bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delirium and Adverse Outcomes in Hospitalized Patients with COVID‐19
Authors: Garcez Flavia B. , Aliberti Marlon J. R. , Poco Paula C. E. , Hiratsuka Marcel , Takahashi Silvia de F. , Coelho Venceslau A. , Salotto Danute B. , Moreira Marlos L. V. , Jacob‐Filho Wilson , Avelino‐Silva Thiago J. 
Published: August 2020

BACKGROUNDLittle is known about the association between acute mental changes and adverse outcomes in hospitalized adults with COVID‐19.OBJECTIVESTo investigate the occurrence of delirium in hospitalized patients with COVID‐19 and explore its association with adverse outcomes.DESIGNLongitudinal observational study.SETTINGTertiary university hospital dedicated to the care of severe cases of COVID‐19 in São Paulo, Brazil.PARTICIPANTSA total of 707 patients, aged 50 years or older, consecutively admitted to the hospital between March and May 2020.MEASUREMENTSWe completed detailed reviews of electronic medical records to collect our data. We identified delirium occurrence using the Chart‐Based Delirium Identification Instrument (CHART‐DEL). Trained physicians with a background in geriatric medicine completed all CHART‐DEL assessments. We complemented our baseline clinical information using telephone interviews with participants or their proxy. Our outcomes of interest were in‐hospital death, length of stay, admission to intensive care, and ventilator utilization. We adjusted all multivariable analyses for age, sex, clinical history, vital signs, and relevant laboratory biomarkers (lymphocyte count, C‐reactive protein, glomerular filtration rate, D‐dimer, and albumin).RESULTSOverall, we identified delirium in 234 participants (33%). On admission, 86 (12%) were delirious. We observed 273 deaths (39%) in our sample, and in‐hospital mortality reached 55% in patients who experienced delirium. Delirium was associated with in‐hospital death, with an adjusted odds ratio of 1.75 (95% confidence interval = 1.15–2.66); the association held both in middle‐aged and older adults. Delirium was also associated with increased length of stay, admission to intensive care, and ventilator utilization.CONCLUSIONDelirium was independently associated with in‐hospital death in adults aged 50 years and older with COVID‐19. Despite the difficulties for patient care during the pandemic, clinicians should routinely monitor delirium when assessing severity and prognosis of COVID‐19 patients.
Human uterine vasculature with respect to uterus transplantation: A comprehensive review
Authors: Kristek Jakub , Johannesson Liza , Novotny Robert , Kachlik David , Fronek Jiri 
Published: August 2020

AbstractDue to the novelty of uterus transplantation, data on preferable inflow and outflow of the graft are limited. This paper reviews the technique, type of vessels and the outcome. A systematic search of the PubMed database was conducted. We extracted and analyzed data on the arteries and veins utilized, types of anastomosis, types of donors, complications and the outcome. Thirty eight sources reported 51 human uterine transplantations, 10 graft thromboses and 25 live births. Inflow was established with two uterine arteries (UA) with/without the anterior division of the internal iliac artery in 62% (n = 31) of cases, two UA arteries with a segment/patch of the internal iliac artery in 34% (n = 17) of cases or two UA with a conduit in 4% of cases (n = 2). Both cases with a conduit developed thrombosis (n = 2). Arterial thrombosis/ischemia developed in 8 of the 51 cases. In 50% of cases with arterial thrombosis, atherosclerosis was identified as a possible cause. Outflow was established by two internal iliac veins with patches/segments in 27.5% of cases (n = 14) followed by two utero‐ovarian veins in 25.5% (n = 13). Venous thrombosis occurred in 3 of the 51 cases. Uterine arteries with/without anterior division of the internal iliac artery were the most frequent arteries used for inflow and produced the highest patency rate. The presence of atherosclerosis and complex arterial reconstruction was associated with a high rate of arterial thrombosis. None of the veins utilized in the procedures appeared to be superior. There are insufficient data to draw a definite conclusion.
Autologous platelet‐rich plasma infusion does not improve pregnancy outcomes in frozen embryo transfer cycles in women with history of repeated implantation failure without thin endometrium
Authors: Tehraninejad Ensieh S. , Kashani Norieh G. , Hosseini Ali , Tarafdari Azam 
Published: August 2020

AbstractAimThe effect of intrauterine infusion of platelet‐rich plasma (PRP) which has been shown to improve the pregnancy outcomes in patients suffering from repeated implantation failure (RIF), is intended to be studied in patients with normal endometrial thickness.MethodsWe recruited 85 patients with RIF and normal endometrial thickness (≥7 mm). After obtaining their consent, they were stratified into the intervention (PRP) and control groups, according to the patient's decision. Out of 85 participants, 42 received PRP, while 43 were included in the control group. In the PRP group, 1 mL of PRP was extracted from 10 cc of whole blood via two rounds of centrifugation and infused 2 days before the embryo transfer (ET).ResultsThe pregnancy outcomes, including biochemical, clinical and ongoing pregnancy (≥20 weeks of gestation) rates were similar between the PRP (35.7, 31.0 and 26.8%, respectively) and control (37.2, 37.2 and 25.6%, respectively) groups.ConclusionWe concluded that PRP is not an effective adjuvant treatment for in vitro fertilization of patients with RIF and normal endometrial thickness undergoing ET.
Fracture Load of Different Zirconia Types: A Mastication Simulation Study
Authors: Abdulmajeed Awab , Sulaiman Taiseer , Abdulmajeed Aous , Bencharit Sompop , Närhi Timo 
Published: August 2020

AbstractPurposeTo assess the effect of yttria mol% concentration and material thickness on the biaxial fracture load (N) of zirconia with and without mastication simulation.Materials and methodsDisk‐shaped specimens (N = 120) of 3 mol% yttria‐partially stabilized zirconia, 3Y‐PSZ (Katana High Translucent, Kuraray Noritake), 4 mol% yttria‐partially stabilized zirconia, 4Y‐PSZ (Katana Super Translucent Multi Layered) and 5 mol% Yttria‐partially stabilized zirconia, 5Y‐PSZ (Katana Ultra Translucent Multi Layered) were prepared to thicknesses of 0.7 and 1.2 mm. For each thickness, the biaxial fracture load (N) was measured with and without mastication simulation with 1.2 million cycles at a 110‐N load and simultaneous thermal cycling at 5°C to 55°C. The data were analyzed by three‐way Analysis of Variance (α = 0.05) and Tukey‐Kramer adjusted multiple comparison test.ResultsYttria mol% concentration and material thickness had a statistically significant effect on the mean biaxial fracture load (F = 388.16, p < 0.001 and F = 714.33, p < 0.001 respectively). The mean biaxial fracture load ranged from the highest to the lowest; 3Y‐PSZ, 4Y‐PSZ, and 5Y‐PSZ (p = 0.012). The mean biaxial fracture load of the 1.2 mm thickness groups was significantly higher than 0.7 mm thickness at any given condition (p = 0.002). Not all specimens survived the mastication simulation protocol. Fifty percent of the 0.7‐mm‐thick 4Y‐PSZ specimens, 70% of the 0.7‐mm‐thick 5Y‐PSZ specimens and 20% of 1.2‐mm‐thick 5Y‐PSZ specimens fractured during mastication simulation. Mastication simulation had no statistically significant effect on the biaxial fracture load (F = 1.24, p = 0.239) of the survived specimens.ConclusionsLowering yttria mol% concentration and increasing material thickness significantly increases the fracture load of zirconia. At 0.7 mm thickness, only 3Y‐PSZ survived masticatory simulation. A minimum material thickness of 1.2 mm is required for 4Y‐PSZ or 5Y‐PSZ.
Standard area diagrams to assess scab severity of entire‐margined leaves of sour passion fruit
Authors: Brás Verônica Vieira , Rios Jonas Alberto , Silva Leandro Castro , Santos Carlos Eduardo Magalhães , Nascimento Roxana Stefane Mendes , Rodrigues Fabrício Ávila 
Published: August 2020

AbstractScab caused by the Cladosporium cladosporioides complex is one of the most important diseases affecting passion fruit yield and fruit quality. Standard area diagrams are useful tools to improve the accuracy and reliability of the estimates of disease severity in many pathosystems. The interpretation of the accuracy of the resulting disease data may be the basis for providing better disease management. This study aimed to develop and validate standard area diagrams (SADs) to quantify scab severity of entire‐margined leaves of sour passion fruit plants. The SADs are composed of ten images of scab severity values (0.4%, 3.5%, 5.4%, 8.0%, 11.1%, 16.2%, 26.1%, 38.2%, 47.9% and 58.9%). Twenty raters (ten experienced and ten inexperienced ones) evaluated the SADs. The raters estimated the same set of fifty images twice. In the examination, the SADs were used, while in the second examination, they were not used. Accuracy was significantly improved by using the SADs. The coefficients of bias (Cb) were 0.96 and 0.98 for the experienced raters and 0.75 and 0.98 for the inexperienced raters without and with SADs, respectively. The correlation coefficient (r) values were 0.95 and 0.97 for the experienced raters and 0.89 and 0.97 for the inexperienced raters without and with the use of the SADs, respectively. Lin's concordance correlation coefficient (ρc) values were 0.91 and 0.95 for the experienced raters and 0.66 and 0.95 for the inexperienced raters without and with the use of the SADs, respectively. Moreover, the coefficient of determination (R2) significantly improved when the SADs were used. The SADs proposed in this study, if properly used, may improve both the accuracy and reliability during the evaluation of scab severity of entire‐margined leaves of sour passion fruit plants.
Childhood stunting and wasting in Myanmar: Key drivers and implications for policies and programmes
Authors: Blankenship Jessica L. , Cashin Jennifer , Nguyen Tuan T. , Ip Hedy 
Published: August 2020

AbstractChild undernutrition is a public health and development problem in Myanmar that is jeopardizing children's physical and cognitive development and the country's social and economic progress. We identified key drivers of child stunting (low height‐for‐age) and wasting (low weight‐for‐height) in a nationally representative sample (n = 3,981) of children 0–59 months of age. The national prevalence of child stunting and wasting was 28% and 7%, respectively. Boys were more likely to be stunted or wasted than girls. Older children 24–35 months were at the highest risk of stunting compared with children under 6 months (risk ratios [RR] 10.34; 95% CI [6.42, 16.65]) whereas the youngest, under 6 months, were at the highest risk of wasting compared with children 36–59 months (RR 2.04; 95% CI [1.16, 3.57]). Maternal height <145 cm (RR 5.10; 95% CI [3.15, 8.23]), perceived small child size at birth (RR 2.08; 95% CI [1.62, 2.69]), and not benefiting from institutional delivery (RR 1.52; 95% CI [1.24, 1.87]) were associated with an increased risk of child stunting, as were maternal occupation, unimproved household drinking water, living in delta, coastal or upland areas, and poorer household wealth index quintile. Increased risk of child wasting was associated with maternal underweight (RR 1.64; 95% CI [1.11, 2.42]) and open defecation (RR 1.91; 95% CI [1.25, 2.92]) as well as maternal occupation and residence in a coastal area. Our findings indicate that the key drivers of child undernutrition in Myanmar are multifaceted and start in utero. Investing in scaling‐up multisectoral approaches that include nutrition‐specific and nutrition‐sensitive interventions with a focus on improving maternal nutrition is essential for reducing child undernutrition and contributing to further gains in the country's human and economic development.
Maternal mid‐upper arm circumference during pregnancy and linear growth among Cambodian infants during the first months of life
Authors: Kpewou Daniel Edem , Poirot Etienne , Berger Jacques , Som Somphos Vicheth , Laillou Arnaud , Belayneh Selamawit Negash , Wieringa Frank T. 
Published: August 2020

AbstractStunting prevalence among children under 5 years remains high in Cambodia, affecting about one‐third of children. In most low‐ and middle‐income countries, linear growth faltering of young children starts in the womb. The 1,000‐days window of opportunity to improve child nutritional status includes pregnancy, as maternal nutritional status is an important determinant of birthweight and child development. In Cambodia, nutritional status of pregnant women is poor, with some studies reporting >20% of pregnant women having a low mid‐upper arm circumference (MUAC < 23 cm). Few studies have investigated associations between maternal nutritional status during pregnancy and neonatal growth. Using data from a Cambodian cohort study conducted from 2016 through 2018 in selected districts of Phnom Penh, Kratie, and Ratanakiri provinces, we investigated associations between maternal MUAC during pregnancy as indicator of maternal nutritional status and their offspring linear growth during early life. Multivariate regression models were used to assess the associations between maternal MUAC during the last trimester of pregnancy and infant's length‐for‐age z‐scores during the first 3.5 months of life. Maternal MUAC was significantly associated with infant's length‐for‐age z‐scores (regression coefficient 0.06, 95% CI [0.03, 0.09]). Infants born from mothers with a low MUAC during pregnancy had a 1.6 times higher risk (odds ratio 1.621, 95% CI [0.998, 2.636]) of being stunted during the first 3.5 months of life compared with infants born from mothers with a MUAC >23 cm. This study underlines the importance of optimum maternal MUAC during pregnancy for optimal infant growth. Interventions that aim to tackle stunting in infants should integrate improving maternal MUAC during pregnancy.
Confucianism and Daoism: On the relationship between theAnalects, Laozi,andZhuangzi, Part II
Authors: D'Ambrosio Paul J. 
Published: August 2020

AbstractThis article is a continuation of Part I, which looked at the relationship between Confucianism and Daoism by first introducing general approaches, before moving on to (1) perspectives on names and actualities; (2) cultivation, learning, the natural; and (3) conceptions of the person. Continuing with the theme‐based comparison of Confucianism and Daoism by looking specifically at theLunyu論語 (Analects of Confucius),Daodejing道德經 (Classic of the Way and Virtuosity) orLaozi老子 (Book of Master Lao), and theZhuangzi莊子 (Book of Master Zhuang), this article looks at (1) politics, nonaction (wuwei無為), and virtuosity (de德); (2) morality, virtues, and human nature (xing性); and finally (3)Dao道, or “the way.” It references Part I, and while it can be read independently, it is best taken as a continuation of Part I. The conclusion included herein summarizes both Part II and Part I.
Saturated RISE Feedback Control for Uncertain Nonlinear MacPherson Active Suspension System to Improve Ride Comfort
Authors: Dinh Huyen T. , Trinh Tuan-Duong , Tran Van-Nhu 
Published: August 2020

Abstract
A continuous saturated controller using smooth saturation functions is established for MacPherson active suspension system which includes nonlinear uncertainties, unknown road excitations, and bounded disturbances. The developed controller exploits the properties of the hyperbolic functions to guarantee saturation limits are not exceeded, while stability analysis procedures of the robust integral of the sign of the error (RISE) control technique utilize the advantages of high gain control strategies in compensating for unknown uncertainties. The saturated controller guarantees asymptotic regulation of the sprung mass acceleration to improve the ride comfort despite model uncertainties and additive disturbances in the dynamics. Simulation results demonstrate the improvement in the ride comfort while tire deflection and the suspension deflection are within admissible range in comparison with three other suspensions.
A Procedure to Define Customized Musculoskeletal Models for the Analysis of the Crutch-Orthosis-Assisted Gait of Spinal Cord Injured Subjects
Authors: Michaud Florian , Lugris Urbano , Cuadrado Javier , Kecskemethy Andres , Ou Ye 
Published: August 2020

Abstract
Subjects suffering from spinal cord injury with lower extremity impairment generally use a wheelchair to move. However, some of them are capable of walking with the help of orthoses and crutches. Standing up and walking regularly have huge benefits for the general health state of these subjects, since it reduces the negative consequences of sedentarism. Therefore, achieving adherence to assisted gait is important, but there is a risk of abandoning due to several issues such as pain, fatigue, or very low speed, which can make the subject return to solely use the wheelchair. Musculoskeletal models can provide estimations of muscular forces and activations, which in turn enable to calculate magnitudes such as joint reactions, energetic cost, and bone stress and strain. These magnitudes can serve to evaluate the impact of assisted gait in the subject's health and to assess the likelihood of adherence. Moreover, they can be used as indicators to compare different assistive devices for a particular subject. As every spinal cord-injured (SCI) subject represents a different case, a procedure to define customized musculoskeletal models for the crutch-orthosis-assisted gait of SCI subjects is proposed in this paper. Issues such as selection of muscles and integration of models of trunk, upper and lower extremities, and assistive devices (crutches and orthoses) are addressed. An inverse-dynamics-based physiological static optimization method that takes into account muscle dynamics at low computational cost is applied to obtain estimates of muscle forces and joint reactions. The method is experimentally validated by electromyography in a case study.
Syncing fault rock clocks: Direct comparison of U-Pb carbonate and K-Ar illite fault dating methods
Authors: Mottram C.M. , Kellett D.A. , Barresi T. , Zwingmann H. , Friend M. , Todd A. , Percival J.B. 
Published: August 2020

Abstract
The timing of slip on brittle faults in Earth’s upper crust is difficult to constrain, and direct radiometric dating of fault-generated materials is the most explicit approach. Here we make a direct comparison between K-Ar dating of fault gouge clay (authigenic illite) and U-Pb dating of carbonate slickenfibers and veins from the same fault. We have dated fault generated materials from the Big Creek fault, a northwest-striking, dextral strike-slip fault system in Yukon Territory, Canadian Cordillera. Both methods yielded dates at ca. 73 Ma and ca. 60–57 Ma, representing at least two periods of fault slip that form part of a complex fault and fluid-flow history. The Cretaceous result lies within previous indirect estimates for major slip on the fault. The Paleocene–Eocene result coincides with the estimated timing of slip of the nearby Tintina and Denali faults, which are crustal-scale, northwest-striking dextral faults, indicating Big Creek fault reactivation during regional faulting. The coincidence of periods of carbonate-crystallizing fracturing and fluid flow with intervals of seismic, gouge-generating slip supports the fault valve model, where fault strength is mediated by fluid pressures, and fluid emplacement requires seismic pumping in otherwise impermeable aseismic fault zones. The reproducibility of slip periods for distinct fault-generated materials using different decay systems indicates that these methods provide complimentary results and can be reliably applied to date brittle fault slip, opening new opportunities for investigating fault conditions with associated mineralizing fluid events.
Prevalence, control, and treatment of diabetes, hypertension, and high cholesterol in the Amish
Authors: He Shisi , Ryan Kathleen A , Streeten Elizabeth A , McArdle Patrick F , Daue Melanie , Trubiano Donna , Rohrer Yvonne , Donnelly Patrick , Drolet Maryann , Newcomer Sylvia , Shaub Susan , Weitzel Nancy , Shuldiner Alan R , Pollin Toni I , Mitchell Braxton D 
Published: August 2020

BackgroundThe burden of diabetes and cardiovascular risk is not uniform across the USA, with much of this disparity tracking differences in socioeconomic status, cultural practices and lifestyle. To further evaluate disparities in these disorders, we assessed the prevalence of diabetes, hypertension, and hypercholesterolemia in an Old Order Amish community that is characterized by distinctive sociocultural practices that include a very cohesive social structure and limited use of modern technologies and medications. We compared prevalence of these conditions with that of the overall US population.MethodWe performed a community-wide survey in 5377 Amish individuals aged 18 years and older from the Lancaster County, Pennsylvania, Amish settlement that included a basic physical examination and fasting blood draw during the period 2010–2018. We then compared the prevalence of diabetes, hypertension, and high cholesterol, defined using standard criteria, between the Amish and the European Caucasian subsample of the 2013–2014 US National Health and Nutrition Examination Survey (NHANES).ResultsPrevalence rates for diabetes, hypertension and hypercholesterolemia were 3.3%, 12.7%, and 26.2% in the Amish compared with 13.2%, 37.8% and 35.7% in NHANES (p<0.001 for all). Among individuals with these disorders, Amish were less likely to be aware that they were affected, and among those aware, were less likely to be treated with a medication for their disorder.ConclusionThere is substantially lower prevalence of diabetes, hypertension and hypercholesterolemia in the Amish compared with non-Amish Caucasians in the USA. Possible factors contributing to this disparity include higher physical activity levels in the Amish or other protective sociocultural factors, a greater understanding of which could inform risk reduction interventions for these chronic diseases.