bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Recovery Following Orthopedic Surgery in Patients at an Academic Hospital in South Africa
Authors: Wessels Erica , Perrie Helen , Scribante Juan , Jooma Zainub 
Published: May 2021

BACKGROUND:
Measurement of perioperative quality of recovery (QoR) is an important tool in improving the patient’s perioperative experience. By making use of the Quality of Recovery-15 (QoR-15) questionnaire, this study aimed to measure the QoR on day 1 in patients following elective and semiurgent orthopedic surgery at an academic hospital. A secondary aim was to determine factors that may influence the QoR.

METHODS:
A cross-sectional research study was performed in 122 patients presenting for elective and semiurgent orthopedic surgery during core working hours between July and November 2019 at Helen Joseph Hospital, Johannesburg, South Africa. Patients completed a baseline QoR-15 assessment preoperatively and a day 1 QoR-15 assessment between 12 and 24 hours postoperatively. Additional information on various anesthetic, surgical, and patient factors was collected.

RESULTS:
Nineteen patients (15.6%) had a poor QoR on day 1 and were found to have started with a significantly worse baseline QoR-15 score than those with no poor QoR (98.5 vs 128.5; P < .001). A significant worsening from the overall mean baseline QoR-15 to the overall mean day 1 QoR-15 score was found (123.8 vs 113.1; P = .001). This worsening score was more pronounced in patients with a poor day 1 QoR-15 score than no poor day 1 score (25.3 vs 8; P = .002). Surgical site was found to have a significant effect on day 1 score (P = .026). A significantly worse severe pain score was found in patients with foot/ankle and knee surgery compared to hand/arm surgery (P = .012 and P = .032, respectively) and is thought to be due to the decreased use of peripheral nerve blocks in lower limb surgery. Sex, American Society of Anesthesiologists (ASA) physical status, type of anesthesia, postoperative analgesia, and antiemetic given (only applicable in general anesthetic cases) were not found to have a significant effect on the day 1 QoR-15 scores.

CONCLUSIONS:
Patients who had a poor QoR on day 1 started with a significantly worse baseline QoR-15 score and experienced a significantly greater negative change in the mean difference. Preoperative identification of patients who are at risk of a poor postoperative QoR may aid in preemptive targeting of limited resources to those who need them most. Postoperative pain, particularly in patients after foot/ankle and knee surgery, is a significant modifiable factor to improve postoperative QoR at our institution.
Ipsilateral Intravenous Catheter Placement in Breast Cancer Surgery Patients
Authors: Naranjo Julian , Portner Erica R. , Jakub James W. , Cheville Andrea L. , Nuttall Gregory A. 
Published: May 2021

BACKGROUND:
There is a continued perception that intravenous line (IV) placement is contraindicated in the arm ipsilateral to prior breast cancer surgery to avoid breast cancer–related lymphedema (BCRL). The aim of this retrospective study was to determine the risk for development of BCRL in ipsilateral arm IV placement compared to contralateral arm IV placement to prior breast cancer surgery.

METHODS:
We performed a retrospective review, via our Integrated Clinical Systems and Epic Electronic Heath Record of IV placement for anesthesia and surgery in patients with a prior history of breast cancer surgery with or without axillary lymph node dissection. Complication rates were compared for IVs placed in the ipsilateral and contralateral arms. We identified 3724 patients undergoing 7896 IV placements between January 1, 2015, and May 5, 2018, with a prior history of breast cancer surgery via their index anesthesia and surgical procedures.

RESULTS:
The median time from breast cancer surgery to IV placement was 1.5 years (range, 1 day to 17.8 years). Of 2743 IVs placed in the arm contralateral to prior breast cancer surgery, 2 had a complication, corresponding to an incidence of 7.3 per 10,000 (95% confidence interval [CI], 0.9–26.3 per 10,000). Of 5153 IVs placed in the arm ipsilateral to prior breast cancer surgery, 2 IVs had a complication, for an incidence of 3.9 per 10,000 (95% CI, 0.5–14.0 per 10,000). The frequency of complications was not found to differ significantly between the groups (P = .91), and the 95% CI for the risk difference (ipsilateral minus contralateral) was −23 to +8 complications per 10,000. The complication rate is similar when only the first IV placed following breast cancer surgery is considered (overall 5.4 per 10,000 [95% CI, 0.7–19.4] per 10,000; contralateral 7.0 [95% CI, 0.2–39.0] per 10,000, ipsilateral 4.4 [95% CI, 0.1–24.2] per 10,000; P = 1.00; 95% CI for risk difference [ipsilateral minus contralateral], −41 to +22 per 10,000).

CONCLUSIONS:
We found very few complications in patients who had an IV placed for surgery following a previous breast cancer surgery and no complications in those patients with IV placement ipsilateral with axillary node dissection. Avoidance of IV placement in the arm ipsilateral to breast cancer surgery is not necessary.
Factors associated with research productivity in higher education institutions in Africa: a systematic review
Authors: Uwizeye Dieudonne , Karimi Florah , Thiong'o Caroline , Syonguvi Jackline , Ochieng Vollan , Kiroro Francis , Gateri Alex , Khisa Anne M. , Wao Hesborn 
Published: May 2021

Background: There are low levels of research productivity among Higher Education Institutions (HEIs) in Africa, a situation that is likely to compromise the development agenda of the continent if not addressed. We conducted a systematic literature review to determine the factors associated with research productivity in HEIs in Africa and the researchers’ motives for research. Methods: We identified 838 papers related to research productivity in HEIs in Africa from various databases, from which we included 28 publications for review. The inclusion criteria were that (i) the paper’s primary focus was on factors associated with research productivity; (ii) the setting was on the higher education institutions in Africa; (iii) the type of publication was peer-reviewed papers and book chapters based on primary or secondary data analysis; and (iv) the language was English or French. Essays, opinions, blogs, editorials, reviews, and commentaries were excluded. Results: Most of the studies operationalized research productivity as either journal publications or conference proceedings. Both institutional and individual factors are associated with the level of research productivity in HEIs in Africa. Institutional factors include the availability of research funding, level of institutional networking, and the degree of research collaborations, while individual factors include personal motivation, academic qualifications, and research self-efficacy. Conclusions: Deliberate efforts in HEIs in Africa that addressed both individual and institutional barriers to research productivity are promising. This study recommends that the leadership of HEIs in Africa prioritizes the funding of research to enable researchers to contribute to the development agenda of the continent. Moreover, HEIs should build institutional support to research through the provision of research enabling environments, policies and incentives; strengthening of researchers’ capabilities through relevant training courses, mentorship and coaching; and embracing networking and collaboration opportunities.
SARS-CoV-2 and the role of fomite transmission: a systematic review
Authors: Onakpoya Igho J. , Heneghan Carl J. , Spencer Elizabeth A. , Brassey Jon , Plüddemann Annette , Evans David H. , Conly John M. , Jefferson Tom 
Published: May 2021

Background:SARS-CoV-2 RNA has been detected in fomites which suggests the virus could be transmitted via inanimate objects. However, there is uncertainty about the mechanistic pathway for such transmissions. Our objective was to identify, appraise and summarise the evidence from primary studies and systematic reviews assessing the role of fomites in transmission. Methods:This review is part of an Open Evidence Review on Transmission Dynamics of SARS-CoV-2. We conduct ongoing searches using WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar; assess study quality based on five criteria and report important findings on an ongoing basis.Results:We found 64 studies: 63 primary studies and one systematic review (n=35). The settings for primary studies were predominantly in hospitals (69.8%) including general wards, ICU and SARS-CoV-2 isolation wards. There were variations in the study designs including timing of sample collection, hygiene procedures, ventilation settings and cycle threshold. The overall quality of reporting was low to moderate. The frequency of positive SARS-CoV-2 tests across 51 studies (using RT-PCR) ranged from 0.5% to 75%. Cycle threshold values ranged from 20.8 to 44.1. Viral concentrations were reported in 17 studies; however, discrepancies in the methods for estimation prevented comparison. Eleven studies (17.5%) attempted viral culture, but none found a cytopathic effect. Results of the systematic review showed that healthcare settings were most frequently tested (25/35, 71.4%), but laboratories reported the highest frequency of contaminated surfaces (20.5%, 17/83). Conclusions:The majority of studies report identification of SARS-CoV-2 RNA on inanimate surfaces; however, there is a lack of evidence demonstrating the recovery of viable virus. Lack of positive viral cultures suggests that the risk of transmission of SARS-CoV-2 through fomites is low. Heterogeneity in study designs and methodology prevents comparisons of findings across studies. Standardized guidelines for conducting and reporting research on fomite transmission is warranted.
Molecular characterization of Plasmodium falciparum PHISTb proteins as potential targets of naturally-acquired immunity against malaria
Authors: Isebe Tony I. , Bargul Joel L. , Gichuki Bonface M. , Njunge James M. , Tuju James , Rono Martin K. 
Published: May 2021

Background: Plasmodium falciparum causes the deadliest form of malaria in humans. Upon infection, the host’s infected red blood cells (iRBCs) are remodelled by exported parasite proteins to provide a niche for parasite development and maturation. Methods: Here we analysed the role of three PHISTb proteins Pf3D7_0532400, Pf3D7_1401600, and Pf3D7_1102500 by expressing recombinant proteins and evaluated antibody responses against these proteins using immune sera from malaria-exposed individuals from Kenya and The Gambia in Africa. Results: Children and adults from malaria-endemic regions recognized the three PHISTb proteins. Responses against PHISTb proteins varied with malaria transmission intensity in three different geographical sites in Kenya (Siaya and Takaungu) and The Gambia (Sukuta). Antibody responses against PHISTb antigens Pf3D7_1102500 and Pf3D7_1401600 were higher in Sukuta, a low transmission region in Gambia, compared to Siaya, a high transmission region in western Kenya, unlike Pf3D7_0532400. Anti-PHIST responses indicate negative correlation between antibody levels and malaria transmission intensity for Pf3D7_1102500 and Pf3D7_1401600. We report a correlation in antibody responses between schizont and gametocyte extract, but this is not statistically significant (cor=0.102, p=0.2851, CI=95%) and, Pf3D7_0532400 (cor=0.11, p=0.249, CI=95%) and Pf3D7_1401600 (cor=0.02, p=0.7968, CI=95%). We report a negative correlation in antibody responses between schizont and Pf3D7_1102500 (cor=-0.008, p=0.9348, CI=95%). There is a correlation between gametocyte extract and Pf3D7_1401600 (cor=-0.0402, p=0.6735, CI=95%), Pf3D7_1102500 (cor=0.0758, p=0.4271, CI=95%) and Pf3D7_0532400 (cor=0.155, p=0.1028, CI=95%). Acquisition of anti-PHIST antibodies correlates with exposure to malaria for Pf3D7_0532400 (p=0.009) but not Pf3D7_1102500 and Pf3D7_1401600 (p=0.507 and p=0.15, respectively, CI=95%). Children aged below 2 years had the lowest antibody levels which do not correlate with age differences. Conclusions: Collectively, these findings provide evidence of natural immunity against PHISTb antigens that varies with level of malaria exposure and underscore their potential as possible serological markers to P. falciparum infection aimed at contributing to malaria control through vaccine development.
Radiation Contribution Assessment to Development of Multiple Oncological Diseases in the Late Period of Acute Radiation Disease
Authors: Galstyan I. , Konchalovsky M. , Kozlova M. , Nugis V. 
Published: May 2021

Purpose: On clinical examples to estimate a probable contribution of the postponed earlier external radiation of all body in the doses exceeding 1 Gy at development of multiple malignant neoplasms of different localization and a leukaemia.
Material and methods: At 8 of 164 patients, it is long observed after the postponed acute radiation syndrome (ARS), multiple oncological diseases are revealed. Dynamics of consecutive forming of solid tumors at 2 patients and also malignant neoplasms and a myelodysplastic syndrome (MDS) with transformation in an acute leukamia at 1 patient is tracked. Observation duration – 31 years, 43 years and 32 years.
Results: Availability of medical care to the patients who transferred ARS and high quality of its rendering at all stages (out-patient, stationary) allowed to reveal malignant neoplasms at early stages of development and to achieve an absolute recovery. However eventually at these patients development and other oncological diseases was observed. The given clinical observations allow to assume that at presented cases radiation acted on various stages of carcinogenesis, and its contribution to development of different oncological diseases in all patients was not identical.
Conclusion: The analysis of clinical observations allows to assume that radiation contribution to genesis of various oncological diseases at the persons which underwent radiation in the doses causing development of ARS is various. Now in our country there are no approaches to quantitative assessment of a contribution of radiation effects to development of malignant neoplasms in each case. The patients who underwent acute single exposition in doses over 1 Gy have to be considered as having predisposition to development of multiple tumors in the remote terms. In this regard they for life need medical follow up for the purpose of early diagnostics and adequate treatment of the developing malignant neoplasms.
Theoretically comparative study of spectrally selective solar absorbers
in concentrated solar-thermoelectric generators working at high
temperature
Authors: Tapsanit Piyawath 
Published: May 2021

A spectrally selective solar absorber (SSA) made from alternating tungsten and

S
i
O

2

layers is an important component in a
concentrated solar-thermoelectric generator (CSTEG). However, the
highly efficient SSA consisting of a high number of tungsten and

S
i
O

2

layers may require complicated
fabrication procedures, thereby raising the overall cost of the CSTEG.
In this study, we have theoretically optimized SSAs consisting of a
different number of layers, and the performances of CSTEGs installed
with different optimized SSAs and thermoelectric materials (

S
i

80

G
e

20

alloys, SnSe crystals) are
theoretically investigated. It is found that two SSAs, one with only
one layer of

S
i
O

2

glass (88 nm) coated on a tungsten
reflective plane, and the other with three alternating layers of

S
i
O

2

(

92

n
m

)

/

t
u
n
g
s
t
e
n

(

7

n
m

)

/

S
i
O

2

(

78

n
m

)

coated on a tungsten reflective
plane, have the highest average solar absorptance equal to 0.7050 and
0.9999, respectively. To reach the same steady-state temperature (

T
h

), the one-layer SSA requires higher
optical concentrations (

C

o
p
t

) than the three-layer SSA. The CSTEG
with

S
i

80

G
e

20

alloys requires much higher optical

C

o
p
t

than the CSTEG with SnSe crystals in
order to reach the same

T
h

because of much a higher rate of heat
flux. At

T
h

=

800

deg
⁡

C

, the CSTEG with

S
i

80

G
e

20

alloys have the output electrical
power per unit cross-sectional area of TEG about 6 times higher than
that of the CSTEG with SnSe crystals. The net efficiency of CSTEG with
SnSe crystals could reach 25.6% if the electrical conductivity of its
p-type thermoelectric leg could be enhanced to be comparable to the
electrical conductivity of its n-type thermoelectric leg.
Broadband transistor-injected dual doping quantum cascade laser
Authors: Lin Zhiyuan , Wang Zhuoran , Yuan Guohui , Leburton Jean-Pierre 
Published: May 2021

A novel design-friendly device called the transistor-injected dual doping quantum cascade laser (

T
I

-

D

2

Q
C
L

) with two different dopings in each stack of a homogeneous superlattice is proposed. By adjusting the base–emitter bias

V

be

of the bipolar transistor to supply electrons in the dual doping regions, charge quasi-neutrality can be achieved to generate different optical transitions in each cascading superlattice stack. These transitions are then stacked and amplified to contribute to a broad flat gain spectrum. Model calculations of a designed

T
I

-

D

2

Q
C
L

show that a broad flat gain spectrum ranging from 9.41 µm to 12.01 µm with a relative bandwidth of 0.24 can be obtained, indicating that the

T
I

-

D

2

Q
C
L

with dual doping pattern may open a new pathway to the appealing applications in both mid-infrared and terahertz frequency ranges, from wideband optical generations to advanced frequency comb technologies.
2000 PPI silicon-based AlGaInP red micro-LED arrays fabricated via wafer bonding and epilayer lift-off
Authors: Zhao Yongzhou , Liang Jingqiu , Zeng Qinghui , Li Yang , Li Panyuan , Fan Kaili , Sun Wenchao , Lv Jinguang , Qin Yuxin , Wang Qiang , Tao Jin , Wang Weibiao 
Published: May 2021

In this article, 2000 PPI red silicon-based AlGaInP micro-LED arrays were fabricated and investigated. The AlGaInP epilayer was transferred onto the silicon substrate via the In-Ag bonding technique and an epilayer lift-off process. The silicon substrate with a high thermal conductivity could provide satisfactory heat dissipation, leading to micro-LED arrays that had a stable emission spectrum with increasing current density from 20 to 420 A/cm2 along with a red-shift of the peak position from 624.69 to 627.12 nm (

Δ

λ

= 2.43 nm). Additionally, increasing the injection current density had little effect on the CIE (x, y) of the micro-LED arrays. Further, the I-V characteristics and light output power of micro-LED arrays with different pixel sizes demonstrated that the AlGaInP red micro-LED array on a silicon substrate had excellent electrical stability and optical output.
Pre-compensation of thermally induced refractive index changes in a depressed core fully aperiodic large-pitch fiber for high average power operation
Authors: Malleville Marie-Alicia , Leconte Baptiste , Dauliat Romain , Jamier Raphaël , Schwuchow Anka , Wondraczek Katrin , Roy Philippe 
Published: May 2021

To prevent the thermally induced spatial beam degradation occurring in high-power fiber lasers and amplifiers, index-depressed core “fully aperiodic large-pitch fibers” (FA-LPFs) have been designed and fabricated. In contrast to previous experimental works performed on FA-LPFs, in which the active core and the surrounding cladding material are quasi-index-matched, the core refractive index is in slight depression compared to the surrounding material (

Δ
n
≈
−

3

×

10

−
5

). Thus, the index-depressed fiber core tends first to behave as an anti-guide, preventing light from being properly guided into it. However, by increasing the absorbed pump power, the thermal load induces a parabolic refractive index change sufficient to compensate for the

−
3

×

10

−
5

index depression in the core, enabling a robust single-mode amplification at high average power. As a proof of concept, using a 110 µm depressed core FA-LPF,

M
2

values of 1.3 were demonstrated in amplifier configuration from 60 W to a maximal value of 170 W of emitted average power only limited by the available pump power.
“I’m not gonna be able to do anything about it, then what’s the point?”: A broad group of stakeholders identify barriers and facilitators to HCV testing in a Massachusetts jail
Authors: Wurcel Alysse G. , Reyes Jessica , Zubiago Julia , Koutoujian Peter J. , Burke Deirdre , Knox Tamsin A. , Concannon Thomas , Lemon Stephenie C. , Wong John B. , Freund Karen M. , Beckwith Curt G. , LeClair Amy M. 
Published: May 2021

Background
Despite national guidelines promoting hepatitis C virus (HCV) testing in prisons, there is substantial heterogeneity on the implementation of HCV testing in jails. We sought to better understand barriers and opportunities for HCV testing by interviewing a broad group of stakeholders involved in HCV testing and treatment policies and procedures in Massachusetts jails.

Methods
We conducted semi-structured interviews with people incarcerated in Middlesex County Jail (North Billerica, MA), clinicians working in jail and community settings, corrections administrators, and representatives from public health, government, and industry between November 2018—April 2019.

Results
51/120 (42%) of people agreed to be interviewed including 21 incarcerated men (mean age 32 [IQR 25, 39], 60% non-White). Themes that emerged from these interviews included gaps in knowledge about HCV testing and treatment opportunities in jail, the impact of captivity and transience, and interest in improving linkage to HCV care after release. Many stakeholders discussed stigma around HCV infection as a factor in reluctance to provide HCV testing or treatment in the jail setting. Some stakeholders expressed that stigma often led decisionmakers to estimate a lower “worth” of incarcerated individuals living with HCV and therefore to decide against paying for HCV testing.”.

Conclusion
All stakeholders agreed that HCV in the jail setting is a public health issue that needs to be addressed. Exploring stakeholders’ many ideas about how HCV testing and treatment can be approached is the first step in developing feasible and acceptable strategies.