bluuebunny/crossref_metadata_2025_split huggingface dataset:
Narrowing antibiotic spectrum of activity for trauma-associated pneumonia through the use of a disease-specific antibiogram
Authors: Ting Michelle H , Radosevich John J , Weinberg Jordan A , Nailor Michael D 
Published: June 2021

BackgroundOrganism susceptibilities for trauma-associated pneumonia (TAP) differ from those in other patient populations, including the critically ill. The purpose of this study was to identify common organisms and their susceptibilities in the respiratory isolates of trauma patients diagnosed with pneumonia within the first 7 days of hospital admission, and to create a TAP-specific disease-state antibiogram to guide empiric antibiotic therapy in this patient population.MethodsThis study was a retrospective review of adult trauma patients with pneumonia admitted between September 1, 2015 and August 31, 2018. Patients included were diagnosed with and treated for pneumonia, with respiratory cultures drawn within the first 7 hospital-days; both culture-positive and culture-negative patients were included. Subgroup antibiograms were made for diagnosis made on days 1–3, 4–5, and 6–7.ResultsThere were 131 patients included with a median age of 45; 85% were male, and 31% were illicit drug users. Most patients (63%) had ventilator-associated pneumonia, and most respiratory samples (77%) were obtained via bronchoalveolar lavage. Cultures were positive in 109 patients and negative in 22. There were 144 total isolates; 54% were Gram-negative bacteria. The most common Gram-negative pathogens wereHaemophilus influenzae(16%) andKlebsiella pneumoniae(15%). The most common Gram-positive pathogen wasStaphylococcus aureus; methicillin-resistantS. aureus(MRSA) constituted 8% of all isolates. With culture-negative patients counted as susceptible, ceftriaxone monotherapy and ceftriaxone+vancomycin susceptibilities were 85% and 94%, respectively. Susceptibilities to cefazolin, ampicillin/sulbactam, cefepime, piperacillin/tazobactam, and levofloxacin were 49%, 69%, 91%, 90%, and 92%, respectively. Illicit drug use and day of pneumonia diagnosis did not appreciably affect antibiotic susceptibilities.ConclusionsFor TAP diagnosed within the first 7 days of hospital admission, ceftriaxone monotherapy is adequate as empiric therapy, including in ventilated patients. The addition of vancomycin can be considered in patients with MRSA risk factors or who are critically ill.Level of evidenceLevel III, prognostic and epidemiological.
Pattern of trauma admission and outcome among patients presented to Jimma University Specialized Hospital, south-western Ethiopia
Authors: Bayissa Badhaasaa Beyene , Alemu Seifu 
Published: June 2021

BackgroundTrauma is an ever evolving world problem that needs close attention and devising means to prevent and treat. The aim of the study is to identify the main reason for trauma admissions and assess the patient outcome after intervention. Therefore, knowing its actual nature might aid in postulating possible intervention as well as prevention measures.MethodA cross-sectional study was conducted from August to December 2015 in Jimma University Specialized Hospital, which is located in south-western Ethiopia. Two hundred and eleven consecutive trauma admissions to surgery department were included in the study. Data were collected and analyzed using computer software SPSS V.23.ResultA total of 211 admitted trauma patients were studied with male to female ratio of 3.14. The leading cause of trauma admission was road traffic collision at 84 (39.8%) and the least being bullet injury which was 6 (2.8%). Hospital mortality was 31 (14.7%). Factors associated with outcome of patients before discharge from hospital were male sex, adjusted OR (AOR)=2.3, 95% CI 1.08 to 4.75; Glasgow Coma Scale score 15/15, AOR=0.04, 95% CI 0.00 to 0.46; and hemoglobin >10 g/L, AOR=0.225, 95% CI 0.074 to 0.464, p<0.05.ConclusionRoad traffic collision takes the top position from all causes of trauma and unlike other developed countries and low and middle-income countries, pedestrians and motorcyclists were the major victims of the collision in this study.Level of evidence VI (This level of effectiveness rating scheme is based on the following: Ackley, B. J., Swan, B. A., Ladwig, G., & Tucker, S. (2008).Evidence-based nursing care guidelines: Medical-surgical interventions.(p. 7).St. Louis, MO: Mosby Elsevier.
Dynamic characteristics of threshold values and extension field selections for a vacuum-blowing cleaning system
Authors: Xi Yuan , Dai Yan , Zhang Xilong , He Gaohong 
Published: June 2021

To provide theoretical guidelines for threshold value selection on the performance characteristics of an extension field, the flow characteristics in a vacuum-blowing cleaning system was simulated using the average velocity and pressure at the front inlet surface and the average velocity of the outlet surface as indices to evaluate the effects of the extension field’s structural parameters. We found that the extension field parameters have implications for the simulation calculations, and that each parameter has a corresponding threshold. If the structural parameter is greater than the corresponding threshold, the calculation result is not affected and the threshold values are analyzed using computational fluid dynamics. The dimensions of the front, back, left, and right extension fields were as follows: lf = lb = ll = lr = 210 mm, and θf = θb = θl = θr = 55°. The flow field distribution characteristics are not distinctly different, with or without the extension field corner. The extension field with a corner can be used if high accuracy is required; however, to reduce the need for grid computation and shorten the calculation time, the corner extension field model is not recommended. Finally, the simulation results were verified experimentally, and can be used to improve the accuracy of the calculations and reduce the required computational resources.
Predicting Poor Outcome of COVID-19 Patients on the Day of Admission with the COVID-19 Score
Authors: Tseng Luke , Hittesdorf Erin , Berman Mitchell F. , Jordan Desmond A. , Yoh Nina , Elisman Katerina , Eiseman Katherine A. , Miao Yuqi , Wang Shuang , Wagener Gebhard 
Published: June 2021

Background. COVID-19 may result in multiorgan failure and death. Early detection of patients at risk may allow triage and more intense monitoring. The aim of this study was to develop a simple, objective admission score, based on laboratory tests, that identifies patients who are likely going to deteriorate. Methods. This is a retrospective cohort study of all COVID-19 patients admitted to a tertiary academic medical center in New York City during the COVID-19 crisis in spring 2020. The primary combined endpoint included intubation, stage 3 acute kidney injury (AKI), or death. Laboratory tests available on admission in at least 70% of patients (and age) were included for univariate analysis. Tests that were statistically or clinically significant were then included in a multivariate binary logistic regression model using stepwise exclusion. 70% of all patients were used to train the model, and 30% were used as an internal validation cohort. The aim of this study was to develop and validate a model for COVID-19 severity based on biomarkers. Results. Out of 2545 patients, 833 (32.7%) experienced the primary endpoint. 53 laboratory tests were analyzed, and of these, 47 tests (and age) were significantly different between patients with and without the endpoint. The final multivariate model included age, albumin, creatinine, C-reactive protein, and lactate dehydrogenase. The area under the ROC curve was 0.850 (CI [95%]: 0.813, 0.889), with a sensitivity of 0.800 and specificity of 0.761. The probability of experiencing the primary endpoint can be calculated as

p
=

e

−
2.4475
+
0.02492
age
−
0.6503
albumin
+
0.81926
creat
+
0.00388
CRP
+
0.00143
LDH

/

1
+

e

−
2.4475
+

0.02492
age
−
0.6503
albumin
+
0.81926
creat
+
0.00388
CRP
+
0.00143
LDH

. Conclusions. Our study demonstrated that poor outcome in COVID-19 patients can be predicted with good sensitivity and specificity using a few laboratory tests. This is useful for identifying patients at risk during admission.
Modeling Clinical Responses to Targeted Therapies by Patient-Derived Organoids of Advanced Lung Adenocarcinoma
Authors: Kim Seok-Young , Kim Sang-Min , Lim Sumin , Lee Ji Yeon , Choi Su-Jin , Yang San-Duk , Yun Mi Ran , Kim Chang Gon , Gu Seo Rin , Park Chaewon , Park A-Young , Lim Sun Min , Heo Seong Gu , Kim HyunKi , Cho Byoung Chul 
Published: June 2021

AbstractPurpose:Patient-derived organoids (PDO) of lung cancer has been recently introduced, reflecting the genomic landscape of lung cancer. However, clinical relevance of advanced lung adenocarcinoma organoids remains unknown. Here, we examined the ability of PDOs to predict clinical responses to targeted therapies in individual patients and to identify effective anticancer therapies for novel molecular targets.Experimental Design:Eighty-four organoids were established from patients with advanced lung adenocarcinoma. Formalin-fixed, paraffin-embedded tumor specimens from corresponding patients were analyzed by whole-exome sequencing (n = 12). Organoids were analyzed by whole-exome sequencing (n = 61) and RNA sequencing (n = 55). Responses to mono or combination targeted therapies were examined in organoids and organoid-derived xenografts.Results:PDOs largely retained somatic alterations including driver mutations of matching patient tumors. PDOs were able to recapitulate progression-free survival and objective responses of patients with non–small cell lung cancer receiving clinically approved tyrosine kinase inhibitors. PDOs recapitulated activity of therapeutic strategies under clinical investigation. YUO-071 harboring an EGFR exon 19 deletion and a BRAF G464A mutation and the matching patient responded to dabrafenib/trametinib combination therapy. YUO-004 and YUO-050 harboring an EGFR L747P mutation was sensitive to afatinib, consistent with the response in the matching patient of YUO-050. Furthermore, we utilized organoids to identify effective therapies for novel molecular targets by demonstrating the efficacy of poziotinib against ERBB2 exon 20 insertions and pralsetinib against RET fusions.Conclusions:We demonstrated translational relevance of PDOs in advanced lung adenocarcinoma. PDOs are an important diagnostic tool, which can assist clinical decision making and accelerate development of therapeutic strategies.
ArSL-CNN a convolutional neural network for Arabic sign language gesture recognition
Authors: Alani Ali A. , Cosma Georgina 
Published: June 2021

<p class="IJASEITAbtract">Sign language (SL) is a visual language means of communication for people who are Deaf or have hearing impairments. In Arabic-speaking countries, there are many Arabic sign languages (ArSL) and these use the same alphabets. This study proposes ArSL-CNN, a deep learning model that is based on a convolutional neural network (CNN) for translating Arabic SL (ArSL). Experiments were performed using a large ArSL dataset (ArSL2018) that contains 54049 images of 32 sign language gestures, collected from forty participants. The results of the first experiments with the ArSL-CNN model returned a train and test accuracy of 98.80% and 96.59%, respectively. The results also revealed the impact of imbalanced data on model accuracy. For the second set of experiments, various re-sampling methods were applied to the dataset. Results revealed that applying the synthetic minority oversampling technique (SMOTE) improved the overall test accuracy from 96.59% to 97.29%, yielding a statistically signicant improvement in test accuracy (p=0.016, α&lt;0=05). The proposed ArSL-CNN model can be trained on a variety of Arabic sign languages and reduce the communication barriers encountered by Deaf communities in Arabic-speaking countries.</p>
Android-based capacitor discharging calculator application
Authors: Kartika Wisnu , Loniza Erika , Safitri Meilia 
Published: June 2021

<span lang="IN">Nowadays, many people using smartphone to connet to her colleague. The electronic device using capacitor and transistor. The electronic device’s size recently become smaller. The capacitor can be used to the most important function that is used to store the energy and on the DC system is used to decrease the ripple from AC source. This research purpose build an apps which can calculate the charge remaining inside the capacitor. The method is using RC time constant. This research work well and can work functionally. </span>
K-means method for clustering learning classes
Authors: D. Indriyanti A. , R. Prehanto D. , Z. Vitadiar T. 
Published: June 2021

<span>Learning class is a collection of several students in an educational institution. Every beginning of the school year the educational institution conducts a grouping class test. However, sometimes class grouping is not in accordance with the ability of students. For this reason, a system is needed to be able to see the ability of students according to the desired parameters. Determination of the weight of test scores is done using the K-Means method as a grouping method. Iteration or repetition process in the K-Means method is very important because the weight value is still very possible to change. Therefore, the repetition process is carried out to produce a value that does not change and is used to determine the ability level of students. The results of the class grouping test scores affect the ability of students. Application of K-Means method is used in building an information system grouping student admissions in an educational institution. Acceptance of students will be grouped into 3 groups of learning classes. The results of testing the system that applies K-Means method and based on data on the admission of prospective students from educational institutions have very high accuracy with an error rate of 0.074. </span>
Relational Egalitarianism and Democracy
Authors: Motchoulski Alexander 
Published: June 2021

Abstract
Relational egalitarians argue that democratic institutions are justified by appeal to relational equality. According to the skeptical challenge, equality of political power is not required for relational equality, and the relational egalitarian case for democracy fails. I defend the relational egalitarian justification of democracy. I develop an analysis of social status and show that inequalities of power will not entail inequalities of status. I then show that inequalities of power will robustly cause inequalities of status and argue that this vindicates the relational egalitarian case for democracy, because such theories have a much more pragmatic standard of success for the justification of democracy than conceptual necessity. I consider the objection that if inequalities of power robustly cause inequalities of status, then relational egalitarians should also oppose democratic institutions, because officials such as legislators or judges will have more power than citizens. In reply, I argue that relational egalitarians are only opposed to inequalities of status that mark a failure of recognition respect, and that inequalities of status that follow from democratically licensed inequalities of power will not mark such a failure. I conclude that the skeptical challenge is unsuccessful, and that the relational egalitarian justification of democracy is sound.
The impact of tropical Atlantic SST variability on the tropical atmosphere during boreal summer
Authors: Ren Hong-Chang , Zuo Jinqing , Li Weijing 
Published: June 2021

AbstractThe interannual variability of boreal summer sea surface temperature (SST) in the tropical Atlantic displays two dominant modes, the Atlantic zonal mode highlighting SST variations in the equatorial–southern tropical Atlantic (ESTA) region and the northern tropical Atlantic (NTA) mode focusing on SST fluctuations in the NTA region except in the Gulf of Guinea. Observational evidence indicates that both the boreal summer ESTA and NTA warming are accompanied by a pair of anomalous low-level anti-cyclones over the western tropical Pacific, and the NTA-related anti-cyclone is more obvious than the ESTA-related one. Both atmosphere-only and partially coupled experiments conducted with the Community Earth System Model Version 1.2 support the observed NTA–Pacific teleconnection. In contrast, the ESTA-induced atmospheric circulation response is negligible over the tropical Pacific in the atmosphere-only experiments, and though the response becomes stronger in the partially coupled experiments, obvious difference still exists between the simulations and observation. The ESTA-induced atmospheric circulation response is featured by an anomalous low-level cyclone over the western tropical Pacific in the partially coupled experiments, opposite to its observed counterpart. It is found that the ESTA warming coincides with significantly La Niña-like SST anomalies in the central–eastern equatorial Pacific, the influence of which on the tropical atmospheric circulation is opposite to that of the ESTA warming, and therefore contributes to difference between the ESTA-related simulations and observation. Moreover, the cold climatological mean SST in the ESTA region is unfavourable to enhancing the ESTA–Pacific teleconnection during boreal summer.
Contribution of Meteorological Downscaling to Skill and Precision of Seasonal Drought Forecasts
Authors: Zamora Ryan A. , Zaitchik Benjamin F. , Rodell Matthew , Getirana Augusto , Kumar Sujay , Arsenault Kristi , Gutmann Ethan 
Published: June 2021

AbstractResearch in meteorological prediction on sub-seasonal to seasonal (S2S) timescales has seen growth in recent years. Concurrent with this, demand for seasonal drought forecasting has risen. While there is obvious synergy between these fields, S2S meteorological forecasting has typically focused on low resolution global models, while the development of drought can be sensitive to the local expression of weather anomalies and their interaction with local surface properties and processes. This suggests that downscaling might play an important role in the application of meteorological S2S forecasts to skillful forecasting of drought. Here, we apply the Generalized Analog Regression Downscaling (GARD) algorithm to downscale meteorological hindcasts from the NASA Goddard Earth Observing System (GEOS) global S2S forecast system. Downscaled meteorological fields are then applied to drive offline simulations with the Catchment Land Surface Model (CLSM) to forecast United States Drought Monitor (USDM) style drought indicators derived from simulated surface hydrology variables. We compare the representation of drought in these downscaled hindcasts to hindcasts that are not downscaled, using the North American Land Data Assimilation System Phase 2 (NLDAS-2) dataset as an observational reference. We find that downscaling using GARD improves hindcasts of temperature and temperature anomalies, but the results for precipitation are mixed and generally small. Overall, GARD downscaling led to improved hindcast skill for total drought across the Contiguous United States (CONUS), and improvements were greatest for extreme (D3) and exceptional (D4) drought categories.
Exploring the Effects of Interruptions in Different Phases of Complex Decision-Making Tasks
Authors: Wu Man , Gao Qin , Liu Yang 
Published: June 2021

Objective The study aims to examine the effects of interruptions in major phases (i.e., problem-identification, alternative-development, and evaluation-and-selection) of complex decision-making tasks. Background The ability to make complex decisions is of increasing importance in workplaces. Complex decision-making involves a multistage process and is likely to be interrupted, given the ubiquitous prevalence of interruptions in workplaces today. Method Sixty participants were recruited for the experiment to complete a procurement task, which required them to define goals, search for alternatives, and consider multiple attributes of alternatives to make decisions. Participants in the three experimental conditions were interrupted to respond to messages during one of these three phases, whereas participants in the control condition were not interrupted. The impacts of interruptions on performance, mental workload, and emotional states were measured through a combination of behavioral, physiological, and subjective evaluations. Results Only participants who were interrupted in the evaluation-and-selection phase exhibited poorer task performance, despite their positive feelings toward interruptions and confidence. Participants who were interrupted in the problem-identification phase reported higher mental workload and more negative perceptions toward interruptions. Interruptions in the alternative-development phase led to more temporal changes in arousal and valence than interruptions in other phases. Conclusion Interruptions during the evaluation-and-selection phase undermine overall performance, and there is a discrepancy between behavioral outcomes and subjective perceptions of interruption effects. Application Interruptions should be avoided in the evaluation-and-selection phase in complex decision-making. This phase information can be either provided by users or inferred from coarse-grained interaction activities with decision-making information systems.
Infection Testing at Scale: An Examination of Pooled Testing Diagnostics
Authors: Jain Tarun , Jain Bijendra Nath 
Published: June 2021

Executive Summary In pandemics or epidemics, public health authorities need to rapidly test a large number of individuals without adequate testing kits. We propose a testing protocol to accelerate infection diagnostics by combining multiple samples, and in case of positive results, re-test individual samples. The key insight is that a negative result in the first stage implies negative infection for all individuals. Thus, a single test could rule out infection in multiple individuals. Using simulations, we show that this protocol reduces the required number of testing kits, especially when the infection rate is low, alleviating a key bottleneck for public health authorities in times of pandemics and epidemics such as COVID-19. Our proposed protocol is expected to be more effective when the infection rate is low, which suggests that it is better suited for early stage and large-scale, population-wide testing. However, the managerial trade-off is that the protocol has costs in additional time for returning test results and an increased number of false negatives. We discuss applications of pooled testing in understanding population-wide testing to understand infection prevalence, to diagnose infections in high-risk groups of individuals, and to identify disease cold spots.
Early outcomes of patient-prosthesis mismatch following aortic valve replacement
Authors: Aitaliyev Serik , Rumbinaitė Egle , Mėlinytė-Ankudavičė Karolina , Nekrošius Rokas , Keturakis Vytenis , Benetis Rimantas 
Published: June 2021

Introduction: Patient-prosthesis mismatch (PPM) has been associated with numerous short- and long-term adverse events. This study aimed to evaluate the effect of PPM on early postoperative results after aortic valve replacement (AVR) in daily practice. Methods: In this single-centre retrospective study, 150 non-consecutive patients from March 2019 to January 2020 with clinically indicated AVR with/without concomitant surgery were analysed. The study protocol included operative mortality, complication rate, and pre- and postoperative echocardiographic data. PPM was considered severe with indexed effective orifice area at <0.65 cm2/m2, moderate at 0.65–0.85 cm2/m2 and none at >0.85 cm2/m2. Results: Moderate PPM was observed in 16 patients (10.6%). No patient had severe PPM. PPM was not related to early mortality ( r = 0.40, p = 0.630), intra- ( r = −0.076, p = 0.352) and postoperative ( r = −0.0134, p = 0.102) events. Conclusion: In this study, moderate PPM was a frequent finding after AVR, whereas severe PPM was not observed. PPM did not affect the early results after AVR. A long-term follow-up study in a large patient population is required to assess the actual influence of residual PPM.