bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurses' knowledge and attitudes regarding physical restraint in Turkish intensive care units
Authors: Ertuğrul Büşra , Özden Dilek 
Published: September 2020

AbstractBackgroundPhysical restraint is still widely used despite studies supporting a reduction in its use. The development of guidelines to reduce the use of PR first requires the identification of factors related to the use of alternative methods.AimThis study aimed to determine factors associated with the use of alternatives to physical restraint (PR) in intensive care units.DesignThis was a cross‐sectional descriptive study.MethodsData were collected from adult intensive care units of three hospitals in Turkey using the Physical Restraint Knowledge, Attitude and Practice Scale and a questionnaire including open‐ended questions.ResultsOverall, 202 nurses (80% response rate) completed the questionnaire. Nurses' knowledge, attitude, and practice scores regarding PR were 6.89 ± 1.79, 29.85 ± 4.93, and 36.76 ± 3.36, respectively. PR was reported to be necessary for patients at risk of self‐harm, with dangerous behaviours, and who were trying to remove their catheters. Most nurses (64.9%) stated that they needed a written doctor's order. Analysis of free‐text responses showed that patient disorientation (because of delirium, sedation, or agitation), nurses' workload, and lack of training regarding restraint were the primary reasons why nurses could not use alternatives. The main alternatives suggested by nurses were categorized as sedation, communication, and environmental regulation. Logistic regression analysis identified training (P = .009), working unit (P = .001), and nurses' practice score to use PR (P = .004) as independent risk factors for not using alternative methods of PR.ConclusionsThe results of this study revealed a moderate level of knowledge, attitude, and practice among nurses regarding the use of PR. Thus, education of nurses about the prevention of delirium and alternatives to PR according to the characteristics of their units is required.Relevance to clinical practiceClinical guidelines and in‐service training need to be developed to increase the use of alternatives to PR and delirium management.
Ex vivo electroretinograms made easy: performing ERGs using 3D printed components
Authors: Bonezzi Paul J. , Tarchick Matthew J. , Renna Jordan M. 
Published: September 2020

Key points
Rod and cone photoreceptors convert light into electrochemical signals that are transferred to second order cells, initiating image‐forming visual processing.
Electroretinograms (ERGs) can detect the associated light‐induced extracellular transretinal events, allowing for physiological assessment of cellular activity from morphologically intact retinas.
We outline a method for economically configuring a traditional patch‐clamp rig for performing high signal‐to‐noise ex vivo ERGs.
We accomplish this by incorporating various 3D printed components and by modifying existing light pathways in a typical patch‐clamp rig.
This methodology provides an additional set of tools to labs interested in studying the physiological function of neuronal populations in isolated retinal tissue.
AbstractRod and cone photoreceptors of the retina are responsible for the initial stages in vision and convey sensory information regarding our visual world across a wide range of lighting conditions. These photoreceptors hyperpolarize in the presence of light and subsequently transmit signals to second‐order bipolar and horizontal cells. The electrical components of these events are experimentally detectable, and in conjunction with pharmacological agents, can be further separated into their respective cellular contributions using electroretinograms (ERGs). Extracellular activity from populations of rods and cones generate the negative‐going a‐wave, while ON‐bipolar cells generate positive‐going b‐waves. ERGs can be performed in vivo or alternatively using an ex vivo configuration, where retinas are isolated and transretinal photovoltages are recorded at high signal‐to‐noise ratios. However, most ERG set‐ups require their own unique set of tools. We demonstrate how, at low cost, to reconfigure a typical patch‐clamp rig for ERG recordings. The bulk of these modifications require implementation of various 3D printed components, which can alternatively aid in generating a stand‐alone ERG set‐up without a patch‐rig. Further, we discuss how to configure an ERG system without a patch‐clamp rig. Compared to in vivo ERGs, these are superior when measuring small responses, such as those that are cone‐evoked or those from immature mouse retinae. This recording configuration provides high signal‐to‐noise detection of a‐waves (300–600 µV) and b‐waves (1–3 mV), and is ultimately capable of discerning small (1–2 µV) photovoltages from noise. These quick and economical modifications allow researchers to equip their technical arsenal with an interchangeable patch‐clamp/ERG system.
Chronic cold exposure induces mitochondrial plasticity in deer mice native to high altitudes
Authors: Mahalingam Sajeni , Cheviron Zachary A. , Storz Jay F. , McClelland Grant B. , Scott Graham R. 
Published: September 2020

Key points
Small mammals native to high altitude must sustain high rates of thermogenesis to cope with cold. Skeletal muscle is a key site of shivering and non‐shivering thermogenesis, but the importance of mitochondrial plasticity in cold hypoxic environments remains unresolved.
We examined high‐altitude deer mice, which have evolved a high capacity for aerobic thermogenesis, to determine the mechanisms of mitochondrial plasticity during chronic exposure to cold and hypoxia, alone and in combination.
Cold exposure in normoxia or hypoxia increased mitochondrial leak respiration and decreased phosphorylation efficiency and OXPHOS coupling efficiency, which may serve to augment non‐shivering thermogenesis. Cold also increased muscle oxidative capacity, but reduced the capacity for mitochondrial respiration via complex II relative to complexes I and II combined.
High‐altitude mice had a more oxidative muscle phenotype than low‐altitude mice.
Therefore, both plasticity and evolved changes in muscle mitochondria contribute to thermogenesis at high altitude.
AbstractSmall mammals native to high altitude must sustain high rates of thermogenesis to cope with cold and hypoxic environments. Skeletal muscle is a key site of shivering and non‐shivering thermogenesis, but the importance of mitochondrial plasticity in small mammals at high altitude remains unresolved. High‐altitude deer mice (Peromyscus maniculatus) and low‐altitude white‐footed mice (P. leucopus) were born and raised in captivity, and chronically exposed as adults to warm (25°C) normoxia, warm hypoxia (12 kPa O2), cold (5°C) normoxia, or cold hypoxia. We then measured oxidative enzyme activities, oxidative fibre density and capillarity in the gastrocnemius, and used a comprehensive substrate titration protocol to examine the function of muscle mitochondria by high‐resolution respirometry. Exposure to cold in both normoxia or hypoxia increased the activities of citrate synthase and cytochrome oxidase. In lowlanders, this was associated with increases in capillary density and the proportional abundance of oxidative muscle fibres, but in highlanders, these traits were unchanged at high levels across environments. Environment had some distinct effects on mitochondrial OXPHOS capacity between species, but the capacity of complex II relative to the combined capacity of complexes I and II was consistently reduced in both cold environments. Both cold environments also increased leak respiration and decreased phosphorylation efficiency and OXPHOS coupling efficiency in both species, which may serve to augment non‐shivering thermogenesis. These cold‐induced changes in mitochondrial function were overlaid upon the generally more oxidative phenotype of highlanders. Therefore, both plasticity and evolved changes in muscle mitochondria contribute to thermogenesis at high altitudes.
Numerical Simulation of Proppant Placement in Scaled Fracture Networks
Authors: Song Y. , Dahi Taleghani A. 
Published: September 2020

Abstract
While hydraulic fracturing is recognized as the most effective stimulation technique for unconventional reservoirs, the production enhancement is influenced by several factors including proppant placement inside the fractures. The goal of this work is to understand the proppant transport and its placement process in T-shaped fracture network through simulations. The proppant transport is studied numerically by coupling a computational fluid dynamic model for the base shear-thinning fluid and the discrete element methods for proppant particles. A scaling analysis has been performed to scale down the model from field scale to lab scale by deriving relevant dimensionless parameters. Different proppant size distributions and injection velocities are considered, as well as the friction and cohesion effects among particle and fracture surface. The simulation results show that in the primary fracture, the injected proppant could divide into three layers: the bottom sand bed zone, the middle rolling surface zone, and the top slurry flow zone. The total number of the proppants do not increase much after the dune reach an equilibrium height. The equilibrium height of sand dune in the minor fracture could be greater than the primary fracture, and the distribution of proppant dunes is symmetric. Two deposit mechanisms have also identified in the bypass fracture network: falling deposition and rolling deposition. Additionally, significant momentum changes due to the change in the flow direction at the intersection with natural fractures is identified as a potential factor in accelerating particle deposition.
Numerical Model of a Deep Surge Cycle in Low-Speed Centrifugal Compressor
Authors: Liśkiewicz Grzegorz , Kulak Michał , Sobczak Krzysztof , Stickland Matthew 
Published: September 2020

Abstract
In this article, a numerical model of the full surge cycle is presented for the low-speed centrifugal blower and compared with the experiment. Surge phenomenon is very dangerous for the compressor operation. Therefore, the possibility of studying its physics experimentally is strongly limited. The application of numerical methods allows one to safely analyze surge physics without causing risks to the operating crew. This article presents a description of the applied numerical method and exhaustive analysis of the flow structures observed at consecutive stages of the surge cycle. The surge is known to be very difficult to be simulated due to large timescale and region of influence. This study also shows the importance of an appropriate choice of the simulation definition and the boundary conditions. The presented method allows gathering information about features such as the regions of flow reversal, pressure distributions, pressure rise, cycle frequency, and others. All the aforementioned information provides important input to the efficient antisurge system design. The model has been validated by a comparison with the experimental data. Thanks to simulation, standardized antisurge solutions could be possibly replaced with more efficient protection schemes tailored to a given machine.
Enhancement of Static and Dynamic Performance of Composite Tapered Pretwisted Rotating Blade With Variable Stiffness
Authors: Farsadi Touraj 
Published: September 2020

AbstractComposite pretwisted tapered rotating thin-walled beams (TWB) can be used as a load-carrying structural part of a composite helicopter, wind turbine, fan, and turbomachinery blades. In the present study, the variable stiffness concept with curvilinear fiber path is used to achieve improved structural statics and dynamics performance of uniform and asymmetric composite thin-walled rotating beams. A parametric study is performed to investigate the effect of different fiber paths on the structural performance metrics including frequency spacing, coupling factor, and critical buckling load. For this purpose, The Euler–Lagrange governing equations of the dynamic system are derived via Hamilton's principle. To solve the governing set of equations, the extended Galerkin’s method (EGM) is employed. To validate the TWB model with curvilinear fibers, commercial finite element analysis tools abaqus is used. The author believes that the results presented here are likely to provide valuable information to the engineers involved in the design of advanced turbomachinery rotating blades using a variable stiffness concept with curvilinear fiber placement.
Age-Related Differences in Perceived Exertion While Walking and Running Near the Preferred Transition Speed
Authors: Kung Stacey M. , Fink Philip W. , Legg Stephen J. , Ali Ajmol , Shultz Sarah P. 
Published: September 2020

Purpose: To investigate whether youth and adults can perceive differences in exertion between walking and running at speeds near the preferred transition speed (PTS) and if there are age-related differences in these perceptions. Methods: A total of 49 youth (10–12 y, n = 21; 13–14 y, n = 10; 15–17 y, n = 18) and 13 adults (19–29 y) completed a walk-to-run transition protocol to determine PTS and peak oxygen uptake. The participants walked and ran on a treadmill at 5 speeds (PTS–0.28 m·s−1, PTS–0.14 m·s−1, PTS, PTS+0.14 m·s−1, PTS+0.28 m·s−1) and rated perceived exertion using the OMNI Perceived Exertion (OMNI-RPE) scale. Oxygen consumption was measured during the walk-to-run transition protocol to obtain the relative intensity (percentage of peak oxygen uptake) at PTS. OMNI-RPE scores at all speeds and percentage of peak oxygen uptake at PTS were compared between age groups. Results: The 10- to 12-year-olds transitioned at a higher percentage of peak oxygen uptake than adults (64.54 [10.18] vs 52.22 [11.40], respectively; P = .035). The 10- to 14-year-olds generally reported higher OMNI-RPE scores than the 15- to 17-year-olds and adults (P < .050). In addition, the 10- to 14-year-olds failed to distinguish differences in OMNI-RPE between walking and running at PTS and PTS+0.14 m·s−1. Conclusions: Children aged 10–14 years are less able to distinguish whether walking or running requires less effort at speeds near the PTS compared with adults. The inability to judge which gait mode is less demanding could hinder the ability to minimize locomotive demands.
Peripheral exudative haemorrhagic chorioretinopathy: a widefield imaging study
Authors: Zicarelli Federico , Preziosa Chiara , Staurenghi Giovanni , Pellegrini Marco 
Published: September 2020

AimsTo study widefield imaging features, analyse risk factors for progression and compare treatment modalities of peripheral exudative haemorrhagic chorioretinopathy (PEHCR).MethodsClinical and imaging data from each visit were collected, including near-infrared reflectance, fluorescein angiography, indocyanine green angiography, optical coherence tomography using the Spectralis platform (Heidelberg Engineering). Clinical features and treatment performed were recorded. Lesions were classified according to treatments used and according to the prognostic index of macular involvement (MI) and intravitreal bleeding (IVB).Results50 eyes of 35 patients were retrospectively enrolled. Using widefield imaging, peripheral subretinal fluid (SRF) was detected in 31 (62%) eyes and peripheral neovascular networks were detected in 42 (84%) eyes and graded as focal, diffuse and subtotal in 22 (44%), 17 (34%) and 11 (22%) eyes, respectively. MI secondary to PEHCR during the follow-up was documented in 17 (34%) eyes, while IVB occurred in 7 (14%) eyes. Both MI and IVB correlated with peripheral SRF and lesion grade. Active treatment included anti-vascular endothelial growth factor (anti-VEGF) injections, photodynamic therapy (PDT) and combined anti-VEGF and PDT for 13 (26%), 1 (2%) and 18 (36%) eyes, respectively. In eyes with risk factors, anti-VEGF and combined treatment inversely correlated with MI incidence.ConclusionsIn our series, peripheral subretinal exudation and the extension of peripheral involvement represented risk factors for MI in eyes with PEHCR. In those high-risk eyes, active treatment is warranted.
Asthma and COVID-19: review of evidence on risks and management considerations
Authors: Hartmann-Boyce Jamie , Gunnell James , Drake Jonny , Otunla Afolarin , Suklan Jana , Schofield Ella , Kinton Jade , Inada-Kim Matt , Hobbs F D Richard , Dennison Paddy 
Published: September 2020

Background
Respiratory illnesses typically present increased risks to people with asthma (PWA). However, data on the risks of COVID-19 to PWA have presented contradictory findings, with implications for asthma management.

Objective
To assess the risks and management considerations of COVID-19 in people with asthma (PWA).

Method
We conducted a rapid literature review. We searched PubMed, medRxiv, LitCovid, TRIP, Google and Google Scholar for terms relating to asthma and COVID-19, and for systematic reviews related to specific management questions within our review, in April 2020. References were screened and data were extracted by one reviewer.

Results
We extracted data from 139 references. The evidence available is limited, with some sources suggesting an under-representation of PWA in hospitalised cases and others showing an increased risk of worse outcomes in PWA, which may be associated with disease severity. Consensus broadly holds that asthma medications should be continued as usual. Almost all aspects of asthma care will be disrupted during the pandemic due not only to limits in face-to-face care but also to the fact that many of the diagnostic tools used in asthma are considered aerosol-generating procedures. Self-management and remote interventions may be of benefit for asthma care during this time but have not been tested in this context.

Conclusions
Evidence on COVID-19 and asthma is limited and continuing to emerge. More research is needed on the possible associations between asthma and COVID-19 infection and severity, as well as on interventions to support asthma care in light of constraints and disruptions to healthcare systems. We found no evidence regarding health inequalities, and this urgently needs to be addressed in the literature as the burdens of asthma and of COVID-19 are not equally distributed across the population.
Understanding the mechanisms of a combined physical and psychological intervention for people with neurogenic claudication: protocol for a causal mediation analysis of the BOOST trial
Authors: Comer Christine , Lee Hopin , Williamson Esther , Lamb Sarah 
Published: September 2020

IntroductionConservative treatments such as exercise are recommended for the management of people with neurogenic claudication from spinal stenosis. However, the effectiveness and mechanisms of effect are unknown. This protocol outlines an a priori plan for a secondary analysis of a multicentre randomised controlled trial of a physiotherapist-delivered, combined physical and psychological intervention (Better Outcomes for Older people with Spinal Trouble (BOOST) programme).Methods and analysesWe will use causal mediation analysis to estimate the mechanistic effects of the BOOST programme on the primary outcome of disability (measured by the Oswestry Disability Index). The primary mechanism of interest is walking capacity, and secondary mediators include fear-avoidance behaviour, walking self-efficacy, physical function, physical activity and/or symptom severity. All mediators will be measured at 6 months and the outcome will be measured at 12 months from randomisation. Patient characteristics and possible confounders of the mediator-outcome effect will be measured at baseline. Sensitivity analyses will be conducted to evaluate the robustness of the estimated effects to varying levels of residual confounding.Ethics and disseminationEthical approval was given on 3 March 2016 (National Research Ethics Committee number: 16/LO/0349). The results of this analysis will be disseminated in peer-reviewed journals and at relevant scientific conferences.Trial registration numberISRCTN12698674.
Liquid biopsy in the clinical management of hepatocellular carcinoma
Authors: von Felden Johann , Garcia-Lezana Teresa , Schulze Kornelius , Losic Bojan , Villanueva Augusto 
Published: September 2020

With increasing knowledge on molecular tumour information, precision oncology has revolutionised the medical field over the past years. Liquid biopsy entails the analysis of circulating tumour components, such as circulating tumour DNA, tumour cells or tumour-derived extracellular vesicles, and has thus come as a handy tool for personalised medicine in many cancer entities. Clinical applications under investigation include early cancer detection, prediction of treatment response and molecular monitoring of the disease, for example, to comprehend resistance patterns and clonal tumour evolution. In fact, several tests for blood-based mutation profiling are already commercially available and have entered the clinical field.In the context of hepatocellular carcinoma, where access to tissue specimens remains mostly limited to patients with early stage tumours, liquid biopsy approaches might be particularly helpful. A variety of translational liquid biopsy studies have been carried out to address clinical needs, such as early hepatocellular carcinoma detection and prediction of treatment response. To this regard, methylation profiling of circulating tumour DNA has evolved as a promising surveillance tool for early hepatocellular carcinoma detection in populations at risk, which might soon transform the way surveillance programmes are implemented. This review summarises recent developments in the liquid biopsy oncological space and, in more detail, the potential implications in the clinical management of hepatocellular carcinoma. It further outlines technical peculiarities across liquid biopsy technologies, which might be helpful for interpretation by non-experts.