bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors affecting prognosis of status epilepticus among patients presenting to a tertiary care hospital
Authors: Jawaid Wajid , Irfan Muhammad , Shafee Sundus Mehtab , Barry Sidra Javed , Mahmood Shah Sayed Mustafa , Shahbaz Naila 
Published: November 2021

Objectives: This study aimed to evaluate the etiology, outcomes and prognostic factors associated with status epilepticus (SE) admissions in Neurology Department of a tertiary care hospital.
Methods: A retrospective review was performed on all SE admissions at Dr. Ruth K.M. Pfau Civil Hospital Karachi over a five-year period from July 2015 to June 2020. Demographic, clinical, and etiological factors were investigated for prognostic value. Statistical tests were applied to determine significant prognostic factors. A five percent significance level was used.
Results: A total of 176 patients were included in the study. Mortality was reported in 22 cases (12.5%) and morbidity at six months was observed in 44 cases (25.0%). Male gender, previous history of SE, prolonged seizure duration, and late presentation to hospital were significantly associated with mortality (p<0.05). De novo cases of SE tended to be older (p=0.048) and were associated with morbidity at follow-up (p=0.000). The most common causes of epilepsy in our patients with SE were CNS infections (n=54) and Idiopathic epilepsy (n=34). Non-compliance to medicines/under-dosing was the most common provocative factor (n=68). Acute symptomatic causes of SE were more likely to be associated with greater morbidity (p=0.000). Refractory and super-refractory SE were strongly associated with higher mortality (p=0.000). A longer duration of hospital stay was associated with higher morbidity (p=0.000).
Conclusion: Male gender, poor control of seizures, CNS infections, prolonged seizures, delayed hospital arrival and refractory/super-refractory status epilepticus were key determinants of mortality in our setting. Previous history of status epilepticus, and acute and symptomatic etiologies were associated with higher morbidity.
doi: https://doi.org/10.12669/pjms.38.1.5195
How to cite this:Jawaid W, Irfan M, Shafee SM, Barry SJ, Shah SMM, Shahbaz N. Factors affecting prognosis of status epilepticus among patients presenting to a tertiary care hospital. Pak J Med Sci. 2022;38(1):16-22. doi: https://doi.org/10.12669/pjms.38.1.5195
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Evaluating user-centered interventions in optimizing utilization of HIV and pregnancy prevention services among adolescent girls and young women (AGYW) in Kenya: a study protocol
Authors: Mutegi Jane , Mugambi Mary , Were Daniel , Musau Abednego , Kirumburu Aigelgel , Kamau Mercy , Wakhutu Brian , Tenga Soud , Odhyambo Geoffrey , Dotson Manya , Reed Jason , Ong'ewn Patricia 
Published: November 2021

Background: Globally, HIV/AIDS is the leading cause of morbidity and mortality among adolescents; sub-Saharan Africa contributes more than two-thirds of all HIV-related adolescent deaths. In Kenya, HIV incidence remains high among youth (15–24 years), with women disproportionately affected. Morbidity and mortality are compounded by a high rate of early and unwanted pregnancies. Existing prevention efforts to reduce youth vulnerabilities overwhelmingly focus on HIV alone, with limited efforts made to address concurrent factors that increase vulnerability of adolescent girls and young women (AGYW) to HIV infection and unplanned pregnancies. Jilinde, is a Bill and Melinda Gates Foundation funded large-scale project that supports the provision of pre-exposure prophylaxis (PrEP) in Kenya. This manuscript presents a protocol for a study that seeks to evaluate the effectiveness of a comprehensive package of user-centered interventions to optimize uptake of HIV and pregnancy prevention services among AGYW in four Kenyan counties. Methods: The study employed a concurrent mixed-methods design including two parallel before and after population-based cross-sectional surveys, focus group discussions, and in-depth interviews. Study participants included 1,280 AGYW, 1,080 individuals from the general population, 80 health service providers, and 32 county health managers. The study involved a formative, implementation phase and endline assessment. Survey data was collected using Research Electronic Data Capture and analyzed using regression modelling while adjusting for confounders. Qualitative data will be analyzed using grounded theory techniques using NVivo 12.0. Discussion: This study will uncover useful insights on the effectiveness of user-centered interventions in increasing concurrent utilization of blended HIV and pregnancy prevention interventions in a routine low resource setting. The findings will be disseminated through technical briefs, manuscripts, conferences, and workshops. The consolidated evidence could inform the scale-up of integrated HIV prevention and sexual and reproductive health interventions targeting AGYW.
Direct laser writing of liquid crystal elastomers oriented by a horizontal electric field
Authors: Carlotti Marco , Tricinci Omar , den Hoed Frank , Palagi Stefano , Mattoli Virgilio 
Published: November 2021

Background: The ability to fabricate components capable of performing actuation in a reliable and controlled manner is one of the main research topics in the field of microelectromechanical systems (MEMS). However, the development of these technologies can be limited in many cases by 2D lithographic techniques employed in the fabrication process. Direct Laser Writing (DLW), a 3D microprinting technique based on two-photon polymerization, can offer novel solutions to prepare, both rapidly and reliably, 3D nano- and microstructures of arbitrary complexity. In addition, the use of functional materials in the printing process can result in the fabrication of smart and responsive devices. Methods: In this study, we present a novel methodology for the printing of 3D actuating microelements comprising Liquid Crystal Elastomers (LCEs) obtained by DLW. The alignment of the mesogens was performed using a static electric field (1.7 V/µm) generated by indium-tin oxide (ITO) electrodes patterned directly on the printing substrates. Results: When exposed to a temperature higher than 50°C, the printed microstructures actuated rapidly and reversibly of about 8% in the direction perpendicular to the director. Conclusions: A novel methodology was developed that allows the printing of directional actuators comprising LCEs via DLW. To impart the necessary alignment of the mesogens, a static electric field was applied before the printing process by making use of flat ITO electrodes present on the printing substrates. The resulting microelements showed a reversible change in shape when heated higher than 50 °C.
Morale and Debt Dynamics
Authors: Barron Daniel , Li Jin , Zator Michał 
Published: November 2021

This paper shows that debt undermines relational incentives and harms worker morale. We build a dynamic model of a manager who uses limited financial resources to simultaneously repay a creditor and motivate a worker. If the manager can divert or misuse revenue, then debt makes the manager less willing to follow through on promised rewards, leading to low worker effort. In profit-maximizing equilibria, the firm prioritizes repaying its debts, leading to gradual increases in effort and wages. These dynamics can persist even after debts have been fully repaid. Consistent with this analysis, we document that a firm’s financial leverage is negatively related to measures of employee morale, wages, and productivity. This paper was accepted by Joshua Gans, business strategy.
Estimating Substitution and Basket Effects in Retail Stores: Implications for Assortment Planning
Authors: Mani Vidya , Thomas Douglas J. , Bansal Saurabh 
Published: November 2021

Many retailers are reducing store footprint and downsizing their assortments accordingly to improve store productivity. Some of the revenue for items removed from the assortment may be recouped by substitution, but also some of the revenue for items kept in the assortment may be lost due to basket abandonment. For a practical setting where baskets may contain any subset of items from thousands of products, estimating both substitution and basket effects is a challenge. To address this, we develop a demand model that combines a multinomial logit (MNL) model to estimate substitution within a subcategory and a purchase-incidence model to estimate basket retention. Using transaction and product availability data from 12 stores of an office supplies retail chain that were dramatically downsized from large- to small-format stores, we show that (i) storewide basket effects are substantial (our model with basket effects predicts out-of-sample transactions with mean absolute percent error (MAPE) of only 7% compared with 22% for a model with only substitution effects), (ii) poor service level can significantly exacerbate lost profit due to abandoned baskets at these stores, and (iii) consideration of the basket effect in assortment selection for the small stores can significantly improve basket retention and increase profits (by up to 16%) at these stores. This paper was accepted by Vishal Gaur, operations management.
Cardiovascular disease risk and key anthropometrics: a trend analysis
Authors: Tetteh Ato Kwamena , Yankey Barbara Araba , Okosun Ike Solomon 
Published: November 2021

Background/Aims Cardiovascular disease risk is increased in individuals with various anthropometric measurements and indices. This study estimated linear trends of cardiovascular disease risk and its association with selected anthropometric measurements. Methods: Bi-annual data from 2007-16 (n=26 201) was obtained from the National Health and Nutrition Examination Survey. Cardiovascular disease risk in this study was assessed as total cholesterol to high-density lipoprotein ratio. We used the multiple linear regression analysis procedures to estimate anthropometric variables that best predict cardiovascular disease risk. Results The mean total cholesterol to high-density lipoprotein ratio for the studied population was 4.0 (95% confidence interval: 3.8-4.2). There was a decrease of 0.05 in mean cardiovascular disease risk bi-annually from 4.1 in 2007-8 to 3.9 in 2015-16 (t=-3.27; P=0.0467). The percentage with desirable cardiovascular disease risk decreased by 0.07 bi-annually from 0.42% in 2007-8 to 0.1% in 2015-16 (P=0.0689). Borderline risk increased by 0.8 bi-annually from 90.7% in 2007-8 to 93.8% in 2015-16 (P=0.1176). High cardiovascular disease risk decreased by 0.7 from 8.9% in 2007-8 to 6.2% in 2015-16 (t=-1.95; P=0.1464). Cardiovascular disease risk was consistently higher in males than females for all the cohorts (P<0.0001). The risk was high among the 30-69 years age group but declined after the age of 70 years. Overall, waist circumference, weight and the waist circumference*weight interaction term, adjusted for age, gender, and race/ethnicity, significantly helped to predict cardiovascular disease risk (P<0.0001). Conclusions The majority of the studied population had either borderline or high risk for cardiovascular diseases based on the total cholesterol/high-density lipoprotein ratio. The study findings suggest the need to intensify existing primary prevention efforts to minimise risk and avert cardiovascular disease progression.
Mechanical complications and fractures after reverse shoulder arthroplasty related to different design types and their rates: part I
Authors: Nabergoj Marko , Denard Patrick J. , Collin Philippe , Trebše Rihard , Lädermann Alexandre 
Published: November 2021

The initial reverse shoulder arthroplasty (RSA), designed by Paul Grammont, was intended to treat rotator cuff tear arthropathy in elderly patients. In the early experience, high complication rates (up to 24%) and revision rates (up to 50%) were reported. The most common complications reported were scapular notching, whereas clinically more relevant complications such as instability and acromial fractures were less commonly described. Zumstein et al defined a ‘complication’ following RSA as any intraoperative or postoperative event that was likely to have a negative influence on the patient’s final outcome. High rates of complications related to the Grammont RSA design led to development of non-Grammont designs, with 135 or 145 degrees of humeral inclination, multiple options for glenosphere size and eccentricity, improved baseplate fixation which facilitated glenoid-sided lateralization, and the option of humeral-sided lateralization. Improved implant characteristics combined with surgeon experience led to a dramatic fall in the majority of complications. However, we still lack a suitable solution for several complications, such as acromial stress fracture.Cite this article: EFORT Open Rev 2021;6:1097-1108. DOI: 10.1302/2058-5241.6.210039
An Automated Incubator for Rearing Black Soldier Fly Larvae (Hermetia illucens)
Authors: Erbland Patrick , Alyokhin Andrei , Peterson Michael 
Published: November 2021

HighlightsBlack soldier fly larvae can be used to convert agricultural wastes into animal feed.A prototype automated incubation system for producing black soldier fly larvae was designed and tested.The system was successful in growing larvae to a harvestable size.The system retained metabolic heat generated by larval and microbial activity.Abstract. Biological conversion of agricultural wastes into animal feed ingredients using larvae of black soldier fly, (Hermetia illucens) is a promising technology that improves the sustainability of agriculture. We designed and tested a prototype automated incubation system for producing black soldier fly larvae. The system consisted of six 50 L plastic bins enclosed on a ventilated metal rack (178 cm high, 66 cm wide). Water was supplied to maintain a moisture level of about 60% in each bin via soaker hoses connected to sensor-activated solenoid valves. The system was successful in maintaining moisture and temperature suitable for larval development and for growing larvae to harvestable size with minimal labor and energy consumption. Biological activity in the bins generated a considerable amount of metabolic heat, most of which was trapped in the substrate in each bin. This heat may be valuable for rearing black soldier fly larvae in areas with cool climates because this species has low tolerance of cold temperatures but challenging in areas with warm climates. Keywords: Biological conversion, Black soldier fly, Metabolic heat generation, Waste management.
Advanced laser development and plasma-physics studies on the multiterawatt laser
Authors: Begishev I. A. , Bagnoud V. , Bahk S.-W. , Bittle W. A. , Brent G. , Cuffney R. , Dorrer C. , Froula D. H. , Haberberger D. , Mileham C. , Nilson P. M. , Okishev A. V. , Shaw J. L. , Shoup M. J. , Stillman C. R. , Stoeckl C. , Turnbull D. , Wager B. , Zuegel J. D. , Bromage J. 
Published: November 2021

The multiterawatt (MTW) laser, built initially as the prototype front end for a petawatt laser system, is a 1053 nm hybrid system with gain from optical parametric chirped-pulse amplification (OPCPA) and Nd:glass. Compressors and target chambers were added, making MTW a complete laser facility (output energy up to 120 J, pulse duration from 20 fs to 2.8 ns) for studying high-energy-density physics and developing short-pulse laser technologies and target diagnostics. Further extensions of the laser support ultrahigh-intensity laser development of an all-OPCPA system and a Raman plasma amplifier. A short summary of the variety of scientific experiments conducted on MTW is also presented.
Dynamic wavefront distortion in resonant scanners
Authors: Akondi Vyas , Kowalski Bartlomiej , Dubra Alfredo 
Published: November 2021

Dynamic mirror deformation can substantially degrade the performance of optical instruments using resonant scanners. Here, we evaluate two scanners with resonant frequencies

>

12

k
H
z

with low dynamic distortion. First, we tested an existing galvanometric motor with a novel, to the best of our knowledge, mirror substrate material, silicon carbide, which resonates at 13.8 kHz. This material is stiffer than conventional optical glasses and has lower manufacturing toxicity than beryllium, the stiffest material currently used for this application. Then, we tested a biaxial microelectromechanical (MEMS) scanner with the resonant axis operating at 29.4 kHz. Dynamic deformation measurements show that wavefront aberrations in the galvanometric scanner are dominated by linear oblique astigmatism (90%), while wavefront aberrations in the MEMS scanner are dominated by horizontal coma (30%) and oblique trefoil (27%). In both scanners, distortion amplitude increases linearly with deflection angle, yielding diffraction-limited performance over half of the maximum possible deflection for wavelengths longer than 450 nm and over the full deflection range for wavelengths above 850 nm. Diffraction-limited performance for shorter wavelengths or over larger fractions of the deflection range can be achieved by reducing the beam diameter at the mirror surface. The small dynamic distortion of the MEMS scanner offers a promising alternative to galvanometric resonant scanners with desirable but currently unattainably high resonant frequencies.
Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects
Authors: Henry Kim , Mayet Aurélie , Hernandez Miguel , Frechard Guillaume , Blanc Pierre-Antoine , Schmitt Marion , André Nathalie , Loreau Jean-Marie , Ginouves Marine , Prévot Ghislaine , Couppié Pierre , Demar Magalie , Blaizot Romain 
Published: November 2021

BackgroundCutaneous Leishmaniasis (CL) is endemic in French Guiana but cases are usually sporadic. An outbreak signal was issued on May 15th2020 with 15 suspected cases after a military training course in the rainforest. An outbreak investigation was carried out.Methodology/Principal findingsThirty cases were confirmed.Leishmania guyanensiswas the most frequent species (90%). The most frequent presentation was ulcerative (90%). Lesions on the face and hands were frequent (40% each). Eight cases (26%) presented a poor outcome after treatment with pentamidine and required a second line with amphotericin B. Three of them required further treatments with meglumine antimoniate or miltefosine. Two spots within the training area were deemed as likely sites of contamination, due to illegal logging. The isolatedLeishmaniastrains did not form a separate cluster. Participation in Week 13 of year 2020 was associated with infection (OR = 4.59 [1.10–19.83]; p = 0.016) while undergoing only the “Fighting” exercise was protective (OR = 0.1 [0–0.74]; p = 0.021). There was no association between infection and other risk factors at the individual level. The attack rate of Regiment B (14/105 = 13.3%) was significantly higher (OR = 4.22 [1.84–9.53], p = 0.0001) compared to Regiment A (16/507 = 3.2%). The attack rate during this training course (30/858 = 3.5%) was significantly higher (OR 2.29 [1.28–4.13]; p = 0.002) than for other missions in French Guiana during the same period (22/1427 = 1.5%).ConclusionsThis outbreak could be explained by a combination of factors: climatic conditions around week 13, at-risk activities including night trainings, absence of impregnation, a lesser experience of rainforest duties in Regiment B and illegal logging attracting sandflies on military training grounds.
Linkage to TB care: A qualitative study to understand linkage from the patients’ perspective in the Western Cape Province, South Africa
Authors: Vanqa Nosivuyile , Hoddinott Graeme , Mbenyana Baxolele , Osman Muhammad , Meehan Sue-Ann 
Published: November 2021

Background
Delayed linkage to tuberculosis (TB) treatment leads to poor patient outcomes and increased onward transmission. Between 12% and 25% of people diagnosed with TB are never linked to a primary health care facility for continued care. The TB health program is for creating processes that promote and facilitates easy access to care. We explored how TB patients experience TB services and how this influenced their choices around linkage to TB care and treatment.

Methods
We enrolled 20 participants routinely diagnosed with TB in hospital or at primary health care facilities (PHC) in a high TB/HIV burdened peri-urban community in South Africa. Using the Western Cape Provincial Health Data centre (PHDC) which consolidates person-level clinical data, we used dates of diagnosis and treatment initiation to select participants who had been linked (immediately, after a delay, or never). Between June 2019 and January 2020, we facilitated in-depth discussions to explore both the participants’ experience of their TB diagnosis and their journey around linking to TB care at a primary health care facility. We analysed the data using case descriptions.

Results
Twelve of twenty (12/20) participants interviewed who experienced a delay linking were diagnosed at the hospital. Participants who experienced delays in linking or never linked explained this as a result of lack of information and support from health care providers. Unpleasant previous TB treatment episodes made it difficult to ‘face’ TB again and being uncertain of their TB diagnosis. In contrast, participants said the main motivator for linking was a personal will to get better.

Conclusion
The health care system, especially in hospitals, should focus on strengthening patient-centred care. Communication and clear messaging on TB processes is key, to prepare patients in transitioning from a hospital setting to PHC facilities for continuation of care. This should not just include a thorough explanation of their TB diagnosis but ensure that patients understand treatment processes. Former TB patients may require additional counselling and support to re-engage in care.