bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unit‐level variation in bed alarm use in US hospitals
Authors: Staggs Vincent S. , Turner Kea , Potter Catima , Cramer Emily , Dunton Nancy , Mion Lorraine C. , Shorr Ronald I. 
Published: June 2020

AbstractBed and chair alarms are widely used in hospitals, despite lack of effectiveness and unintended negative consequences. In this cross‐sectional, observational study, we examined alarm prevalence and contributions of patient‐ and unit‐level factors to alarm use on 59 acute care nursing units in 57 US hospitals participating in the National Database of Nursing Quality Indicators®. Nursing unit staff reported data on patient‐level fall risk and fall prevention measures for 1,489 patients. Patient‐level propensity scores for alarm use were estimated using logistic regression. Expected alarm use on each unit, defined as the mean patient propensity‐for‐alarm score, was compared with the observed rate of alarm use. Over one‐third of patients assessed had an alarm in the “on” position. Patient characteristics associated with higher odds of alarm use included recent fall, need for ambulation assistance, poor mobility judgment, and altered mental status. Observed rates of unit alarm use ranged from 0% to 100% (median 33%, 10th percentile 5%, 90th percentile 67%). Expected alarm use varied less (median 31%, 10th percentile 27%, and 90th percentile 45%). Only 29% of variability in observed alarm use was accounted for by expected alarm use. Unit assignment was a stronger predictor of alarm use than patient‐level fall risk variables. Alarm use is common, varies widely across hospitals, and cannot be fully explained by patient fall risk factors; alarm use is driven largely by unit practices. Alarms are used too frequently and too indiscriminately, and guidance is needed for optimizing alarm use to reduce noise and encourage mobility in appropriate patients.
N‐Functionalised Imidazoles as Stabilisers for Metal Nanoparticles in Catalysis and Anion Binding
Authors: Serpell Christopher J. , Cookson James , Beer Paul D. 
Published: June 2020

AbstractMetal nanoparticles (NPs) have physicochemical properties which are distinct from both the bulk and molecular metal species, and provide opportunities in fields such as catalysis and sensing. NPs typically require protection of their surface to impede aggregation, but these coatings can also block access to the surface which would be required to take advantage of their unusual properties. Here, we show that alkyl imidazoles can stabilise Pd, Pt, Au, and Ag NPs, and delineate the limits of their synthesis. These ligands provide an intermediate level of surface protection, for which we demonstrate proof‐of‐principle in catalysis and anion binding.
Treatment of refractory oral lichen planus using direct antiviral agents in a patient with chronic hepatitis C: A case report
Authors: Harada Koji , Nakashima Daisuke , Nagao Yumiko , Hidaka Isao , Sakaida Isao , Mishima Katsuaki 
Published: June 2020

AbstractOral lichen planus (OLP) is a chronic inflammatory and immunologically mediated mucocutaneous disease with a high prevalence in hepatitis C virus (HCV)‐infected patients. Interferon (IFN)‐free direct‐acting antiviral drugs (DAA) have been recommended for the treatment of patients with extrahepatic manifestations of HCV infection. Herein, we present the case of a 65‐year‐old woman who was diagnosed with OLP and chronic hepatitis C. She received DAA treatment with sofosbuvir (SOF) and ribavirin (RBA) at 75 years of age, which led to partial disappearance of the OLP and complete eradication of HCV. Thus, the patient was effectively treated without any major side effects.
Proportion and clinical profile of type 1 diabetes patients with a clinical time‐action of insulin glargine U100 shorter than 24 hours
Authors: Albareda Mercè , Lara Mercè , Martin‐Baranera Montserrat , Barnés Raquel , Vila Lluís 
Published: June 2020

AbstractWe aimed to estimate the proportion of type 1 diabetes mellitus (T1DM) patients for whom insulin glargine 100U/ml (Gla‐100) does not clinically cover a period of 24 hours and compare them with T1DM patients treated with a single dose of insulin Gla‐100.We undertook a cross‐sectional observational study of people with T1DM. The study participants were divided into two groups according to the perceived clinical duration of the action of insulin Gla‐100. Group 1 (duration 24 hours) comprised participants treated with a single dose of insulin Gla‐100; Group 2 (duration <24 hours) comprised participants treated with two doses of insulin Gla‐100 or one dose plus premixed insulin with the midday meal. Data were collected on anthropometric measures, treatment and metabolic control.In total, 252 people with T1DM were analysed: 157 from Group 1 and 95 from Group 2. In 37.7% of the participants (95% CI 31.7–43.7%) the clinical duration of Gla‐100 was less than 24 hours. The people in Group 2 were older, had longer duration of diabetes and higher BMI. They also required higher doses of insulin and were less insulin sensitive. The independent variables related to the shorter clinical action of insulin Gla‐100 were a higher dose of insulin and a longer duration of diabetes.It was concluded a high percentage of patients with T1DM present an effective clinical action of Gla‐100 of <24 hours, related to longer duration of diabetes and a need for higher insulin dose. Copyright © 2020 John Wiley & Sons.
A case of type B insulin resistance presenting at a district general hospital
Authors: Ramlochansingh Osada , Surchi Haval , Stears Anna , O'Rahilly Sir Stephen , Mimmack Michael , Jayne David 
Published: June 2020

Abstract
Type B insulin resistance is a rare autoimmune condition with just over 100 cases described in the literature. We describe here the case of a young female who presented to our district general hospital with a rapid onset of profound insulin resistance not ameliorated by intensive insulin therapy.A previously fit and well 30‐year‐old woman was referred to hospital for hyperglycaemia without ketosis and clinical features consistent with diabetes. She had a normal BMI and no family history of note. Initially, treatment with oral medication was prescribed but due to a worsening of hyperglycaemia and HbA1c over the next few days, insulin therapy was introduced. It was quickly recognised that large doses of insulin given via subcutaneous and intravenous routes had little effect on her blood glucose with levels remaining well above 20mmol/L at maximum therapy.The presence of acanthosis nigricans along with cutaneous stigmata of connective tissue disease was noted and the case was referred to a specialist centre for further testing due to apparent severe insulin resistance. Antibody testing and further investigations were conducted revealing a final diagnosis of type B insulin resistance with an associated new diagnosis of systemic lupus erythematosus.Treatment of this patient's diabetes with immunosuppressive medication has been commenced with the hope of inducing remission. Copyright © 2020 John Wiley & Sons.
Effect of Preinjury Oral Anticoagulants on Outcomes Following Traumatic Brain Injury from Falls in Older Adults
Authors: Hecht Jason P. , LaDuke Zachary J. , Cain‐Nielsen Anne H. , Hemmila Mark R. , Wahl Wendy L. 
Published: June 2020

BackgroundWarfarin has been the oral anticoagulant of choice for the treatment of thromboembolic disease. However, upward of 50% of all new anticoagulant prescriptions are now for direct oral anticoagulants (DOAC). Despite this, outcome data evaluating preinjury anticoagulants remain scarce following traumatic brain injury (TBI). Our study objective is to determine the effects of preinjury anticoagulation on outcomes in older adults with TBI.MethodsPatient data were obtained from 29 level 1 and 2 trauma centers from 2012 to June 30, 2018. Overall, 8312 patients who were aged 65 years or older, suffering a ground level fall, and with an Abbreviated Injury Scale (AIS) head score of ≥ 3 were identified. Patients were excluded if they presented with no signs of life or a traumatic mechanism besides ground level fall. Statistical comparisons were made using multivariable analyses with anticoagulant/antiplatelet use as the independent variable.ResultsOf the total patients with TBI, 3293 were on antiplatelet agents (AP), 669 on warfarin, 414 on warfarin + AP, 188 on DOACs, 116 on DOAC + AP, and 3632 on no anticoagulant. There were 185 (27.7%) patients on warfarin and 43 (22.9%) on a DOAC with a combined outcome of mortality or hospice as compared to 575 (15.8%) in the no anticoagulant group (p<0.001). After adjusting for patient factors, there was an increased risk of mortality or hospice in the warfarin (OR 1.60; 95% CI 1.27–2.01) and DOAC group (OR 1.67; 95% CI 1.07–2.59) as compared to no anticoagulant. Warfarin + AP was associated with an increased risk of mortality or hospice (OR 1.61; 95% CI 1.18–2.21) that was not seen with DOAC + AP (OR 0.93; 95% CI 0.46–1.87) as compared to no anticoagulant.ConclusionsIn older adults with TBI, preinjury treatment with warfarin or DOACs resulted in an increased risk of mortality or hospice whereas preinjury AP therapy did not increase risk. Future studies are needed with larger sample sizes to directly compare TBI outcomes associated with preinjury warfarin versus DOAC use.
Failure analysis of field‐failed bypass diodes
Authors: Xiao Chuanxiao , Hacke Peter , Johnston Steve , Sulas‐Kern Dana B. , Jiang Chun‐Sheng , Al‐Jassim Mowafak 
Published: June 2020

AbstractDefective bypass diodes are often found as the largest factor leading to power loss in solar modules. Here, we report on failure mechanisms by investigating shunted bypass diodes from a rooftop installation, using a combination of multiple characterizations including current–voltage analysis, thermal‐runaway testing, X‐ray computed tomography, lock‐in thermography, focused ion‐beam cross‐section imaging, chemical decapsulation, optical microscopy, and scanning electron microscopy with energy‐dispersive X‐ray spectroscopy. Differing from static discharge typically associated with lightning strikes on modules, we found diode failure by the mechanism of thermal damage under continuous, long‐term overstress in forward bias. Our conclusion is based on evidence of energy dissipated—the small to medium extent of melt‐through on the Schottky diode face. The diode failure shows distortions or roughening of the Schottky diode metal‐semiconductor interface with the die attach, and some failures are accompanied by die‐attach solder melting. We propose that nonuniform irradiance on the modules caused diode shunting due to extended periods of heat dissipation in the modules, because modules in this string were placed in two different orientations. In contrast, a second parallel module string of the same module type on the same rooftop with a unique plane of array did not show any diode failures. The thermal damage failure of melt‐through was caused by the long‐term current generated by overstressing of diodes that may have had crystalline and impurity defects.
Mixed brushes consisting of oppositely charged Y‐shaped polymers in salt free, monovalent, and divalent salt solutions
Authors: Miliou Kalliopi , Gergidis Leonidas N. , Vlahos Costas 
Published: June 2020

AbstractThe conformation and the internal stratification of mixed brushes formed from oppositely charged Y(−) and Y(+)‐shaped chains in salt free, monovalent, and divalent salt solutions were studied by means of molecular dynamics simulations using the primitive model. Scaling relations of mixed brush height with respect to the grafting surface per chain, the ratio of the total positive to the total negative charge of polyelectrolyte chains, and salt concentrations were obtained. The simulations predicted that mixed brushes show a unique response to divalent salt (1:2) solutions. For symmetric brushes having the same spacer lengths, number of chains and charged units fractions the increase of the salt concentration leads to the enrichment of the outer brush surface with Y(+) units and the lamella microphase separation. For asymmetric brushes in high salt concentration cylindrical domain microphases are formed.
Validity, intra and inter‐reliability of manual evaluation of the respiratory muscle strength in asthmatic patients
Authors: da Luz Goulart Cassia , Trimer Renata , Garcia‐Araujo Adriana Sanches , Caruso Flavia Rossi , Ricci Paula Angélica , dos Santos Polliana Batista , Mendes Renata Gonçalves , Borghi‐Silva Audrey 
Published: June 2020

AbstractObjectiveThis study investigated the concurrent validity, inter and intra‐reliability of manual evaluation in Asthma patients.MethodsTwenty six asthma patients were assessed. Maximal respiratory muscle strength (Mrms) was tested by inspiratory and expiratory pressure (MIP and MEP, respectively) trough manovacuometer. In addition, Mrms of diaphragm (anterior and posterior), Intercostals (lower and upper portion) and Rectus abdominal were obtained manually, according to Medical Research Council (MRC) scale. Two independents evaluators, previously trained, made both measurements.ResultsReproducibility of Mrms intra‐evaluators: anterior diaphragm (ICCs, 0.79 and 0.67); Posterior portion of the diaphragm (ICCs, 0.43 and 0.51); Upper intercostals (ICCs, 0.47 and 0.40); Lower intercostals (ICCs, 0.81 and 0.51) and rectus abdominal (ICCs, 1.0). Inter‐reproducibility of anterior diaphragm was low to moderate, while intercostals (upper and lower portion) was relatively low. However, rectus abdominal presented high reproducibility reflecting in almost perfect agreement. In addition, we found positive correlations between MIP versus Lower Intercostals (r = .60, p = .007) and MEP versus rectus abdominal (r = .41, p = .04).ConclusionIn asthmatic patients, manual evaluation of the respiratory muscles is reliable. In addition, maximal respiratory pressures using manometer assessment were related to manual evaluation, in special to diaphragm and rectus abdominal muscles.
A flexible two‐dimensional basic warranty policy with two continuous warranty regions
Authors: Zheng Rui , Su Chun 
Published: June 2020

AbstractFlexible warranty policies can satisfy customers by allowing them to select the warranty regions according to their usage rates. However, customers are usually unaware of their future usage rates when they purchase a product, which makes it difficult to make sound decisions. To address the problem, this paper proposes a flexible two‐dimensional basic warranty policy with two continuous rectangular regions. Customers can gain experience of their usage rates through the first region, and thus make the second region more cost‐effective. The total price of the two subregions is equal to the basic warranty price, which is prespecified by the manufacturer. The objective is to determine the optimal boundary between the two regions from the perspective of customers. First, the learning effect is used to depict the process of gaining experience from the first region. A warranty pricing model is then developed based on the polynomial failure intensity model. On that basis, the customer's expected repair cost over the warranty period is analyzed, and a numerical method is proposed for the optimization problem. A numerical example is presented to demonstrate the effectiveness of the proposed policy. The results show that customers can benefit more from the proposed policy than from the iso‐cost warranty policy.
Mediastinal malignant mesothelioma discovered in a patient with dysphagia
Authors: Amore Dario , Massa Simona , Caterino Umberto , Casazza Dino , Palma Albina , Curcio Carlo 
Published: June 2020

Key messageA mediastinal mass in patients with a history of asbestos exposure should raise the suspicion of malignant mesothelioma.
Determination of suitable TPH remediation approach via MANOVA and inferential statistics assessment
Authors: Okonofua Ehizonomhen S. , Babatola Josiah O. , Ojuri Oluwapelumi O. , Lasisi Kayode H. 
Published: June 2020

AbstractSoil contamination resulting from petroleum hydrocarbon contaminants poses a fairly substantial hazard to human health and the environment. Phytoremediation, land farming, and chemico–biological stabilization were used to treat total petroleum hydrocarbons (TPHs) and polycyclic aromatic hydrocarbons (PAHs) at a crude oil polluted soil site in Nigeria. A field pilot study was conducted by preparing nine cells with subcells attached to each serving as a control with an overall area of 1.53 m2. A complete block design method was used for the study. The prepared soil sample cells were divided into three groups with each group having approximately 300 kg of soil and delineated as low, medium, and high test plots. The low samples were spiked with 6.1 kg of crude oil, the medium samples were spiked with 12.2 kg of crudeoil, and the high samples were spiked with 18.3 kg of crude oil. Each row containing three cells with low, medium, and high concentrations were treated separately using the three treatment methods. The ratio of the soil sample to the organic amendment for the treatments was 2:1. The results showed over 90% degradation in the initial concentration of TPH and PAHs across different contaminant levels except in the control subcells where only 30% of degradation was recorded. Multivariate analysis of variance was employed to assess the significant difference in each treatment group while inferential statistics using a mean performance plot was used to ascertain the optimum treatment method. Land farming, chemico–biological stabilization, and phytoremediation ranked 1, 2, and 3, respectively. In conclusion, the three treatment methods employed all degraded the contaminants (TPH and PAHs) with land farming emerging as the best method.
Six pilot‐scale studies evaluating the in situ treatment of PFAS in groundwater
Authors: McGregor Rick 
Published: June 2020

AbstractPer‐ and polyfluoroalkyl substances (PFAS) have been identified by many regulatory agencies as emerging contaminants of concern in a variety of media including groundwater. Currently, there are limited technologies available to treat PFAS in groundwater with the most frequently applied approach being extraction (i.e., pump and treat). While this approach can be effective in containing PFAS plumes, previous studies of pump and treat programs have met with limited remedial success. In situ treatment studies of PFAS have been limited to laboratory and a few field studies. Six pilot‐scale field studies were conducted in an unconfined sand aquifer coimpacted by petroleum hydrocarbon along with PFAS to determine if a variety of reagents could be used to attenuate dissolved phase PFAS in the presence of petroleum hydrocarbons. The six reagents consisted of two chemical oxidants, hydrogen peroxide (H2O2) and sodium persulfate (Na2S2O8), and four adsorbents, powdered activated carbon (PAC), colloidal activated carbon (CAC), ion‐exchange resin (IER), and biochar. The reagents were injected using direct push technology in six permeable reactive zone (PRZ) configurations. Groundwater concentrations of various PFAS entering the PRZs ranged up to 24,000 µg/L perfluoropentanoic acid, up to 6,200 µg/L pentafluorobenzoic acid, up to 16,100 µg/L perfluorohexanoic acid, up to 6,080 µg/L perfluoroheptanoic acid, up to 450 µg/L perfluorooctanoic acid, and up to 140 µg/L perfluorononanoic acid. Performance groundwater sampling within and downgradient of the PRZs occurred for up to 18 months using single and multilevel monitoring wells. Results of groundwater sampling indicated that the PFAS were not treated by either the persulfate nor the peroxide and, in some cases, the PFAS increased in concentration immediately following the injection of peroxide and persulfate. Concentrations of PFAS in groundwater sampled within the PAC, CAC, IER, and biochar PRZs immediately after the injection were determined to be less than the method detection limits. Analyses of groundwater samples over the 18‐month monitoring period, indicated that all the PRZs exhibited partial or complete breakthrough of the PFAS over the 18‐month monitoring period, except for the CAC PRZ which showed no PFAS breakthrough. Analysis of cores for the CAC, PAC, and biochar PRZs suggested that the CAC was uniformly distributed within the target injection zone, whereas the PAC and biochar showed preferential injection into a thin coarse‐sand seam. Similarly, analysis of the sand packs of monitoring wells installed before the injection of the CAC, PAC, and biochar indicated that the sand packs of the PAC and biochar preferentially accumulated the reagents compared with the reagent concentrations within the surrounding aquifer by up to 18 times.
Towards Synergy of rGO and Ni doped CeO2 in their copmposite as Efficient Catalyst for Oxygen Reduction Reaction
Authors: Hota Ipsha , Debnath A. K. , Muthe K. P. , Varadwaj K. S. K. , Parhi P. 
Published: June 2020

AbstractThe persistently increasing energy consumption and the deficiency of conventional fuels have raised serious concern in the recent years. The advanced energy conversion technologies like fuel cells have been benefitted by the development of suitable catalytic materials that can effectively carry out appropriate electrochemical processes like oxygen reduction reaction (ORR). Direct Methanol Fuel cells (DMFCs) act as an energy conversion device and the efficiency can be enhanced with active ORR catalysts. Here, we have reported the ORR activity of Ni doped CeO2/rGO synthesized by microwave mediated hydrothermal method. We have observed that the synergistic interaction between Ni doped CeO2 and rGO is responsible for the enhanced ORR activity. The optimized 5% Ni‐CeO2/rGO was evaluated as the most efficient ORR catalyst among all other composites with onset ORR potential −0.17 V vs. Ag/AgCl and limiting current density 3.67 mA/cm2. The 5% Ni‐CeO2/rGO catalyst showed better stability and methanol tolerant when compared with commercial Pt/C.
Phosphorus Containing Coatings: Technologies and Applications
Authors: Makha Mohammed , Ghailane Anas , Larhlimi Hicham , Busch Heinz , Alami Jones 
Published: June 2020

AbstractPhosphorus Containing Coatings (PCCs) are an interesting class of materials that attracted considerable attention for use in different domains. A variety of PCCs characterized by outstanding electrical, biological, and chemical properties have been manufactured using various physical and chemical deposition processes. Thanks to developments in thin film and surface deposition technologies, it has become possible to manipulate the formation of PCCs according to the desired application, which has therefore been a mean of promoting this type of material towards new products and processes. This review explores the potential of the PCCs and deposition methods which can be used for their fabrication. Highlights on the connections between processing methods and the resulting film characteristics will be provided. The resulting coatings’ properties are discussed in the context of the characteristics necessary for achieving high‐performance PCCs in different sectors. Important prospects for PCCs research and their practical use in different fields will also be provided, and light will be shed on the future research directions for further progress of promising PCCs for the next film technology generations.