bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma-enhanced atomic layer deposition of titanium molybdenum nitride: Influence of RF bias and substrate structure
Authors: Chowdhury Md. Istiaque , Sowa Mark , Van Meter Kylie E. , Babuska Tomas F. , Grejtak Tomas , Kozen Alexander C. , Krick Brandon A. , Strandwitz Nicholas C.
Published: August 2021

In this work, TiMoN thin films were deposited by plasma-enhanced atomic layer deposition with an equal number of Ti and Mo precursor exposures at a substrate temperature of 250 °C. Tetrakis(dimethylamido) titanium and bis(tert-butylimido)bis(dimethylamido) molybdenum were used as sources for Ti and Mo, respectively. N2 and N2/H2 plasma were used, respectively, for TiN and MoN cycles as a source for N. Negative RF substrate bias voltage of magnitude, |Vbias|, of 0, 31, 62, 125, and 188 V were applied during the plasma half cycle. Nanocrystalline rock salt crystal structures were found by x-ray diffraction for films deposited on single-crystal Si and Si-thermal oxide substrates. Applying |Vbias| generated voids by the bombardment of high-energy ions, lowering the density. Further increase of |Vbias| caused the annihilation of voids and a slight increase in density. Four-point probe measurement showed increased electrical resistivity due to a reduction in grain size caused by continuous renucleation during growth. High-energy ions at high |Vbias| sputtered away the films resulting in low growth rates. Stripe test revealed inferior wear rates and coefficients of friction at higher |Vbias| due to low-density porous films. Epitaxial films deposited on c-plane sapphire had (111) orientation and considerable mosaicity with twinned domains rotated at 60° to each other.
Atomic layer deposition onto fabrics of carbon and silicon carbide fibers: Preparation of multilayers comprising alumina, titania-furfuryl alcohol hybrid, and titanium phosphate
Authors: Dill Pauline , Pachel Florian , Militzer Christian , Held Alexander , Puchas Georg , Knohl Stefan , Krenkel Walter , Tegenkamp Christoph , Goedel Werner Andreas
Published: August 2021

High temperature-resistant fabrics can be used as a reinforcement structure in ceramic matrix composites. They often need a coating for oxidation protection and mechanical decoupling from the matrix. Atomic layer deposition (ALD) provides very thin conformal coatings even deep down into complex or porous structures and thus might be a suitable technique for this purpose. Carbon fiber fabrics (size 300 mm × 80 mm) and SiC fiber fabrics (size 400 mm × 80 mm) were coated using ALD with a multilayer system: a first layer made of 320 cycles of alumina (Al2O3) deposition, a second layer made of 142 cycles of titania-furfuryl alcohol hybrid (TiO2-FFA), and a third layer made of 360 cycles of titanium phosphate (TixPOy). Scanning electron microscopy reveals that the coatings are uniform and that the thickness of each layer is almost independent of the place in the reactor while coating. Appearance and thickness do not show any dependence on the type of fiber used as a substrate. Energy dispersive x-ray spectroscopy confirmed the expected elemental composition of each layer. Thermogravimetric analysis under oxidizing environment revealed that the first layer increases the onset temperature of fiber oxidation significantly, while the following two layers improve the oxidative protection only to a much smaller degree. Varying the geometry and size of the sample holder and especially the stacking of several fabric specimens on top of each other allowed increasing the total area of coated fabric up to 560 cm2 per batch. It was demonstrated that four-layered fiber coatings could be obtained with high uniformity even on these much more complicated geometries.
Erratum: Hybrid millidecade spectra: A practical format for exchange of long-term ambient sound data [JASA Express Lett. 1(1), 011203 (2021)]
Authors: Bruce Martin S. , Gaudet Briand J. , Klinck Holger , Dugan Peter J. , Miksis-Olds Jennifer L. , Mellinger David K. , Mann David A. , Boebel Olaf , Wilson Colleen C. , Ponirakis Dimitri W. , Moors-Murphy Hilary
Published: August 2021

In the original paper [JASA Express Lett. 1(1), 011203 (2021)], a method for processing, storing, and sharing high-bandwidth, passive acoustic spectral data that optimizes data volume while maintaining reasonable data resolution was proposed. The format was a hybrid that uses 1-Hz resolution up to 455 Hz and millidecade frequency bands above 455 Hz. The choice of 455 Hz was based on a method of computing the edge frequencies of millidecade bands that is not compatible with summing millidecades to decidecades. This has been corrected. The new transition frequency is the first frequency with a millidecade with greater than 1 Hz, 435 Hz.
Do Physical Education Teachers Use Socioconstructivist Communication Patterns in Their Classes?
Authors: García-Fariña Abraham , Jiménez Jiménez Francisco , Anguera M. Teresa
Published: August 2021

Purpose: This study aims to identify socioconstructivist communication patterns used by physical education teachers and their evolution after participating in a training intervention. Method: The authors analyzed 812 units (messages containing constructivist discursive strategies) employed by two physical education teachers in two teaching modules using observational methodology. The data were analyzed by polar coordinate analysis. Results: In the pretraining phase, Teacher 1 presents two discursive patterns with questions–answers–literal incorporation of student-answers into the teachers’ communication, and another formed by praise questions. Teacher 2 generated praise-questions only. In the posttraining phase, Teacher 1 maintains one of the initial patterns and generates another consisting of questions-incorporation of students’ actions into the teacher’s communication. Teacher 2 incorporates two new patterns composed of information demands that are associated with the use of a specific frame of reference, or meta-statement. Discussion: The use of polar coordinate analysis revealed the presence of communication patterns and their evolution. Conclusion: The training intervention has resulted in changes in the communicative patterns of teachers. The custom-made instrument has allowed knowing the discursive strategies
Genetics papers from China face ethical scrutiny
Authors: Normile Dennis
Published: August 2021

Questions about consent and potential for abuse trigger investigations
Daily energy expenditure through the human life course
Authors: Pontzer Herman , Yamada Yosuke , Sagayama Hiroyuki , Ainslie Philip N. , Andersen Lene F. , Anderson Liam J. , Arab Lenore , Baddou Issaad , Bedu-Addo Kweku , Blaak Ellen E. , Blanc Stephane , Bonomi Alberto G. , Bouten Carlijn V. C. , Bovet Pascal , Buchowski Maciej S. , Butte Nancy F. , Camps Stefan G. , Close Graeme L. , Cooper Jamie A. , Cooper Richard , Das Sai Krupa , Dugas Lara R. , Ekelund Ulf , Entringer Sonja , Forrester Terrence , Fudge Barry W. , Goris Annelies H , Gurven Michael , Hambly Catherine , El Hamdouchi Asmaa , Hoos Marjije B. , Hu Sumei , Joonas Noorjehan , Joosen Annemiek M. , Katzmarzyk Peter , Kempen Kitty P. , Kimura Misaka , Kraus William E. , Kushner Robert F. , Lambert Estelle V. , Leonard William R. , Lessan Nader , Martin Corby , Medin Anine C. , Meijer Erwin P. , Morehen James C. , Morton James P. , Neuhouser Marian L. , Nicklas Teresa A. , Ojiambo Robert M. , Pietiläinen Kirsi H. , Pitsiladis Yannis P. , Plange-Rhule Jacob , Plasqui Guy , Prentice Ross L. , Rabinovich Roberto A. , Racette Susan B. , Raichlen David A. , Ravussin Eric , Reynolds Rebecca M. , Roberts Susan B. , Schuit Albertine J. , Sjödin Anders M. , Stice Eric , Urlacher Samuel S. , Valenti Giulio , Van Etten Ludo M. , Van Mil Edgar A. , Wells Jonathan C. K. , Wilson George , Wood Brian M. , Yanovski Jack , Yoshida Tsukasa , Zhang Xueying , Murphy-Alford Alexia J. , Loechl Cornelia , Luke Amy H. , Rood Jennifer , Schoeller Dale A. , Westerterp Klaas R. , Wong William W. , Speakman John R. ,   IAEA DLW Database Consortium§
Published: August 2021

A lifetime of change

Measurements of total and basal energy in a large cohort of subjects at ages spanning from before birth to old age document distinct changes that occur during a human lifetime. Pontzer
et al
. report that energy expenditure (adjusted for weight) in neonates was like that of adults but increased substantially in the first year of life (see the Perspective by Rhoads and Anderson). It then gradually declined until young individuals reached adult characteristics, which were maintained from age 20 to 60 years. Older individuals showed reduced energy expenditure. Tissue metabolism thus appears not to be constant but rather to undergo transitions at critical junctures. —LBR
Boridene: Two-dimensional Mo
4/3
B
2-x
with ordered metal vacancies obtained by chemical exfoliation
Authors: Zhou Jie , Palisaitis Justinas , Halim Joseph , Dahlqvist Martin , Tao Quanzheng , Persson Ingemar , Hultman Lars , Persson Per O. Å. , Rosen Johanna
Published: August 2021

Boridene: a 2D boride

A range of two-dimensional (2D) materials, including graphene and hexagonal boron nitride, have been synthesized and studied because of the unusual properties that occur when one dimension becomes very small. MXenes are a family of materials made of layers of inorganic transition metal carbides and nitrides that are a few atoms thick and are manufactured by selective etching. Attempts to make similar boridene materials have been challenging because of the reactive nature of boride phases and because the parent materials tend to dissolve rather than selectively etch. Zhou
et al
. synthesized boridene in the form of single-layer 2D molybdenum boride sheets by selective etching in aqueous hydrofluoric acid to produce sheets with ordered metal vacancies, opening up an additional family of materials for study. —MSL
Chemically recyclable thermoplastics from reversible-deactivation polymerization of cyclic acetals
Authors: Abel Brooks A. , Snyder Rachel L. , Coates Geoffrey W.
Published: August 2021

Tough recyclable polyacetals

Cyclic acetals such as dioxolane are appealing building blocks for recyclable plastics but have proven to be difficult to polymerize controllably. Abel
et al
. show that optimal pairing of a bromomethyl ether and indium or zinc Lewis acid produces polydioxolane with high tensile strength that may be advantageous for packaging applications. Heating this plastic in strong acid easily breaks it back down to its acetal monomer, which can then be recovered by distillation from mixed plastic waste streams in high yield. —JSY
Spatial transcriptomics of planktonic and sessile bacterial populations at single-cell resolution
Authors: Dar Daniel , Dar Nina , Cai Long , Newman Dianne K.
Published: August 2021

Spying on microbial communities, cell by cell

Within any community of organisms, gene expression is heterogeneous, which can manifest in genetically identical individuals having a different phenotype. One has to look at individuals in context and analyze patterns in both space and time to see the full picture. Aiming to fill a gap in current methods, Dar
et al
. developed a transcriptome-imaging method named parallel sequential fluorescence in situ hybridization (par-seqFISH). They applied this technique to the opportunistic pathogen
Pseudomonas aeruginosa
, focusing on biofilms where growth conditions can change at microscopic scale. Development of these communities, as revealed by mRNA composition, were followed in space and time. The results revealed a heterogeneous phenotypic landscape, with oxygen availability shaping the metabolism at a spatial scale of microns within a single contiguous biofilm segment. This tool should be applicable to complex microbial communities in the environment and the human microbiome. —MAF
Secreted pectin monooxygenases drive plant infection by pathogenic oomycetes
Authors: Sabbadin Federico , Urresti Saioa , Henrissat Bernard , Avrova Anna O. , Welsh Lydia R. J. , Lindley Peter J. , Csukai Michael , Squires Julie N. , Walton Paul H. , Davies Gideon J. , Bruce Neil C. , Whisson Stephen C. , McQueen-Mason Simon J.
Published: August 2021

Potato pectin falls to
Phytophthora

Phytophthora infestans
is a plant oomycete pathogen that drove the potato famines of the 1800s and continues to afflict potato fields today. The polysaccharide pectin makes up about a third of the cell wall in potatoes. Sabbadin
et al
. identified a family of lytic polysaccharide monooxygenases (LMPOs) that cleave pectin and are upregulated in
P. infestans
during infection. Silencing the relevant LMPO gene successfully inhibited
P. infestans
infections. These findings open doors for disease intervention targets and for biotech applications. —PJH
Draft Genome Sequence of Stenotrophomonas maltophilia Strain PE591, a Polyethylene-Degrading Bacterium Isolated from Savanna Soil
Authors: Frederico Tayná Diniz , Peixoto Julianna , de Sousa Jéssica Fernandes , Vizzotto Carla Simone , Steindorff Andrei Stecca , Pinto Otávio Henrique Bezerra , Krüger Ricardo Henrique
Published: August 2021

We report the genome sequence of a polyethylene-degrading bacterial strain identified as
Stenotrophomonas maltophilia
strain PE591, which was isolated from plastic debris found in savanna soil. The genome was assembled in 16 scaffolds with a length of 4,751,236 bp, a GC content of 66.5%, and 4,432 predicted genes.
Curved orogenic belts, back-arc basins, and obduction as consequences of collision at irregular continental margins
Authors: Schliffke Nicholas , van Hunen Jeroen , Gueydan Frédéric , Magni Valentina , Allen Mark B.
Published: August 2021

Continental collisions commonly involve highly curved passive plate margins, leading to diachronous continental subduction during trench rollback. Such systems may feature back-arc extension and ophiolite obduction postdating initial collision. Modern examples include the Alboran and Banda arcs. Ancient systems include the Newfoundland and Norwegian Caledonides. While external forces or preexisting weaknesses are often invoked, we suggest that ophiolite obduction can equally be caused by internal stress buildup during collision. Here, we modeled collision with an irregular subducting continental margin in three-dimensional (3-D) thermo-mechanical models and used the generated stress field evolution to understand resulting geologic processes. Results show how tensional stresses are localized in the overriding plate during the diachronous onset of collision. These stresses thin the overriding plate and may open a back-arc spreading center. Collision along the entire trench follows rapidly, with inversion of this spreading center, ophiolite obduction, and compression in the overriding plate. The models show how subduction of an irregular continental margin can form a highly curved orogenic belt. With this mechanism, obduction of back-arc oceanic lithosphere naturally evolves from a given initial margin geometry during continental collision.
Primary lung sarcoma with gastric metastasis and morphological divergence presenting as melena
Authors: Eiswerth Michael J , Pinter Alexander , Reynolds Samuel Benjamin , Guardiola John
Published: August 2021

A 61-year-old man was admitted to the medical intensive care unit following a 2-week history of weakness, lightheadedness and melena resulting in an acute anaemia. Upper endoscopy revealed multiple large gastric masses without evidence of active bleeding. CT of the chest revealed a large right upper lobe mass with bony destruction of the third rib and invasion into the anterior chest wall and mediastinum, as well as a soft-tissue density in the left kidney. Biopsy and histopathological review of both pulmonary and gastric masses revealed two distinct sarcomatous malignancies that, while both from a primary lung source, differed in their morphology. Natural history and behaviour are not well understood in sarcomas due to their rarity, but abdominal metastasis is considered an uncommon event in the progression of the disease. Gastrointestinal bleeding as the presenting symptom of a primary lung sarcoma is an atypical finding with no previously reported cases.
How B-Lynch suture and bilateral internal iliac artery ligation saved the uterus of a young patient with severe postpartum haemorrhage
Authors: Win San San , Lasimbang Helen Benedict , Lynn AUng Sai Nay , Yeap Tat Boon
Published: August 2021

Obstetric haemorrhage is the leading cause of maternal death worldwide (27.1%) and more than 66% of its deaths were classified as postpartum haemorrhage (PPH). The most common cause of PPH is uterine atony. Obstetrician should be skillful in managing obstetric emergencies; especially pertaining to PPH. Application of the B-Lynch suture on an atonic uterus is one of the surgical options in PPH patients who wish to conserve the uterus and it has a very high success rate.

We present a primigravida patient who developed massive primary PPH followed by disseminated intravascular coagulation, which was successfully managed with B-Lynch suture and bilateral internal iliac artery ligation. We described in detail regarding the management of massive PPH and application of these surgical procedures on the atonic uterus with an attempt to preserve the uterus and future fertility in this young patient.
Building the evidence base for global health policy: the need to strengthen institutional networks, geographical representation and global collaboration
Authors: Jakab Zsuzsanna , Selbie Duncan , Squires Neil , Mustafa Saqif , Saikat Sohel
Published: August 2021

National public health institutes and WHO collaborating centres, and their global networks, are a key resource to support public health system strengthening with essential public health functions and generate evidence for health policy central to national health and socioeconomic development. The COVID-19 pandemic has laid bare global inequities in public health capacities, made urgent the need to examine sources of global knowledge and understand how to better invest in and use public health institutes and their capacities. This analysis paper incorporates experiences and perspectives from the WHO and International Association of National Public Health Institutes including the ongoing pandemic and work conducted in the UK-WHO ‘Tackling Deadly Diseases in Africa Programme’. We acknowledge geographical disparities in public health capacities both within and across countries and regions, provide examples of novel ways of working for global health actors, and define the challenging environment in which public health authorities operate. We identify four incentives for all countries to invest in public health and strengthen institutions: (1) transparency and trust; (2) socioeconomic dividends; (3) collective health protection and (4) knowledge sharing and equity. By pursuing shared priorities; enabling voices from low-resource settings to be more equitably heard; facilitating collaboration and learning within and across regions, we articulate actionable next steps to develop and better harness public health institutes and international networks.
Predictive modeling of COVID-19 case growth highlights evolving racial and ethnic risk factors in Tennessee and Georgia
Authors: Gray Jamieson D , Harris Coleman R , Wylezinski Lukasz S , Spurlock, III Charles F
Published: August 2021

Introduction

The SARS-CoV-2 (COVID-19) pandemic has exposed the need to understand the risk drivers that contribute to uneven morbidity and mortality in US communities. Addressing the community-specific social determinants of health (SDOH) that correlate with spread of SARS-CoV-2 provides an opportunity for targeted public health intervention to promote greater resilience to viral respiratory infections.

Methods

Our work combined publicly available COVID-19 statistics with county-level SDOH information. Machine learning models were trained to predict COVID-19 case growth and understand the social, physical and environmental risk factors associated with higher rates of SARS-CoV-2 infection in Tennessee and Georgia counties. Model accuracy was assessed comparing predicted case counts to actual positive case counts in each county.

Results

The predictive models achieved a mean R2of 0.998 in both states with accuracy above 90% for all time points examined. Using these models, we tracked the importance of SDOH data features over time to uncover the specific racial demographic characteristics strongly associated with COVID-19 incidence in Tennessee and Georgia counties. Our results point to dynamic racial trends in both states over time and varying, localized patterns of risk among counties within the same state. For example, we find that African American and Asian racial demographics present comparable, and contrasting, patterns of risk depending on locality.

Conclusion

The dichotomy of demographic trends presented here emphasizes the importance of understanding the unique factors that influence COVID-19 incidence. Identifying these specific risk factors tied to COVID-19 case growth can help stakeholders target regional interventions to mitigate the burden of future outbreaks.
Probiotics for the prevention of antibiotic-associated diarrhoea: a systematic review and meta-analysis
Authors: Goodman Clare , Keating Georgia , Georgousopoulou Ekavi , Hespe Charlotte , Levett Kate
Published: August 2021

Objective

To evaluate existing evidence for the use of probiotics in preventing antibiotic-associated diarrhoea (AAD) in adults.

Design

Systematic review and meta-analysis of randomised controlled trials (RCTs).

Data sources

We performed a literature search of the electronic databases CINAHL Plus, EMBASE, MEDLINE (Ovid) and Web of Science from database inception to May 2021 as well as hand searching of trial registries and reference lists of related reviews.

Study selection

Two reviewers identified whether RCTs met the following inclusion criteria: adult population to whom antibiotics were administered; a probiotic intervention; a placebo, alternative dose, alternative probiotic strain or no treatment control; and incidence of AAD as the outcome.

Data extraction and synthesis

Two reviewers independently collected data and assessed risk of bias using preconstructed data extraction forms. We used a random effects model for all analyses. Subgroup analyses were performed to evaluate species-specific and dose-specific response.

Results

Forty-two studies (11,305 participants) were included in this review. The pooled analysis suggests that co-administration of probiotics with antibiotics reduces the risk of AAD in adults by 37% (risk ratio (RR)=0.63 (95% CI 0.54 to 0.73), p<0.00001). The overall quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria was found to be moderate. In subgroup analyses, high dose compared with low dose of the same probiotic demonstrated a positive protective effect (RR 0.54 (95% CI 0.38 to 0.76), p<0.01), and only certain species, mainly of the lactobacillus and bifidobacteria genera, were found to be effective. Studies with a low baseline AAD risk did not show any difference in risk but studies with moderate or high baseline AAD risk demonstrated a significant risk reduction.

Conclusions

Probiotics are effective for preventing AAD. Secondary analyses of higher dosages and certain species have shown increased effectiveness. Our results may not be applicable in clinical scenarios of lower baseline AAD risk.
Point-of-care testing and treatment of sexually transmitted and genital infections during pregnancy in Papua New Guinea (WANTAIM trial): protocol for an economic evaluation alongside a cluster-randomised trial
Authors: Batura Neha , Saweri Olga PM , Vallely Andrew , Pomat William , Homer Caroline , Guy Rebecca , Luchters Stanley , Mola Glen , Vallely Lisa M , Morgan Christopher , Kariwiga Grace , Wand Handan , Rogerson Stephen , Tabrizi Sepehr N , Whiley David M , Low Nicola , Peeling Rosanna W , Siba Peter M , Riddell Michaela , Laman Moses , Bolnga John , Robinson Leanne J , Morewaya Jacob , Badman Steven , Kelly-Hanku Angela , Toliman Pamela J , Peter Wilfred , Peach Elizabeth , Garland Suzanne , Kaldor John , Wiseman Virginia
Published: August 2021

Introduction

Left untreated, sexually transmitted and genital infections (henceforth STIs) in pregnancy can lead to serious adverse outcomes for mother and child. Papua New Guinea (PNG) has among the highest prevalence of curable STIs including syphilis, chlamydia, gonorrhoea, trichomoniasis and bacterial vaginosis, and high neonatal mortality rates. Diagnosis and treatment of these STIs in PNG rely on syndromic management. Advances in STI diagnostics through point-of-care (PoC) testing using GeneXpert technology hold promise for resource-constrained countries such as PNG. This paper describes the planned economic evaluation of a cluster-randomised cross-over trial comparing antenatal PoC testing and immediate treatment of curable STIs with standard antenatal care in two provinces in PNG.

Methods and analysis

Cost-effectiveness of the PoC intervention compared with standard antenatal care will be assessed prospectively over the trial period (2017–2021) from societal and provider perspectives. Incremental cost-effectiveness ratios will be calculated for the primary health outcome, a composite measure of the proportion of either preterm birth and/or low birth weight; for life years saved; for disability-adjusted life years averted; and for non-health benefits (financial risk protection and improved health equity). Scenario analyses will be conducted to identify scale-up options, and budget impact analysis will be undertaken to understand short-term financial impacts of intervention adoption on the national budget. Deterministic and probabilistic sensitivity analysis will be conducted to account for uncertainty in key model inputs.

Ethics and dissemination

This study has ethical approval from the Institutional Review Board of the PNG Institute of Medical Research; the Medical Research Advisory Committee of the PNG National Department of Health; the Human Research Ethics Committee of the University of New South Wales; and the Research Ethics Committee of the London School of Hygiene and Tropical Medicine. Findings will be disseminated through national stakeholder meetings, conferences, peer-reviewed publications and policy briefs.

Trial registration number

ISRCTN37134032.
Stakeholder engagement in economic evaluation: Protocol for using the nominal group technique to elicit patient, healthcare provider, and health system stakeholder input in the development of an early economic evaluation model of chimeric antigen receptor T-cell therapy
Authors: Wilson Mackenzie , Thavorn Kednapa , Hawrysh Terry , Graham Ian D , Atkins Harold , Kekre Natasha , Coyle Doug , Lalu Manoj M , Fergusson Dean A , Chan Kelvin KW , Ollendorf Daniel A , Presseau Justin
Published: August 2021

Introduction

Chimeric antigen receptor T-cell (CAR-T) therapy is a class of immunotherapy. An economic evaluation conducted at an early stage of development of CAR-T therapy for treatment of adult relapsed or refractory acute lymphoblastic leukaemia could provide insight into factors contributing to the cost of treatment, the potential clinical benefits, and what the health system can afford. Traditionally, stakeholders are engaged in certain parts of health technology assessment processes, such as in the identification and selection of technologies, formulation of recommendations, and implementation of recommendations; however, little is known about processes for stakeholder engagement during the conduct of the assessment. This is especially the case for economic evaluations. Stakeholders, such as clinicians, policy-makers, patients, and their support networks, have insight into factors that can enhance the validity of an economic evaluation model. This research outlines a specific methodology for stakeholder engagement and represents an avenue to enhance health economic evaluations and support the use of these models to inform decision making for resource allocation. This protocol may inform a tailored framework for stakeholder engagement processes in future economic evaluation model development.

Methods and analysis

We will involve clinicians, healthcare researchers, payers, and policy-makers, as well as patients and their support networks in the conduct and verification of an early economic evaluation of a novel health technology to incorporate stakeholder-generated knowledge. Three stakeholder-specific focus groups will be conducted using an online adaptation of the nominal group technique to elicit considerations from each. This study will use CAR-T therapy for adults with relapsed or refractory B-cell acute lymphoblastic leukaemia as a basis for investigating broader stakeholder engagement processes.

Ethics and dissemination

This study received ethics approval from the Ottawa Hospital Research Institute Research Ethics Board (REB 20200320-01HT) and the results will be shared via conference presentations, peer-reviewed publications, and ongoing stakeholder engagement.
Opioid analgesic use after ambulatory surgery: a descriptive prospective cohort study of factors associated with quantities prescribed and consumed
Authors: Shanahan Christopher W , Reding Olivia , Holmdahl Inga , Keosaian Julia , Xuan Ziming , McAneny David , Larochelle Marc , Liebschutz Jane
Published: August 2021

Objectives

To prospectively characterise: (1) postoperative opioid analgesic prescribing practices; (2) experience of patients undergoing elective ambulatory surgeries and (3) impact of patient risk for medication misuse on postoperative pain management.

Design

Longitudinal survey of patients 7 days before and 7–14 days after surgery.

Setting

Academic urban safety-net hospital.

Participants

181 participants recruited, 18 surgeons, follow-up data from 149 participants (82% retention); 54% women; mean age: 49 years.

Interventions

None.

Primary and secondary outcome measures

Total morphine equivalent dose (MED) prescribed and consumed, percentage of unused opioids.

Results

Surgeons postoperatively prescribed a mean of 242 total MED per patient, equivalent to 32 oxycodone (5 mg) pills. Participants used a mean of 116 MEDs (48%), equivalent to 18 oxycodone (5 mg) pills (~145 mg of oxycodone remaining per patient). A 10-year increase in patient age was associated with 12 (95% CI (−2.05 to –0.35)) total MED fewer prescribed opioids. Each one-point increase in the preoperative Graded Chronic Pain Scale was associated with an 18 (6.84 to 29.60) total MED increase in opioid consumption, and 5% (−0.09% to –0.005%) fewer unused opioids. Prior opioid prescription was associated with a 55 (5.38 to –104.82) total MED increase in opioid consumption, and 19% (−0.35% to –0.02%) fewer unused opioids. High-risk drug use was associated with 9% (−0.19% to 0.002%) fewer unused opioids. Pain severity in previous 3 months, high-risk alcohol, use and prior opioid prescription were not associated with postoperative prescribing practices.

Conclusions

Participants with a preoperative history of chronic pain, prior opioid prescription, and high-risk drug use were more likely to consume higher amounts of opioid medications postoperatively. Additionally, surgeons did not incorporate key patient-level factors (eg, substance use, preoperative pain) into opioid prescribing practices. Opportunities to improve postoperative opioid prescribing include system changes among surgical specialties, and patient education and monitoring.
Effects of the COVID-19 pandemic on the follow-up and treatment of patients with idiopathic pulmonary fibrosis: a cross-sectional, multicentre phone call survey
Authors: Coskun Funda , Hanta Ismail , Cilli Aykut , Ozkaya Guven , Ursavas Ahmet , Sevinc Can
Published: August 2021

Objective

To learn about the attitudes and behaviours of patients with idiopathic pulmonary fibrosis (IPF) in relation to the difficulties experienced during the COVID-19 pandemic.

Design

A cross-sectional, multicentre phone call survey.

Setting

Four university hospitals in Turkey.

Participants

The study included patients with IPF receiving antifibrotics for at least 3 months and with doctor appointment and/or scheduled routine blood analysis between March and May 2020 (the first 3 months after the official announcement of the COVID-19 pandemic in Turkey).

Interventions

Phone calls (a 5 min interview) were performed in June 2020. A questionnaire and the Hospital Anxiety-Depression Scale were applied.

Main outcome measures

Patients’ preferences for disease monitoring, patients’ attitudes and behaviours towards IPF, drug continuation, COVID-19 diagnosis and anxiety/depression status.

Results

The study included 115 patients with IPF (82 male; mean age, 68.43±7.44 years). Of the patients, 73.9% had doctor appointment and 52.2% had scheduled routine blood testing; 54.5% of patients with doctor appointment self-cancelled their appointments and 53.3% of patients with scheduled routine blood testing did not undergo testing. Of the patients, 32.2% were on nintedanib and 67.8% were on pirfenidone; self-initiated drug discontinuation rate was 22.6%. The percentage of patients communicating with their physicians was 35.7%. The route of communication was by phone (34.8%). The frequency of depression and anxiety was 27.0% and 38.3%, respectively. The rates of drug discontinuation (35.1% vs 16.7%, p<0.05) and depression (37.8% vs 21.8%, p=0.07) were higher in nintedanib users than in pirfenidone users. Only two (1.7%) patients had COVID-19 diagnosis.

Conclusions

During the COVID-19 pandemic, a significant proportion (>50%) of patients self-cancelled their appointments and nearly a quarter of patients discontinued their medications. Providing a documentation of the problems experienced by patients with IPF about management of the necessary requirements during the COVID-19 pandemic, this study may be a model for patients with chronic diseases.
Improving lung function in adolescents with CF by tracking annual rate of lung function decline
Authors: Schiff Sydney , Starks Miah , Linnemann Rachel W
Published: August 2021

Background

For patients with cystic fibrosis (CF), sustaining lung function through the adolescent years is crucial to slow the progressive decline that leads to significant morbidity and early mortality. This holds true for patients with high per cent predicted forced expiratory volume in 1 s (ppFEV1), as they may receive less vigilant monitoring and treatment. Early identification of lung function decline followed by aggressive treatment can lead to preservation of lung function.

Intervention

The Emory+Children’s Pediatric Cystic Fibrosis Program implemented multiple quality improvement (QI) initiatives to identify and aggressively treat adolescent patients with a rapid decline in lung function. These initiatives included (1) lung zones to categorise and highlight lung function decline, (2) individual lung decline tables for quick reference, (3) a lung health algorithm to encourage uniformity, (4) a rapid decliner checklist to identify potential reasons for individual decline and (5) an automated individual patient-level data report and centre scorecard. We tested these interventions with plan–do–study–act cycles and refined as needed.

Results

Implementation of these QI initiatives resulted in overall improvement in lung function and slowing of lung function decline among adolescents with CF . This improvement could be attributed to the more standardised and proactive approach to decreases in lung function and the increased clinician attention to patients with rapid decline, especially for patients with high baseline ppFEV1.
Reducing potentially avoidable tasks in a hyperacute stroke unit
Authors: Tireli Derya , Jensen Michael Broksgaard
Published: August 2021

The workflow in a stroke unit can be very high, and this is especially noticeable during evening and night shifts, where staffing is reduced but the patient’s need for frequent and intensive care is not. The specialised and standardised settings in a stroke regime are constant and demanding for healthcare providers who, therefore, must work efficiently. Patient admissions, acute situations and routine tasks are major contributors to the burden of work during evening and night shifts for junior doctors on call. Thus, it is important to reduce the number of potentially avoidable tasks done by these junior doctors during night shifts so they have more time to perform tasks of high priority. The aim of this project was to reduce the potentially avoidable tasks occurring at night for the on-call junior doctor to only one per shift. We investigated the types of tasks that frequently occur for the on-call junior doctor during the night shift and improved our daily morning and evening rounds to reduce the number of tasks during the night shift. Using the plan–do–study–act method, we made improvements through education, knowledge sharing, checklists and feedback, and we reduced the number of potentially avoidable tasks for on-call junior doctors from a median of 11 to a median of 3 per week, demonstrating that the workload for the on-call junior doctor during the night shift can be reduced through a systematic approach to improving the work routines of doctors and nurses.
Prevalence and significance of pulmonary disease on lung ultrasonography in outpatients with SARS-CoV-2 infection
Authors: Fairchild Robert M , Horomanski Audra , Mar Diane A , Triant Gabriela R , Lu Rong , Lu Di , Guo Haiwei Henry , Baker Matthew C
Published: August 2021

Background

The majority of patients with SARS-CoV-2 infection are diagnosed and managed as outpatients; however, little is known about the burden of pulmonary disease in this setting. Lung ultrasound (LUS) is a convenient tool for detection of COVID-19 pneumonia. Identifying SARS-CoV-2 infected outpatients with pulmonary disease may be important for early risk stratification.

Objectives

To investigate the prevalence, natural history and clinical significance of pulmonary disease in outpatients with SARS-CoV-2.

Methods

SARS-CoV-2 PCR positive outpatients (CV(+)) were assessed with LUS to identify the presence of interstitial pneumonia. Studies were considered positive based on the presence of B-lines, pleural irregularity and consolidations. A subset of patients underwent longitudinal examinations. Correlations between LUS findings and patient symptoms, demographics, comorbidities and clinical outcomes over 8 weeks were evaluated.

Results

102 CV(+) patients underwent LUS with 42 (41%) demonstrating pulmonary involvement. Baseline LUS severity scores correlated with shortness of breath on multivariate analysis. Of the CV(+) patients followed longitudinally, a majority showed improvement or resolution in LUS findings after 1–2 weeks. Only one patient in the CV(+) cohort was briefly hospitalised, and no patient died or required mechanical ventilation.

Conclusion

We found a high prevalence of LUS findings in outpatients with SARS-CoV-2 infection. Given the pervasiveness of pulmonary disease across a broad spectrum of LUS severity scores and lack of adverse outcomes, our findings suggest that LUS may not be a useful as a risk stratification tool in SARS-CoV-2 in the general outpatient population.
Coil embolisation for massive haemoptysis in cystic fibrosis
Authors: Dohna Martha , Renz Diane Miriam , Stehling Florian , Dohna-Schwake Christian , Sutharsan Sivagurunathan , Neurohr Claus , Wirtz Hubert , Eickmeier Olaf , Grosse-Onnebrink Jörg , Sauerbrey Axel , Soditt Volker , Poplawska Krystyna , Wacker Frank , Montag Michael Johannes
Published: August 2021

Introduction

Massive haemoptysis is a life-threatening event in advanced cystic fibrosis (CF) lung disease with bronchial artery embolisation (BAE) as standard of care treatment. The aim of our study was to scrutinise short-term and long-term outcomes of patients with CF and haemoptysis after BAE using coils.

Methods

We carried out a retrospective cohort study of 34 adult patients treated for massive haemoptysis with super selective bronchial artery coil embolisation (ssBACE) between January 2008 and February 2015. Embolisation protocol was restricted to the culprit vessel(s) and three lobes maximum. Demographic data, functional end-expiratory volume in 1 s in % predicted (FEV1% pred.) and body mass index before and after ssBACE, sputum colonisation, procedural data, time to transplant and time to death were documented.

Results

Patients treated with ssBACE showed significant improvement of FEV1% pred. after embolisation (p=0.004) with 72.8% alive 5 years post-ssBACE. Mean age of the patients was 29.9 years (±7.7). Mean FEV1% pred. was 45.7% (±20.1). Median survival to follow-up was 75 months (0–125). Severe complication rate was 0%, recanalisation rate 8.8% and 5-year-reintervention rate 58.8%. Chronic infection withPseudomonas aeruginosawas found in 79.4%,Staphylococcus areusin 50% andAspergillus fumigatusin 47.1%.

Discussion

ssBACE is a safe and effective treatment for massive haemoptysis in patients with CF with good results for controlling haemostasis and excellent short-term and long-term survival, especially in severely affected patients with FEV<40% pred. We think the data of our study support the use of coils and a protocol of careful and prudent embolisation.
Seasonal patterns of forage quality in six native forb species
Authors: Vera-Velez Roy , Lamb Eric G.
Published: August 2021

The forage value of native forbs is rarely considered in pasture mixtures, even though such species can make up a substantial proportion of the diet of cattle on native rangelands. Incorporating non-leguminous forbs into pasture grazing systems can provide additional ecosystem services such as pollination habitat, and ideally those forbs would also provide some forage value. We therefore assessed the seasonal variation in protein and fiber [neutral detergent fiber (NDF) and acid detergent fiber (ADF)] content of six common western Canadian native forb and sub-shrub species: yarrow (Achillea millefolium), smooth aster (Symphyotricum laeve), prairie crocus (Pulsatilla patens), prairie rose (Rosa arkansana), Canada goldenrod (Solidago canadensis), and American vetch (Vicia americana). The legume V. americana displayed the highest protein followed by S. canadensis and S. laeve. V. americana also has the highest fiber concentration through the growing season. S. canadensis and S. laeve had lower fiber content; thus, making them a good choice for addition in seed mixes to meet the energy and nutrient requirements of cattle. Forb protein and fiber content showed opposite trends during the growing season. Crude protein decreased while NDF and ADF increased as a general pattern tied to physiological stage and degree of senescence. The promising nutritional profile of some forb species suggests that these species should be considered in pasture mixes.
Canadian private protected areas are located in regions of higher vertebrate species richness than government protected areas
Authors: Custode Leonardo B. , Guzzo Matthew M. , Bush Natasha , Ewing Claire , Procko Michael , Knight Samantha M. , Rousseau-Clair Marie-Michele , Norris D. Ryan
Published: August 2021

Nongovernmental organizations contribute to the securement and management of protected areas, but it is not well known how their lands compare to government protected areas or the effectiveness of different land acquisition strategies. Using data from the International Union for Conservation of Nature and BirdLife International, we estimated total and at-risk terrestrial native vertebrate species richness in southern Canada among ( i) private protected areas secured by the Nature Conservancy of Canada (NCC), government protected areas, and randomly sampled land; ( ii) conservation agreements and fee simple (directly acquired) NCC properties; and ( iii) purchased or donated fee simple properties. Controlling for property size and ecoregion, NCC protected areas were predicted to be in areas with 6% and 13% more total and at-risk species than randomly sampled land and 4% and 6% more total and at-risk species than government protected areas. Within NCC protected areas, conservation agreements were predicted to be in areas with 2% and 4% more total and at-risk species than fee simple properties, but purchased properties had similar numbers of total and at-risk species as donated properties. Although we caution that diversity estimates were based on course-grained range maps, our findings suggest that private protected areas are important in conserving biodiversity.
ICT, INNOVATION AND SME EXPORT LIKELIHOOD: EVIDENCE FROM SMEs IN THE ASEAN ECONOMIES
Authors: HAINI HAZWAN
Published: August 2021

This study examines the impact of information and communication technologies (ICTs) and innovation on small and medium enterprises (SMEs) export likelihood using a two-stage instrumental variable logistic estimator in 6,844 ASEAN SMEs. Adopting ICT technologies allows SMEs to overcome the constraints faced when exporting, while innovation allows SMEs to gain a competitive advantage. Meanwhile, the ASEAN economies are committed toward regional integration and have implemented policies to develop the SME and ICT sector. Results indicate that both ICT technologies and innovation contribute positively to export likelihood, albeit the magnitude of ICT technologies on export likelihood is greater. Furthermore, the results show that ICT technologies can overcome the constraints faced by marginalized businesses in terms of exporting, and can also enhance export likelihood in the manufacturing industry. Policy implications are discussed.
Kinetics of phase separation in Fe–Cr–X (X =Mo, Cu) ternary alloys — a dynamical wave study
Authors: Younis M. , Seadawy Aly R. , Bilal M. , Rehman S. U. , Latif S. , Rizvi S. T. R.
Published: August 2021

Ternary alloys of Fe are very important materials having good corrosion resistance and are also famous for several high-temperature applications. The dynamical behavior of exact traveling waves for the kinetics of phase separation in Fe–Cr–X (X[Formula: see text]Mo, Cu) ternary alloys is modelled by convective-diffusive Cahn–Hilliard (CH) equation. A variety of nonlinear dynamical exact and solitary wave structures are extracted in several forms like rational, hyperbolic, trigonometric function solutions by the utilization of a sound computational integration tool, i.e., [Formula: see text]-model expansion method. Besides, we also secure mixed combined solitons and singular periodic wave solutions with unknown parameters. Moreover, the constraint conditions observed during derivation lead to substantial solutions. The findings elucidate that the governing model theoretically possesses significantly rich structures of exact traveling wave solutions. Hence, our technique via fortification of symbolic computations provides an active and potent mathematical implementation for solving diverse benevolent nonlinear wave problems.
New traveling solutions of the fractional nonlinear KdV and ZKBBM equations with 𝒜ℬℛ fractional operator
Authors: Khater Mostafa M. A.
Published: August 2021

This research paper investigates novel explicit wave solutions of the fractional Korteweg–de Vries (KdV) equation and the fractional Zakharov–Kuznetsov–Benjamin–Bona–Mahony (ZKBBM) equation. These models are used as gravity models in water and an interaction model between the long waves. The Atangana–Baleanu ([Formula: see text]) fractional operator is utilized for the first time to convert the fractional form of both models into nonlinear partial differential equations with an integer order. The extended simplest equation method is employed to construct some distinct types of solitary wave solutions such as exponential, rational, hyperbolic and trigonometric functions. For more illustration of our obtained solutions, some figures for them are given. The power and practical properties of the used method are tested.