bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Capsaicin Atomization–Induced Cough on Sputum Excretion in Tracheotomized Patients After Hemorrhagic Stroke: A Randomized Controlled Trial
Authors: Wu Chao , Zhang Yijie , Yang Li , Shen Fang , Ma Chen , Shen Meifen 
Published: October 2021

Background
Timely and effective removal of respiratory secretions is of great significance for tracheotomized patients. The purpose of this study is to investigate the effectiveness of capsaicin nebulization to stimulate cough to promote early clearance of respiratory secretions in tracheotomized patients after hemorrhagic stroke.

Method
This study implemented a randomized controlled design. Sixty-three patients who were tracheotomized following a hemorrhagic stroke completed this randomized controlled trial. In the control group, 33 cases were given a routine care after tracheotomy. In the intervention group, 30 cases were given a capsaicin solution nebulization in addition to the routine care. The daily sputum output and the number of sputum suctioning were observed. The differences in sputum viscosity, cough function, and Clinical Pulmonary Infection Score (CPIS) were compared between the two groups before and after the intervention. Vital sign changes during capsaicin nebulization and suctioning were compared between the two groups in a pilot study.

Results

The daily sputum output of the capsaicin intervention group was significantly higher than that of the control group (
p
< .05). The number of sputum suctioning of capsaicin group was less than that of the control group after intervention (
p
< .05). The CPIS score of the capsaicin group was lower than that of the control group (
p
< .05) after a 1-week intervention. Patients' heart rate, respiratory rate, and oxygen saturation during capsaicin nebulization were not statistically different from those during routine sputum suctioning (
p
> .05).

Conclusions

Capsaicin atomization–induced cough can effectively promote sputum excretion of hemorrhagic stroke patients undergoing tracheotomy and has a good safety profile. The Clinical Trial registration number of this study is ChiCTR2000037772 (
http://www.chictr.org.cns
).

Supplemental Material

https://doi.org/10.23641/asha.16821352
A novel evolving framework for energy management in wind‐gas reinforced unit commitment with demand response
Authors: Safipour Hamed , Abdollahi Amir , Hajmohammadi Mohammad Sadegh , Alizadeh Mohammad Iman 
Published: October 2021

AbstractThis research work tries to investigate the provision of flexibility on both sides of production and demand security constraint unit commitment (SCUC) before the schedule is considered. To this end, a powerful heuristic technique based on modified firefly algorithm (FA) is devised to achieve the optimal solution. Moreover, fast‐starting gas units (FGUs) are considered as providers of lateral flexibility as a result of their quickness in starting work and high ramp capability. Considering the fact that the normal operation of units is subject to the supply of reliable gas through connected gas transmission lines, the uncertainty of gas supply in the suggested model is considered to imitate the effects of deviation in the volume of gas over pipelines. The application of the suggested model has been tested on IEEE‐118 bus.
Dynamic atmospheres and winds of cool luminous giants
Authors: Höfner S. , Bladh S. , Aringer B. , Eriksson K. 
Published: October 2021

Context. The winds observed around asymptotic giant branch (AGB) stars are generally attributed to radiation pressure on dust formed in the extended dynamical atmospheres of these long-period variables. The composition of wind-driving grains is affected by a feedback between their optical properties and the resulting heating due to stellar radiation.
Aims. We explore the gradual Fe enrichment of wind-driving silicate grains in M-type AGB stars to derive typical values for Fe/Mg and to test the effects on wind properties and synthetic spectra.
Methods. We present new radiation-hydrodynamical DARWIN models that allow for the growth of silicate grains with a variable Fe/Mg ratio and predict mass-loss rates, wind velocities, and grain properties. Synthetic spectra and other observables are computed a posteriori with the COMA code.
Results. The self-regulating feedback between grain composition and radiative heating, in combination with quickly falling densities in the stellar wind, leads to low values of Fe/Mg, typically a few percent. Nevertheless, the new models show distinct silicate features around 10 and 18 microns. Fe enrichment affects visual and near-IR photometry moderately, and the new DARWIN models agree well with observations in (J − K) versus (V − K) and Spitzer color–color diagrams. The enrichment of the silicate dust with Fe is a secondary process, taking place in the stellar wind on the surface of large Fe-free grains that have initiated the outflow. Therefore, the mass-loss rates are basically unaffected, while the wind velocities tend to be slightly higher than in corresponding models with Fe-free silicate dust.
Conclusions. The gradual Fe enrichment of silicate grains in the inner wind region should produce signatures observable in mid-IR spectro-interferometrical measurements. Mass-loss rates derived from existing DARWIN models, based on Fe-free silicates, can be applied to stellar evolution models since the mass-loss rates are not significantly affected by the inclusion of Fe in the silicate grains.
Topische Anwendung von Heilpflanzen zur Unterstützung der Wundheilung
Authors: Embacher Karin , Zilkowski Ilona , Turek Claudia , Stintzing Florian C 
Published: October 2021

ZusammenfassungDie Wundheilung ist ein komplexer Prozess, der durch eine auf den jeweiligen Wundzustand abgestimmte Versorgung unterstützt werden kann. Der Artikel betrachtet bekannte (Arnika, Johanniskraut, Ringelblume/Calendula), aber auch in Vergessenheit geratene Heilpflanzen (Beinwell, Brennnessel, Deutsche Schwertlilie, Lebensbaum/Thuja, Waldbingelkraut, Wundklee) im Hinblick auf ihr wundheilungsförderndes und antimikrobielles Potenzial bei topischer Anwendung. Auf Grundlage aktueller Literaturdaten aus In-vitro- und In-vivo-Untersuchungen sowie klinischen Studien werden die Pflanzen und ihre Wirkmechanismen den Wundheilungsphasen zugeordnet. Besonderes Augenmerk wird zudem auf die Vorteile der Kombination von Heilpflanzen gelegt, um ein breiteres Wirkspektrum über verschiedene Phasen der Wundheilung hinweg zu erhalten und eine umfassende Unterstützung dieser anzustreben.
Völlig unterschiedlich oder doch recht ähnlich? Die
soziodemografische Struktur der AOK Niedersachsen im Vergleich zur
niedersächsischen und bundesweiten Allgemein- und
Erwerbsbevölkerung
Authors: Epping Jelena , Geyer Siegfried , Eberhard Sveja , Tetzlaff Juliane 
Published: October 2021

Zusammenfassung
Ziel der Studie Routinedaten von Krankenkassen sind als Datenquelle
mittlerweile gut etabliert. Hinsichtlich der Verallgemeinerbarkeit der
Ergebnisse bei Analysen mit Daten einer Krankenkasse treten Fragen der
Repräsentativität der Versichertenpopulation auf, insbesondere
da nicht alle Studien auf soziodemografische Merkmale adjustieren. Diese Arbeit
untersucht mittels deskriptiver Analyse, ob und inwieweit sich die
Sozialstruktur der Versichertenpopulation der AOK Niedersachsen von der
Sozialstruktur der Allgemeinbevölkerung und der
sozialversicherungspflichtig Beschäftigten in Niedersachsen (NDS) und in
der Bundesrepublik (BRD) unterscheiden.
Methodik Die Datengrundlage bilden pseudonymisierte Daten der AOK NDS, die
Beschäftigtenstatistik der Bundesagentur für Arbeit und der
Bevölkerungsstand in NDS und der BRD. Die Versichertenpopulation wird an
zwei Stichtagen 31.12.2012 und 31.12.2017 hinsichtlich der Geschlechter-und
Altersstruktur mit der Bevölkerung in NDS und der BRD verglichen.
Anschließend werden die Daten der sozialversicherungspflichtig
Beschäftigten in der AOK NDS und aus der Beschäftigtenstatistik
der Bundesagentur für Arbeit gegenübergestellt, um
Ausbildungsabschlüsse, Komplexität der ausgeübten
Tätigkeit und elf Berufsbereiche zu vergleichen.
Ergebnisse Die Geschlechterstruktur unterscheidet sich nicht zwischen den
drei Vergleichspopulationen. Verglichen mit der Bevölkerung in NDS und
der BRD ist der Anteil der unter 30-Jährigen in der AOK NDS
überdurchschnittlich, der Anteil der Personen zwischen 50 und 76 Jahren
etwas unterdurchschnittlich. Sozialversicherungspflichtig Beschäftigte
mit Hochschulabschluss und in Tätigkeiten mit höherer
Komplexität sind in der AOK NDS unterrepräsentiert. Die
Verteilung der sozialversicherungspflichtig Beschäftigten auf elf
Berufsbereiche unterscheidet sich ebenfalls.
Schlussfolgerung Die Studie zeigt, dass soziodemographische und
sozio-ökonomische Merkmale in Studien mit Krankenkassendaten wann immer
möglich berücksichtigt werden sollten. In Zukunft wird das
Informationssystem Versorgungsdaten krankenkassenübergreifende Analysen
mit Sekundärdaten ermöglichen. Fragestellungen der
gesundheitlichen Ungleichheit können damit jedoch aufgrund des Fehlens
von sozio-ökonomischen Merkmalen nicht beantwortet werden. Auch die
Identifikation von vulnerablen Gruppen, die gezielt geeigneten Maßnahmen
zugeführt werden könnten, ist ohne Berücksichtigung von
sozio-ökonomischen Merkmalen erschwert.
Analyse der Zeitangaben in Krankenhausabrechnungsdaten bei
ST-Streckenhebungs-Herzinfarkt und Linksherzkatheterintervention
Authors: Nimptsch Ulrike , Busse Reinhard 
Published: October 2021

Zusammenfassung
Hintergrund und Ziel Krankenhausabrechnungsdaten enthalten neben
demografischen, medizinischen und administrativen Informationen auch Zeitangaben
zum Behandlungsverlauf, beispielsweise den Zeitpunkt der Aufnahme oder den
Zeitpunkt der Durchführung einer Prozedur. Anhand dieser Datenfelder
könnten wesentliche Prozessindikatoren berechnet werden, mit denen die
Qualität der Versorgung beurteilt werden kann. Allerdings liegen zur
Plausibilität der Zeitangaben in den Abrechnungsdaten bislang kaum
Informationen vor. Ziel dieser Arbeit ist, die Zeitangaben in den Daten am
Beispiel von ST-Streckenhebungs-Herzinfarkt und Linksherzkatheterintervention zu
untersuchen, um damit einen ersten Anhaltspunkt für die Bewertung der
Plausibilität zu erhalten.
Methode Anhand der deutschlandweiten Krankenhausabrechnungsdaten
(DRG-Statistik) von 2014 bis 2017 wurden Behandlungsfälle mit akutem
ST-Streckenhebungs-Herzinfarkt im erstbehandelnden Krankenhaus identifiziert.
Gegenstand der explorativen Analyse waren der Zeitpunkt (Datum und Uhrzeit) der
Aufnahme, sowie der Zeitpunkt (Datum und Uhrzeit) der
Linksherzkatheterintervention. Aus der Differenz zwischen Aufnahmezeit und
Interventionszeit wurde das Zeitintervall berechnet und in Kategorien
eingeteilt.
Ergebnisse Die Analyse des Aufnahmezeitpunktes der
Behandlungsfälle mit ST-Streckenhebungs-Herzinfarkt
(N=254 719) nach Wochentag und Stunde zeigte ein Muster mit
Häufigkeitsgipfeln an Werktagen zwischen 9:00 und 13:00 Uhr. Die
Betrachtung der dokumentierten Zeiten der Linksherzkatheterintervention
(N=206 079) zeigte eine ähnliche Verteilung, die jedoch
an allen Wochentagen durch Häufigkeitsspitzen jeweils um 12:00 Uhr und
um 0:00 Uhr charakterisiert war. Der Anteil der Behandlungsfälle mit
unplausiblen Zeitintervallen sank von 9,5% im Jahr 2014 auf 7,8%
im Jahr 2017 und zeigte eine hohe Variation auf der Krankenhausebene.
Schlussfolgerung Eine Nutzung der Datenfelder für Zeitangaben in
Krankenhausabrechnungsdaten könnte wertvolle Informationen zur Bewertung
der Behandlungsprozesse liefern und klinisch tätiges Personal von
separaten Dokumentationsaufgaben entlasten. Die Ergebnisse dieser Analyse zeigen
jedoch, dass implausible Angaben und verschiedene Unsicherheiten die
Interpretierbarkeit stark einschränken. Um die Qualität der
Dokumentation von Zeitangaben zu verbessern, müssten Anreize für
eine korrekte Dokumentation geschaffen und konkrete Vorgaben (z. B. zur
Definition des Aufnahmezeitpunktes) gemacht werden.
The Impact of SARS-CoV-2 Infection on Blood Coagulation and Fibrinolytic Pathways: A Review of Prothrombotic Changes Caused by COVID-19
Authors: Bahraini Mehran , Dorgalaleh Akbar 
Published: October 2021

AbstractThe cardinal pathology of coronavirus disease 2019 (COVID-19) is a primary infection of pulmonary tract cells by severe acute respiratory syndrome coronavirus 2, provoking a local inflammatory response, often accompanied by cytokine storm and acute respiratory distress syndrome, especially in patients with severe disease. Systemic propagation of the disease may associate with thrombotic events, including deep vein thrombosis, pulmonary embolism, and thrombotic microangiopathy, which are important causes of morbidity and mortality in patients with COVID-19. This narrative review describes current knowledge of the pathophysiological mechanisms of COVID-19-associated coagulopathy, with focus on prothrombotic changes in hemostatic mediators, including plasma levels of clotting factors, natural anticoagulants, components of fibrinolytic system, and platelets. It will also highlight the central role of endothelial cells in COVID-19-associated coagulopathy. This narrative review discusses also potential therapeutic strategies for managing thrombotic complications. Awareness by medical experts of contributors to the pathogenesis of thrombotic events in COVID-19 is imperative to develop therapeutics not limited to regular anticoagulants. Instituting cooperation among medical personnel and researchers may lessen this novel virus' impact now, and in the event of recurrence.
Status of AI-Enabled Clinical Decision Support Systems Implementations in China
Authors: Ji Mengting , Chen Xiaoyun , Genchev Georgi Z. , Wei Mingyue , Yu Guangjun 
Published: October 2021

Abstract
Background AI-enabled Clinical Decision Support Systems (AI + CDSSs) were heralded to contribute greatly to the advancement of health care services. There is an increased availability of monetary funds and technical expertise invested in projects and proposals targeting the building and implementation of such systems. Therefore, understanding the actual system implementation status in clinical practice is imperative.
Objectives The aim of the study is to understand (1) the current situation of AI + CDSSs clinical implementations in Chinese hospitals and (2) concerns regarding AI + CDSSs current and future implementations.
Methods We investigated 160 tertiary hospitals from six provinces and province-level cities. Descriptive analysis, two-sided Fisher exact test, and Mann-Whitney U-test were utilized for analysis.
Results Thirty-eight of the surveyed hospitals (23.75%) had implemented AI + CDSSs. There were statistical differences on grade, scales, and medical volume between the two groups of hospitals (implemented vs. not-implemented AI + CDSSs, p <0.05). On the 5-point Likert scale, 81.58% (31/38) of respondents rated their overall satisfaction with the systems as “just neutral” to “satisfied.” The three most common concerns were system functions improvement and integration into the clinical process, data quality and availability, and methodological bias.
Conclusion While AI + CDSSs were not yet widespread in Chinese clinical settings, professionals recognize the potential benefits and challenges regarding in-hospital AI + CDSSs.
Painting the postfoundational picture
Authors: Declercq Jana , Macgilchrist Felicitas , Vandendaele Astrid , Jacobs Geert 
Published: October 2021

Abstract
This introductory chapter lays the ontological and
epistemological groundwork for this book, by providing a review
of its key themes and concepts, and outlining the book’s theoretical and
methodological position. More specifically, the book’s topic is introduced
based on a number of data points from the contributing chapters. These point
to the ubiquity of participation, engagement and collaboration, but also to
the tension they potentially create, including in the context of newsmaking. To
understand the key concepts in this central argument, two bodies of
literature are discussed. We first delineate
how we understand newsmaking, and focus on a number of recent changes in
this domain that are relevant for our central argument, such as that
newsmaking is increasingly engaging with a number of communities and
professional stakeholders, and that user-generated content and audience
feedback have become central. Second, the literature on participation,
engagement and collaboration is reviewed, exploring how predominant these
concepts have become in many realms of life, and how they are often related
to democratic ideals. Subsequently, we argue for the relevance of a
postfoundational perspective, and for the value of fieldwork approaches.
“It is, perhaps more than ever before, a matter of participation”
Authors: Jacobs Thomas , Jacobs Geert 
Published: October 2021

Abstract
This chapter presents a discourse-analytical approach to
a series of blogposts uploaded to the website of Brussels-based libertarian
think tank between 2015 and 2018 in reaction to the controversy over the
Transatlantic Trade and Investment Partnership (TTIP). In these blogposts,
economic experts and professionals reflect about how to successfully
persuade the public of the case for free trade. We argue that these
blogposts rest on two ultimately incompatible ontologies – one founded in
economic science, the other based on a rudimentarily constructionist
understanding of media and the public debate. The tension generated by the
clash of these ontologies turns the blogposts into an interesting example of
the negotiation of professional identities at a time when participation,
collaboration and engagement are increasingly getting sedimented as the
baseline for newsmaking practices.
Building an intersubjective understanding of the patient’s mental
suffering
Authors: Weiste Elina 
Published: October 2021

Abstract
The experience of suffering may result in a breakdown of
commonly shared meaning, namely the disintegration of
intersubjectivity. This article investigates patients’ expressions
of suffering and professionals’ attempts to maintain intersubjective
understanding in interactions that are conducted in psychiatric
outpatient care. The analysis demonstrates that patients’
expressions of suffering involve a strong emotional experience and a
particular kind of passivity: tolerance of agonising pain and
endurance of what is unbearable. For their part, professionals
attempt to verbalise and explain the patient’s experience in order
to build a shared world of meaning. The article argues that by
locating suffering in the symptoms of an illness, professionals
structure suffering into a medical problem. This enables them to
suggest appropriate treatment options aimed at eliminating
suffering.
A case study of a quadrilingual child
Authors: Håkansson Gisela , Waters Birgitta 
Published: October 2021

Abstract
This paper reports on a case study of a quadrilingual child, Stefan, born and raised in Sweden and exposed to four languages before his first birthday: English, French, Russian and Swedish. We examine his vocabularies in these languages by the Cross-Linguistic Lexical Tasks (Haman, Łuniewska, & Pomiechowska, 2015), designed to measure vocabulary in monolingual and multilingual children. Stefan’s scores on comprehension and production reveal proficiency in all his languages, to varying degrees, and with comprehension exceeding production. While highlighting direct and indirect exposure as explanation for the variation in proficiency, we also discuss cognate vocabulary as an important factor for multilingual language development. In the production tasks, Stefan demonstrates not only vocabulary knowledge but also language-specific use of morphosyntax.
Crosslinguistic nonword repetition and narrative performance over time
Authors: Boerma Tessel , Blom Elma 
Published: October 2021

Abstract
Previous research has shown that a crosslinguistic nonword repetition and narrative tasks can support the identification of developmental language disorder (DLD) in 5- and 6-year-old bilingual children. The tasks disentangled the effects of DLD and bilingualism and demonstrated good clinical validity. The present longitudinal study investigated whether similar results could be obtained at older ages by following the same children over a three-year period. The tasks were found to remain sensitive to DLD and insensitive to bilingualism. The magnitude of the effect of DLD decreased over time. Together, the instruments attained adequate diagnostic accuracy in a monolingual and bilingual group at each wave of testing, indicating that they can effectively identify DLD in different learning contexts and at different ages.
Enhancing the photoluminescence response of thick Ge-on-Si layers using photonic crystals
Authors: Yurasov D V , Yablonskiy A N , Baidakova N A , Shaleev M V , Rodyakina E E , Dyakov S A , Novikov A V 
Published: October 2021

Abstract
More than an order of magnitude enhancement of the room-temperature photoluminescence (PL) signal from rather thick germanium layers grown on Si(001) was obtained through the utilization of 2D photonic crystals (PhCs). A set of PhCs with different periods and filling factors was fabricated and studied using micro-PL spectroscopy. Optical features of the fabricated PhCs were also theoretically modeled using rigorously coupled wave analysis, which allowed us to bring the observed peaks in the PL response into correlation with the different modes of PhC. In particular, we were able to associate the well-resolved peaks in the PL spectra with the optically active modes of the PhCs. The obtained results proved the possibility of using a homogeneously distributed active medium in PhCs without the formation of specially designed cavities in order to redistribute the internal emitted light into the required modes and efficiently extract it in the far field. The relative simplicity and higher tolerance to fabrication imperfections, as well as the large working area of these kinds of PhCs compared to PhCs with microcavities, can be advantageous for creating a PhC-based Si-compatible light source for the telecom band.
Cascaded PT-symmetric artificial sheets: multimodal manipulation of self-dual emitter-absorber singularities, and unidirectional and bidirectional reflectionless transparencies
Authors: Yang Minye , Ye Zhilu , Farhat Mohamed , Chen Pai-Yen 
Published: October 2021

Abstract
We introduce cascaded parity-time (PT)-symmetric artificial sheets (e.g. metasurfaces or frequency selective surfaces) that may exhibit multiple higher-order laser-absorber modes and bidirectional reflectionless transmission resonances within the PT-broken phase, as well as a unidirectional reflectionless transmission resonance associated with the exceptional point (EP). We derive the explicit expressions of the gain–loss parameter required for obtaining these modes and their intriguing physical properties. By exploiting the cascaded PT structures, the gain–loss threshold for the self-dual laser-absorber operation can be remarkably lowered, while the EP remains unaltered. We further study interferometric sensing based on such a multimodal laser-absorber and demonstrate that its sensitivity may be exceptionally high and proportional to the number of metasurfaces along the light propagation direction.