelines. A total of six electronic databases including MEDLINE, Embase, the Cochrane Library, Web of Science, ClinicalTrials.gov and International Clinical Trials Registry Platform were searched in February 2021 using a comprehensive search strategy.

Two sets of independent reviewers performed screening, risk of bias (ROB) assessment using the Cochrane ROB tool and data extraction. Narrative coalescence of selected articles was demonstrated using tables. No meta-analysis was performed due to the lack of homogenous intervention strategies and study settings.

Result

A total of five studies were included for the review with a combined population of 1734 from three countries. Three of the studies showed a significant reduction in T2DM incidence after the intervention of physical training and dietary modifications. Four of the studies also demonstrated a significant reduction of different secondary outcomes like weight, BMI, fasting and 2-hour plasma glucose and HbA1c. All the studies demonstrated a low ROB in most of the bias assessment domains with some unclear results in allocation concealments.

Conclusions

Emphasising non-pharmacological interventions for T2DM prevention can improve health outcomes and lessen the economic burdens, which will be of paramount importance in LMICs.

Systematic review registration number

CRD42020191507
A dynamical model of radiating stars and their thermal behavior
Authors: Verma Grishma , Kumar Rajesh
Published: June 2022

In this paper, we have studied a new class dynamical model of spherically symmetric radiating collapsing stars. The solution of field equations has been discussed by using the boundary condition and obtained all the physical parameters in terms of mass M and surface radius $$R_0$$

R
0

which will be significant in astrophysical applications. We have also studied the thermal behavior of the stars and discussed the horizon formation and its temperature. We have shown that horizon temperature increases with time under certain conditions.
Harmonic flow correlations in Au+Au reactions at 1.23 AGeV: a new testing ground for the equation-of-state and expansion geometry
Authors: Reichert Tom , Steinheimer Jan , Herold Christoph , Limphirat Ayut , Bleicher Marcus
Published: June 2022

Correlations between the harmonic flow coefficients $$v_1$$

v
1

, $$v_2$$

v
2

, $$v_3$$

v
3

and $$v_4$$

v
4

of nucleons in semi-peripheral Au+Au collisions at a beam energy of 1.23 AGeV are investigated within the hadronic transport approach ultra-relativistic quantum molecular dynamics (UrQMD). In contrast to ultra-relativistic collision energies (where the flow coefficients are evaluated with respect to the respective event plane), we predict strong correlations between the flow harmonics with respect to the reaction plane. Based on an event-by-event selection of the midrapidity final state elliptic flow of nucleons we show that as a function of rapidity, (I) the sign of the triangular flow changes, (II) that the shape of $$v_4$$

v
4

changes from convex to concave, and (III) that $$v_3\propto v_1v_2$$

v
3

∝

v
1

v
2

and $$v_4\propto v_2^2$$

v
4

∝

v
2
2

for all different event classes, indicating strong correlations between all investigated harmonic flow coefficients.
Competitive Online Optimization with Multiple Inventories
Authors: Lin Qiulin , Mo Yanfang , Su Junyan , Chen Minghua
Published: June 2022

We study an online inventory trading problem where a user seeks to maximize the aggregate revenue of trading multiple inventories over a time horizon. The trading constraints and concave revenue functions are revealed sequentially in time, and the user needs to make irrevocable decisions. The problem has wide applications in various engineering domains. Existing works employ the primal-dual framework to design online algorithms with sub-optimal, albeit near-optimal, competitive ratios (CR). We exploit the problem structure to develop a new divide-and-conquer approach to solve the online multi-inventory problem by solving multiple calibrated single-inventory ones separately and combining their solutions. The approach achieves the optimal CR of łn θ + 1 if Nłeq łn θ + 1, where N is the number of inventories and θ represents the revenue function uncertainty; it attains a CR of 1/[1-e^-1/(łnθ+1) ] in [łn θ +1, łn θ +2) otherwise. The divide-and-conquer approach reveals novel structural insights for the problem, (partially) closes a gap in existing studies, and generalizes to broader settings. For example, it gives an algorithm with a CR within a constant factor to the lower bound for a generalized one-way trading problem with price elasticity with no previous results. When developing the above results, we also extend a recent CR-Pursuit algorithmic framework and introduce an online allocation problem with allowance augmentation, both of which can be of independent interest.
The Value of Cooperation
Authors: Wei Tan Chee
Published: June 2022

The well-known Additive Increase-Multiplicative Decrease (AIMD) abstraction for network congestion control was first published by Dah-Ming Chiu and Raj Jain in their seminal work [4] in 1989 and soon played a prominent part in TCP algorithm design for the Internet. The ingenuity of AIMD lies in the abstraction of Internet congestion control, and ever since its inception has also been a staple part of teaching curriculum for performance evaluation and computer networking courses at universities worldwide. In this paper, we describe teaching examples for university students to appreciate the AIMD abstraction from the theoretical aspects such as convex optimization and Perron-Frobenius theory to the data science aspect. The essence of cooperation encompassed by AIMD reverberates even in teaching networks formed by students and educators, giving rise to online classroom flipping teaching tools and data analytics to close the gap between teachers and students.
The CME method
Authors: Almousa Salah Al-Deen , Horv´ath G´abor , Horv´ath Ill ´es , M´esz´aros Andr´as , Telek Mikl ´os
Published: June 2022

Numerical inverse Laplace transformation (NILT) is an important tool in the field of system modelling and performance analysis. The recently introduced CME method has many important advantages over the alternative numerical inverse Laplace transformation (NILT) methods. It avoids Gibbs oscillation (i.e., does not generate overshoot and undershoot), preserves the monotonicity of functions, its accuracy is gradually improving with the order, and it is numerically more stable than the alternative methods. In this paper we demonstrate these advantages and introduce our tool which implements the CME method and other popular NILT methods.
Software Model Refactoring Driven by Performance Antipattern Detection
Authors: Cortellessa Vittorio , Di Pompeo Daniele , Stoico Vincenzo , Tucci Michele
Published: June 2022

The satisfaction of ever more stringent performance requirements is one of the main reasons for software evolution. However, determining the primary causes of performance degradation is generally challenging, as they may depend on the joint combination of multiple factors (e.g., workload, software deployment, hardware utilization). With the increasing complexity of software systems, classical bottleneck analysis seems to show limitations in capturing complex performance problems. Hence, in the last decade, the detection of performance antipatterns has gained momentum as an effective way to identify performance degradation causes. In this tool paper we introduce PADRE (Performance Antipattern Detection and REfactoring), a tool for: (i) detecting performance antipattern in UML models, and (ii) refactoring models with the aim of removing the detected antipatterns. PADRE has been implemented within Epsilon, which is an open-source platform for model-driven engineering, and it grounds on a methodology that allows performance antipattern detection and refactoring within the same implementation context.
LogStamp
Authors: Tao Shimin , Meng Weibin , Cheng Yimeng , Zhu Yichen , Liu Ying , Du Chunning , Han Tao , Zhao Yongpeng , Wang Xiangguang , Yang Hao
Published: June 2022

Logs are one of the most critical data for service management. It contains rich runtime information for both services and users. Since size of logs are often enormous in size and have free handwritten constructions, a typical log-based analysis needs to parse logs into structured format first. However, we observe that most existing log parsing methods cannot parse logs online, which is essential for online services. In this paper, we present an automatic online log parsing method, name as LogStamp. We extensively evaluate LogStamp on five public datasets to demonstrate the effectiveness of our proposed method. The experiments show that our proposed method can achieve high accuracy with only a small portion of the training set. For example, it can achieve an average accuracy of 0.956 when using only 10% of the data training.
Correlation-Aware Flow Consolidation for Load Balancing and Beyond
Authors: Ketabi Shiva , Buckley Matthew , Pazhooheshy Parsa , Farahvash Faraz , Ganjali Yashar
Published: June 2022

Existing load balancing solutions rely on direct or indirect measurement of rates (or congestion) averaged over short periods of time. Sudden fluctuations in flow rates can lead to significant undershooting/ overshooting of target link loads. In this paper, we make the case for taking variations and correlations of flows into account in load balancing. We propose correlation-aware flow consolidation, i.e. aggregating inversely correlated (or uncorrelated) flows into superflows and using them as building blocks for load balancing. Superflows are smoother than individual flows, and thus are easier to estimate with a higher confidence, and can reduce overshooting/ undershooting of link capacities. We present heuristic methods combined with predictive models to consolidate flows and show they can lead to significant reductions in rate standard deviations compared to correlation-agnostic solutions (up to 33% and 12% improvements at the 50th and 99th percentiles respectively for 20 superflows based on real traffic traces).
Improving detection of scanning attacks on heterogeneous networks with Federated Learning
Authors: de Carvalho Bertoli Gustavo , Pereira Júnior Lourenço Alves , Saotome Osamu
Published: June 2022

Scanning attacks are the first step in the attempt to compromise the security of systems. Machine learning (ML) has been used for network intrusion detection systems (NIDS) to protect systems by learning misbehavior based on network traffic. This paper demonstrates that Federated Learning (FL) is a promising approach to achieve better detection performance than traditional local training and inference on distributed agents. Also, this FL approach brings privacy, efficiency, and it is suitable for distributed ML-based NIDS solutions. We present a horizontal FL setup using Logistic Regression with FedAvg strategy applied to 13 agents (data silos) capable of providing an iterative process of constant learning improvement. Our results indicate a more stable learning process when observed the F1-score average, whereas the traditional NIDS approach (local trained models) present lesser performance and bigger variability to classify scanning and benign traffic. We tested our model performance on the TON_IoT dataset containing network traffic from a virtualized heterogeneous network composed of cloud, fog, and edge layers.
Effect of Hydrogen Plasma Treatment on Atomic Layer Deposited Silicon Nitride Film
Authors: Jung Chanwon , Song Seokhwi , Kim Jisoo , Park Suhyeon , Kim Byunguk , Kim Kyunghoo , Jeon Hyeongtag
Published: June 2022

Changes in the thin film properties of SiNx deposited via atomic layer deposition using remote N2 plasma were investigated based on the frequency of adding a hydrogen (H2) plasma treatment step during the process. The deposition rate decreased from 0.36 to 0.32 A cycle−1 when compared to SiNx deposited through the conventional deposition process for a thin film that was subjected to H2 treatment processes every 10th cycle, every 5th cycle, and every single cycle of SiNx deposition compared to the deposition process without H2 plasma at a temperature of 400 °C. As the hydrogen treatment process increased beyond a 5:1 ratio, the hydrogen content in the thin film increased based on secondary ion mass spectroscopy analysis, and a change in binding energy state was shown via X-ray photoelectron spectroscopy. The thin film deposited using the hydrogen plasma treatment process at a ratio of 10:1 showed similar characteristics to the SiNx thin film deposited through the conventional atomic layer deposition process and showed excellent etch resistance without an increase in the etch rate. The step coverage characteristics were increased by 16% compared to the deposition process without a H2 plasma treatment process.
Reflective narratives on unfolding ethics case vignettes: integration into the physiology course of first-year medical students
Authors: Anto Taniya , D Savitha
Published: June 2022

Unfolding case vignettes exploring ethical issues were introduced into the physiology curriculum of first-year medical students. The effectiveness of guided reflections following the case vignettes was explored. The analysis of the reflections and feedback on the program revealed that students became more empathetic. The reflections broadened their perspective and encouraged critical thinking. The analysis led to development of a rubric to grade the level of empathy, which can be used for quantitative assessment of empathy.
What Can an Organ-on-a-Chip Teach Us About Human Lung Pathophysiology?
Authors: Bai Haiqing , Ingber Donald E.
Published: June 2022

The intertwined relationship between structure and function has been key to understanding human organ physiology and disease pathogenesis. An organ-on-a-chip (organ chip) is a bioengineered microfluidic cell culture device lined by living cells and tissues that recapitulates organ-level functions in vitro. This is accomplished by recreating organ-specific tissue-tissue interfaces and microenvironmental biochemical and mechanical cues while providing dynamic perfusion through endothelium-lined vascular channels. In this review, we discuss how this emerging technology has contributed to the understanding of human lung structure-function relationships at the cell, tissue, and organ levels.
Degree‐Based Entropy for a Non‐Kekulean Benzenoid Graph
Authors: Ashraful Alam Md. , Ghani Muhammad Usman , Kamran Muhammad , Shazib Hameed Muhammad , Hussain Khan Riaz , Baig A. Q.
Published: June 2022

Tessellations of kekulenes and cycloarenes have a lot of potential as nanomolecular belts for trapping and transporting heavy metal ions and chloride ions because they have the best electronic properties and pore sizes. The aromaticity, superaromaticity, chirality, and novel electrical and magnetic properties of a class of cycloarenes known as kekulenes have been the subject of several experimental and theoretical studies. Through topological computations of superaromatic structures with pores, we investigate the entropies and topological characterization of different tessellations of kekulenes. Using topological indices, the biological activity of the underlying structure is linked to its physical properties in (QSPR/QSAR) research. There is a wide range of topological indices accessible, including degree‐based indices, which are used in this work. With the total π‐electron energy, these indices have a lot of iteration. In addition, we use graph entropies to determine the structural information of a non‐Kekulean benzenoid graph. In this article, we study the crystal structure of non‐Kekulean benzenoid graph and then calculate some entropies by using the degree‐based topological indices. We also investigate the relationship between degree‐based topological indices and degree‐based entropies. This relationship is very helpful for chemist to study the physicochemical characterization of non‐Kekulean benzenoid chemical. These numerical values correlate with structural facts and chemical reactivity, biological activities, and physical properties.
Design, Synthesis, and Biological Evaluation of Novel Pyrrolo [2,3-b] Pyridine Derivatives for Nonalcoholic Fatty Liver Disease
Authors: Ma Jialin , Li Jing , Yao Dongping , Wang Qi , Chen Xinzhou , Tao Feiyan , Chen Bin , Xie Yongmei , Bai Lang , Zhang Yiwen
Published: June 2022

Nonalcoholic fatty liver disease (NAFLD) is featured with liver fat infiltration and accumulation with no connection with overdrinking. With the rising trends and no FDA-approved drugs, NAFLD attracts global attention. In this study, we successfully synthesized 18 novel SIS3 derivatives and evaluated them for pharmacological activity. F-9 and F-15 had potent weight-losing effects. Importantly, intraperitoneal administration of F-9 at 10 mg·kg−1·day−1 for 5 weeks had the most excellent effects to reduce the weight of the body, liver, and fat, as well as adjusting serum levels of AST, ALT, TC, TG, HDL, and LDL. H&E staining showed that F-9 could suppress fat deposition and increase the adipocyte size in the liver.
Characteristics of Plantar Pressure Distribution in Diabetes with or without Diabetic Peripheral Neuropathy and Peripheral Arterial Disease
Authors: Cao Zijun , Wang Fang , Li Xuemei , Hu Jun , He Yaoguang , Zhang Jianguo
Published: June 2022

Background. Excessive plantar pressure leads to increased risk of diabetic foot ulcers. Diabetic peripheral neuropathy (DPN) and peripheral arterial disease (PAD) have been considered to be associated with alterations in gait and plantar pressure in diabetic patients. However, few studies have differentiated the effects with each of them. Objective. To investigate the plantar pressure distribution in diabetic patients, with DPN and PAD as independent or combined factors. Methods. 112 subjects were recruited: 24 diabetic patients with both DPN and PAD (DPN-PAD group), 12 diabetic patients with DPN without PAD (DPN group), 10 diabetic patients with PAD without DPN (PAD group), 23 diabetic patients without DPN or PAD, and 43 nondiabetic healthy controls (HC group). The in-shoe plantar pressure during natural walking was measured. Differences in peak pressure, contact area, proportion of high pressure area (%HP), and anterior/posterior position of centre of pressure (COP) were analysed. Results. Compared with HC group, in DPN-PAD group and DPN group, the peak pressures in all three forefoot regions increased significantly; in PAD group, the peak pressure in lateral forefoot increased significantly. The contact area of midfoot in the DPN-PAD group decreased significantly. PAD group had larger HP% of lateral forefoot, DPN group had larger HP% of inner forefoot, and DPN-PAD group had larger HP% of total plantar area. There was a significant tendency of the anterior displacement of COP in the DPN-PAD group and DPN group. No significant differences were observed between the D group and HC group. Conclusion. DPN or PAD could affect the plantar pressure distribution in diabetic patients independently or synergistically, resulting in increased forefoot pressure and the area at risk of ulcers. DPN has a more pronounced effect on peak pressure than PAD. The synergistic effect of them could significantly reduce the plantar contact area of midfoot.
The Effect of a Combined Modified Pectoral and Stellate Ganglion Block on Stress and Inflammatory Response in Patients Undergoing Modified Radical Mastectomy
Authors: Geng Jun , Wang Jing , Zhang Yaowen , Song Wenxiang , Zhu Junjia , Chen Jianqing , Wu Zhen
Published: June 2022

Background and Aims. Regional anaesthesia reports to attenuate stress and inflammatory responses associated with surgical resection; however, the effectiveness of combined nerve blocks is less often investigated. We evaluated whether a combination of a pectoral nerve block (PNB) and stellate ganglion block (SGB) is more effective than a PNB alone in reducing these responses in women undergoing modified radical mastectomy (MRM). Methods. This is a prospective randomized controlled trial. Fifty patients with breast cancer were randomly allocated to receive an ultrasound-guided PNB (

n
=
25

, PNB only group) or ultrasound-guided PNB combined with SGB (

n
=
25

, combined blockade group). The primary outcome was perioperative plasma level of interleukin- (IL-) 6. Secondary outcomes included perioperative plasma levels of cortisol, glucose, IL-8, and tumour necrosis factor- (TNF-) α, pain scores, haemodynamic variables, sleep quality, and complications postsurgery. Results. The combined blockade group exhibited significantly lower IL-6 and TNF-α levels 24 h postsurgery. Cortisol levels were significantly lower in the combined blockade group at the end of the surgery. Glucose levels at the time of incision were lower in the combined blockade group. Pain scores up to 12 h postsurgery were significantly lower in the combined blockade group, which also exhibited better perioperative haemodynamic stability. Patients in the combined blockade group reported better sleep quality on the night of surgery. Conclusion. In patients undergoing MRM, PNB combined with SGB block effectively blunted perioperative inflammatory response than PNB alone. A combined block approach can also alleviate stress response and postoperative acute pain with stable perioperative haemodynamics and better postoperative sleep quality.
Growth of InAs(Bi)/GaAs Quantum Dots under a Bismuth Surfactant at High and Low Temperature
Authors: Bailey N. J. , Carr M. R. , David J. P. R. , Richards R. D.
Published: June 2022

Indium arsenide quantum dots are of great interest for next‐generation telecom optoelectronics if their emission wavelength can be red shifted into the correct range. One method to achieve this is the deposition of a surfactant, such as bismuth, during quantum dot growth. Here, we present a series of indium arsenide quantum dot layers grown using several bismuth fluxes and two different growth temperatures. The effects of bismuth flux on quantum dot morphology and optical properties are studied by atomic force microscopy and photoluminescence measurements. Bimodal distributions of quantum dots are seen at low growth temperature, while at high temperature, a single dominant distribution is seen in most of the layers. A medium bismuth flux was seen to produce the highest integrated photoluminescence intensity at high growth temperature, whereas intensity saturates between medium and high fluxes at low growth temperatures. A significant increase in uncorrected aspect ratio seen for the layer grown with a low bismuth flux at high growth temperature presents a new opportunity for control of quantum dot morphology using bismuth.