bluuebunny/crossref_metadata_2025_split huggingface dataset:
Static grid carbon factors – Can we do better?
Authors: Risner Jamie , Sutherland Anna 
Published: February 2021

The average carbon intensity (gCO2e/kWh) of electricity provided by the UK National Grid is decreasing and becoming more time variable. This paper reviews the impact on energy calculations of using various levels of data resolution (half hourly, daily, monthly and annual) and of moving to region specific data. This analysis is in two parts, one focused on the potential impact on Part L assessments and the other on reported carbon emissions for existing buildings. Analysis demonstrated that an increase in calculated emissions of up to 12% is possible when using an emissions calculation methodology employing higher resolution grid carbon intensity data. Regional analysis indicated an even larger calculation discrepancy, with some regions annual emissions increasing by a factor of ten as compared to other regions. This paper proposes a path forward for the industry to improve the accuracy of analysis by using better data sources. The proposed change in calculation methodology is analogous to moving from using an annual average external temperature to using a CIBSE weather profile for a specific city or using a future weather file. Practical application: This paper aims to quantify the inaccuracy of a calculation methodology in common use in the industry and key to building regulations (specifically Building Regulations Part L – Conservation of Fuel and Power) – translating electricity consumption into carbon emissions. It proposes an alternative methodology which improves the accuracy of the calculation based on improved data inputs.
Dynamics of appearance and decay of gaseous microemboli during in vitro extracorporeal circulation
Authors: Harea George T , Karaliou Vitali , Roberts Teryn R , Choi Jae-Hyek , Beely Brendan M , Cancio Leopoldo C , Batchinsky Andriy I 
Published: February 2021

Introduction: Extracorporeal life support (ECLS) patients are at risk for complications caused by gaseous microemboli (GME). GMEs can cause hypoxia, inflammation, coagulation, and end-organ damage. The objective of this in vitro study was to assess dynamics of GME formation during circulation of whole blood or a glycerol blood surrogate. We hypothesized that there is no difference in GME counts and sizes between whole blood and the glycerol blood surrogate and that the membrane lung reduces GME counts over time. Methods: A circulation platform was developed using the Cardiohelp ECLS system to run either donor blood or glycerol solution. We conducted 10 repetitions consisting of three phases of ultrasound GME detection using the EDAC™ Quantifier (Luna Innovations, Charlottesville, VA, USA) for each group. Phases were 3-minute recordings at the initiation of 2 L/min flow (Phase 1), post-injection of a GME suspension (Phase 2), and 10 minutes after injection (Phase 3). The number and size of GME pre- and post-ML were recorded separately and binned based on diameter ranges. Results: In Phase 1, GME count in blood was higher than in glycerol. In Phase 2, there was a large increase in GME counts; however, most GME were reduced post-membrane in both groups. In Phase 3, there was a significant decrease in GME counts compared to Phase 2. GME > 100 μm in glycerol decreased post membrane. Conclusions: We demonstrated GME formation and decay dynamics during in vitro circulation in an ECLS system with blood and glycerol. GME counts were higher in blood, likely due to varying rheological properties. There were decreases in GME levels post membrane in both groups after GME injection, with the membrane lung effectively trapping the GME, and additional reduction 10 minutes after GME injection.
Human perceptual learning is delayed by the N-methyl-D-aspartate receptor partial agonist D-cycloserine
Authors: Dempsey-Jones Harriet , Steudte-Schmiedgen Susann , Browning Michael , Makin Tamar R , Woud Marcella L , Harmer Catherine J , Margraf Juergen , Reinecke Andrea 
Published: February 2021

Background: The optimisation of learning has long been a focus of scientific research, particularly in relation to improving psychological treatment and recovery of brain function. Previously, partial N-methyl-D-aspartate agonists have been shown to augment reward learning, procedural learning and psychological therapy, but many studies also report no impact of these compounds on the same processes. Aims: Here we investigate whether administration of an N-methyl-D-aspartate partial agonist (D-cycloserine) modulates a previously unexplored process – tactile perceptual learning. Further, we use a longitudinal design to investigate whether N-methyl-D-aspartate-related learning effects vary with time, thereby providing a potentially simple explanation for apparent mixed effects in previous research. Methods: Thirty-four volunteers were randomised to receive one dose of 250 mg D-cycloserine or placebo 2 h before tactile sensitivity training. Tactile perception was measured using psychophysical methods before and after training, and 24/48 h later. Results: The placebo group showed immediate within-day tactile perception gains, but no further improvements between-days. In contrast, tactile perception remained at baseline on day one in the D-cycloserine group (no within-day learning), but showed significant overnight gains on day two. Both groups were equivalent in tactile perception by the final testing – indicating N-methyl-D-aspartate effects changed the timing, but not the overall amount of tactile learning. Conclusions: In sum, we provide first evidence for modulation of perceptual learning by administration of a partial N-methyl-D-aspartate agonist. Resolving how the effects of such compounds become apparent over time will assist the optimisation of testing schedules, and may help resolve discrepancies across the learning and cognition domains.
Perfusion imaging-based tissue-level collaterals predict ischemic lesion net water uptake in patients with acute ischemic stroke and large vessel occlusion
Authors: Faizy Tobias D , Kabiri Reza , Christensen Soren , Mlynash Michael , Kuraitis Gabriella , Broocks Gabriel , Hanning Uta , Nawabi Jawed , Lansberg Maarten G , Marks Michael P , Albers Gregory W , Fiehler Jens , Wintermark Max , Heit Jeremy J 
Published: February 2021

Ischemic lesion Net Water Uptake (NWU) quantifies cerebral edema formation and likely correlates with the microvascular perfusion status of patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO). We hypothesized that favorable tissue-level collaterals (TLC) predict less NWU and good functional outcomes. We performed a retrospective multicenter analysis of AIS-LVO patients who underwent thrombectomy triage. TLC were measured on cerebral perfusion studies using the hypoperfusion intensity ratio (HIR; volume ratio of brain tissue with [Tmax > 10 sec/Tmax > 6 sec]); favorable TLC were regarded as HIR [Formula: see text] 0.4. NWU was determined using a quantitative densitometry approach on follow-up CT. Primary outcome was NWU. Secondary outcome was a good functional outcome (modified Rankin Scale [mRS] 0–2). 580 patients met inclusion criteria. Favorable TLC ( β: 4.23, SE: 0.65; p < 0.001) predicted smaller NWU after treatment. Favorable TLC (OR: 2.35, [95% CI: 1.31–4.21]; p < 0.001), and decreased NWU (OR: 0.75, [95% CI: 0.70–0.79]; p < 0.001) predicted good functional outcome, while controlling for age, glucose, CTA collaterals, baseline NIHSS and good vessel reperfusion status. We conclude that favorable TLC predict less ischemic lesion NWU after treatment in AIS-LVO patients. Favorable TLC and decreased NWU were independent predictors of good functional outcome.
Predictive value of cervical length by ultrasound and cervical strain elastography in labor induction at term
Authors: Zhou Yimin , Jin Neng , Chen Qinqing , Lv Min , Jiang Ying , Chen Yuan , Xi Fangfang , Yang Mengmeng , Zhao Baihui , Huang Hefeng , Luo Qiong 
Published: February 2021

Objective This study aimed to examine whether addition of cervical elastographic parameters measured by ElastoScan for the cervix (E-cervix) improves the predictive value of cervical length (CL) in induction of labor at term by dinoprostone. Methods We conducted a prospective, observational study between January 2020 and June 2020 in term primiparous women (n = 73) who were scheduled for labor induction by a 10-mg dinoprostone vaginal insert. The time intervals from the start of labor induction to regular uterine contractions and to vaginal delivery were calculated as the primary outcomes. We divided subjects into two groups using a threshold of 24 hours. Ultrasound measurements were compared between the two groups and the area under the curve (AUC) of the prediction model was calculated. Results Women who delivered vaginally within 24 hours had a shorter CL and softer cervix than those who delivered after 24 hours. The combination of CL and elastographic parameters increased the AUC to 0.672 compared with CL alone (AUC = 0.637). Conclusions Measurement by E-cervix is relatively reproducible. Addition of cervical strain elastography slightly improves the predictive performance of CL in vaginal delivery within 24 hours. This technique is a promising ancillary tool for use with ultrasound.
Views about sensory modulation from people with schizophrenia and treating staff: A multisite qualitative study
Authors: Machingura Tawanda , Lloyd Chris , Murphy Karen , Goulder Sarah , Shum David , Green and Heather 
Published: February 2021

Introduction Current non-pharmacological treatment options for people with schizophrenia are limited. There is, however, emerging evidence that sensory modulation can be beneficial for this population. This study aimed to gain insight into sensory modulation from the user’s and the treating staff’s perspectives. Method A qualitative content analysis design was used. Transcripts from occupational therapists ( n=11) and patients with schizophrenia ( n=13) derived from in-depth semi-structured interviews were analysed for themes using content analysis. Results Five themes emerged from this study: Service user education on the sensory approach is the key; A variety of tools should be tried; Sensory modulation provides a valued treatment option; There are challenges of managing perceived risk at an organisational level; and There is a shortage of accessible and effective training. Conclusion People with schizophrenia and treating staff had congruent perceptions regarding the use of sensory modulation as a treatment option. The findings suggest that sensory modulation can be a valued addition to treatment options for people with schizophrenia. We suggest further research on sensory modulation intervention effectiveness using quantitative methods so these results can be further explored.
Laparoscopic single port radical prostatectomy in the 2020: Why not? Our experience
Authors: Sortino Giuseppe , Giannubilo Willy , Di Biase Manuel , Marconi Andrea , Diambrini Maurizio , Ferrara Vincenzo 
Published: February 2021

Objectives: To analyze the feasibility, safety and advantages of Laparo-Endoscopic Single-site Surgery radical prostatectomy (LESS-RP) based on our personal experience. Patients and methods: Details of 520 patients were retrospectively analyzed, from 2009 to 2019. Extraperitoneal approach, with only two accesses (2.5 cm and 5 mm respectively) was used to perform radical prostatectomy. Perioperative characteristics and postoperative oncologic and functional outcomes are reported. Results: The mean age was 66.6 ± 5.6 years. Mean PSA level was 9 ± 3.5 ng/ml. According to D’Amico classification, the percentage of patients with low-, intermediate-, and high-risk disease cases were 116 (22.4%), 275 (52.8%), and 129 (24.8%) respectively. Mean operative time was 156 ± 43 min. Mean estimated blood loss was 214 ± 93 ml. Positive surgical margins (PSMs) were detected in 110 (21.2%) patients. PSM rates in pT2 and pT3 stages were 20.1% and 22.9%, respectively. The overall complication rate was 9.2%, based on the modified Clavien classification. The 12 months continence and potency rates were 90.9% and 49.1%, respectively. The biochemical recurrence rate was 6.8%, at the median follow-up time of 26.7 months (IQR 12–32). Conclusions: Our analyses show that LESS-RP is a safe procedure, if performed by surgeons with adequate experience and skills. Unlike the classic laparoscopic prostatectomy, this technique allows better aesthetic and psychological results, reduced postoperative pain, and a faster return to normal daily activity with the same functional and oncological results.
Do low dose CT-KUBs really expose patients to more radiation than plain abdominal radiographs?
Authors: Yang Bob , Suhail Noorunisa , Marais Johan , Brewin James 
Published: February 2021

Background: Urolithiasis patients often require frequent urinary tract imaging, leading to high radiation exposure. CT Kidney-Ureter-Bladder (CT-KUB) is the gold standard in urolithiasis detection, however it is thought to harbour significant radiation load. Urologists have therefore utilised abdominal radiographs (XR-KUB) as an alternative, though with markedly lower sensitivity and specificity. We present the first contemporary UK study comparing the effective doses of XR-KUBs with low dose CT-KUBs. Method: Fifty-three patients were retrospectively identified in a single centre who underwent both a XR-KUB and a CT-KUB in 2018. Effective-Dose was measured by converting the recorded ‘Dose Area/Length Product’ via the International Commission on Radiological Protection formula. Results: The average effective dose of XR-KUBs and low dose CT-KUBs were 5.10 mSv and 5.31 mSv respectively. Thirty-four percent (18/53) of patients had a XR-KUBs with a higher effective dose than their low dose CT-KUB. Patients with higher Weight, BMI and AP diameter had higher effective doses for both their XR and low dose CT-KUBs. All patients in our study weighing over 92 kg or with a BMI greater than 32 had a XR-KUBs with a higher effective dose than their low dose CT-KUB. Conclusion: This data supports moving away from XR-KUBs for the investigation of urolithiasis, particularly in patients with a high BMI.
Atteintes Neurodéveloppementales, Comorbidités Psychiatriques Et Pathologies Associées Chez Des Patients Atteints de Schizophrénie Très Précoce Avec Symptômes Autistiques Prémorbides.
Authors: Fernandez A , Pasquet-Levy M , Laure G , Thümmler S , Askenazy F 
Published: February 2021

Introduction: La schizophrénie très précoce (STP) est une forme rare (1/40000), grave et neurodéveloppementale de schizophrénie débutant avant 13 ans. Les comorbidités et atteintes associées spécifiques des STP étant peu étudiées, l’objectif de notre étude a été de les évaluer sur le plan psychiatrique, neurodéveloppemental et somatique. Méthode: Il s’agit d’une étude ancillaire du protocole GenAuDiss. Un entretien psychiatrique standardisé (K-SADS-PL DSM5) et un bilan neuropsychologique (WISC-V/WAIS-IV) ont été effectués chez les patients atteints de STP ainsi qu’une anamnèse concernant la grossesse, la périnatalité, le développement, la biographie et les antécédents médicaux et psychiatriques, personnels et familiaux. Résultats: 20 sujets ont été inclus. L’âge moyen de début du trouble était de 8,90 ans (+/−2,30). Les comorbidités psychiatriques (DSM5) étaient le Trouble Déficitaire de l’Attention avec Hyperactivité (15/20 patients), les troubles anxieux (14/20) et le Trouble du Spectre de l’Autisme (13/20). Le QI moyen était de 70,26 (+/−18,09). Un retard de langage et une rupture de parcours scolaire étaient notés chez 18/20 patients. Enfin, l’affection somatique principale associée était l’asthme (15/20 patients). Discussion: Nous avons mis en évidence chez nos patients atteints de STP une fréquence élevée de comorbidités dont au moins un trouble psychiatrique systématique. Or, bien que la schizophrénie infantile soit une pathologie de pronostic sévère impactant le patient, sa famille et la société, sa prise en charge demeure essentiellement symptomatique. En pratique clinique, il apparaît nécessaire de rechercher systématiquement ces comorbidités et de les prendre en charge pour améliorer la qualité globale des soins.
Prefrailty: The Relationship Between Daily Activities and Social Participation in Older Persons
Authors: Costenoble Axelle , Knoop Veerle , Debain Aziz , Vermeiren Sofie , Vella Azzopardi Roberta , Rossi Gina , Smeys Celeste , Baltazar Kéren Duarte , Bautmans Ivan , Verté Dominique , Gorus Ellen , De Vriendt Patricia 
Published: February 2021

Objectives: To analyze prefrailty’s relationship with limitations in activities of daily living (ADLs) and restrictions in social participation. Method: Robust (Fried 0/4; n = 214; Mage = 82.3 years [ SD ±2.1]) and prefrail (Fried 1–2/4; n = 191; Mage = 83.8 years [ SD ±3.2]) community-dwelling older individuals were included. Frailty scores were obtained from weight loss, exhaustion, gait speed, and grip strength. A total disability index (DI) expressed dependency for basic (b-), instrumental (i-), and advanced (a-)ADLs. Total participation score, being a member, total number of memberships, being a board member, level of participation, membership over time, volunteering, and formal participation represented social participation. Results: Logistic regression retained age (OR = 1.224; 95% CI = [1.122, 1.335]), sex (OR = 3.818; 95% CI = [2.437, 5.982]), and a-ADL-DI (OR = 1.230; 95% CI = [1.018, 1.486]) as variables significantly related to prefrailty (68.3%; χ2 = 68.25; df = 3; p < .001). Discussion: Subtle limitations in a-ADLs, higher age, and being a man were associated with prefrailty, revealing the possible role of personal and culturally related a-ADLs as red flags for (pre)frailty.
Exclusive Breastfeeding Moderates the Association Between Prenatal and Postpartum Depression
Authors: Figueiredo Bárbara , Pinto Tiago Miguel , Costa Raquel 
Published: February 2021

Background Exclusive breastfeeding has a wide range of benefits for maternal health. However, the benefit of exclusive breastfeeding for maternal mental health needs to be further explored. Research Aim To determine the moderating role of exclusive breastfeeding at 3 months on the association between prenatal and postpartum depression. Methods This study had a prospective, longitudinal, and comparative design with two groups and three assessment waves. The sample comprised 334 participants (70 depressed and 264 non-depressed) recruited at public health services in northern Portugal. Participants completed a measure of depression symptoms between the second and the third trimester of pregnancy and between 3 and 6 months, and a measure of breastfeeding status at 3 months. Results Exclusive breastfeeding at 3 months moderated the association between prenatal and postpartum depression. Participants with prenatal depression who were exclusively breastfeeding at 3 months showed fewer symptoms of depression and lower rates of depression between 3 and 6 months postpartum, compared to participants with prenatal depression who were not exclusively breastfeeding. Participants without prenatal depression who were exclusively breastfeeding at 3 months showed similar depression symptoms and similar rates of depression between 3 and 6 months postpartum, compared to participants without prenatal depression who were not exclusively breastfeeding. Conclusion Exclusive breastfeeding has a potential protective influence on postpartum depression among women with prenatal depression. Public health policies targeting women with prenatal depression should be implemented and include practices to promote and support exclusive breastfeeding in order to enhance women’s exclusive breastfeeding and mental health.
A Case Study Supporting Lack of SARS-CoV-2 Spread to a 3-Month Old Infant Through Exclusive Breastfeeding
Authors: Liu Wei , Liu Yujie , Liu Zhenjun , Hong Changxin , Liu Jian , Luo Sihui , Zheng Xueying 
Published: February 2021

Introduction During the Coronavirus Disease 2019 global pandemic, maternal and newborn wellbeing has received much attention. Detailed reports of infected women breastfeeding their infants are uncommon. Due to incomplete information available, full data about those infants’ outcomes are lacking, and evidence of infectivity through breastfeeding has not been documented. Main Issue Here, we report about a mother who breastfed her infant until she was confirmed with the SARS-Cov-2 infection. After follow-up, we have confirmed that the infant, who was breastfed by the infected mother, was not infected. Methods A 33-year-old woman gave birth to a full-term male infant on November 8, 2019. Since birth, she had been exclusively breastfeeding the baby until she was confirmed with the SARS-Cov-2 infection on February 8, 2020. She was hospitalized, isolated from her baby, and stopped breastfeeding. Even though she remained asymptomatic, her milk was expressed using a breast pump and discarded. The mother’s milk sample was collected on February 9, 2020, and the result of the nucleic acid test for COVID-19 was negative. Her infant was asymptomatic and remained virus negative. Her laboratory findings and chest Computed Tomography imaging was normal. She was treated according to the national protocol with aerosolized interferon α2β, lopinavir/ritonavir and ribavirin. Her serum SARS-CoV-2 specific antibodies(IgG and IgM) tested positive when discharged. She returned to breastfeeding after discharge. Conclusion Our findings suggest that breastfeeding may be less of a risk than anticipated. Additional research is needed to explore this possibility.
A1C Reduction in Patients Who Declined Pharmacist-Led Diabetes Management Services
Authors: Ahmed Fahamina , Hammad Samah A. , Lin Jonathan F. , Gennaro Teresa L. , Gaspard Alexis L. , Sarpong Daniel F. , Onor IfeanyiChukwu O. 
Published: February 2021

Introduction: The purpose of this research is to assess the mean change in A1C associated with patients who declined a pharmacy-led diabetes management program and to evaluate effects of predictor variables on the odds of achieving improved A1C in these patients. Study design: Retrospective, single-center, single-group, cohort study. Methods: Patients 18 years or older with uncontrolled type 2 diabetes (defined as A1C ≥ 9%) who declined pharmacy-led diabetes management services were included in the study. The primary outcome of the study was to assess the mean change in A1C from time of phone call offering pharmacy management services (initial) to last observed A1C (final recorded A1C). Results: A total of 91 patients were included, 46 males and 45 females. The significant reduction in the mean change from baseline A1C to the final measured A1C was −0.59 (95% CI, −0.9327% to −0.2447%, P-value = 0.0010). This resulted in 8.79% of patients’ final A1C falling into the range of < 7%. Conclusion: Our study found a paradoxical reduction in A1C among patients who declined pharmacy-led diabetes management services, however, our study is limited by having no comparison group. Further research needs to be conducted to identify correlations between characteristics of patients declining diabetes management services in order to assist with identifying patient-specific methods for improving patient outcomes.