bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research on the synergy incentive evolution among the EPC subjects of energy efficiency retrofitting of existing buildings from the perspective of fairness cognition
Authors: Yang Yanping , Wang Bojun , Liu Xiaodan 
Published: June 2020

Abstract
In the energy performance contracting (EPC) mode, the energy services company (ESCO) involved in energy efficiency retrofitting of existing buildings often faces the parallel construction of multiple tender segments and multi-professional subcontractors. The one-to-many structure for ESCO and subcontractors causes difficulties to the project quality management and directly affects the effect of energy efficiency retrofitting of existing buildings. Therefore, this paper constructs a revenue-sharing incentive model by considering situation where subjects have fairness cognition. Through the social calculation experiment of the model, results show the following: (1) increasing the revenue-sharing coefficient will help to optimize the engineering quality of energy efficiency retrofitting and increase the energy-saving income; (2) in order to get better incentive effect, the engineering quality grade of energy efficiency retrofitting should match with the incentive strength; (3) because of the impact of fairness cognition, the incentive level difference is too large, and the incentive effect will gradually weaken in the subsequent incentive cycle; (4) subcontractor’s effort level changes can prompt ESCO to adjust the corresponding incentive intensity. Finally, some suggestions are put forward to optimize the engineering quality management of energy efficiency retrofitting of existing building, which is of great significance to improve the effect of energy efficiency retrofitting of existing building under EPC mode.
A machine learning–based clinical decision support system to identify prescriptions with a high risk of medication error
Authors: Corny Jennifer , Rajkumar Asok , Martin Olivier , Dode Xavier , Lajonchère Jean-Patrick , Billuart Olivier , Bézie Yvonnick , Buronfosse Anne 
Published: June 2020

Abstract

Objective
To improve patient safety and clinical outcomes by reducing the risk of prescribing errors, we tested the accuracy of a hybrid clinical decision support system in prioritizing prescription checks.

Materials and Methods
Data from electronic health records were collated over a period of 18 months. Inferred scores at a patient level (probability of a patient’s set of active orders to require a pharmacist review) were calculated using a hybrid approach (machine learning and a rule-based expert system). A clinical pharmacist analyzed randomly selected prescription orders over a 2-week period to corroborate our findings. Predicted scores were compared with the pharmacist’s review using the area under the receiving-operating characteristic curve and area under the precision-recall curve. These metrics were compared with existing tools: computerized alerts generated by a clinical decision support (CDS) system and a literature-based multicriteria query prioritization technique. Data from 10 716 individual patients (133 179 prescription orders) were used to train the algorithm on the basis of 25 features in a development dataset.

Results
While the pharmacist analyzed 412 individual patients (3364 prescription orders) in an independent validation dataset, the areas under the receiving-operating characteristic and precision-recall curves of our digital system were 0.81 and 0.75, respectively, thus demonstrating greater accuracy than the CDS system (0.65 and 0.56, respectively) and multicriteria query techniques (0.68 and 0.56, respectively).

Discussion
Our innovative digital tool was notably more accurate than existing techniques (CDS system and multicriteria query) at intercepting potential prescription errors.

Conclusions
By primarily targeting high-risk patients, this novel hybrid decision support system improved the accuracy and reliability of prescription checks in a hospital setting.
Radiographic and clinical characteristics associated with a positive PART (Prone Apprehension Relocation Test): a new provocative exam to elicit hip instability
Authors: Spiker Andrea M , Fabricant Peter D , Wong Alexandra C , Suryavanshi Joash R , Sink Ernest L 
Published: June 2020

AbstractHip instability due to mild dysplasia can be a diagnostic challenge. The physical exam is an important adjunct to radiographic evaluation for the clinical diagnosis of hip instability. Herein, we describe a new maneuver to replicate hip instability pain, called the PART (Prone Apprehension Relocation Test). We retrospectively identified patients in our institution’s hip preservation registry who presented for evaluation of hip pain. We divided patients into ‘positive’ or ‘negative’ PART and analyzed associated clinical and radiographic findings. Ninety patients (159 hips) were included, 83 female and 7 male, average age 27.3 ± 9.1 years. Thirty-four hips (21.4%) had a positive PART. There were no significant differences in hip range of motion, lateral center edge angle, or in acetabular depth. There was, however, a significant difference in acetabular version at 3 o’clock between the two test groups (18.5 ± 6.9° in negative, 21.2 ± 4.9° in positive, P = 0.045). There was no association between PART and previously described anterior apprehension testing. Historical methods of diagnosing hip dysplasia may not adequately identify patients with clinical hip instability. We describe a new provocative exam, the PART, which may be helpful in replicating hip instability symptoms in patients with anterior acetabular undercoverage. PART positive patients had significantly more acetabular anteversion at the 3 o’clock position, which is measured on computed tomography and is not visible on standard anteroposterior (AP) pelvis or false profile radiographs. We believe that the PART is a valuable supplement to clinical examination and radiographic measurements to identify patients with symptomatic hip instability.
Racial and Ethnic Disparities Among Participants in US-Based Phase 3 Randomized Cancer Clinical Trials
Authors: Grant Stephen R , Lin Timothy A , Miller Austin B , Mainwaring Walker , Espinoza Andres F , Jethanandani Amit , Walker Gary V , Smith Benjamin D , Ashleigh Guadagnolo B , Jagsi Reshma , David Fuller C , Thomas Charles R , Ludmir Ethan B 
Published: June 2020

Abstract
Although improving representation of racial and ethnic groups in United States clinical trials has been a focus of federal initiatives for nearly 3 decades, the status of racial and ethnic minority enrollment on cancer trials is largely unknown. We used a broad collection of phase 3 cancer trials derived from ClinicalTrials.gov to evaluate racial and ethnic enrollment among US cancer trials. The difference in incidence by race and ethnicity was the median absolute difference between trial and corresponding Surveillance, Epidemiology, and End Results data. All statistical tests were 2-sided. Using a cohort of 168 eligible trials, median difference in incidence by race and ethnicity was +6.8% for Whites (interquartile range [IQR] = +1.8% to +10.1%; P &lt; .001 by Wilcoxon signed-rank test comparing median difference in incidence by race and ethnicity to a value of 0), -2.6% for Blacks (IQR = -5.1% to +1.2%; P = .004), -4.7% for Hispanics (IQR = -7.5% to -0.3%; P &lt; .001), and -4.7% for Asians (IQR = -5.7% to -3.3%; P &lt; .001). These data demonstrate overrepresentation of Whites, with continued underrepresentation of racial and ethnic minority subgroups.
U.S. Army Medical Corps Recruitment, Job Satisfaction, and Retention: Historical Perspectives and Current Issues
Authors: Marble W Sanders , Cox E Darrin , Hundertmark Julie A , Goymerac Paul J , Murray Clinton K , Soderdahl Douglas W 
Published: June 2020

Abstract

Introduction
This study was conducted to identify and understand the current factors affecting recruitment, job satisfaction, and retention of U.S. Army Medical Corps officers and provide historical background to understand if the current factors are dissimilar.

Materials and Methods
An anonymous, voluntary questionnaire was sent to U.S. Army Medical Corps officers, and responses were tabulated and analyzed. Historical research was conducted and historical analysis applied.

Results
Recruiting, job satisfaction, and retention among Army Medical Corps Officers have been problematic throughout the 50-year history of the all-volunteer force. Recruiting has largely been of medical students, with very limited numbers of direct accessions. At times, satisfactory overall numbers have camouflaged shortages in key go-to-war specialties. Also, satisfactory numbers in a specialty have sometimes camouflaged problems in depth of experience. Satisfaction has been seen as a problem but apparently only studied informally and/or episodically. Retention has largely been addressed through service obligations, followed by monetary bonuses, although these have to be across the Department of Defense, limiting service flexibility. There has never been consistent, longitudinal sampling of opinion among Medical Corps Officers to allow senior leaders to influence the Department of Defense policy. A recent (2016) study provides substantial data but should be repeated rather than being isolated.

Conclusion
As the situation in the Department of Defense and Army Medical Department changes, with more focus on go-to-war specialties, the Army needs to better measure opinion among Medical Corps Officers to inform policy. These studies should be conducted regularly to generate reliable information on trends and allow prioritization of effort to areas that hamper recruiting, undermine satisfaction, and prevent retention.
Air Force Medical Personnel: Perspectives Across Deployment
Authors: Moore Brian A , Hale Willie J , Judkins Jason L , Lancaster Cynthia L , Baker Monty T , Isler William C , Peterson Alan L ,   STRONG STAR Consortium
Published: June 2020

AbstractIntroductionContingency operations during the past 18 years have exposed millions of U.S. military service members to numerous combat and operational stressors. Despite this, a relative dearth of literature has focused on the experiences of deployed military medical personnel. As such, the present study aimed to address this gap in the literature by conducting individual and small group interviews with Air Force medical personnel who had recently returned from a deployment to Iraq. Interviews targeted self-reported factors related to psychological risk and resiliency across the deployment cycle, while also seeking recommendations for future military medical personnel preparing for medical deployments.Materials and MethodsInductive thematic analyses were conducted on transcripts from 12 individual and structured group interviews conducted with recently deployed U.S. Air Force medical personnel (N = 28). An interview script consisting of 18 prompts was carefully developed based on the experiences of study personnel. Two team members (n = 1 research psychologist; n = 1 military medical provider) coded exemplars from interview transcripts. A third team member (research psychologist) reviewed coded exemplars for consistency and retained themes when saturation was reached.ResultsIn total we report on 6 primary themes. Participants reported feeling prepared to conduct their mission while deployed but often felt unprepared for the positions they assumed and the traumas they commonly experienced. Most participants reported deployment to be a rewarding experience, citing leader engagement, and social support as key protective factors against deployment-related stressors. Finally, following deployment, participants largely reported positive experiences reintegrating with their families but struggled to reintegrate into their workplace.ConclusionFindings from the present study indicate that the military is largely doing a good job preparing Air Force medical providers to deploy. Results of the present study indicate that military medical personnel would benefit from: (1) increased predictability surrounding deployment timelines, (2) improved cross-cultural training, (3) advanced training for atypical injuries in unconventional patient populations, and (4) improvements in postdeployment workplace reintegration. The present research has the potential to positively impact the overall quality of life for deploying military service members and their families; while simultaneously highlighting the successes and shortfalls in the deployment process for U.S. military medical personnel.
Maternity Leave Length Impact on Breastfeeding and Postpartum Depression
Authors: Shumbusho Diane I , Kucera Calen W , Keyser Erin A 
Published: June 2020

Abstract

Introduction
In January 2016, the U.S. Department of Defense increased the duration of paid maternity leave for active duty service members from 6 weeks to 12 weeks. Our study aims to determine the impact of maternity leave length on breastfeeding duration and postpartum depression rates in active duty service members.

Materials and Methods
An institutional review board-approved survey of 9 questions was given to patients at the Brooke Army Medical Center Obstetrics and Gynecology Clinic. Patients were offered voluntary participation if they had delivered a baby while on active duty in the preceding 20 years. The survey included questions about length of maternity leave, duration of breastfeeding, age at delivery, route of delivery, and whether the patient suffered from postpartum depression.

Results
A total of 214 surveys were collected. Fisher exact test was used to compare rates of breastfeeding and postpartum depression between the 2 groups. A total of 87% of service members initiated breastfeeding. Among women who had 6 weeks versus 12 weeks of maternity leave, 51.64% versus 56.96% breastfed up to 6 months, p = 0.45.
The overall rate of postpartum depression was 13.5%. Among women who had 6 weeks versus 12 weeks of maternity leave, 16.1% versus 9.5% reported postpartum depression, p = 0.11.

Conclusion
The ideal maternity leave duration is unknown. With recent changes to the Department of Defense maternity leave policy, we aimed to evaluate the effect this had on breastfeeding and postpartum depression rates. No statistically significant difference was seen when we compared rates of breastfeeding in women who had 6 weeks versus 12 weeks of maternity leave. Further research is required to determine the ideal maternity leave duration and best practices to promote breastfeeding.
When looking at postpartum depression, our study shows that postpartum depression was noted in 16% of patients who took 6 weeks versus 9% of those who took 12 weeks of maternity leave. No statistically significant difference was seen; however, this was likely because of the small sample size. Only 29 out of 214 women suffered from depression regardless of length of maternity leave. More research is needed to determine if maternity leave length does indeed impact postpartum depression rates.
STAG3 homozygous missense variant causes primary ovarian insufficiency and male non-obstructive azoospermia
Authors: Jaillard Sylvie , McElreavy Kenneth , Robevska Gorjana , Akloul Linda , Ghieh Farah , Sreenivasan Rajini , Beaumont Marion , Bashamboo Anu , Bignon-Topalovic Joelle , Neyroud Anne-Sophie , Bell Katrina , Veron-Gastard Elisabeth , Launay Erika , van den Bergen Jocelyn , Nouyou Bénédicte , Vialard François , Belaud-Rotureau Marc-Antoine , Ayers Katie L , Odent Sylvie , Ravel Célia , Tucker Elena J , Sinclair Andrew H 
Published: June 2020

Abstract
Infertility, a global problem affecting up to 15% of couples, can have varied causes ranging from natural ageing to the pathological development or function of the reproductive organs. One form of female infertility is premature ovarian insufficiency (POI), affecting up to 1 in 100 women and characterised by amenorrhoea and elevated FSH before the age of 40. POI can have a genetic basis, with over 50 causative genes identified. Non-obstructive azoospermia (NOA), a form of male infertility characterised by the absence of sperm in semen, has an incidence of 1% and is similarly heterogeneous. The genetic basis of male and female infertility is poorly understood with the majority of cases having no known cause. Here, we study a case of familial infertility including a proband with POI and her brother with NOA. We performed whole-exome sequencing (WES) and identified a homozygous STAG3 missense variant that segregated with infertility. STAG3 encodes a component of the meiosis cohesin complex required for sister chromatid separation. We report the first pathogenic homozygous missense variant in STAG3 and the first STAG3 variant associated with both male and female infertility. We also demonstrate limitations of WES for the analysis of homologous DNA sequences, with this variant being ambiguous or missed by independent WES protocols and its homozygosity only being established via long-range nested PCR.
Complete Replacement of the Galactolipid Biosynthesis Pathway with a Plant-Type Pathway in the Cyanobacterium Synechococcus elongatus PCC 7942
Authors: Apdila Egi Tritya , Inoue Shukumi , Shimojima Mie , Awai Koichiro 
Published: June 2020

AbstractMonogalactosyldiacylglycerol (MGDG) and digalactosyldiacylglycerol (DGDG) are the major components of thylakoid membranes and well-conserved from cyanobacteria to chloroplasts. However, cyanobacteria and chloroplasts synthesize these galactolipids using different pathways and enzymes, but they are believed to share a common ancestor. This fact implies that there was a replacement of the cyanobacterial galactolipid biosynthesis pathway during the evolution of a chloroplast. In this study, we first replaced the cyanobacterial MGDG biosynthesis pathway in a model cyanobacterium, Synechococcus elongatus PCC 7942, with the corresponding plant-type pathway. No obvious phenotype was observed under the optimum growth condition, and the content of membrane lipids was not largely altered in the transformants. We next replaced the cyanobacterial DGDG biosynthesis pathway with the corresponding plant-type pathway using the strain described above and isolated the strain harboring the replaced plant-type pathway instead of the whole galactolipid biosynthesis pathway. This transformant, SeGPT, can grow photoautotrophically, indicating that cyanobacterial galactolipid biosynthesis pathways can be functionally complemented by the corresponding plant-type pathways and that the lipid products MGDG and DGDG, and not biosynthesis pathways, are important. While SeGPT does not show strong growth retardation, the strain has low cellular chlorophyll content but it retained a similar oxygen evolution rate per chlorophyll content compared with the wild type. An increase in total membrane lipid content was observed in SeGPT, which was caused by a significant increase in DGDG content. SeGPT accumulated carotenoids from the xanthophyll groups. These results suggest that cyanobacteria have the capacity to accept other pathways to synthesize essential components of thylakoid membranes.
Effect of superabsorbent polymer on mechanical properties of cement stabilized base and its mechanism
Authors: Guan Yongsheng , Zhang Zhixiang , Zhang Xiaorui , Zhu Junqing , Zhou Wen , Huang Qi , Zhang Yuqing 
Published: June 2020

Abstract
Superabsorbent polymers (SAPs) are cross-linked polymers that can absorb and retain large amounts of water. In recent years, a growing interest was seen in applying SAPs in concrete to improve its performance due to its efficiency in mitigating shrinkage. This paper presents findings in a study on effect of SAPs on performance of cement-treated base (CTB), using the experience of internal curing of concrete. CTB specimens with and without SAPs were prepared and tested in the laboratory. Tests conducted include mechanical property testing, dry shrinkage testing, differential thermal analysis, mercury intrusion porosimetry and scanning electron microscope testing. It was found that 7-day and 28-day unconfined compressive strength of CTB specimens with SAPs was higher than regular CTB specimens. 28d compressive strength of CTB specimens with SAPs made by Static pressure method was 5.87 MPa, which is 27% higher than that of regular CTB specimens. Drying shrinkage of CTB specimens with SAPs was decreased by 52.5% comparing with regular CTB specimens. Through the microstructure analysis it was found that CTB specimens with SAPs could produce more hydration products, which is also the reason for the strength improvement.
Adaptability evaluation of pavement structure to replacement treatment subgrade of black cotton soil
Authors: Luan Yingcheng , Ma Yuan , Zhang Weiguang , Zhang Yuqing , Ma Tao , Lee Jusang 
Published: June 2020

Abstract
Aiming at the typical engineering problem of black cotton soil (BCS) subgrade under the alternation of dry and wet climate in the region of Nairobi, Kenya, this paper takes the pavement structure as the research object, and the numerical calculation model of BCS subgrade is established based on the consolidation coupling theory of unsaturated soil. Taking the modulus and thickness of the subbase as variables, the deformation characteristics and additional stresses of different pavement structures are analysed. Then the adaptability of different pavement structures to replacement treatment subgrade of BCS is evaluated by gray incidence decision analysis method. The results show that whatever the pavement structure is, neither subgrade modulus nor thickness is sensitive to the pavement surface deformation, and the deformation differences between each pavement structure are more obvious in wet season; the additional stress at control layer bottom and pavement surface decreases with the increase of subbase modulus, whereas the stress may increase at subbase bottom; the additional stress at subbase bottom, control layer bottom and pavement surface all decreases with the increase of subbase thickness for pavement Structure I and II. For pavement Structure III, the change of subbase thickness is not sensitive to the additional stress at the control layer bottom and pavement surface, whereas the stress at subbase bottom increases with the increase of subbase thickness. It is concluded that the most adaptable structure is pavement Structure I, which can minimize the comprehensive level of pavement settlement and additional stress.
A Teaching Model to Promote NCLEX-RN Success
Authors: Wilson-Anderson Kaye 
Published: June 2020

Abstract
Nurse educators in RN programs are called to address the nursing shortage, assist increasingly diverse learners to succeed on the National Council Licensure Examination the first time, and prepare the new nurse graduate to transition into an ever-changing health care system. This article purposes a teaching model to empower both the nurse educator and the student. As graduates have gained locus of control, National Council Licensure Examination pass rates have increased from 82 percent to 93 percent. The discussion examines a variety of strategies to facilitate nurse graduate success.
Caring for the Deaf: Nursing Students’ Knowledge and Awareness
Authors: Diaz Sandra , Goyal Deepika 
Published: June 2020

Abstract
Navigating an increasingly complex health care system is challenging for marginalized populations, including the Deaf and hard of hearing who rely heavily on nurses’ and hospital-provided interpreters’ knowledge of the American Sign Language. This study examined Deaf culture knowledge and awareness among undergraduate and graduate nursing students in the United States. Study findings indicated low knowledge regarding cochlear implants, use of interpreters, and parental newborn hearing test rights. Integrating care of the deaf into all levels of nursing education will serve to promote patient health literacy and health outcomes while advancing the science of nursing education.