bluuebunny/crossref_metadata_2025_split huggingface dataset:
4D spinless topological insulator in a periodic electric circuit
Authors: Yu Rui , Zhao Y X , Schnyder Andreas P 
Published: April 2020

Abstract
According to the mathematical classification of topological band structures, there exist a number of fascinating topological states in dimensions larger than three with exotic boundary phenomena and interesting topological responses. While these topological states are not accessible in condensed matter systems, recent works have shown that synthetic systems, such as photonic crystals or electric circuits, can realize higher-dimensional band structures. Here, we argue that, because of its symmetry properties, the 4D spinless topological insulator is particularly well suited for implementation in these synthetic systems. We explicitly construct a 2D electric circuit lattice, whose resonance frequency spectrum simulates the 4D spinless topological insulator. We perform detailed numerical calculations of the circuit lattice and show that the resonance frequency spectrum exhibits pairs of 3D Weyl boundary states, a hallmark of the nontrivial topology. These pairs of 3D Weyl states with the same chirality are protected by classical time-reversal symmetry that squares to +1, which is inherent in the proposed circuit lattice. We also discuss how the simulated 4D topological band structure can be observed in experiments.
Performance of VERA in 10 micro-arcsecond astrometry
Authors: Nagayama Takumi , Kobayashi Hideyuki , Hirota Tomoya , Honma Mareki , Jike Takaaki , Kim Mi Kyoung , Nakagawa Akiharu , Omodaka Toshihiro , Oyama Tomoaki , Sakai Daisuke , Shibata Katsunori M , Tamura Yoshiaki 
Published: April 2020

Abstract
Very Long Baseline Interferometry (VLBI) astrometry using the phase-referencing technique remains an open issue for the quantitative characterization of the observing conditions to achieve a feasible parallax precision of 10 micro-arcseconds (μas). To address this issue, we evaluated the astrometric performance of the VLBI Exploration of Radio Astrometry (VERA) through the parallax measurements of five distant star-forming regions under good observing conditions of close separations (${0{^{\circ}_{.}}5}$–${1{_{.}^{\circ}}3}$) and high elevations (≥50°). Their parallaxes measured 89–200 μas, corresponding to distances of 5–11 kpc with an error of 11–20 μas. Furthermore, we investigated the contributions to the position error budget and concluded that the tropospheric residual contribution is the dominant error source. We also confirmed that the astrometric error propagation strongly depends on the term $\Delta \sec Z$, which stands for the difference between $\sec Z$ of the target and its reference source, where Z is the zenith angle during the observations. We found that for a source pair with a $\Delta \sec Z$ less than 0.01 (for example, a set of a close separation of $\le {{0{^{\circ}_{.}}5}}$ and a high elevation of ≥50°), we can achieve the parallax precision of 10 μas using a typical monitoring program comprising 10 observing epochs over a span of two years.
Random Tanglegram Partitions (Random TaPas): An Alexandrian Approach to the Cophylogenetic Gordian Knot
Authors: Balbuena Juan Antonio , Pérez-Escobar Óscar Alejandro , Llopis-Belenguer Cristina , Blasco-Costa Isabel 
Published: April 2020

AbstractSymbiosis is a key driver of evolutionary novelty and ecological diversity, but our understanding of how macroevolutionary processes originate extant symbiotic associations is still very incomplete. Cophylogenetic tools are used to assess the congruence between the phylogenies of two groups of organisms related by extant associations. If phylogenetic congruence is higher than expected by chance, we conclude that there is cophylogenetic signal in the system under study. However, how to quantify cophylogenetic signal is still an open issue. We present a novel approach, Random Tanglegram Partitions (Random TaPas) that applies a given global-fit method to random partial tanglegrams of a fixed size to identify the associations, terminals, and nodes that maximize phylogenetic congruence. By means of simulations, we show that the output value produced is inversely proportional to the number and proportion of cospeciation events employed to build simulated tanglegrams. In addition, with time-calibrated trees, Random TaPas can also distinguish cospeciation from pseudocospeciation. Random TaPas can handle large tanglegrams in affordable computational time and incorporates phylogenetic uncertainty in the analyses. We demonstrate its application with two real examples: passerine birds and their feather mites, and orchids and bee pollinators. In both systems, Random TaPas revealed low cophylogenetic signal, but mapping its variation onto the tanglegram pointed to two different coevolutionary processes. We suggest that the recursive partitioning of the tanglegram buffers the effect of phylogenetic nonindependence occurring in current global-fit methods and therefore Random TaPas is more reliable than regular global-fit methods to identify host–symbiont associations that contribute most to cophylogenetic signal. Random TaPas can be implemented in the public-domain statistical software R with scripts provided herein. A User’s Guide is also available at GitHub.[Codiversification; coevolution; cophylogenetic signal; Symbiosis.]
Outcomes Following Intensive Care Unit Admission in a Pediatric Cohort in Malawi
Authors: Purcell Laura N , Prin Meghan , Sincavage John , Kadyaudzu Clement , Phillips Michael R , Charles Anthony 
Published: April 2020

AbstractIntroductionThe burden of critical illness in low- and middle-income countries (LMICs) is high; however, there is a paucity of data describing pediatric critical care outcomes in this setting.MethodsWe performed a prospective observational study of the pediatric (≤18 years) intensive care population in Malawi, from August 2016 to May 2018. Data collected include patient demographics and clinical data, admission criteria and outcome. A multivariate Poisson regression was performed to determine risk factors for mortality.ResultsOver the study period, 499 patients were admitted to the intensive care unit (ICU) and 105 (21.0%) were children. The average age was 10.6 ± 5.4 years. Primary indications for ICU admission were sepsis (n = 30, 30.3%) and traumatic brain injury (TBI, n = 23, 23.2%). Of those who died, sepsis (n = 18, 32.7%), acute respiratory failure (n = 11, 20.0%) and TBI (n = 11, 20.0%) were the primary admission diagnoses. Overall, ICU mortality was 54.3% (n = 57). Multivariate regression for increased ICU mortality revealed: age ≤5 years [risk ratio (RR) 1.96, 95% CI 1.10–2.26, p &lt; 0.001], hemoglobin &lt; 10 g/dl (RR 1.58, 95% CI 1.08—2.01, p = 0.01) and shock requiring epinephrine support (RR 2.76, 95% CI 1.80–4.23, p &lt; 0.001).ConclusionsPediatric ICU mortality is high. Predictors of mortality were age ≤5 years, anemia at ICU admission and the need for epinephrine support. Training of pediatric intensive care specialists and increased blood product availability may attenuate the high mortality for critically ill children in Malawi.
La ratification de la Convention du Cap et de son Protocole ferroviaire : la délicate alchimie du choix des déclarations (ou du bon usage du sur-mesure d’un point de vue français)
Authors: Riffard Jean-François ,   À notre ami Pierre Crocq
Published: April 2020

Abstract
In order not to lag behind a movement already widely engaged at the international level and to benefit from the advantages of an instrument whose success is well established, France is considering ratifying very soon the Cape Town Convention and its Luxemburg Rail Protocol. While such a decision can be enthusiastically approved, this ratification, which does not rise any major legal difficulties, will nevertheless lead the French authorities to examine the often neglected but very important in practice, issue of declarations. We know that the Convention is not a full “one-size-fits-all” instrument, and that adaptation to national legal contexts and traditions is, in some sensitive areas, necessary. This study proposes to consider the declarations that France might or might not have to make under the CTC and the Rail Protocol and the challenges that are attached to these choices.
Subclinical hypothyroidism
Authors: Simon Chelsea , Weidman-Evans Emily , Allen Sarah 
Published: April 2020

ABSTRACT
Subclinical hypothyroidism affects 4.3% of the US population. Despite this prevalence, whether to treat or to observe patients with subclinical hypothyroidism remains controversial. Guidelines for overt hypothyroidism strongly favor treatment for symptomatic benefits, but the same benefits of levothyroxine treatment have not been proven for patients with subclinical hypothyroidism—most likely due to the asymptomatic nature of the condition. Additionally, a connection between subclinical hypothyroidism and cardiovascular complications has not been definitively established, although the evidence favors a relationship. This article describes the background, presentation, and diagnostics of subclinical hypothyroidism, treatment, and potential cardiovascular complications, so clinicians can decide if initiating treatment is best for their patients with subclinical hypothyroidism.
Substance Use Disorder in Physicians after Completion of Training in Anesthesiology in the United States from 1977 to 2013
Authors: Warner David O. , Berge Keith , Sun Huaping , Harman Ann , Wang Ting 
Published: April 2020

Background
Substance use disorder among physicians can expose both physicians and their patients to significant risk. Data regarding the epidemiology and outcomes of physician substance use disorder are scarce but could guide policy formulation and individual treatment decisions. This article describes the incidence and outcomes of substance use disorder that resulted in either a report to a certifying body or death in physicians after the completion of anesthesiology training.

Methods
Physicians who completed training in U.S. anesthesiology residency programs from 1977 to 2013 and maintained at least one active medical license were included in this retrospective cohort study (n = 44,736). Substance use disorder cases were ascertained through records of the American Board of Anesthesiology and the National Death Index.

Results
Six hundred and one physicians had evidence of substance use disorder after completion of training, with an overall incidence of 0.75 per 1,000 physician-years (95% CI, 0.71 to 0.80; 0.84 [0.78 to 0.90] in men, 0.43 [0.35 to 0.52] in women). The highest incidence rate occurred in 1992 (1.79 per 1,000 physician-years [95% CI, 1.12 to 2.59]). The cumulative percentage expected to develop substance use disorder within 30 yr estimated by Kaplan–Meier analysis equaled 1.6% (95% CI, 1.4 to 1.7%). The most common substances used by 353 individuals for whom information was available were opioids (193 [55%]), alcohol (141 [40%]), and anesthetics/hypnotics (69 [20%]). Based on a median of 11.1 (interquartile range, 4.4 to 19.8) yr of follow-up, the cumulative proportion of survivors estimated to experience at least one relapse within 30 yr was 38% (95% CI, 31 to 43%). Of the 601 physicians with substance use disorder, 114 (19%) were dead from a substance use disorder–related cause at last follow-up.

Conclusions
A substantial proportion of anesthesiologists who develop substance use disorder after the completion of training die of this condition, and the risk of relapse is high in those who survive.

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Mature Follicle Count and Multiple Gestation Risk Based on Patient Age in Intrauterine Insemination Cycles With Ovarian Stimulation
Authors: Evans M. Blake , Stentz Natalie C. , Richter Kevin S. , Schexnayder Brian , Connell Matt , Healy Mae W. , Devine Kate , Widra Eric , Stillman Robert , DeCherney Alan H. , Hill Micah J. 
Published: April 2020

OBJECTIVE:
To estimate the risk of a multiple gestation pregnancy in ovarian stimulation intrauterine insemination (IUI) cycles when stratified by patient age and mature follicle number.

METHODS:
We conducted a retrospective cohort study at a single private practice fertility center of IUI cycles performed from 2004 to 2017. Intervention(s) were ovarian stimulation and IUI if postwash total motile sperm count was more than 8 million. Mature follicles were defined as 14 mm or more as measured on the day of ovulation trigger. Main outcomes and measures were rates of clinical pregnancy and multiple gestation.

RESULTS:
We identified 24,649 women who underwent a total of 50,473 IUI cycles. Increasing the number of mature follicles from one to five at the time of IUI in women younger than age 38 years increased the clinical pregnancy rate from 14.6% to 21.9% (adjusted odds ratio [aOR] 1.6, 95% CI 1.4–1.9), almost entirely from a marked increase in multiple gestations per cycle from 0.6% to 6.5% (aOR 9.9, 95% CI 6.9–14.2). There was little increase in singleton pregnancies per IUI (14.1–16.4%) regardless of mature follicle number. The per-pregnancy twin and higher-order multiple gestation risk significantly increased (3.9–23.3%, P<.01 and 0.2–10.6%, P<.01, respectively) when comparing one with five mature follicles present at the time of IUI (P<.01). In women younger than age 38 years with more than three follicles present, more than one quarter of all pregnancies were multiples. Similar findings occurred in women aged 38–40 years. In women older than age 40 years, up to four follicles tripled the odds of pregnancy (aOR 3.1, 95% CI 2.1–4.5) while maintaining a less than 12% risk of multiple gestation per pregnancy and a 1.0% absolute risk of multiples.

CONCLUSION:
Caution should be used in proceeding with IUI after ovarian stimulation when there are more than two mature follicles in women younger than age 40 years owing to the substantially increased risk of multiple gestation without an improved chance of singleton clinical pregnancy.
Uterine Exteriorization Compared With In Situ Repair of Hysterotomy After Cesarean Delivery
Authors: Mireault Danny , Loubert Christian , Drolet Pierre , Tordjman Laurent , Godin Nadia , Richebé Philippe , Zaphiratos Valerie 
Published: April 2020

OBJECTIVE:
To compare the effect of exteriorized with in situ uterine repair on intraoperative nausea and vomiting during elective cesarean delivery under spinal anesthesia using a phenylephrine infusion.

METHODS:
This study was a randomized double-blinded controlled trial of 180 women undergoing elective cesarean delivery using a standardized anesthetic protocol. Patients were randomized to exteriorization (n=90) or in situ uterine repair (n=90). The spinal anesthetic, phenylephrine infusion, and blood pressure management were all standardized. The primary outcome was postdelivery intraoperative nausea and vomiting using a 4-point scale (0–3). A sample size of 80 patients per group was needed to demonstrate a 50% reduction in intraoperative nausea and vomiting with in situ repair.

RESULTS:
From November 2015 through July 2018, 180 patients were enrolled. Incidence of postdelivery intraoperative nausea and vomiting was 39% in the exteriorization group compared with 22% in the in situ group (P=.01). Incidence of hypotension (80% vs 50%; P<.001) and tachycardia (33% vs 17%; P=.02) was significantly higher in the exteriorization group, and more phenylephrine boluses were administered to this group (median 4 boluses [first and third quartiles 1.25–7] vs 2 [0–4]; P<.001). The duration of surgery, blood loss, and postoperative hemoglobin decline were similar between groups.

CONCLUSION:
In situ uterine repair for elective cesarean delivery under spinal anesthesia with a phenylephrine infusion is associated with less postdelivery intraoperative nausea and vomiting.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT02587013.
Tracking Cognitive Spare Capacity During Speech Perception With EEG/ERP: Effects of Cognitive Load and Sentence Predictability
Authors: Hunter Cynthia R. 
Published: April 2020

Objectives:
Listening to speech in adverse listening conditions is effortful. Objective assessment of cognitive spare capacity during listening can serve as an index of the effort needed to understand speech. Cognitive spare capacity is influenced both by signal-driven demands posed by listening conditions and top-down demands intrinsic to spoken language processing, such as memory use and semantic processing. Previous research indicates that electrophysiological responses, particularly alpha oscillatory power, may index listening effort. However, it is not known how these indices respond to memory and semantic processing demands during spoken language processing in adverse listening conditions. The aim of the present study was twofold: first, to assess the impact of memory demands on electrophysiological responses during recognition of degraded, spoken sentences, and second, to examine whether predictable sentence contexts increase or decrease cognitive spare capacity during listening.

Design:
Cognitive demand was varied in a memory load task in which young adult participants (n = 20) viewed either low-load (one digit) or high-load (seven digits) sequences of digits, then listened to noise-vocoded spoken sentences that were either predictable or unpredictable, and then reported the final word of the sentence and the digits. Alpha oscillations in the frequency domain and event-related potentials in the time domain of the electrophysiological data were analyzed, as was behavioral accuracy for both words and digits.

Results:
Measured during sentence processing, event-related desynchronization of alpha power was greater (more negative) under high load than low load and was also greater for unpredictable than predictable sentences. A complementary pattern was observed for the P300/late positive complex (LPC) to sentence-final words, such that P300/LPC amplitude was reduced under high load compared with low load and for unpredictable compared with predictable sentences. Both words and digits were identified more quickly and accurately on trials in which spoken sentences were predictable.

Conclusions:
Results indicate that during a sentence-recognition task, both cognitive load and sentence predictability modulate electrophysiological indices of cognitive spare capacity, namely alpha oscillatory power and P300/LPC amplitude. Both electrophysiological and behavioral results indicate that a predictive sentence context reduces cognitive demands during listening. Findings contribute to a growing literature on objective measures of cognitive demand during listening and indicate predictable sentence context as a top-down factor that can support ease of listening.
Key Components of ICU Recovery Programs: What Did Patients Report Provided Benefit?
Authors: McPeake Joanne , Boehm Leanne M. , Hibbert Elizabeth , Bakhru Rita N. , Bastin Anthony J. , Butcher Brad W. , Eaton Tammy L. , Harris Wendy , Hope Aluko A. , Jackson James , Johnson Annie , Kloos Janet A. , Korzick Karen A. , MacTavish Pamela , Meyer Joel , Montgomery-Yates Ashley , Quasim Tara , Slack Andrew , Wade Dorothy , Still Mary , Netzer Giora , Hopkins Ramona O. , Mikkelsen Mark E. , Iwashyna Theodore J. , Haines Kimberley J. , Sevin Carla M. 
Published: April 2020

Objectives:
To understand from the perspective of patients who did, and did not attend ICU recovery programs, what were the most important components of successful programs and how should they be organized.

Design:
International, qualitative study.

Setting:
Fourteen hospitals in the United States, United Kingdom, and Australia.

Patients:
We conducted 66 semi-structured interviews with a diverse group of patients, 52 of whom had used an ICU recovery program and 14 whom had not.

Interventions:
None.

Measurements and Main Results:
Using content analysis, prevalent themes were documented to understand what improved their outcomes. Contrasting quotes from patients who had not received certain aspects of care were used to identify perceived differential effectiveness. Successful ICU recovery programs had five key components: 1) Continuity of care; 2) Improving symptom status; 3) Normalization and expectation management; 4) Internal and external validation of progress; and 5) Reducing feelings of guilt and helplessness. The delivery of care which achieved these goals was facilitated by early involvement (even before hospital discharge), direct involvement of ICU staff, and a focus on integration across traditional disease, symptom, and social welfare needs.

Conclusions:
In this multicenter study, conducted across three continents, patients identified specific and reproducible modes of benefit derived from ICU recovery programs, which could be the target of future intervention refinement.
Cardiovascular Considerations in Treating Patients With Coronavirus Disease 2019 (COVID-19)
Authors: Dixon Dave L. , Van Tassell Benjamin W. , Vecchié Alessandra , Bonaventura Aldo , Talasaz Azita H. , Kakavand Hessam , D'Ascenzo Fabrizio , Perciaccante Antonio , Castagno Davide , Ammirati Enrico , Biondi-Zoccai Giuseppe , Stevens Michael P. , Abbate Antonio 
Published: April 2020

Abstract:
A novel betacoronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly across the globe since December 2019. Coronavirus disease 2019 (COVID-19) has a significantly higher mortality rate than seasonal influenza and has disproportionately affected older adults, especially those with cardiovascular disease and related risk factors. Adverse cardiovascular sequelae, such as myocarditis, acute myocardial infarction, and heart failure, have been reported in patients with COVID-19. No established treatment is currently available; however, several therapies, including remdesivir, hydroxychloroquine and chloroquine, and interleukin (IL)-6 inhibitors, are being used off-label and evaluated in ongoing clinical trials. Considering these therapies are not familiar to cardiovascular clinicians managing these patients, this review describes the pharmacology of these therapies in the context of their use in patients with cardiovascular-related conditions.
Guillain–Barré syndrome in a heart transplantation recipient
Authors: Wei Ching-Wen , Liu Chin-Yu , Chang Chung-Yi , Liu Wei-Chun , Cheng Hao-Chun , Tung Heng-Hsin , Chiang Nian-Chen , Chang Hsin-Huei 
Published: April 2020

ABSTRACT
A rare case of a heart transplantation recipient with Guillain–Barré syndrome occurred, which was associated with peripheral nervous system damage. Based on a review of epidemiological research, the symptom development process, and diagnostic tools, the authors highlight the extreme rarity of this postinfectious immune disease. After diagnosis, plasma exchange and immunoregulatory therapy should be performed because they result in rapid recovery. If there is delayed diagnosis and treatment, there is a high risk of disability or death. When patients experience acute limb paralysis as the main symptom, nurse practitioners (NPs) should focus on the patient's history, particularly with regard to infectious agents. Closely monitoring the patient to detect respiratory failure and the need for early respiratory intervention can help the patient to avoid the severe complication of permanent brain injury. For NPs, performance of early differential diagnosis is important, especially among patients who have immunosuppressive dependence after transplantation.