bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep machine learning of the spectral power distribution of the LED system with multiple degradation mechanisms
Authors: Yuan Cadmus C A , Fan JiaJie , Fan XueJun 
Published: December 2020

Abstract
The performance and reliability of the light-emitting diode (LED) system significantly depend on the thermal–mechanical loading-enhanced multiple degradation mechanisms and their interactions. The complexity of the LED system restricts the theoretical understanding of the root causes of the luminous fluctuation or the establishment of the direct correlation between the thermal aging loading and the luminous outputs. This paper applies the deep machine learning techniques and develops a gated network with the two-step learning algorithm to build the empirical relationship between the design parameters and the thermal aging loading and the luminous output of LED products. The flexibility of the proposed method will be demonstrated by integrating it with different neural network architectures. The proposed gated network concept has been validated in both multiple LED chip packaging and LED luminaire under thermal aging loading. The validation of the luminous data of multiple LED chip packaging shows that the maximum differences of the correlated color temperature (CCT) and color coordinate are 2.6% and 1.0%, respectively. Moreover, the machine learning results of the LED luminaire exhibit that the differences of lumen depreciation, CCT and color coordinate are 1.6%, 1.9% and 1.1%, after 2160 h of thermal aging.
Considerations for Acute and Emergent Deployed Mental Health Patient Management and Theater Transports: A Scoping Review
Authors: Migliore Laurie , Braun Lisa , Stucky Christopher H , Gardner Cubby , Huffman Sarah , Jumpp Savannah , Bell Emily 
Published: December 2020

ABSTRACT

Background
Although combat stress and psychiatric casualties of war have consistently contributed to the need for deployed patient transport to higher echelons of care, little is known regarding specific evidence-based strategies for providing psychological support and optimal transport interventions for warriors.

Study Objective
The purpose of this scoping review is to map existing literature related to considerations for deployed mental health patient transport. The review’s primary aims are to identify the existing scientific research evidence, determine research and training gaps, and recommend critical areas for future military research.

Methods
We used Arksey and O’Malley’s six-stage scoping review methodological framework (identify the research question, identify relevant studies, select studies, chart data, report results, and consultation). Using a systematic search strategy, we evaluated peer-reviewed literature from five databases (PubMed, CINAHL, PsycINFO, Web of Science, and Embase) and gray literature from the Defense Technical Information Center. All publications were independently screened for eligibility by two researchers during three review rounds (title, abstract, and full text).

Results
We identified 1,384 publications, 61 of which met our inclusion criteria. Most publications and technical reports were level IV evidence and below, primarily retrospective cohort studies and epidemiologic surveillance reports. Few rigorously designed studies were identified. Eight research themes and a variety of research and critical training gaps were derived from the reviewed literature. Themes included (1) characterizing mental health patients aeromedically evacuated from theater; (2) in-flight sedation medications; (3) need for aeromedical evacuation (AE) in-theater education, training, and guidelines for staff; (4) epidemiological surveillance of AE from theater; (5) mental health management in deployed settings; (6) suicide-related event management; (7) transport issues for mental health patients; and (8) psychological stressors of AE. Research is needed to establish clinical practice guidelines for mental health condition management in theater and throughout the continuum of en route care.
Importance of magnetic fields in highly eccentric discs with applications to tidal disruption events
Authors: Lynch Elliot M , Ogilvie Gordon I 
Published: December 2020

ABSTRACT
Whether tidal disruption events (TDEs) circularize or accrete directly as a highly eccentric disc is the subject of current research and appears to depend sensitively on the disc thermodynamics. In a previous paper, we applied the theory of eccentric discs to TDE discs using an α-prescription for the disc stress, which leads to solutions that exhibit extreme, potentially unphysical, behaviour. In this paper, we further explore the dynamical vertical structure of highly eccentric discs using alternative stress models that are better motivated by the behaviour of magnetic fields in eccentric discs. We find that the presence of a coherent magnetic field has a stabilizing effect on the dynamics and can significantly alter the behaviour of highly eccentric radiation-dominated discs. We conclude that magnetic fields are important for the evolution of TDE discs.
Transanal Minimally Invasive Surgery: An Effective Approach for Patients Who Require Redo Pelvic Surgery for Anastomotic Failure
Authors: Hill Susanna S. , Harnsberger Cristina R. , Hahn Sue J. , Sturrock Paul R. , Davids Jennifer S. , Alavi Karim , Maykel Justin A. 
Published: December 2020

BACKGROUND:
Anastomotic leaks cause significant patient morbidity that may require redo pelvic surgery. Transanal minimally invasive surgery facilitates direct access to the pelvis with increased visualization and maneuverability for technically difficult redo surgery.

OBJECTIVE:
This study aimed to assess the feasibility and outcomes of transanal minimally invasive surgery in redo proctectomy for anastomotic complications.

DESIGN:
This was a retrospective cohort study.

SETTINGS:
This study was conducted at a single tertiary-care institution.

PATIENTS:
Consecutive patients undergoing transanal minimally invasive redo proctectomy were included.

INTERVENTIONS:
Transanal minimally invasive redo proctectomy was performed.

MAIN OUTCOME MEASURES:
The primary end point was intraoperative feasibility. The secondary end points were safety, perioperative morbidity, and symptom resolution.

RESULTS:
Seven patients underwent redo proctectomy via transanal minimally invasive surgery for anastomotic defect (n = 6) or stricture (n = 1). Median time from initial to redo operation was 27 months (range, 13–67). Redo proctectomy included redo low anterior resection with coloanal anastomosis and diverting loop ileostomy (n = 4), completion proctectomy with end colostomy (n = 2), and pouch resection with end ileostomy (n = 1). Six patients had an open abdominal approach. There were no conversions for the anal approach. Median operative time was 6.4 hours (range, 4.0–7.1). All 4 planned redo coloanal anastomoses were successfully created. Hospital length of stay was a median of 8 days (interquartile range, 6–9). Intraoperative complications included 2 patients with carbon dioxide emboli, which resolved with supportive care; there was no adjacent organ injury. Three patients were readmitted within 30 days. There were no postoperative anastomotic leaks, and all 4 patients with diverted ileostomies underwent reversal at a median of 4 months (interquartile range, 4–6). All symptoms prompting redo surgery remain resolved at a median follow-up of 20 months.

LIMITATIONS:
This study was limited by its small sample size and its single-institution focus.

CONCLUSION:
For those with expertise in transanal surgery, transanal minimally invasive surgery is a safe and effective option for patients with anastomotic failure requiring redo proctectomy because it provides direct access to and visualization of the pelvis.
The Efficacy of Psychological Interventions on Health-Related Quality of Life for Patients With Heart Failure and Depression
Authors: Helal Sameera I. , Lee Geraldine , Evans Catherine , Grealish Annmarie 
Published: December 2020

Background
Depression is prevalent among adults with chronic heart failure (CHF) and is associated with higher rates of morbidity and mortality and higher healthcare costs.

Objectives
The aim of this study was to explore the efficacy of psychological interventions in reducing depression and improving quality of life and clinical outcomes (mortality, hospitalization) among adults with CHF.

Methods
This study performed a systematic review involving searches of 6 databases (MEDLINE, CINAHL, EMBASE, PsycINFO, ASSIA, and SSCI), the Cochrane library, and gray literature, completed in January 2020. Experimental and nonexperimental quantitative studies of psychological interventions for adults with CHF were included. Each study was quality appraised, and key data were extracted and tabled. Overall findings are presented as a narrative synthesis.

Results
Nine studies met eligibility. Study authors sampled 757 participants and evaluated 4 psychological interventions: cognitive behavioral therapy alone or combined with exercise, mindfulness-based psychoeducation, coping skills training, and innovative holistic meditation. Cognitive behavioral therapy was significantly associated with improved depression and quality of life, and reduced hospitalization risk. Mindfulness-based psychoeducation, holistic meditation, and coping skills training positively impacted depression and quality of life. Coping skills training also reduced hospitalization and mortality risks.

Conclusion
Although this review indicates that psychological interventions can be beneficial to adults with CHF who have depression, the overall weight of evidence contains a number of biases. Larger, higher-powered studies are needed to confirm or refute these findings and to better understand how specific intervention and sample characteristics relate to outcomes.
Resilience and Depressive Symptoms in Adults With Cardiac Disease
Authors: Ketcham Amy , Matus Austin , Riegel Barbara 
Published: December 2020

Background
Depressive symptoms predict hospitalization and mortality in adults with cardiac disease. Resilience, defined as a dynamic process of positively responding to adversity, could protect against depressive symptoms in cardiac disease. No systematic review has been conducted on the relationship between these variables in this population.

Objective
The aim of this review was to explore the association between psychological resilience and depressive symptoms in adults with cardiac disease.

Methods
Seven databases (PubMed, EMBASE, CINAHL, PsycInfo, Web of Science, SCOPUS, and Cochrane) were searched from inception to December 2019 using the search terms “cardiac disease,” “depressive symptoms,” “depression,” and “resilience.” Inclusion criteria dictated that studies reported original research on the association between resilience and depressive symptoms in adults with a cardiac disease broadly defined. Quality ratings were performed by 2 independent raters.

Results
We identified 13 studies for final review. Study sample sizes ranged from 30 to 1022 participants, average age ranged from 52 to 72 years, and all studies had majority male participants (64%–100%). Resilience and depressive symptoms were inversely related in 10 of 13 studies. The 3 studies with poor-quality sampling techniques or significant loss to follow-up found no relationship.

Conclusions
Resilience seems to protect against depression in adults with cardiac disease. Gaps in the literature include poor understanding of the direction of causality. Methods of promoting resilience need to be identified and studied.
Simulation to Train Pediatric ICU Teams in Endotracheal Intubation of Patients with COVID-19
Authors: Balikai Shilpa C. , Badheka Aditya , Casey Andrea , Endahl Eric , Erdahl Jennifer , Fayram Lindsay , Houston Amanda , Levett Paula , Seigel ; Howard , Vijayakumar Niranjan , Cifra Christina L. 
Published: December 2020

Introduction:
To prevent transmission of severe acute respiratory syndrome coronavirus 2 to healthcare workers, we must quickly implement workflow modifications in the pediatric intensive care unit (PICU). Our objective was to rapidly train interdisciplinary PICU teams to safely perform endotracheal intubations in children with suspected or confirmed coronavirus disease 2019 using a structured simulation education program.

Methods:
We conducted a quality improvement study in a tertiary referral PICU. After developing stakeholder-driven guidelines for modified intubation in this population, we implemented a structured simulation program to train PICU physicians, nurses, and respiratory therapists. We directly observed PICU teams’ adherence to the modified intubation process before and after simulation sessions and compared participants’ confidence using the Simulation Effectiveness Tool-Modified (SET-M, Likert scale range 0: do not agree to 2: strongly agree regarding statements of confidence).

Results:
Fifty unique PICU staff members participated in 9 simulation sessions. Observed intubation performance improved, with teams executing a mean of 7.3–8.4 out of 9 recommended practices between simulation attempts (P = 0.024). Before undergoing simulation, PICU staff indicated that overall they did not feel prepared to intubate patients with suspected or confirmed SARS-CoV-2 (mean SET-M score 0.9). After the simulation program, PICU staff confidence improved (mean SET-M score increased from 0.9 to 2, P < 0.001).

Conclusion:
PICU teams’ performance and confidence in safely executing a modified endotracheal intubation process for children with suspected or confirmed SARS-CoV-2 infection improved using a rapidly deployed structured simulation education program.
Breaking Inertia: Movement Along the PrEP Cascade in a Longitudinal US National Cohort of Sexual Minority Individuals at Risk for HIV
Authors: Mehrotra Megha L. , Westmoreland Drew A. , Patel Viraj V. , Hojilla J. Carlo , Grov Christian ,   On Behalf of the Together 5000 Team
Published: December 2020

Background:The pre-exposure prophylaxis (PrEP) cascade outlines sequential steps to maximize PrEP's impact and highlights potential intervention targets to improve PrEP implementation. We evaluate the PrEP cascade in theTogether 5000study (T5K).Methods:T5K is an internet-based, US national cohort study of PrEP-eligible men and trans persons who have sex with men who were not taking PrEP at enrollment. Using longitudinal data from baseline (2017–2018) and year 1 follow-up (2018–2019, n = 4229), we evaluated 5 steps of the PrEP cascade—PrEP contemplation: believes they are a good candidate for PrEP; PrEParation: plans to initiate PrEP; PrEP action: speaks to a provider about PrEP; PrEP initiation: receives a prescription for PrEP; and PrEP maintenance: continues to take PrEP. We compared the cascade across geographic region and identified factors associated with gaps in the cascade.Results:After 1 year, 1092 (26%) participants had initiated PrEP, 709 (17%) were still using PrEP, and 177 (4%) were no longer clinically indicated for PrEP. Participants in the South and Midwest were less likely to speak to a provider about PrEP or initiate PrEP. Baseline characteristics associated with lower odds of PrEP initiation at year 1 include: not having a college degree; earning <$20,000/year; not having health insurance; having very low food security; and not having a primary care doctor.Conclusions:Lack of health care access is a major barrier to PrEP implementation and may exacerbate disparities in PrEP uptake across geographic regions.
Reliability and Validity of a Pediatric Fall Risk Assessment Scale for Hospitalized Patients in Taiwan
Authors: Chang Ching-Mei , Wen Cheng-Fan , Lin Hsien-Feng 
Published: December 2020

Background and Objectives:
A valid fall risk assessment scale could increase the efficacy of fall prevention programs. Most fall scales were developed for adults, and it is very difficult to predict and prevent falls in pediatric inpatients. This study aimed to investigate the reliability and validity of a pediatric fall assessment scale (PFAS).

Methods:
This study was conducted as a cohort study in Taichung City, Taiwan. We analyzed the scale for internal consistency, test-retest reliability, and construct validity. A receiver operating characteristic (ROC) curve was generated to show sensitivity and specificity for predicting falls.

Results:
The results indicated that test-retest reliability was 0.89 (P = .000). The area under the ROC curve was 0.797. For the ROC curves for the pediatric fall risk assessment scale, with 11.5 points being the minimum score for a high risk of fall, sensitivity was 71.8%, specificity 74.6%, and the 95% CI was 0.746-0.848.

Conclusion:
The results of the data analysis showed that the PFAS is an appropriate scale for assessing the fall risk of hospitalized pediatric patients in Taiwan and potentially in other nations.
Art Heals: Randomized Controlled Study Investigating the Effect of a Dedicated In-house Art Gallery on the Recovery of Patients After Major Oncologic Surgery
Authors: Lone Zaeem , Hussein Ahmed A. , Khan Hijab , Steele Morgan , Jing Zhe , Attwood Kristopher , Lin-Hill Joe , Davidson Russell , Guru Khurshid A. 
Published: December 2020

Introduction:
We sought to investigate the effect of exposure to a dedicated art gallery during the perioperative period on the recovery of patients undergoing major oncologic procedures.

Methods:
Eighty patients were randomized into 2 arms; standard of care versus exposure to art. All patients completed a survey assessing their baseline art knowledge, and 4 poststudy validated questionnaires assessing their pain (Pain Rating Scale), hope (Herth Hope Index), anxiety (State-Trait Anxiety Inventory for Adults), and mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale). A linear model adjusted for baseline scores was run comparing the scores among the 2 study arms. Stepwise multivariate regression analyses were used to identify predictors of improved pain, hope, anxiety, and wellbeing.

Results:
Both groups were comparable in terms of demographics, passion, and knowledge about art. There was no statistically significant difference in pain scores between the 2 groups. The exposure to art group experienced higher hope (2.4 points higher vs 0.05, P = 0.004), lower anxiety (8 points lower vs –0.9, P < 0.0001), and higher mental well-being scores (5.23 points higher vs –0.05, P < 0.0001) in comparison to the standard of care group. On multivariate analyses, exposure to art was significantly associated with improved hope, anxiety, and mental well-being after adjusting for patient and disease characteristics.

Conclusions:
Dedicated exposure to art was associated with improved hope, anxiety, and mental well-being of patients after major oncologic surgery.
Does Esophagectomy Provide a Survival Advantage to Patients Aged 80 Years or Older? Analyzing 5066 Patients in the National Database of Hospital-based Cancer Registries in Japan
Authors: Motoyama Satoru , Maeda Eri , Iijima Katsunori , Sato Yusuke , Koizumi Shigeto , Wakita Akiyuki , Nagaki Yushi , Fujita Hiromu , Yoneya Takatoshi , Imai Kazuhiro , Terata Kaori , Minamiya Yoshihiro , Higashi Takahiro 
Published: December 2020

Objective:
To determine whether esophagectomy provides a survival advantage in octogenarians with resectable thoracic esophageal cancer.

Summary Background Data:
Elderly patients with thoracic esophageal cancer do not always receive the full standard treatment; however, advanced age alone should not preclude the use of effective treatment that could meaningfully improve survival.

Methods:
We retrieved the 2008 to 2011 data from the National Database of Hospital-based Cancer Registries from the National Cancer Centerin Japan, divided the patients into a ≥75 group (75–79 years; n = 2935) and a ≥80 group (80 years or older; n = 2131), and then compared the patient backgrounds and survival curves. A multivariable Cox proportional hazards regression model was developed to compare the effects of esophagectomy and chemoradiotherapy in the 2 groups.

Results:
A significantly greater percentage of patients were treated with esoph-agectomy in the ≥75 group (34.6%) than the ≥80 group (18.4%). Among patients who received esophagectomy, the 3-year survival rate was 51.1% in the ≥ 75 group and 39.0% in the ≥80 group (P < 0.001). However, among patients who received chemoradiotherapy, there was no difference in survival curve between the 2 groups (P = 0.17). Multivariable Cox proportional hazard analysis revealed that esoph-agectomy for clinical Stage ii-iii patients was significantly associated to better survival (adjusted HR: 0.731) (95%CI: 0.645–0.829, P < 0.001) in the ≥75 group but not the ≥ 80 group when compared with chemoradiotherapy.

Conclusions:
Many octogenarians do not necessarily get a survival benefit from esophagectomy. However, patients should be evaluated based on their overall health before ruling out surgery based on age alone.
Blinded study: prospectively defined high frequency oscillations predict seizure outcome in individual patients
Authors: Dimakopoulos V , Mégevand P , Boran E , Momjian S , Seeck M , Vulliémoz S , Sarnthein J 
Published: December 2020

AbstractBackgroundInterictal high frequency oscillations (HFO) are discussed as biomarkers for epileptogenic brain tissue that should be resected in epilepsy surgery to achieve seizure freedom. The prospective classification of tissue sampled by individual electrode contacts remains a challenge. We have developed an automated, prospective definition of clinically relevant HFO in intracranial EEG (iEEG) from MNI Montreal and tested it in iEEG from Zurich. We here validate the algorithm on iEEG recorded in an independent epilepsy center so that HFO analysis was blinded to seizure outcome.MethodsWe selected consecutive patients from Geneva University Hospitals who underwent resective epilepsy surgery with postsurgical follow-up > 12 months. We analyzed long-term iEEG recordings during non-rapid eye movement (NREM) sleep that we segmented into intervals of 5 min. HFOs were defined in the ripple (80-250 Hz) and the fast ripple (FR, 250-500 Hz) frequency band. Contacts with the highest rate of ripples co-occurring with FR (FRandR) designated the HFO area. If the HFO area was not fully resected and the patient suffered from recurrent seizures (ILAE 2-6), this was classified as a true positive (TP) prediction.ResultsWe included iEEG recordings from 16 patients (median age 32 y, range [18-53]) with stereotactic depth electrodes and/or with subdural electrode grids (median follow-up 27 mo, range [12-55]). The HFO area had high test-retest reliability across intervals (median dwell time 95%). We excluded two patients with dwell time < 50% from further analysis.The HFO area was fully included in the resected volume in 2/4 patients who achieved postoperative seizure freedom (ILAE 1, specificity 50%) and was not fully included in 9/10 patients with recurrent seizures (ILAE > 1, sensitivity 90%), leading to an accuracy of 79%.ConclusionsWe validated the automated procedure to delineate the clinical relevant HFO area in individual patients of an independently recorded dataset and achieved the same good accuracy as in our previous studies.SignificanceThe reproducibility of our results across datasets is promising for a multicienter study testing the clinical application of HFO detection to guide epilepsy surgery.