bluuebunny/crossref_metadata_2025_split huggingface dataset:
Better Outcomes for Older people with Spinal Trouble (BOOST) trial: statistical analysis plan for a randomised controlled trial of a combined physical and psychological intervention for older adults with neurogenic claudication
Authors: Marian Ioana R. , Williamson Esther , Garrett Angela , Lamb Sarah E. , Dutton Susan J. 
Published: July 2020

Abstract
Background
Neurogenic claudication is a common spinal condition affecting older adults that has a major effect on mobility and implicitly independence. The effectiveness of conservative interventions in this population is not known. We describe the statistical analysis plan for the Better Outcomes for Older people with Spinal trouble (BOOST) randomised controlled trial.

Methods/design
BOOST is a pragmatic, multicentre, parallel, two-arm, randomised controlled trial. Participants are community-dwelling adults, 65 years or older, with neurogenic claudication, registered prospectively, and randomised 2:1 (intervention to control) to the combined physical and psychological BOOST group physiotherapy programme or best practice advice. The primary outcome is the Oswestry Disability Index at 12 months. Secondary outcomes include the Short Physical Performance Battery, Swiss Spinal Stenosis Scale, 6 Minute Walk Test, Fear Avoidance Beliefs Questionnaire, and Tilburg Frailty Indicator. Outcomes are measured at 6 and 12 months by researchers blinded to treatment allocation. The primary statistical analysis is by intention to treat. Further study design details are published in the BOOST protocol.

Discussion
The planned statistical analyses for the BOOST trial aim to reduce the risk of outcome reporting bias from prior data knowledge. Any changes or deviations from this statistical analysis plan will be described and justified in the final study report.

Trial registration
This study has been registered in the International Standard Randomised Controlled Trial Number registry, reference number ISRCTN12698674. Registered on 10 November 2015.
Identifying targets for antibiotic stewardship interventions through analysis of the antibiotic prescribing process in hospitals - a multicentre observational cohort study
Authors: Wathne Jannicke Slettli , Skodvin Brita , Charani Esmita , Harthug Stig , Blix Hege Salvesen , Nilsen Roy M. , Kleppe Lars Kåre Selland , Vukovic Marta , Smith Ingrid 
Published: July 2020

Abstract
Background
In order to change antibiotic prescribing behaviour, we need to understand the prescribing process. The aim of this study was to identify targets for antibiotic stewardship interventions in hospitals through analysis of the antibiotic prescribing process from admission to discharge across five groups of infectious diseases.

Methods
We conducted a multi-centre, observational cohort study, including patients with lower respiratory tract infections, exacerbation of chronic obstructive pulmonary disease, skin- and soft tissue infections, urinary tract infections or sepsis, admitted to wards of infectious diseases, pulmonary medicine and gastroenterology at three teaching hospitals in Western Norway. Data was collected over a 5-month period and included antibiotics prescribed and administered during admission, antibiotics prescribed at discharge, length of antibiotic therapy, indication for treatment and discharge diagnoses, estimated glomerular filtration rate (eGFR) on admission, antibiotic allergies, place of initiation of therapy, admittance from an institution, patient demographics and outcome data. Primary outcome measure was antibiotic use throughout the hospital stay, analysed by WHO AWaRe-categories and adherence to guideline. Secondary outcome measures were a) antibiotic prescribing patterns by groups of diagnoses, which were analysed using descriptive statistics and b) non-adherence to the national antibiotic guidelines, analysed using multivariate logistic regression.

Results
Through analysis of 1235 patient admissions, we identified five key targets for antibiotic stewardship interventions in our population of hospital inpatients; 1) adherence to guideline on initiation of treatment, as this increases the use of WHO Access-group antibiotics, 2) antibiotic prescribing in the emergency room (ER), as 83.6% of antibiotic therapy was initiated there, 3) understanding prescribing for patients admitted from other institutions, as this was significantly associated with non-adherence to guideline (OR = 1.44 95% CI 1.04, 2.00), 4) understanding cultural and contextual drives of antibiotic prescribing, as non-adherent prescribing differed significantly between the sites of initiation of therapy (between hospitals and ER versus ward) and 5) length of therapy, as days of antibiotic therapy was similar across a wide range of diagnoses and with prolonged therapy after discharge.

Conclusions
Analysing the process of antibiotic prescribing in hospitals with patient-level data identified important targets for antibiotic stewardship interventions in hospitals.
Total knee arthroplasty following intramedullary tibial nailing
Authors: Smith Evan J. , Heng Marilyn , Bedair Hany S. , Melnic Christopher M. 
Published: July 2020

Abstract
Introduction/purpose
Total knee arthroplasty (TKA) in the setting of previous periarticular hardware increases resource utilization, readmissions, complications, and revision rates. Despite the frequency of intramedullary nail (IMN) fixation for tibial fractures, little guidance exists on the management of these patients and no series have reported on outcomes of patients undergoing TKA in the setting of a retained or removed IMN.

Methods
This is a retrospective case series of patients who underwent TKA after IMN fixation of tibial fractures. Patient and case data, including need for hardware removal, staged vs non-staged procedures, operative time, and need for revision implants, were recorded. Postoperative data, including complications and revision, were recorded. Oxford Knee Score (OKS) was performed at follow-up.

Results
Nine patients were identified consisting of eight women and one man. Follow-up ranged from 0.8–13 years. Non-staged removal of the intramedullary hardware occurred in three cases that had increased operative lengths recorded. There were no complications related to wound healing or infection. No patients required revision. Two of the three patients who underwent non-staged TKA developed arthrofibrosis requiring manipulation. OKS scores in patients who underwent non-staged surgery were consistently low.

Conclusions
Conversion TKA after tibial IMN fixation can result in satisfying outcomes in many patients. However, intramedullary hardware presents challenges to TKA similar to more extensively studied conversion TKA scenarios. Removing hardware in either a staged or non-staged fashion results in increased resource utilization and imparts perioperative challenges with only theoretical benefits of one approach compared to the other. Increased stiffness may be associated with a non-staged approach to hardware removal and TKA. Several technical factors may permit component positioning without removal of hardware. Despite limitations, this is the first series to discuss this challenging clinical scenario and provides surgeons with technical guidance and data on operative outcomes.
Exercise Performance Is Impaired during the Midluteal Phase of the Menstrual Cycle
Authors: FREEMAS JESSICA A. , BARANAUSKAS MARISSA N. , CONSTANTINI KEREN , CONSTANTINI NAAMA , GREENSHIELDS JOEL T. , MICKLEBOROUGH TIMOTHY D. , RAGLIN JOHN S. , SCHLADER ZACHARY J. 
Published: July 2020

ABSTRACT

Purpose
This study aimed to test the hypothesis that aerobic exercise performance is impaired in the midluteal (ML) compared with the midfollicular (MF) phase of the menstrual cycle.

Methods
Twelve recreationally active eumenorrheic women (25 ± 6 yr) completed exercise sessions during the MF and the ML phases. Each session consisted of an 8-km cycling time trial that was preceded by 10 min of cycling performed at a constant power below and above gas exchange threshold. Heart rate, ventilation, and oxygen uptake were continuously measured. RPE and ratings of fatigue were assessed during the time trial using visual analog scales. Total mood disturbance was calculated from the POMS questionnaire administered before and 20 min postexercise.

Results
Salivary progesterone concentration was 578 ± 515 pg·mL−1 higher in ML compared with MF phase (P < 0.01), whereas estradiol concentration did not differ between phases (167 ± 55 vs 206 ± 120 pg·mL−1, P = 0.31). Total mood disturbance before exercise was greater during the ML phase compared with the MF phase (P < 0.01), but this difference was abolished postexercise (P = 0.14). Mean power output was lower during the ML phase (115 ± 29 vs 125 ± 28 W, P < 0.01), which led to a slower time trial in the ML phase (18.3 ± 2.0 min) compared with the MF phase (17.8 ± 1.7 min, P = 0.03). Ratings of fatigue were greater during the ML phase from 2 to 8 km (P ≤ 0.01), whereas no differences in RPE were observed. Heart rate (P = 0.85), minute ventilation (P = 0.53), and oxygen uptake (P = 0.32) did not differ between phases during the time trial.

Conclusion
Aerobic exercise performance is worse in the ML phase compared with the MF phase in recreationally active women, which was accompanied by a more negative mood state preexercise and increased ratings of fatigue.
Effects of aflatoxin B1 on the submandibular salivary gland of albino rats and possible therapeutic potential of Rosmarinus officinalis: a light and electron microscopic study
Authors: Ashraf Bassant , Ghazy Dahlia , Shamel Mohamed 
Published: July 2020

Background: Aflatoxin B1 (AFB1), a highly toxic mycotoxin, is one of the contaminants of food items such as corn, rice, nuts, and flour. This study aimed to evaluate the effect of AFB1 on the histology and ultrastructure of the submandibular salivary glands (SMSG) of albino rats and examine the possible therapeutic effect of Rosmarinus officinalis extract. Methods: This study used 21 adult male albino rats equally divided into three groups as follows: Group C (saline-treated control group); Group A (AFB1 treated group) subjected to intraperitoneal injection of AFB1 (2 mg/kg) once daily for four weeks; Group R (rosemary-treated group) subjected to AFB1 as in Group A followed by two weeks of intraperitoneal injection of Rosmarinus officinalis extract (400mg/kg) once daily. At the end of the experimental periods, SMSGs were excised and fixed for histological and ultrastructural examinations. Results: SMSGs of the AFB1 group presented atrophied serous acini with numerous cytoplasmic vacuolations; their granular convoluted tubules, striated ducts and excretory ducts presented signs of degeneration in their cell lining with the presence of abundant cytoplasmic vacuolations. In addition, dilated blood vessels engorged with red blood cells were frequently seen. Ultrastructural findings of the AFB1 group showed some acinar cells with degenerated mitochondria presenting loss of cristae and vacuolations as well as irregular, shrunken nuclei with condensed chromatin. Dilated rough endoplasmic reticulum were observed in granular convoluted tubules and striated ducts. The glands of animals that received rosemary extract almost regained their normal architecture. Conclusions: It can be concluded that rosemary extract has an ameliorative effect on the deleterious histological and ultrastructural changes induced by chronic AFB1 intake in rat SMSGs.
Insights into population structure of East African sweetpotato cultivars from hybrid assembly of chloroplast genomes
Authors: Zhou Chenxi , Duarte Tania , Silvestre Rocio , Rossel Genoveva , Mwanga Robert O. M. , Khan Awais , George Andrew W. , Fei Zhangjun , Yencho G. Craig , Ellis David , Coin Lachlan J. M. 
Published: July 2020

Background:The chloroplast (cp) genome is an important resource for studying plant diversity and phylogeny. Assembly of the cp genomes from next-generation sequencing data is complicated by the presence of two large inverted repeats contained in the cp DNA.Methods:We constructed a complete circular cp genome assembly for the hexaploid sweetpotato using extremely low coverage (<1×) Oxford Nanopore whole-genome sequencing (WGS) data coupled with Illumina sequencing data for polishing.Results:The sweetpotato cp genome of 161,274 bp contains 152 genes, of which there are 96 protein coding genes, 8 rRNA genes and 48 tRNA genes. Using the cp genome assembly as a reference, we constructed complete cp genome assemblies for a further 17 sweetpotato cultivars from East Africa and anI. trilobaline using Illumina WGS data. Analysis of the sweetpotato cp genomes demonstrated the presence of two distinct subpopulations in East Africa. Phylogenetic analysis of the cp genomes of the species from the ConvolvulaceaeIpomoeasectionBatatasrevealed that the most closely related diploid wild species of the hexaploid sweetpotato isI. trifida.Conclusions:Nanopore long reads are helpful in construction of cp genome assemblies, especially in solving the two long inverted repeats. We are generally able to extract cp sequences from WGS data of sufficiently high coverage for assembly of cp genomes. The cp genomes can be used to investigate the population structure and the phylogenetic relationship for the sweetpotato.
Fast-iterative blind phase-shifting digital holographic microscopy using two images
Authors: Castañeda Raul , Buitrago-Duque Carlos , Garcia-Sucerquia Jorge , Doblas Ana 
Published: July 2020

Digital holographic microscopy (DHM) has consolidated as a tool for diagnosis and measuring in life sciences, thanks to its capability to perform quantitative phase imaging. The reduction of the acquisition and computation time has driven the development of diverse reconstruction methodologies using a single-shot and two-frame approach. Methods based on the Fourier transform, the Hilbert transform, and the phase derivative are counted among the most utilized. The sensitivity of those methods is highly dependent on the compensation of the phase step, which requires the accurate knowledge of the phase shift between the two recorded holograms. Here, an alternative fast-iterative method based on the demodulation of the different components of the recorded interferograms is presented. The novelties of the proposed two-frame approach are: minimum number of images, since it requires 2 recorded holograms; a minimum phase error of the order of 0.005% independently of the phase step ranging from 0 to 180 deg.; a maximum correlation coefficient equal to 1 between the phase and the retrieved phase image; and, finally, a reduced processing time compared with the previous three-frame approach. Experimental results demonstrate the goodness and feasibility of the proposed technique.
Modeling UV-C irradiation chambers for mask decontamination using Zemax OpticStudio
Authors: Wilde Jeffrey P. , Baer Thomas M. , Hesselink Lambertus 
Published: July 2020

Ultraviolet decontamination
of personal protective equipment, particularly masks, is important in
situations where mask reuse is practiced. To assist in the development
of UV-C decontamination chambers, we have constructed ray tracing
models in Zemax OpticStudio v20.1 for two distinct geometries, namely,
a rectangular cabinet and a cylindrical can. These models provide
irradiance distributions that can be used for comparison with
experiment, as well as to predict local irradiance variation over the
surface of a mask. In this paper we describe the model details,
including: (1) a mask object in CAD format; (2) our assumptions for
modeling surface properties; (3) the use of polygon object detectors
for local irradiance analysis; and (4) experimental results that
compare favorably to the simulations.
All-photonic 20-MHz clock for latency monitoring in a 5G network at 10  Gbps over optical fiber
Authors: Nfanyana Ketshabile , Wassin Shukree , Karembera Reinhard , Jena James , Gibbon Tim 
Published: July 2020

Innovation and advancement in technologies such as self-driving cars, machine learning, remote health and factory floor automation have led to extremely stringent next-generation communication requirements. For instance, in a self-driving car, sensor data may be streamed to a cloud-based computer. Decentralized machine learning relying on augmented data may be used to control the vehicle. Large amounts of sensor data, along with the real-time nature of the applications, demand requirements on the 5G networks needed to support applications such as this. Specifications for 5G networks require extremely low end-end latency

<

1

m
s

. This latency requirement is tenfold more stringent than the 4G requirement of

<

10

m
s

. In this paper, we present a novel clock method for tracking and monitoring 5G latency. The method is all-optical, can accurately track

<

1

m
s

latency, and is spectrally efficient. We experimentally demonstrate generation of a 10 Gbps intensity-modulated data signal with 12.3 GHz carrier frequency, embedded with 20 MHz phase-modulated clock. The signal is successfully transmitted over 26.6 km of nonzero dispersion shifted fiber (NZDSF) single-mode fiber at 1550 nm. Error-free forward error correction data transmission was archived with 12.05 dB receiver penalty. Phase noise of

−

40.55

d
B
c

/

H
z

and

−

77.84

d
B
c

/

H
z

were attained at 1 Hz and 1 kHz offsets, respectively, for the clock.
High-energy laser pulses for extended duration megahertz-rate flow diagnostics
Authors: Felver Josef , Slipchenko Mikhail N. , Braun Erik L. , Meyer Terrence R. , Roy Sukesh 
Published: July 2020

Optical diagnostics of highly dynamic supersonic and hypersonic flows requires laser sources with a combination of high pulse intensities and fast repetition rates. A burst-mode Nd:YAG laser system is presented for increasing the overall energy of 532 nm pulse trains by

∼

100

×

and the number of high-energy pulses by

30

×

for extended duration megahertz-rate flow diagnostics. At a lower repetition rate of 100 kHz, unprecedented energies near 1 J/pulse are achieved at 532 nm over a 1.1 ms burst. The laser performance is characterized and demonstrated for megahertz-rate laser-induced breakdown spectroscopy in a Mach 2 turbulent jet.
Additive manufacturing of highly reconfigurable plasmonic circuits for terahertz communications
Authors: Cao Yang , Nallappan Kathirvel , Guerboukha Hichem , Xu Guofu , Skorobogatiy Maksim 
Published: July 2020

While in most existing terahertz communications systems, the THz carrier wave is transmitted via free-space channels, the THz waveguide-based integrated solutions can be of great utility at both the transmitter and receiver ends, thus simplifying the miniaturization and mass production of cost-effective THz communications systems. Here we present a new type of modular THz integrated circuits based on the two-wire plasmonic waveguide components fabricated using a combination of stereolithography (SLA) 3D printing, wet chemistry metal deposition, and hot stamping techniques. Particular attention is paid to the design of the optical circuits based on the two-wire waveguides suspended inside a protective micro-sized enclosure. Such waveguides feature low transmission and bending losses, as well as low dispersion. Using such waveguides as basic building blocks, we then demonstrate several key optical subcomponents, such as low-loss broadband2×1THzcouplers that use two coalescing two-wire waveguide bends, as well as broadband waveguide Bragg gratings that feature a paper sheet with a periodic sequence of metal strips inserted into the air gap of a two-wire waveguide. Finally, using these developed subcomponents, a two-channel add-drop multiplexer is demonstrated to operate at 140 GHz. We believe that the reported micro-encapsulated two-wire waveguide-based modular platform can have a strong impact on the field of THz signal processing and sensing due to the ease of device fabrication and handling, high degree of reconfigurability, and high potential for real-time tunability.
Impact of Clinical Pharmacists in Inflammatory Bowel Disease Centers During the COVID-19 Pandemic
Authors: Bhat Shubha , Farraye Francis A. , Moss Alan C. 
Published: July 2020

INTRODUCTION:
To characterize the clinical pharmacists' impact on caring for patients with inflammatory bowel disease during COVID-19.

METHODS:
A clinical pharmacist's encounters between March 17 and April 14, 2020, were audited to determine encounter frequency and indication.

RESULTS:
The clinical pharmacist addressed COVID-19 and inflammatory bowel disease treatment concerns with 140 patients, conducted 34 medication education and monitoring visits, reviewed 141 patients' charts and helped rescheduled 18 patients who missed their biologic infusion, transitioned 12 patients to home infusions, and assisted 5 patients with medication access.

DISCUSSION:
Clinical pharmacists embedded in gastroenterology practices permit for continued optimal patient care during a pandemic.
Oncogenic Features in Histologically Normal Mucosa: Novel Insights Into Field Effect From a Mega-Analysis of Colorectal Transcriptomes
Authors: Dampier Christopher H. , Devall Matthew , Jennelle Lucas T. , Díez-Obrero Virginia , Plummer Sarah J. , Moreno Victor , Casey Graham 
Published: July 2020

INTRODUCTION:
Colorectal cancer is a common malignancy that can be cured when detected early, but recurrence among survivors is a persistent risk. A field effect of cancer in the colon has been reported and could have implications for surveillance, but studies to date have been limited. A joint analysis of pooled transcriptomic data from all available bulk RNA-sequencing data sets of healthy, histologically normal tumor-adjacent, and tumor tissues was performed to provide an unbiased assessment of field effect.

METHODS:
A novel bulk RNA-sequencing data set from biopsies of nondiseased colon from screening colonoscopy along with published data sets from the Genomic Data Commons and Sequence Read Archive were considered for inclusion. Analyses were limited to samples with a quantified read depth of at least 10 million reads. Transcript abundance was estimated with Salmon, and downstream analysis was performed in R.

RESULTS:
A total of 1,139 samples were analyzed in 3 cohorts. The primary cohort consisted of 834 independent samples from 8 independent data sets, including 462 healthy, 61 tumor-adjacent, and 311 tumor samples. Tumor-adjacent gene expression was found to represent an intermediate state between healthy and tumor expression. Among differentially expressed genes in tumor-adjacent samples, 1,143 were expressed in patterns similar to tumor samples, and these genes were enriched for cancer-associated pathways.

DISCUSSION:
Novel insights into the field effect in colorectal cancer were generated in this mega-analysis of the colorectal transcriptome. Oncogenic features that might help explain metachronous lesions in cancer survivors and could be used for surveillance and risk stratification were identified.