bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-flow Nasal Cannula therapy: A feasible treatment for vulnerable older COVID-19 patients on the wards
Authors: Steenkiste Job van , Herwerden Michael C. van , Weller Dolf , Bout Christiaan J. van den , Ruiter Rikje , Hollander Jan G. den , Moussaoui Rachida el , Verhoeven Gert T. , Noord Charlotte van , Dorpel Marinus van den 
Published: November 2020

Abstract
Background: In the midst of the COVID-19 crisis, many frail elderly adults were admitted to our hospital with COVID-19. Some faced severe respiratory failure but were not eligible for invasive mechanical ventilation, due to frailty, functional status, comorbidity or wish of the patient. Our main objective was to investigate whether High-flow nasal cannula (HFNC) treatment on the wards could be an effective alternative treatment for these patients.Methods: A retrospective cohort study amongst COVID-19 adult patients with respiratory failure defined as persisting hypoxemia despite maximum conventional oxygen administration requiring invasive mechanical ventilation in the Intensive Care Unit (ICU) but being treated with HFNC as they were non-eligible due to frailty or wish of the patient.Results: The study included 32 patients between March 9th and May 1st, 2020. The median age was 79.0 years (74.5-83.0) with a median of three comorbidities (3-4) and a median Clinical Frailty Score of 4 out of 9 (3-6). The median SpO2/FiO2 Ratio was 157.5 indicating moderate ARDS. Overall survival rate in the HFNC cohort was 25%. Age (80.5 (78.0-84.3) vs 69.5 (65.5-74.3) p=0.0040) and hypertension (92% vs 25%, p=0.0008) were correlated with mortality.Conclusion: This study suggests that HFNC could be an effective last resort respiratory management strategy for respiratory failure in vulnerable elderly COVID-19 patients who failed on conventional high dose oxygen supply and are not eligible for invasive mechanical ventilation.
Study of 10kW molten carbonate fuel cell power generation system and its performance test
Authors: Lu Chengzhuang , Zhang Ruiyun , Li Hao , Cheng Jian , Xu Shisen , Yang Guanjun , Huang Hua 
Published: November 2020

Abstract
High-temperature fuel cells are a power technology that can improve the efficiency of electricity generation and achieve near-zero emissions of carbon dioxide. The present work explores the performance of the 10kW high-temperature molten carbonate fuel cell (MCFC). The key materials of the molten carbonate fuel cell single cell were characterized and analyzed by X-ray diffraction(XRD) and scanning electron microscope (SEM). The results show that the pore size of key electrode material was 6.5 μm and the matrix material is α-LiAlO2.The open circuit voltage of the single cell is 1.23 V in experiment. The current density is greater than 100 mA / cm^2 when the operating voltage is 0.7 V. The 10 kW fuel cell stack was constitutive of 80 pieces single fuel cells with area of 2000 cm2. The open circuit voltage of the stack reaches above 85 V. The fuel cell stack power and current density can reach 11.7 kW and 104.5 mA/cm^2 when the operating voltage is 56 V. The influence and long-term stable operation of the stack were also analyzed and discussed. The successful operation of 10kW high temperature fuel cell promotes the scale of domestic fuel cell and provides the research basis of fuel cell capacity enhancement and distributed generation in the next step.
Lower Diagnostic Costs Associated with Early Deployment of Capsule Endoscopy in Non-Hematemesis Gastrointestinal Bleeding: a Cost-Utilization Analysis
Authors: Jawaid Salmaan , Maranda Louise , Cave David 
Published: November 2020

Abstract
Introduction: Often, the diagnostic workup of patients presenting with non-hematemesis gastrointestinal bleeding (NHGIB) is inconclusive. Consequently, the diagnostic evaluation may incur unnecessary health care costs and diagnostic times. The use of a cost decision-analytical model of the current diagnostic management strategy applied to patients presenting with NHGIB may reveal alternative strategies for the evaluation of NHGIB.Methods: Cost decision-analytical model that retrospectively follows the diagnostic course of 231 consecutive patients presenting with NHGIB to the emergency department (ED) of a tertiary medical center. We measured the effect (cost and relative times) of selecting a specific procedure, plus the effect of pursuing secondary procedures after non-diagnostic primary procedures. Results: A primary VCE had a diagnostic rate of 68% vs. 45% and 48% for a primary EGD and COLO, respectively. Combining the diagnostic rates for each primary procedure with the cost of performing subsequent procedures (after non-diagnostic primary procedures), demonstrates the primary use of VCE (n=9) results in a total cost of $12,146 vs. $12,746 and $13,162 for a primary EGD (n=47) and COLO (n=33), respectively. Similarly, the use of VCE as a primary diagnostic procedure in NHGIB patients admitted to the floor would take 74 unit hours to reach a diagnosis compared to 104 and 131 for EGD and COLO, respectively. Conclusion: Our model suggests initial use of VCE for the diagnosis of acute NHGIB, may reduce time to diagnosis and management costs.
CT- 3-DimenSional airway evaluation-guided intraluminal placement of endobronchial blocker in pediatric patients: a randomized controlled study
Authors: Xu Yingyi , Zhang Na , Wei Wei , Tan Yonghong , Zeng Minting , Hou Jianning , Liu Wei 
Published: November 2020

Abstract
Background: One-lung ventilation (OLV) with endobronchial blocking is commonly used in anesthesia for pediatric thoracic surgery. Bronchoscopy is commonly used to guide the endobronchial blocker placement. However, when bronchoscopy is not applicable, the proper placement of endobronchial blocker is challenging. Computed tomography (CT)-3-DimenSional evaluation may be used to accurately measure the airway of pediatric patients. The present study was aimed to propose a new approach of CT-3-DimenSional airway evaluation-guided endobronchial blocker placement in pediatric patients and to determine its efficiency in clinical application. Methods: A total of 127 pediatric patients of 0.5-3 years old scheduled for elective thoracic surgery under OLV were randomized into the bronchoscopy group and the CT group. The degree of lung collapse, postoperative airway mucosal injury, pulmonary infection within 72 hour after surgery, hoarseness after tracheal extubation, Durations of postoperative mechanical ventilation, intensive care unit (ICU) stay, and hospitalization, the successful rate of the first blocker positioning, and the required time and repositionings for successful blocker placement were compared between the two groups. Results: The degree of lung collapse, postoperative airway mucosal injury, pulmonary infection within 72 hour after surgery, hoarseness after tracheal extubation, durations of postoperative mechanical ventilation, ICU stay, and hospitalization were similar between the two groups (all P > 0.05). Conclusions: For pediatric patients who would undergo surgery with OLV, preoperative CT 3-DimenSional airway evaluation could be used to guide endobronchial blocker placement, with a blocking efficiency similar to that of bronchoscopy-guided blocker placement.
Comparison of bispectral index and patient state index during sevoflurane anesthesia in children: a prospective observational study
Authors: Ji Sang-Hwan , Jang Young-Eun , Kim Eun-Hee , Lee Ji-Hyun , Kim Jin-Tae , Kim Hee-Soo 
Published: November 2020

Abstract
Background: Cortical electroencephalography (EEG)-based devices are used to monitor the depth of anesthesia. In this study, we compared the values of bispectral index (BIS) and patient state index (PSI) during sevoflurane anesthesia in children. The ability/accuracy of BIS and PSI to predict the maintenance and recovery state of anesthesia was evaluated based on prediction probability (Pk) values and the secondary outcomes were agreement and correlation of two monitors.Methods: Fifty children (3-12 years old) were enrolled and the patients received sevoflurane anesthesia with remifentanil. Before the induction of anesthesia, BIS and PSI sensors were simultaneously placed on the forehead, and data were collected until the end of anesthesia. Maintenance state was defined as the period following intubation until the cessation of sevoflurane, while recovery state was defined as the period following the cessation of sevoflurane until awake. The prediction probability (Pk), agreement or correlation of BIS and PSI in different anesthesia state were calculated.Results: Anesthesia reduced mean BIS and PSI values. Pk of BIS (95% Confidential Interval (CI) [0.78-0.91])) and PSI (95% CI [0.82-0.91]) for anesthesia were 0.85 and 0.87, respectively. Agreement was 0.79 for recovery state and 0.73 for maintenance state.Conclusions: Pk values were comparable for BIS and PSI. Agreement between BIS and PSI measurements in the same state was relatively good. Therefore, these monitors are appropriate for monitoring for different state of anesthesia in pediatric population.Trial Registry Number: Clinical Trials.gov NCT03792334.
Incidence, characteristics, and outcomes of delirium in patients with noninvasive ventilation: A prospective observational study
Authors: Zhang Rui , Bai Linfu , Han Xiaoli , Huang Shicong , Zhou Lintong , Duan Jun 
Published: November 2020

Abstract
Background: Knowledge of delirium in noninvasive ventilation (NIV) patients is lacking. We investigated the incidence, characteristics, and outcomes of delirium in NIV patients. Methods: A prospective observational study was performed in an intensive care unit (ICU) of a teaching hospital. Patients in whom NIV was used as a first-line intervention were enrolled. During NIV intervention, delirium was screened using the Confusion Assessment Method for the ICU each day. The association between delirium and poor outcomes (e.g., NIV failure, ICU and hospital mortality) was investigated using forward stepwise multivariate logistic regression analyses.Results: We enrolled 1083 patients. Of these, 196 patients (18.1%) experienced delirium during NIV intervention. Patients with delirium had higher NIV failure rates (37.8% vs. 21.0%, p < 0.01), higher ICU mortality (33.2% vs. 14.3%, p < 0.01), and higher hospital mortality (37.2% vs. 17.0%, p < 0.01) than subjects without delirium. They also had a longer duration of NIV (median 6.3 vs. 3.7 days, p < 0.01), and stayed longer in the ICU (median 9.0 vs. 6.0 days, p < 0.01) and the hospital (median 14.5 vs. 11.0 days, p < 0.01). Furthermore, delirium was independently associated with NIV failure, ICU mortality, and hospital mortality (OR = 1.97, 2.58, and 2.55, respectively; all p values < 0.01). These results were confirmed in COPD and non-COPD cohorts. According to subtype, compared to hyperactive delirium patients, hypoactive and mixed delirium patients spent more days and many more days on NIV (median 3.4 vs. 6.5 vs. 10.1 days, p < 0.01). Similar outcomes were found for length of stay in the ICU and hospital. However, NIV failure, ICU mortality, and hospital mortality did not differ among the three subtypes.Conclusions: Delirium is associated with increases in poor outcomes (NIV failure, ICU mortality, and hospital mortality) and the use of medical resources (duration of NIV, and lengths of stay in the ICU and hospital). Regarding subtype, hypoactive and mixed delirium are associated with higher, and much higher, consumption of medical resources, respectively, compared to hyperactive delirium.
Crowded Household, Subdivided Flats, and Dilapidated Housing Are Risk Factors of Bedbug (Cimex Lectularius and Cimex Hemipterus) Infestation: a Cross-sectional Study of Hong Kong Households
Authors: Fung Eddy Hin Chung , Wong Hung , Chiu Siu Wai , Hui Jerome Ho Lam , Lam Hon Ming , Chung Roger Yat-nork , Wong Samuel Yeung-shan , Chan Siu Ming 
Published: November 2020

Abstract
Background: Bedbugs have been a neglected issue globally, disproportionately affecting low-income households. The features of many deprived housing units in Hong Kong provide suitable habitats for bedbug infestations. This study aims to identify the housing risk factors for bedbug infestations in Hong Kong.Methods: Using a cross-sectional study design, online self-reported questionnaires in Chinese were distributed between June 2019 to July 2020. Data collected were socio-demographics, crowded household condition, housing type, dilapidated housing features, and frequency of noticing bedbugs in the participant’s place of residence in the past year. The latter was transformed into a dichotomous dependent variable, “bedbug infestation”. Weighted bivariate and multivariate analysis using binary logistic regression were performed on SPSS 24.Results: The study sampled N=696 participants, 63.7% have had bedbug infestations. Bivariate analysis shows a positive correlation between the number of dilapidated housing features and bedbug infestation (OR=1.28, 95% CI 1.18-1.39, p<0.001). N=663 were included in the multivariate analysis. Those aged 45-64 (OR=2.53, 95% CI 1.30-4.91, p=0.006) and have primary education or below (OR=9.43, 95% CI 3.12-28.44, p<0.001) have significantly greater odds of bedbug infestation compared to their respective reference groups, ≥65 and tertiary education. Having monthly household income ≤HKD30,000 (OR=1.69, 95% CI 1.15-2.5, p=0.008) and living in subdivided flats (OR=16.53, 95% CI 1.01-269.72, p=0.049) and crowded household (OR=1.55, 95% CI 1.06-2.28, p=0.024) increases the odds of bedbug infestation. Dilapidated housing features that significantly increase the odds of bedbug infestation are having second-hand furniture (OR=2.97, 95% CI 1.16-7.58, p=0.023), housing cleanliness issues (OR=2.66, 95% CI 1.13-6.25, p=0.024), presence of bedbugs in neighbouring residential units (OR=3.32, 95% CI 1.57-7.04, p=0.002), and presence of bedbugs on the streets (OR=1.9, 95% CI 1.12-3.23, p=0.018).Conclusions: Crowded household, subdivided flats, and dilapidated housing are risk factors for bedbug infestations. To better control bedbug infestations, there needs to be a shift from viewing infestations as a personal hygiene to a public health issue. Efforts and policies should focus on addressing the housing risk factors identified in this study and prioritise vulnerable groups such as the elderly, low education level, low-income groups, and occupants of subdivided flats.
Dating the emergence of the first case of COVID-19 with flights: a retrospective modelling study&nbsp;
Authors: Yang Liwei , Zhu Jing Yan , Zhang Yihe , Zhou Wenjie , Si Yicheng 
Published: November 2020

Abstract
Commercial flights contributed to the early-stage international transmission of SARS-CoV-2. Understanding the effect of international and inter-state flights on virus transmission is important to evaluate the initial response of the outbreak. This study investigated the likely date of the emergence of the first COVID-19 case. We constructed a geographical-structured epidemiology model, integrating 2541 province-level units, 250 country-level units, and 26,094,036 flight plans to evaluate the possible date of the emergence of the first case. Using the model, we estimated the number of cumulative deaths and the date of first death caused by COVID-19 in different countries. The pattern of the three parameters we evaluated suggests a high likelihood of the emergence of the first case of COVID-19 be around September 15 and September 22, 2019.
Erasable superconductivity in topological insulator Bi2Se3 induced by voltage pulse
Authors: Le Tian , Ye Qikai , Chen Chufan , Yin Lichang , Zhang Dongting , Wang Xiaozhi , Lu Xin 
Published: November 2020

Abstract
Three-dimensional topological insulators (TIs) attract much attention due to its topologically protected Dirac surface states. Doping into TIs or their proximity with normal superconductors can promote the realization of topological superconductivity (SC) and Majorana fermions with potential applications in quantum computations. Here, we observed an emergent superconductivity in local mesoscopic point-contacts on the topological insulator Bi2Se3 by applying a voltage pulse through the contacts, evidenced by the Andreev reflection peak in the point-contact spectra and a visible resistance drop in the four-probe electrical resistance measurements. More intriguingly, the superconductivity can be erased with thermal cycles by warming up to high temperatures (300 K) and induced again by the voltage pulse at the base temperature (1.9 K), suggesting a signicance for designing new types of quantum devices. Nematic behaviouris also observed in the superconducting state, similar to the case of CuxBi2Se3 as topological superconductor candidates.
Crossed Cerebellar Diaschisis: Risk Factors and Prognostic Value in Medically Intractable Epilepsy by 18F-FDG PET/CT
Authors: Hou Yaqin , Guo Kun , Fan Xiaotong , Shang Kun , Wang Jingjuan , Wang Zhenming , Shan Yongzhi , Zhao Guoguang , Lu Jie 
Published: November 2020

Abstract
Purpose Crossed cerebellar diaschisis (CCD) has been widely studied in hemispheric stroke but is less characterized in epilepsy. In this study, we used 18F-FDG positron emission tomography (PET)/computed tomography (CT) to investigate the risk factors for CCD and its prognostic value for intractable epilepsy. Methods One hundred medically intractable epilepsy patients pathologically diagnosed with focal cortical dysplasia (FCD) postoperatively were included and classified into two groups: CCD+ and CCD-. All patients underwent 18F-FDG PET/CT preoperatively. PET/CT images were analysed qualitatively by visual assessment and semi-quantitatively using the absolute asymmetry index (|AI|). Clinical factors, including age, sex, body mass index (BMI), age at seizure onset, epilepsy duration, seizure type, epilepsy severity, electroencephalography(EEG) and brain magnetic resonance imaging (MRI), were retrospectively assessed from medical records. Follow-up outcomes were evaluated according to the Engel classification at 3, 6, 12, 24 and 36 months postoperatively.Results Of the 100 patients, 77 (77%) were classified as CCD-, and 23 (23%) were classified as CCD+. CCD+ patients had a higher number of lobes involved on PET (3.61±2.16 vs 2.26±1.01, P<0.001) and more cases of occipital hypometabolism (21.74% vs 5.19%, P=0.03) than CCD- patients. CCD- patients showed more negative MRI results than CCD+ patients (P=0.02). Patients with a poor prognosis had more cases of parietal hypometabolism on PET (P=0.02). At 12 months postoperatively, 71%(29/41) of CCD- patients and 31%(4/13) of CCD+ patients presented a favourable prognosis (P=0.02). Significant differences in the average |AI| values in the posterior frontal and anterior temporal lobes were found between CCD+ and CCD- patients (P<0.05), but no significant correlation of the |AI| between supratentorial regions and the contralateral cerebellum was identified in CCD+ patients. Conclusion The number of lobes involved on PET, structural anomalies on MRI, the lesion location on PET, the |AI| values in the posterior frontal and anterior temporal lobes may be predisposing factors for CCD. CCD occurrence may help predict the prognosis of FCD patients at 12 months postoperatively, and parietal hypometabolism on PET may indicate a poor prognosis.
One-Hour Plasma Glucose as a Long-Term Predictor of Cardiovascular Events and All-Cause Mortality in a Chinese Older Male Population Without Diabetes: A 20-year Retrospective and Prospective Study
Authors: Rong Lingjun , Miao Xinyu , Gong Yanping , Li Chunlin , Sun Banruo 
Published: November 2020

Abstract
BackgroundThe association between one-hour plasma glucose (1h-PG) and the incidence of type 2 diabetes has been investigated in previous studies. However, the predictive value of 1h-PG for the risk of cardiovascular disease (CVD) and all-cause mortality, especially in older Asians, has been investigated in only a few studies. Therefore, the influence of 1h-PG on the incidence of CVD and mortality was evaluated in the present study. MethodsThe participants were recruited from the Chinese People’s Liberation Army General Hospital, and were categorized into 1h-PG tertiles. The primary outcomes were all-cause mortality, myocardial infarction, unstable angina, and stroke. Multivariate adjusted Cox proportional hazard regression models were performed to examine the association between risk factors and outcomes and to estimate the risk of CVD and all-cause mortality based on 1h-PG.ResultsThe study included 862 male participants. Median age was 74.0 (25th–75th percentile: 68.0–79.0) years. There were 480 CVD events and 191 deaths during 15,527 person-years of follow-up. The adjusted hazard ratio (HR) of 1h-PG as a continuous variable was 1.097 (95% CI 1.027–1.172; P = 0.006) for CVD events and 1.196 (95% CI 1.115-1.281; P < 0.001) for higher risk of mortality. When compared with the lowest 1h-PG tertile, the other tertiles were associated with CVD events (HR 1.464, 95% CI 1.031–2.080; P = 0.033 and HR 1.538, 95% CI 1.092–2.166; P = 0.014, for tertile 2 and tertile 3 compared with tertile 1, respectively), and the highest 1h-PG tertile had a significantly higher risk of mortality (HR 2.384, 95% CI 1.631-3.485; P < 0.001) after full adjustment.ConclusionHigher 1h-PG is associated with an increased risk of all-cause mortality and CVD. 1h-PG might be a better predictor of CVD than 2h-PG in older adults.
Effect of Intensive Lifestyle Intervention on the Association between Weight Variability and Mortality and Cardiovascular Events in Overweight or Obese Adults with Type 2 Diabetes Mellitus
Authors: Liu Menghui , Chen Xiaohong , Zhang Shaozhao , Yang Daya , Lin Yifen , Xiong Zhenyu , Huang Yiquan , Zhong Xiangbin , Wang Lichun , Zhuang Xiaodong , Liao Xinxue 
Published: November 2020

Abstract
Background: The association among intensive lifestyle intervention (ILI), weight variability and the risks of death and cardiovascular events have limited data. We aimed to examine whether the weight variability is associated with all-cause mortality and cardiovascular events, and whether the intensive lifestyle intervention (ILI) will affect these associations in overweight or obese individuals with type 2 diabetes mellitus (T2DM).Methods: Individuals from the Action for Health in Diabetes (Look AHEAD) trial who measured the weight variability based on 5 equally spaced medical measurements of within 4 years were enrolled. A multivariate-adjusted Cox regression models were used to evaluate the associations between weight variability and adverse outcomes including the all-cause mortality and primary cardiovascular disease (CVD) outcome, and the effects of ILI on these associations.Results: Among the 3,859 participants with a median follow-up of 9.6 years, those with the highest quartile of weight variability experienced a double higher risk of death compared with those the lowest quartile (HR 2.25; 95% CI 1.44-3.52), but no difference was found in primary CVD outcome (HR 1.02; 95% CI 0.78-1.33). Moreover, the restricted cubic splines revealed that the risk of death grew with the increased weight variability. Of note, the association between weight variability and all-cause mortality was not observed in ILI arm (the highest vs. lowest quartile group, [HR 1.30; 95% CI 0.67-2.50]) and was just found in diabetes support and education (DSE) arm (the highest vs. lowest quartile group, [HR 3.31; 95% CI 1.84-5.95]).Conclusions: Among the overweight or obese individuals with T2DM, the weight variability was independently associated with increased risks of all-cause mortality, but this association might be removed by ILI.Trial registrations ClinicalTrials.gov identifiers: NCT00017953.