bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling and control of nuclear–renewable integrated energy systems: Dynamic system model for green electricity and hydrogen production
Authors: Jacob Roshni Anna , Zhang Jie
Published: August 2023

The need for decarbonization and diversification of energy resources has led to the development of integrated energy systems (IESs), where multiple resources supply more than one energy sector. One such IES with small modular nuclear reactors and renewables (wind and solar) as generating resources, catering to the demand of the electric grid while producing hydrogen for industries, is modeled in this paper. The physics-based component models are represented using the Modelica language and interconnected to form the IES. The control and coordination of the overall system are ensured by designing a suitable control architecture composed of individual subsystem-level controls and supervisory control. The dynamic performance and the load-following capability of the IES are evaluated, while satisfying the safe operational limits of the components. Different configurations and modes of IES operation are considered, where the adaptability of the control system in the presence of varying demands and renewable generations is validated. The simulation results indicate that hydrogen as a flexible load facilitates the supply of varying grid demand. Additionally, the renewables are also accommodated into the IES owing to the flexibility of the balance of plant associated with the nuclear reactors.
Computational quantum chemistry of metal–organic frameworks
Authors: Choudhuri Indrani , Ye Jingyun , Truhlar Donald G.
Published: August 2023

Metal–organic frameworks (MOFs) have premium exceptional properties for a variety of functions, such as gas separation and storage and catalysis. The large variety of possible inorganometallic nodes and organic linkers provide an almost unlimited number of combinations for assembling MOFs, which makes the experimental characterization and examination of all potentially useful combinations practically impossible. Furthermore, experimental studies of MOFs typically fall short in uncovering crucial details regarding their mechanisms of action or the molecular details responsible for their functional properties, such as the nature of adsorbate binding or the structures of transition states. Computational modeling has, therefore, become an efficient and important tool for strategizing the functionalization of MOFs and explicating the mechanisms of their functions. Here, we review the computational methodologies used for computational studies of MOFs, especially Kohn–Sham density functional theory and combined quantum mechanical and molecular mechanical methods for calculating their structural, electronic, and magnetic properties, as well as for understanding the mechanisms of MOFs' applications to magetic devices, thermal conduction, gas adsorption, separation, storage, and sensing, thermal catalysis, photocatalysis, and electrocatalysis.
Hyperspectral image ground-object identification method based on spectral segment fusion combination and depth residual network
Authors: Chen Yang , Yan Junhua , Gao Yinsen , Zhang Yin , Liu Yong , Shi Mengwei
Published: August 2023

An algorithm based on the spectral segment fusion combination and deep residual network is proposed to improve the recognition accuracy of the objects of interest in the WHU-Hi dataset, particularly for cruciferous plants. The accuracy of the objects of interest was effectively improved, as well as the recognition accuracy of other ground objects, and the time efficiency was improved as well. The optimal combination of spectral segments was determined, and spatial and spectral information was extracted from the deep residual network for ground object recognition research. Experimental results showed that the classification accuracy of the cruciferous plants of interest, namely, pak choi, Brassica chinensis, and small Brassica chinensis, increased from 81.36%, 84.2%, and 83.8% to 98.32%, 99.22%, and 98.35%, respectively. In addition, the accuracy of interested trees and grass also increased from 77.6% and 89.09% to 99.12% and 98.33%, respectively, and the overall accuracy, KAPPA, and average accuracy of the three datasets were all improved. The time efficiency was also improved by an order of magnitude.
Thermo-electrical influence of graphene nano-strip on viscothermoelastic nanobeam vibration based on Lord–Shulman model
Authors: Alzahrani Mohammed Salem J. , Alghamdi Najat A. , Alshehri Hajar A.
Published: August 2023

Thermoelastic, homogeneous, and isotropic nanobeams have a significant analysis in this study that has been established within the context of the Lord–Shulman heat conduction equation. A graphene strip at the first end of the nanobeam acts as the basis for an application that includes an electrical current with a low voltage. The thermal effect of the electrical current has thermally loaded the nanobeam under constant side ratios and simply supported boundary conditions. The Laplace transform method was used to resolve the governing differential equations for the time variable. In the domain of the Laplace transform, the solutions were calculated. The numerical computation of the Laplace transform inversions was performed using Hoing’s approximation approach based on an iteration formula. Graphs illustrating various situations were used to demonstrate the numerical results for various electrical voltage and resistivity values for the graphene nano-strip. Nanobeam functions were found to be significantly influenced by electrical voltage and electrical resistance. Therefore, by varying the voltage and resistance applied to the nanobeam, vibration and temperature increments could be controlled.
Rapid calculation method for water flow rate at gas drilling site based on pressure drop
Authors: Li Yibo , Li Yongjie , Meng Yingfeng , He Xianzheng , Huang Wanni , Wang Hao
Published: August 2023

Water production in the bottom hole is a frequent occurrence during gas drilling, posing a significant threat to the safety of the process. Obtaining the water flow rate quickly is critical to making further engineering decisions. This paper proposes a rapid calculation method of water flow rate based on the principle of pressure drop. The method can quickly identify the multiphase flow pattern and calculate the flow pressure drop, thereby establishing the relationship between the gas injection pressure and the water flow rate. At the gas drilling site, the gas injection pressure is continuously monitored in real-time, which enables rapid acquisition of the real-time water flow rate. The concept of ultimate water-carrying kinetic energy is introduced, which combined with the boundary of annular flow to other flow patterns, can determine the maximum water-carrying flow rate. The feasibility of this method is validated using the field-measured data of well X8-3.
Excited dipole bound electronic states of potassium iodide anions: A theoretical perspective
Authors: Lian Yi , Xiao Lidan , Li Lulu , Bian Lili , Xu Haifeng , Yan Bing
Published: August 2023

The information about electronic excited states of molecular anions is of pivotal importance for understanding electron attachment/detachment processes. Here, we present a high-level theoretical study on electronic states of potassium iodide anions (KI−). By the evaluation of different basis sets, we present accurate spectroscopic constants of the anionic ground electronic state using the multireference configuration interaction with Davidson correction method. The equation-of-motion electron-attachment coupled-cluster singles and doubles method is carried out to calculate electron binding energies (EBEs) of electronic states. With the addition of different s-/p-/d-diffusion functions in the basis set, we have identified possible excited dipole bound states (DBSs) of KI−. The results indicate that, owing to the large dipole moment of KI molecules, the anions can hold three excited DBSs, i.e., two σ-type DBSs and one π-type DBS, with the EBEs of 39 meV (σ-DBS1), 4.7 meV (π-DBS), and only 1.8 meV (σ-DBS2) below the neutral ground state. Molecular orbitals, potential energy curves, and spectroscopic constants of DBSs are presented. Our study would shed some light on the electronic states of potassium iodide molecular anions.
Study on the evolution and stability of gas–liquid interfaces based on composite structures on the sidewall surface of a microchannel
Authors: Zhu Ming , Huang Jian , Zhou Qiang , Yao Zhaohui
Published: August 2023

The gas–liquid interface plays a crucial role in reducing the flow resistance of superhydrophobic surfaces. However, this interface is highly unstable and prone to collapse under flow shear, environmental pressure fluctuations, phase transitions, and diffusion between dissolved gases and free gases. Once the gas–liquid interface collapses, the flow resistance increases rapidly. Therefore, it is necessary to study the stability of the gas–liquid interface. This paper considers a three-dimensional-printed composite structure combining transverse posts and reentrant structures in a microchannel. This structure effectively improves the stability of the gas–liquid interface, allowing it to maintain stability even on surfaces made of hydrophilic materials. Under the effect of the transverse posts, the length of the gas–liquid interface above the groove increases from micrometers to millimeters. The lattice Boltzmann method is applied to analyze how the composite structure effectively improves the stability of the gas–liquid interface. Through analysis of the interface collapse process, the factors affecting the stability of the gas–liquid interface in this structure are explored, providing a theoretical foundation for structural optimization.
The effect of electric field on the pyrolysis of transformer insulation oil–paper based on molecular dynamics
Authors: Zhang Xiaoxing , Cai Fujin , Jin Shuo , Lin Hui , Fang Rui , Wu Yunjian
Published: August 2023

The regular operation of transformers is significantly impacted by the insulation effectiveness of the transformer insulation oil–paper. In order to explore the mechanism of the influence of an electric field on the thermal decomposition performance of insulating oil–paper, this paper simulated the process of electrothermal coupling decomposition of insulating oil–paper from the micro-level based on molecular dynamics. It was determined that the insulating oil is made up of three 16-carbon hydrocarbon molecules, while the insulating paper is made up of 30 fibrous disaccharide molecules. Using the molecular dynamics simulation approach, the pyrolysis of the insulating oil and insulating paper under various electric field strengths was simulated, and the lysis of reactants and the distribution of products were statistically examined. This paper also studied how the electric field affected the microscopic process of the insulating oil–paper pyrolysis. The findings demonstrate that under the influence of electrothermal coupling, the big molecules of the insulating oil and insulating paper are pyrolyzed to produce a variety of tiny molecules. For the insulating oil, it is easily subject to electron displacement polarization under the influence of an external electric field since it contains non-polar molecules, especially impacted by an electric field of 100 V/m. For the insulating paper, its polar nature, on the other hand, makes itself a good candidate for guiding polarization when exposed to an external electric field. So, the greater the electric field strength is, the greater the impact on the thermal decomposition of the insulating paper is.
Patient representation in New Zealand general practice and rural health case-based teaching: a quality improvement exercise
Authors: Gu Jessica , Ross Jim , Leitch Sharon
Published: August 2023

Introduction Healthcare inequity disproportionately affects minority populations in Aotearoa New Zealand. Healthcare providers may contribute to inequity due to their biases. Medical education can unintentionally promote biases by reinforcing stereotypes or limiting exposure to diversity. Teaching staff from the Department of General Practice and Rural Health suggested a need to review current teaching materials to ascertain if they have the potential to contribute to this bias. Aim The aim of this study was to review case-based teaching material to determine its representation of the New Zealand population, and whether there is potential to contribute to implicit bias. Methods Document analysis of 135 cases used to teach fourth- and fifth-year medical students in the Department of General Practice and Rural Health, Otago Medical School was performed. Demographic, clinical and social features of each case were recorded and analysed. Results Cases typically included patient age (129/135, 95.6%), sex (127/135, 94.1%) and occupation status (91/136, 66.9%). Ethnicity (31/135, 23.0%), living situation (55/135, 40.7%), relationship status (57/135, 42.2%) and sexual orientation (52/135, 40.0%) were less frequently defined. Cases typically represented the population majority norms. Discussion Case-based teaching materials require regular review and updating to match population demographics. There is potential to improve representation of diversity, and hence cultural safety, though review and revision of written teaching cases.
Ammonia volatilisation losses from urea applied to acidic cropping soils is regulated by pH buffering capacity
Authors: Hearn L. O. , Barton L. , Schwenke G. D. , Murphy D. V.
Published: August 2023

Context Ammonia (NH3) volatilisation can be a significant nitrogen (N) loss pathway in the grains industry following the surface broadcast application of urea. However, the extent of urea volatilisation from acidic soils and the soil properties that regulate this N loss pathway have not been investigated widely. Aims We conducted a laboratory incubation experiment to measure NH3 volatilisation loss potential following the broadcast application of urea prills (1–2 mm diameter; 50 kg N ha−1) onto moistened acidic and neutral cropping soils, sampled from four long-term cropping research sites. Methods The selected soils varied in pH, clay content, organic carbon, pH buffering capacity (pHBC) and cation exchange capacity. Volatilised NH3 was captured in a phosphoric acid trap after 7, 14 and 21 days and then measured using colorimetric analysis. We compared the measured NH3 losses with predicted NH3 losses derived from an existing empirical NH3 volatilisation prediction model. Key results Of the applied urea-N, 0.9–25% was volatilised. Cumulative NH3 losses were strongly related (R2 = 0.77) with soil pHBC derived from a pedotransfer function. The existing NH3 loss model generally had poor predictive capacity (RMSE = 34%). Conclusions Using clay content as a surrogate variable for pHBC in the predictive model for sandy kaolinitic soils where it is largely a function of organic carbon content can cause poor estimates of NH3 volatilisation loss potential. Implications Grain production on sandy, acidic soils with low pHBC could lead to substantial NH3 volatilisation losses if urea is broadcast.
Thinking about God increases acceptance of artificial intelligence in decision-making
Authors: Karataş Mustafa , Cutright Keisha M.
Published: August 2023

Thinking about God promotes greater acceptance of Artificial intelligence (AI)-based recommendations. Eight preregistered experiments (n= 2,462) reveal that when God is salient, people are more willing to consider AI-based recommendations than when God is not salient. Studies 1 and 2a to 2d demonstrate across a wide variety of contexts, from choosing entertainment and food to mutual funds and dental procedures, that God salience reduces reliance on human recommenders and heightens willingness to consider AI recommendations. Studies 3 and 4 demonstrate that the reduced reliance on humans is driven by a heightened feeling of smallness when God is salient, followed by a recognition of human fallibility. Study 5 addresses the similarity in mysteriousness between God and AI as an alternative, but unsupported, explanation. Finally, study 6 (n= 53,563) corroborates the experimental results with data from 21 countries on the usage of robo-advisors in financial decision-making.
Coulomb staircase in an asymmetrically coupled quantum dot
Authors: McArdle G , Davies R , Lerner I V , Yurkevich I V
Published: August 2023

We investigate the Coulomb blockade in quantum dots asymmetrically coupled to the leads for an arbitrary voltage bias focusing on the regime where electrons do not thermalise during their dwell time in the dot. By solving the quantum kinetic equation, we show that the current–voltage characteristics are crucially dependent on the ratio of the Fermi energy to charging energy on the dot. In the standard regime when the Fermi energy is large, there is a Coulomb staircase which is practically the same as in the thermalised regime. In the opposite case of the large charging energy, we identify a new regime in which only one step is left in the staircase, and we anticipate experimental confirmation of this finding.
Assesment of Drinking and Irrigation Groundwater Quality Analysing in Sasti Coal Mines and Sasti Village Rajura Tahsil Chandrapur District State Maharashtra India
Authors: Karmore Jaishree , Charpe P.S
Published: August 2023

The groundwater sample determine by 10 different location in sasti village and coal mines area. Tahsil Rajura District Chandrapur State Maharashtra India. There are main source of irrigation and drinking water. We collected bore hole and hand pump sample from 10 different location for analysing groundwater quality. Using some parameters like Total dissolve salt, pH, temperature, Hardness, Acidity, Alkalinity, CO2, chloride, calcium, Sulphate, fluoride, with concentration. This all Borehole and hand pump both are use in daily routine of drinking and irrigation purpose by human being. The result compared with the BIS Bureau of Indian standard (2012) WHO and CPCB, APHA (1998). Water quality result indicated considerable changes in physic-chemical parameters. Hydro-geological impact also responsible to causes of ground water. These is very critical for human being and critical to have an essential comprehension of the ongoing contamination status in different location in this area. Found high concentration of fluoride and other parameters in analyzing result.
Seismic performance of high rise building having a shear wall with opening and without opening
Authors: Harne V.R. , Hande Radhika
Published: August 2023

Engineers are primarily interested in determining how a structure will behave when subjected to horizontal forces, and high-rise buildings need to be sufficiently stiff to withstand the horizontal forces produced by earthquakes. Shear walls are added to the inside of the planned building in order to resist the horizontal forces, or lateral loads, produced by earthquakes and to increase the structure’s rigidity. Shear walls may have one or more functional openings, such as doors, windows, and other types of openings. The size and location of openings can vary depending on their purpose. The size and location of shear walls are critical. This study uses Response Spectrum Analysis to investigate the nature of the earthquake-exposed structure and the placement of Shear walls within a G+ 10 multi-story residential building. The storey drift, storey shear, maximum permissible displacement, and stiffness of the multi-story building with G + 10 are all examined. In accordance with IS 1893 (Part-1) 2016, the study and modelling of the entire structure are carried out for seismic zone V using the well-known FEM integrated programme Etabs. In this project, the dynamic analysis is performed on medium soil for an irregular structure. It is concluded that the structure with shear walls will show better results in terms of all the seismic parameters when compared with the structures without a shear wall and shear walls with openings.
Risk Assessment of an Old Building Exposed to Loads Beyond the Scope of its Design
Authors: Ghugal U , Bele R , Siddh S P , Geete S S
Published: August 2023

In order to save money, time, and work for expanding the current residential space for residential or illegal commercial use, many people modify the existing structure. Most of these are residential bungalows/small houses that were inherited from preceding generations. For Example, many people inherit one or two storied building which was constructed about 30-40 years ago. They modify the building for more space with some rehabilitation and repair, instead of demolishing and designing a new structure. This might save money but cause a problem later because the existing structure has already reached half its service life and increasing the size of the structure will result in introduction of even more load on the existing structure. Nowadays many people also utilize the modified residential structure for small-scale commercial use (Example: Setting up an MSME, GYM). All these factors might be a threat to the overall structure and its surroundings because the preliminary structure which has already reached more than half of its service life might not always be able to sustain the excessive loads for which it wasn’t designed.

This paper refers & analyzes a live structure by increasing the number of floors (beyond the scope of design) to check for stability, safety, and usability of the resulting structure. While considering different cases in which the structure is either used for ‘purely residential’ or ‘combined residential and small-scale commercial purposes. Finally, it concludes the preliminary risk due to the structure to the surrounding structures and residents.
River snail shell as a highly effective renewable heterogeneous base catalyst for the production of biodiesel
Authors: Loryuenyong Vorrada , Kooljaruswech Supapisit , Maneenil Supapiwat , Duangjit Surajit , Buasri Achanai
Published: August 2023

The biodiesel manufacturing process favors heterogeneous catalysts over homogeneous catalysts. The main drawbacks of using homogeneous catalysts are their non-renewable nature, separation, and washing, which can be avoided by using heterogeneous catalysts. This research looks into the shell of a river snail (Viviparidae) that has been improved with modified activated carbon (MAC) as a heterogeneous solid base catalyst for palm oil transesterification. The waste shell was repeatedly washed to remove any organic impurities attached to it and then dried in an oven. It was calcined in an air atmosphere for 2 h at a high temperature of 900 °C. The calcined sample (calcium oxide: CaO) was powdered and mixed with MAC. X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and the Brunauer-Emmet-Teller (BET) method were used to characterize the CaO/MAC (mass fraction 3:1) catalyst. In order to optimize the reaction conditions for biodiesel production, operating parameters such as methanol to oil mole ratio, catalyst amount, reaction time, and microwave electrical power were investigated. As a result, the best reaction parameters were discovered to be 12:1 methanol to oil mole ratio, 2.5 wt.% CaO/MAC based on oil weight, 4 min of reaction time, and 600 W microwave electrical power. After being reused five times, the biodiesel yield could still reach 90%, indicating that the novel catalyst had good stability and recyclability. The biodiesel fuel properties obtained in this study were compared to the international biodiesel standards ASTM D6751 and EN14214. River snail shell can be thought of as a nature-based benign and resourceful material for biodiesel production, opening up a new path for fuel sustainability.
Preparation of Copper Oxide Films by Electrochemical Deposition Technique for Extended Gate Field Effect Transistor pH Sensor
Authors: Thiwawong Thutiyaporn , Lertnawanin Kotchakorn , Tunhoo Benchapol
Published: August 2023

In this work, copper oxide (CuO) film was prepared by electrochemical deposition technique on commercial indium-tin oxide/glass substrate with two electrode configuration. The precursor solution was the 0.1 molar aqueous of copper sulfate. The films were prepared at different times of 30 to 120 second. Then, the deposited films were annealed at 450 °C to achieve CuO film. The influence of electro-deposition voltage and deposition times on structural property, morphological features had been studied. The CuO films were used to fabricate the pH sensor based on extended-gate field effect transistor (EGFET). The sensitivity and linearity of prepared device was performed in the standard buffer solutions with pH range of 2-12. It was found that the device demonstrated the sensitivity and linearity of 28.5 mV/pH and 90.1 %. It can be seen that the prepared CuO films can be used as pH sensing application with EGFET device.
Uniformity of AZO conductive film on microchannel plate by atomic layer deposition and effect of annealing on bulk resistance
Authors: Zhu Yufeng , Xu Zihao , He Huiyang , Wang Guozheng , Xia Jingxuan , Wang Ji , Yang Jikai , Li Ye
Published: August 2023

AZO(ZnO/Al2O3) conductive films were deposited in the microchannel of microchannel plate (MCP) by atomic layer deposition (ALD). The prepared films were characterized, including analysis of the thickness and composition uniformity of AZO films. The MCP bulk resistance was also measured, and the effect of annealing treatment on bulk resistance was investigated. The results suggest that the use of trimethylaluminum in the preparation of AZO composite film within the microchannel of MCP leads to corrosion of ZnO, resulting in non-uniformity in film thickness and incorrect composition of the film. The problem was resolved by increasing the pulse time of trimethylaluminum to 500 ms, resulting in the successful preparation of an AZO film with a uniform thickness and composition in the microchannel. After annealing, the bulk resistance of MCP increases while the variation of bulk resistance with voltage decreases. Specifically, the bulk resistance of the MCP having a ZnO/Al2O3 ratio of 7/2 only experiences changes of the same order of magnitude (∼108 Ω) after undergoing a 60-minute annealing process in N2 at 300 °C, thus satisfying the requirements of MCP.
Spontaneous movement of a retrotransposon generated genic dominant male sterility providing a useful tool for rice breeding
Authors: Xu Conghao , Xu Yifeng , Wang Zhengji , Zhang Xiaoyu , Wu Yuying , Lu Xinyan , Sun Hongwei , Wang Lei , Zhang Qinglu , Zhang Qinghua , Li Xianghua , Xiao Jinghua , Li Xu , Zhao Mingfu , Ouyang Yidan , Huang Xianbo , Zhang Qifa
Published: August 2023

Male sterility in plants provides valuable breeding tools in germplasm innovation and hybrid crop production. However, genetic resources for dominant genic male sterility, which hold great promise to facilitate breeding processes, are extremely rare in natural germplasm. Here we characterized the Sanming Dominant Genic Male Sterility in rice and identified the gene SDGMS using a map-based cloning approach. We found that spontaneous movement of a 1978-bp long terminal repeat (LTR) retrotransposon into the promoter region of the SDGMS gene activates its expression in anther tapetum, which causes abnormal programmed cell death of tapetal cells resulting in dominant male sterility. SDGMS encodes a ribosome inactivating protein showing N-glycosidase activity. The activation of SDGMS triggers transcription reprogramming of genes responsive to biotic stress leading to a hypersensitive response which causes sterility. The results demonstrate that an ectopic gene activation by transposon movement can give birth to a novel trait which enriches phenotypic diversity with practical utility.
Renal Safety of Long-term Tenofovir Disoproxil Fumarate Treatment in Patients With Chronic Hepatitis B
Authors: Woldemedihn Gezahegn M , Aberra Hanna , Desalegn Hailemichael , Berhe Nega , Belay Denekew Bitew , Rueegg Corina S , Johannessen Asgeir
Published: August 2023

Background

Data on renal safety of tenofovir disoproxil fumarate (TDF) treatment among individuals with chronic hepatitis B (CHB) are inconsistent. The current study aimed to assess the effect of long-term TDF treatment on renal outcomes in adult patients with CHB.

Methods

From a CHB cohort in Ethiopia, we included 233 patients treated with TDF and 126 untreated controls. Levels of creatinine and creatinine clearance over time were described in patients with and without TDF treatment. Linear mixed effects models with a treatment × time interaction were used to investigate the effect of TDF on creatinine and creatinine clearance. In treated patients only, change in creatinine and creatinine clearance was estimated separately in the first year as compared with subsequent years via linear mixed effects models.

Results

Median follow-up in the treated group was 51 months (IQR, 27–72), and 75% of patients were male (median age, 33 years; IQR, 26–40). Median follow-up in the untreated group was 69 months (IQR, 66–72), and 48% of participants were male (median age, 33 years; IQR, 27–41). We found no change in creatinine over time in TDF-treated patients as compared with a slight increase in untreated patients (P interaction = .003). There was a decrease in creatinine clearance over time in both groups, which was stronger in patients without TDF treatment (P interaction = .007). In TDF-treated patients, changes in creatinine and creatinine clearance occurred mainly within the first 12 months after treatment initiation.

Conclusions

This study showed no evidence of long-term renal toxicity of TDF treatment in patients with CHB.
The STOP COVID 2 Study: Fluvoxamine vs Placebo for Outpatients With Symptomatic COVID-19, a Fully Remote Randomized Controlled Trial
Authors: Reiersen Angela M , Mattar Caline , Bender Ignacio Rachel A , Boulware David R , Lee Todd C , Hess Rachel , Lankowski Alexander J , McDonald Emily G , Miller J Philip , Powderly William G , Pullen Matthew F , Rado Jeffrey T , Rich Michael W , Schiffer Joshua T , Schweiger Julie , Spivak Adam M , Stevens Angela , Vigod Simone N , Agarwal Payal , Yang Lei , Yingling Michael , Gettinger Torie R , Zorumski Charles F , Lenze Eric J
Published: August 2023

Background

Prior randomized clinical trials have reported benefit of fluvoxamine ≥200 mg/d vs placebo for patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods

This randomized, double-blind, placebo-controlled, fully remote multisite clinical trial evaluated whether fluvoxamine prevents clinical deterioration in higher-risk outpatients with acute coronavirus disease 2019 (COVID-19). Between December 2020 and May 2021, nonhospitalized US and Canadian participants with confirmed symptomatic infection received fluvoxamine (50 mg on day 1, 100 mg twice daily thereafter) or placebo for 15 days. The primary modified intent-to-treat (mITT) population included participants who started the intervention within 7 days of symptom onset with a baseline oxygen saturation ≥92%. The primary outcome was clinical deterioration within 15 days of randomization, defined as having both (1) shortness of breath (severity ≥4 on a 0–10 scale or requiring hospitalization) and (2) oxygen saturation <92% on room air or need for supplemental oxygen.

Results

A total of 547 participants were randomized and met mITT criteria (n = 272 fluvoxamine, n = 275 placebo). The Data Safety Monitoring Board recommended stopping early for futility related to lower-than-predicted event rates and declining accrual concurrent with vaccine availability in the United States and Canada. Clinical deterioration occurred in 13 (4.8%) participants in the fluvoxamine group and 15 (5.5%) participants in the placebo group (absolute difference at day 15, 0.68%; 95% CI, −3.0% to 4.4%; log-rank P = .91).

Conclusions

This trial did not find fluvoxamine efficacious in preventing clinical deterioration in unvaccinated outpatients with symptomatic COVID-19. It was stopped early and underpowered due to low primary outcome rates.

Clinical Trials Registration

ClinicalTrials.gov Identifier: NCT04668950.
Is a change in economic status associated with anxiety, depression and suicide ideation during the COVID-19 pandemic in South Korean adults?
Authors: Lee Eun-whan , Nam Jin Young
Published: August 2023

Background

Coronavirus disease 2019 (COVID-19) affected global economic changes and mental health outcomes. However, sex differences are unclear regarding the relationship between economic status change and mental health outcomes during the pandemic. Therefore, we investigated whether change in economic status is associated with depression, anxiety and suicidal ideation, based on sex.

Methods

We used data from the COVID-19 National Mental Health Survey 2021 in South Korea. We used the Generalized Anxiety Disorder (GAD) 7-item scale for measuring anxiety, the Patient Health Questionnaire-9 scale for measuring depression and self-reported questionnaires for investigating suicidal ideation and COVID-19-related suicidal ideation.

Results

Among 2000 participants, those with a worse economic status change had a 2.7-fold higher risk of GAD (prevalence ratio [PR], 2.70; 95% confidence interval [CI], 2.07–3.51); 2.5-fold higher depression risk (PR, 2.55; 95%CI, 2.05–3.18); 2.1-fold higher risk of suicidal ideation (PR, 2.09; 95%CI, 1.72–2.53); and 4.0-fold higher risk of COVID-19-related suicidal ideation (PR, 4.03; 95%CI, 2.78–5.83). Women whose economic status worsened had a 3.5-fold higher risk of COVID-19-related suicidal ideation (PR, 3.49; 95%CI, 2.01–6.06).

Conclusion

Worse economic change is associated with negative mental health outcomes during the COVID-19 pandemic; particularly, women experiencing financial hardships during the pandemic had a higher risk of COVID-19-related suicidal ideation.
Limb length deceleration or coronal plane deformity correction using tension band plates: does plate configurations determine the intraarticular deformity of proximal tibia?
Authors: Jain Ankit , Agarwal Anil , Patel Yogesh , Sharma Lokesh
Published: August 2023

We studied whether the two-plate tension band configuration is more prone for intraarticular deformations than the single plate application used for coronal plane deformities (CPD). The study was based on radiological chart review (retrospective cross-sectional) of records of children [15 patients (30 plates) with limb length discrepancies (LLD) and 20 patients (36 plates) with CPD]. Interscrew angle, slope angle, and roof angle were compared in the initial postoperative and final radiographs to determine changes of tibial morphology. The mean patient age and follow up for the LLD and CPD groups respectively were 6.5 years, 39.8 months and 8.1 years, 15.5 months respectively. The interscrew angles widened between initial and final radiographs in the CPD group and for both sides in the LLD group. The initial and final slope angles were not significantly different in both LLD and CPD groups. Similar trend was observed for roof angle in either group. In the intergroup comparisons between LLD and CPD group, the slope angle of medial/lateral operated side in LLD group versus that of the operated side in CPD group matched statistically in the final radiographs. Similarly, the final roof angle in LLD and CPD groups was statistically similar. No significant intraarticular morphological change was demonstrated following tension band plating epiphysiodesis of the proximal tibia for our series involving young children. It was observed neither with the two-plate configuration used for limb length decelerations nor with the single plate application for coronal plane corrections.
Changes in process and outcome for ST elevation myocardial infarction in central China from 2011 to 2018
Authors: Zhang You , Wang Shan , Qi Datun , Wang Xianpei , Li Muwei , Zhu Zhongyu , Cheng Qianqian , Hu Dayi , Gao Chuanyu
Published: August 2023

Background:

Limited data are available on the changes in the quality of care for ST elevation myocardial infarction (STEMI) during China's health system reform from 2009 to 2020. We aimed to assess the changes in care processes and outcome for STEMI patients in Henan province of central China between 2011 and 2018.

Methods:

We compared the data from the Henan STEMI survey conducted in 2011–2012 (n = 1548, a cross-sectional study) and the Henan STEMI registry in 2016–2018 (n = 4748, a multicenter, prospective observational study). Changes in care processes and in-hospital mortality were determined. Process of care measures included reperfusion therapies, aspirin, P2Y12 antagonists, β-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and statins. Therapy use was analyzed among patients who were considered ideal candidates for treatment.

Results:

STEMI patients in 2016–2018 were younger (median age: 63.1 vs. 63.8 years) with a lower proportion of women (24.4% [1156/4748] vs. 28.2 [437/1548]) than in 2011–2012. The composite use rate for guideline-recommended treatments increased significantly from 2011 to 2018 (60.9% [5424/8901] vs. 82.7% [22,439/27,129], P <0.001). The proportion of patients treated by reperfusion within 12 h increased from 44.1% (546/1237) to 78.4% (2698/3440) (P <0.001) with a prolonged median onset-to-first medical contact time (from 144 min to 210 min, P <0.001). The use of antiplatelet agents, statins, and β-blockers increased significantly. The risk of in-hospital mortality significantly decreased over time (6.1% [95/1548] vs. 4.2% [198/4748], OR: 0.67, 95% CI: 0.50–0.88, P = 0.005) after adjustment.

Conclusions:

Gradual implementation of the guideline-recommended treatments in STEMI patients from 2011 to 2018 has been associated with decreased in-hospital mortality. However, gaps persist between clinical practice and guideline recommendation. Public awareness, reperfusion strategies, and construction of chest pain centers need to be further underscored in central China.
Amplitude Integrated Electroencephalography: Simulated Assessment of Neonatal Seizure Detection in PICU Patients
Authors: MacDarby Laura J. , Byrne Lauren K. , O’Brien Emily T. , Curley Gerard F. , Healy Martina , McHugh John C.
Published: August 2023

OBJECTIVES:

Amplitude integrated electroencephalography (aEEG) is a mainstay of care in neonatal ICUs; however, knowledge gaps exist in relation to its accuracy for identifying seizures in older children. We aimed to review the diagnostic accuracy of existing neonatal seizure detection criteria for seizure detection in older children in hospital.

DESIGN:

Retrospective study.

SETTING:

PICU/Neurophysiology Department in Dublin.

PATIENTS:

One hundred twenty patients (2 mo to 16 yr old) were chosen from a database of formal 10–20 system, 21-lead electroencephalography recordings (2012–2020), comprising 30 studies with seizures, 90 without.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Electroencephalography studies containing electrographic seizures (ESzs) were annotated to describe number, duration, distribution, and spread. Two-channel aEEG (using leads C3–P3, C4–P4) recordings were generated and independently reviewed by a professional specialist in clinical neurophysiology blinded to outcome and without reference to the raw electroencephalography trace. Logistic regression was used to identify factors associated with correct seizure identification on aEEG. Median patient age was 6.1 years. Abnormal recordings featured 123 seizures. Status epilepticus (SE) was evident by electroencephalography in 10 cases. Using neonatal criteria, aEEG had a sensitivity of 70% and negative predictive value of 90% for identifying any ESz. Accurate detection of individual seizures was diminished when seizures were very short or occurred during waking. Sensitivity for individual seizures was 81% when seizures less than 1 minute were excluded. aEEG correctly identified SE in 70% of the 10 cases, although ESz were confirmed to be present in 80% of this subpopulation.

CONCLUSIONS:

aEEG criteria for neonatal seizure identification can be applied with caution to older children and should be supplemented by formal electroencephalography. Seizure identification is better for longer seizures and those arising from sleep. SE is not always recognized by aEEG among older children.
Reducing Postoperative Length of Stay for Idiopathic Scoliosis Patients using Quality Improvement Methodology
Authors: Seilhamer Crystal , Miller Kelly , Holstine Jessica
Published: August 2023

INTRODUCTION:

Approximately 1%–3% of the US population is diagnosed with scoliosis. In addition, 80% of those diagnosed have idiopathic scoliosis, with about 10% requiring surgical intervention. This Quality Improvement initiative aimed to reduce the length of stay (LOS) after posterior spinal fusion for these patients. According to the Pediatric Health Information System, our institution had a poorer performance, with an actual LOS greater than or equal to the expected LOS compared with peer institutions.

METHODS:

The aim was to increase the percentage of idiopathic scoliosis patients with a procedure to discharge LOS of less than or equal to 4 days after posterior spinal fusion from 39.13% to 90%. Interventions included implementing a new pain management protocol, a daily checklist, education on expectations of postoperative pain, and updated order sets.

RESULTS:

Interventions improved patients discharged in less than 4 days from 39.13% to 93.48% (P ≤ 0.001), reducing the average postprocedure LOS from 4.93 to 2.59 (P ≤ 0.001) days. A key process measure tracked was the percentage of patients off the patient-control analgesia pump by postoperative day 2, which increased from 13% to 97.75% (P ≤ 0.001). These improvements did not affect the balancing measure of readmissions or Emergency Department visits for pain.

CONCLUSIONS:

By implementing a more standardized pathway, including a patient-focused daily checklist for providers and families, we established expectations for LOS and pain. This checklist and updates to the pain management protocol successfully reduced the length of stay in idiopathic scoliosis patients after posterior spinal fusion.
Effectiveness of Human-Supported and Self-Help eHealth Lifestyle Interventions for Patients With Cardiometabolic Risk Factors: A Meta-Analysis
Authors: Cohen Rodrigues Talia R. , Breeman Linda D. , Kinik Asena , Reijnders Thomas , Dusseldorp Elise , Janssen Veronica R. , Kraaijenhagen Roderik A. , Atsma Douwe E. , Evers Andrea W.M. ,   on behalf of the BENEFIT consortium
Published: August 2023

Objective

eHealth is a useful tool to deliver lifestyle interventions for patients with cardiometabolic diseases. However, there are inconsistent findings about whether these eHealth interventions should be supported by a human professional, or whether self-help interventions are equally effective.

Methods

Databases were searched between January 1995 and October 2021 for randomized controlled trials on cardiometabolic diseases (cardiovascular disease, chronic kidney disease, type 1 and 2 diabetes mellitus) and eHealth lifestyle interventions. A multilevel meta-analysis was used to pool clinical and behavioral health outcomes. Moderator analyses assessed the effect of intervention type (self-help versus human-supported), dose of human support (minor versus major part of intervention), and delivery mode of human support (remote versus blended). One hundred seven articles fulfilled eligibility criteria and 102 unique (N = 20,781) studies were included.

Results

The analysis showed a positive effect of eHealth lifestyle interventions on clinical and behavioral health outcomes (p < .001). However, these effects were not moderated by intervention type (p = .169), dose (p = .698), or delivery mode of human support (p = .557).

Conclusions

This shows that self-help eHealth interventions are equally effective as human-supported ones in improving health outcomes among patients with cardiometabolic disease. Future studies could investigate whether higher-quality eHealth interventions compensate for a lack of human support.

Meta-analysis registration: PROSPERO CRD42021269263.
Percutaneous treatment of liver hydatid cysts: to PAIR or not to PAIR
Authors: Akhan Okan
Published: August 2023

Purpose of review

The aim is to review recent literature for percutaneous treatment of liver hydatid cysts (cystic echinococcosis: CE) via different techniques such as PAIR (puncture, aspiration, injection, and reaspiration), standard catheterization, and modified catheterization technique (MoCaT).

Recent findings

PAIR is an established technique and considered to be safe and effective for CE1 and CE3a as it is associated with lower morbidity, mortality, recurrence, and shorter hospital stay as compared with surgery. Standard catheterization is also dedicated for the treatment of CE1 and CE3a. PAIR should be preferred for treatment of liver CE1 and CE3a cysts, since PAIR is associated with lower major complication rates and shorter hospital stay. However, standard catheterization technique is indicated when cysto-biliary fistula develops or any technical difficulty arises during the PAIR. In these cases it is needed to switch PAIR to standard catheterization to complete the procedure.

For CE1 and CE3a cysts, PAIR and standard catheterization are the choice for percutaneous treatments, while MoCaT is a treatment option for CE2 and CE3b cysts.
Early decreased respiratory chain capacity in resuscitated experimental sepsis is a major contributor to lactate production
Authors: von Seth Magnus , Hillered Lars , Otterbeck Alexander , Hanslin Katja , Larsson Anders , Sjölin Jan , Lipcsey Miklós
Published: August 2023

Background

Increased plasma lactate levels in patients with sepsis may be due to insufficient oxygen delivery, but mitochondrial dysfunction or accelerated glycolysis may also contribute. We studied the effect of the latter on muscle metabolism by using microdialysis in a sepsis model with sustained oxygen delivery and decreased energy consumption or mitochondrial blockade.

Methods

Pigs were subjected to continuous E. coli infusion (sepsis group, n = 12) or saline infusion (sham group, n = 4) for 3 hours (h). Protocolized interventions were applied to normalize the oxygen delivery and blood pressure. Microdialysis catheters were used to monitor muscle metabolism (naïve). The same catheters were used to block the electron transport chain with cyanide or the Na+/K+-ATPase inhibitor, ouabain locally.

Results

All pigs in the sepsis group had positive blood cultures and a Sequential Organ Failure Assessment (SOFA) score increase by at least 2, fulfilling the sepsis criteria. Plasma lactate was higher in the sepsis group than in the sham group (p < 0.001), whereas muscle glucose was lower in the sepsis group (p < 0.01). There were no changes in muscle lactate levels over time but lactate to pyruvate ratio (LPR) was elevated in the Sepsis vs. the Sham group (p < 0.05). Muscle lactate, LPR, and glutamate levels were higher in the sepsis group than in the sham group in the cyanide catheters (p < 0.001, all comparisons) and did not normalize in the former group.

Conclusions

In this experimental study on resuscitated sepsis, we observed increased aerobic metabolism and preserved mitochondrial function. Sepsis and electron transport chain inhibition led to increased LPR, suggesting a decreased mitochondrial reserve capacity in early sepsis.