bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review of allergic reactions from use of chlorhexidine on medical products in clinical settings over 40 years: Risks and mitigations
Authors: Gerges Bahgat Z. , Rosenblatt Joel , Truong Y-Lan , Reitzel Ruth A. , Raad Isaam 
Published: June 2021

AbstractChlorhexidine is an antimicrobial agent widely used for infection prevention in medical settings. Nevertheless, allergic reactions ranging from mild to severe have been reported following its use. In this review, we analyzed all case reports published between the introduction of chlorhexidine and the end of 2019 for allergic responses associated with the use of medical devices and or other medical products containing chlorhexidine (CHX) to ascertain the prevalence of severe CHX allergic reactions and what practices might best mitigate those risks.In total, 77 publications containing 124 reported cases of allergic reactions were grouped into 3 product categories, catheters, semisolids, and fluid products. The country, type of reaction, route of sensitization, allergy confirmation, and intervention or mitigation was extracted for each case. Overall, 30 cases were associated with catheters, 46 cases were associated with semisolid products, and 48 cases were associated with the use of other medical products. Severe cases were managed with intravenous fluids, steroids, and epinephrine (adrenaline). None of the reported cases were fatal. The allergy risks can be mitigated by better warning and training clinicians and by recording and screening patient histories for CHX presensitization from prior exposure. For patients undergoing pre-use blood tests, IgE antibody screens can also be performed. Finally, as a precaution in the event a rare severe allergic reaction occurs, procedure carts and rooms can be prestocked with injectable epinephrine and other rapidly acting anti-inflammatory medications.
Economic burden of surgical management of surgical site infections following hip and knee replacements in Calgary, Alberta, Canada
Authors: Mponponsuo Kwadwo , Leal Jenine , Puloski Shannon , Chew Derek , Chavda Swati , Au Flora , Rennert-May Elissa 
Published: June 2021

AbstractObjective:To evaluate the cost of 1-stage and 2-stage revisions, debridement, antibiotic and implant retention (DAIR) and DAIR with liner exchange for complex surgical site infections (SSIs) following hip and knee replacements.Design:Retrospective population-based economic analysis of patients undergoing intervention for SSIs between April 1, 2012 and March 31, 2019.Setting:The study was conducted in the Calgary zone of Alberta Health Services (AHS) in Canada.Participants:Individuals >18 years with complex SSI following hip or knee replacement.Methods:Patients with complex SSIs were identified using the AHS infection prevention and control database. A combination of microcosting and gross costing methods were used to estimate 12- and 24-month costs following the initial hospital admission for arthroplasty. Subgroup, inverse Gaussian and γ regression analyses were used to evaluate the impact of age and comorbidities on cost.Results:In total, 142 patients with complex SSIs were identified, with a mean age of 66.8 years. Total direct medical costs in United States dollars of 2-stage revisions were ($100,992 (95% CI, 34,587–167,396) at 12 months. The 1-stage revision ($41,176; 95% CI, 23,361–58,991), DAIR with liner exchange ($41,267; 95% CI, 29,923–52,612) and DAIR ($46,605; 95% CI, 15,277–76,844) were associated with fewer costs at 12 months. Age >65 years and chronic complications of diabetes and hypertension were associated with increased costs in subgroup and regression analysis.Conclusions:Medical costs are highest at 12 months and for 2-stage revisions in hip and knee complex SSI cases. Further work should explore surgical outcomes correlated with costs to enhance patient care.
Should market harms be an exception to the Harm Principle?
Authors: Endörfer Richard 
Published: June 2021

AbstractMany proponents of the Harm Principle seem to implicitly assume that the principle is compatible with permitting the free exchange of goods and services, even if such exchanges generate so-called market harms. I argue that, as a result, proponents of the Harm Principle face a dilemma: either the Harm Principle’s domain cannot include a large number of non-market harm cases or market harms must be treated on par with non-market harms. I then go on to discuss three alternative arguments defending the status of market harms as exceptions to the Harm Principle and discuss why these arguments also fail.
Risk factors for antibiotic resistance development in healthcare settings in China: a systematic review
Authors: Chen Qi , Li Duguang , Beiersmann Claudia , Neuhann Florian , Moazen Babak , Lu Guangyu , Müller Olaf 
Published: June 2021

Abstract
Antibiotic resistance (ABR) threatens the effectiveness of infectious disease treatments and contributes to increasing global morbidity and mortality. In this study, we systematically reviewed the identified risk factors for ABR among people in the healthcare system of mainland China. Five databases were systematically searched to identify relevant articles published in either English and Chinese between 1 January 2003 and 30 June 2019. A total of 176 facility-based references were reviewed for this study, ranging across 31 provinces in mainland China and reporting information from over 50 000 patients. Four major ABR risk factor domains were identified: (1) sociodemographic factors (includes migrant status, low income and urban residence), (2) patient clinical information (includes disease status and certain laboratory results), (3) admission to healthcare settings (includes length of hospitalisation and performance of invasive procedures) and (4) drug exposure (includes current or prior antibiotic therapy). ABR constitutes an ongoing major public health challenge in China. The healthcare sector-associated risk factors was the most important aspect identified in this review and need to be addressed. Primary health care system and ABR surveillance networks need to be further strengthened to prevent and control the communicable diseases, over-prescription and overuse of antibiotics.
CERAMIC SEQUENCE, CHRONOLOGY, AND CULTURAL DYNAMICS OF THE UCAREO-ZINAPÉCUARO, MICHOACÁN OBSIDIAN SOURCE AREA
Authors: Healan Dan M. , Hernández Christine 
Published: June 2021

AbstractThis article presents the ceramic sequence and chronology resulting from a multi-year program of survey, excavation, and analysis of pre-Hispanic settlement and exploitation within the Zinapécuaro-Ucareo (“U-Z”), Michoacan obsidian source area. Pottery analysis and classification aided by seriation analysis identified nine ceramic complexes and seven ceramic phases and sub-phases that both expand and refine the ceramic sequence previously established for the region by Gorenstein's (1985) investigations at nearby Acámbaro, Guanajuato. Initially established by ceramic cross-dating, the U-Z ceramic chronology has been largely confirmed by 30 radiocarbon dates and spans over 2,000 years of pre-Hispanic settlement, which included at least two notable episodes of trait-unit and site-unit intrusion from the eastern El Bajío and central Mexico. One of these episodes involved the appearance of two enclaves settled by individuals from the Acambay valley c. 90 km to the East, most likely from the site of Huamango, which our data indicate would have been occupied during the Middle Postclassic period.
Cardiovascular causes of tracheobronchial compression: a decade experience in a Paediatric Congenital Heart Centre
Authors: Yubbu Putri , Abdul Latiff Haifa , Musa Husna , Devaraj Navin Kumar , Mohd Razif Nurul Adha , Sivalingam Sivakumar , Samion Hasri 
Published: June 2021

AbstractBackground:Vascular compression of the airway often complicates CHD management. This study evaluated the use of CT in determining cardiovascular causes, clinical manifestations, and outcome of tracheobronchial compression among children with CHD.Methods:A retrospective review of clinical records of all patients with CT scan evidence of tracheobronchial compression from January 2007 to December 2017 at National Heart Institute. Cardiovascular causes of tracheobronchial compression were divided into three groups; group I: vascular ring/pulmonary artery sling, II: abnormally enlarged or malposition cardiovascular structure due to CHD, III: post-CHD surgery.Results:Vascular tracheobronchial compression was found in 81 out of 810 (10%) patients who underwent CT scan. Group I lesions were the leading causes of vascular tracheobronchial compression (55.5%), followed by group II (34.6%) and group III (9.9%). The median age of diagnosis in groups I, II, and III were 16.8 months, 3 months, and 15.6 months, respectively. Half of group I patients are manifested with stridor and one-third with recurrent chest infections. Persistent respiratory symptoms, lung atelectasis, or prolonged respiratory support requirement were clues in groups II and III. Higher morbidity and mortality in younger infants with severe obstructive airway symptoms, associated airway abnormalities, and underlying complex cyanotic CHD.Conclusions:Vascular ring/pulmonary artery sling and abnormally enlarged or malposition cardiovascular structure were the leading causes of cardiovascular airway compression. A high index of suspicion is needed for early detection due to its non-specific presentation. The outcome often depends on the severity of airway obstruction and complexity of cardiac lesions.
A compassionate imagery intervention for patients with persecutory delusions
Authors: Forkert Ava , Brown Poppy , Freeman Daniel , Waite Felicity 
Published: June 2021

AbstractBackground:Negative beliefs about the self, including low self-compassion, have been identified as a putative causal factor in the occurrence of paranoia. Therefore, improving self-compassion may be one route to reduce paranoia.Aims:To assess the feasibility, acceptability, and potential clinical effects of a brief compassionate imagery intervention for patients with persecutory delusions.Method:Twelve patients with persecutory delusions received an individual four-session compassionate imagery intervention. Assessments of self-concept and paranoia were completed before treatment, immediately after treatment, and at 1-month follow-up. A qualitative study exploring participants’ experiences of the treatment was also completed.Results:Twelve out of 14 eligible patients referred to the study agreed to take part. All participants completed all therapy sessions and assessments. Post-treatment, there were improvements in self-compassion (change score –0.64, 95% CI –1.04, –0.24, d = –1.78), negative beliefs about the self (change score 2.42, 95% CI –0.37, 5.20, d = 0.51), and paranoia (change score 10.08, 95% CI 3.47, 16.69, d = 0.61). There were no serious adverse events. Three themes emerged from the qualitative analysis: ‘effortful learning’, ‘seeing change’ and ‘taking it forward’. Participants described a process of active and effortful engagement in therapy which was rewarded with positive changes, including feeling calmer, gaining clarity, and developing acceptance.Conclusion:This uncontrolled feasibility study indicates that a brief compassionate imagery intervention for patients with persecutory delusions is feasible, acceptable, and may lead to clinical benefits.
Borehole‐Based Characterization of Deep Mixed‐Mode Crevasses at a Greenlandic Outlet Glacier
Authors: Hubbard Bryn , Christoffersen Poul , Doyle Samuel H. , Chudley Thomas R. , Schoonman Charlotte M. , Law Robert , Bougamont Marion 
Published: June 2021

AbstractOptical televiewer borehole logging within a crevassed region of fast‐moving Store Glacier, Greenland, revealed the presence of 35 high‐angle planes that cut across the background primary stratification. These planes were composed of a bubble‐free layer of refrozen ice, most of which hosted thin laminae of bubble‐rich “last frozen” ice, consistent with the planes being the traces of former open crevasses. Several such last‐frozen laminae were observed in four traces, suggesting multiple episodes of crevasse reactivation. The frequency of crevasse traces generally decreased with depth, with the deepest detectable trace being 265 m below the surface. This is consistent with the extent of the warmer‐than‐modeled englacial ice layer in the area, which extends from the surface to a depth of ∼400 m. Crevasse trace orientation was strongly clustered around a dip of 63° and a strike that was offset by 71° from orthogonal to the local direction of principal extending strain. The traces’ antecedent crevasses were therefore interpreted to have originated upglacier, probably ∼8 km distant involving mixed‐mode (I and III) formation. We conclude that deep crevassing is pervasive across Store Glacier, and therefore also at all dynamically similar outlet glaciers. Once healed, their traces represent planes of weakness subject to reactivation during subsequent advection through the glacier. Given their depth, it is highly likely that such traces—particularly those formed downglacier—survive surface ablation to reach the glacier terminus, where they may represent foci for fracture and iceberg calving.
A Positive Cloud‐to‐Ground Flash Caused by a Sequence of Bidirectional Leaders that Served to Form a Ground‐Reaching Branch of a Pre‐Existing Horizontal Channel
Authors: Wu Bin , Lyu Weitao , Qi Qi , Ma Ying , Chen Lyuwen , Jiang Ruijiao , Zhu Yanan , Rakov Vladimir A. 
Published: June 2021

AbstractHigh‐speed video and electric field change data were used to analyze the initiation and propagation of four predominantly vertical bidirectional leaders making connection to a predominantly horizontal channel previously formed aloft. The four bidirectional leaders sequentially developed along the same path and served to form a positive branch of the horizontal in‐cloud channel, which became a downward positive leader producing a 135‐kA positive cloud‐to‐ground (+CG) return stroke. The positive (lower) end of each bidirectional leader elongated abruptly at the time of connection of the negative (upper) end to the pre‐existing channel aloft. Thirty‐six negative streamer‐like filaments (resembling recently reported “needles”) extended sideways over ∼110 to 740 m from the pre‐existing horizontal channel at speeds of ∼0.5 to 1.9 × 107 m/s, in response to the injection of negative charge associated with the +CG.
Impacts of Ionospheric Ions on Magnetic Reconnection and Earth's Magnetosphere Dynamics
Authors: Toledo‐Redondo S. , André M. , Aunai N. , Chappell C. R. , Dargent J. , Fuselier S. A. , Glocer A. , Graham D. B. , Haaland S. , Hesse M. , Kistler L. M. , Lavraud B. , Li W. , Moore T. E. , Tenfjord P. , Vines S. K. 
Published: June 2021

AbstractIonospheric ions (mainly H+, He+, and O+) escape from the ionosphere and populate the Earth's magnetosphere. Their thermal energies are usually low when they first escape the ionosphere, typically a few electron volt to tens of electron volt, but they are energized in their journey through the magnetosphere. The ionospheric population is variable, and it makes significant contributions to the magnetospheric mass density in key regions where magnetic reconnection is at work. Solar wind—magnetosphere coupling occurs primarily via magnetic reconnection, a key plasma process that enables transfer of mass and energy into the near‐Earth space environment. Reconnection leads to the triggering of magnetospheric storms, auroras, energetic particle precipitation and a host of other magnetospheric phenomena. Several works in the last decades have attempted to statistically quantify the amount of ionospheric plasma supplied to the magnetosphere, including the two key regions where magnetic reconnection occurs: the dayside magnetopause and the magnetotail. Recent in situ observations by the Magnetospheric Multiscale spacecraft and associated modeling have advanced our current understanding of how ionospheric ions alter the magnetic reconnection process, including its onset and efficiency. This article compiles the current understanding of the ionospheric plasma supply to the magnetosphere. It reviews both the quantification of these sources and their effects on the process of magnetic reconnection. It also provides a global description of how the ionospheric ion contribution modifies the way the solar wind couples to the Earth's magnetosphere and how these ions modify the global dynamics of the near‐Earth space environment.
Light and Shadow in Mapping Alpine Snowpack With Unmanned Aerial Vehicles in the Absence of Ground Control Points
Authors: Revuelto Jesús , López‐Moreno Juan Ignacio , Alonso‐González Esteban 
Published: June 2021

AbstractRecent developments in unmanned aerial vehicles (UAV) and structure from motion (SfM) algorithms have shown reliable results for retrieving snow depth distribution. However, their ability to obtain accurate results usually relies on deploying and measuring the exact position of ground control points (GCP) for georeferencing the information. Commercial UAVs can now provide real time kinematic (RTK) positioning of the images with centimetric accuracy. Nonetheless, their operational applicability for observing snow distribution in highly heterogeneous mountain areas has not been evaluated. This study presents a complete assessment of the reliability of snow depth observations from a fixed‐wing UAV working in RTK mode with an RGB camera. During the 2018–2019 season, seven field campaigns (13 UAV flights) were undertaken covering 0.48 km2 in complex alpine terrain in the Pyrenees. The UAV observations obtained under different light conditions and flight block configurations (altitude and image overlaps) in the same day were evaluated with terrestrial laser scanner acquisitions. Two SfM processing options of the UAV images were also compared. When the study area received direct solar light, the results were comparable to previous studies that had used GCPs, with an average root mean squared error of 0.19 m and an average absolute snow volume discrepancy lower than 4%. However, when large areas were under shadow from the terrain, or solar light was affected by clouds, the estimated error tripled. The quality of the snow depth maps was little affected by the snow covered area and the flight mission configurations.
Innovative Study of Resistor Shunt‐Based Bridged‐T Topology With Bandpass Negative Group Delay Behavior
Authors: Xu Zhifei , Nebhen Jamel , Chan George , Rahajandraibe Wenceslas , Ravelo Blaise 
Published: June 2021

AbstractIn this paper, new bridged‐T network operating with bandpass (BP) negative group delay (NGD) function is introduced. The circuit design is innovatively based on an inductorless passive RC‐network. The innovative bridged‐T topology is implemented with a R‐shunt configuration. The analytical transfer function of voltages and equivalent impedance‐matrix are carefully calculated. The BP NGD analysis and design of the bridged‐T topology is developed. The BP NGD properties and specifications are analytically investigated. A proof of concept of R‐shunt bridged‐T prototype with a surface‐mounted device printed circuit board is designed, fabricated, and measured to verify the BP NGD behavior from theoretical equations and simulations. As expected, the theoretical, simulation, and measurements results are in very good agreement. From measurement results, the fabricated BP NGD C‐shunt bridged‐T reaches a delay of about −45 ns and a center frequency of about 0.5 MHz over a −3 dB attenuation.
Demonstration of epitaxial growth of strain-relaxed GaN films on graphene/SiC substrates for long wavelength light-emitting diodes
Authors: Yu Ye , Wang Tao , Chen Xiufang , Zhang Lidong , Wang Yang , Niu Yunfei , Yu Jiaqi , Ma Haotian , Li Xiaomeng , Liu Fang , Deng Gaoqiang , Shi Zhifeng , Zhang Baolin , Wang Xinqiang , Zhang Yuantao 
Published: June 2021

AbstractStrain modulation is crucial for heteroepitaxy such as GaN on foreign substrates. Here, the epitaxy of strain-relaxed GaN films on graphene/SiC substrates by metal-organic chemical vapor deposition is demonstrated. Graphene was directly prepared on SiC substrates by thermal decomposition. Its pre-treatment with nitrogen-plasma can introduce C–N dangling bonds, which provides nucleation sites for subsequent epitaxial growth. The scanning transmission electron microscopy measurements confirm that part of graphene surface was etched by nitrogen-plasma. We study the growth behavior on different areas of graphene surface after pre-treatment, and propose a growth model to explain the epitaxial growth mechanism of GaN films on graphene. Significantly, graphene is found to be effective to reduce the biaxial stress in GaN films and the strain relaxation improves indium-atom incorporation in InGaN/GaN multiple quantum wells (MQWs) active region, which results in the obvious red-shift of light-emitting wavelength of InGaN/GaN MQWs. This work opens up a new way for the fabrication of GaN-based long wavelength light-emitting diodes.
Acute myeloid leukemia with IDH1 and IDH2 mutations: 2021 treatment algorithm
Authors: Issa Ghayas C. , DiNardo Courtney D. 
Published: June 2021

AbstractAcute myeloid leukemia is a genetically heterogeneous hematologic malignancy; approximately 20% of AML harbors a mutation in the isocitrate dehydrogenase (IDH) genes, IDH1 or IDH2. These recurrent mutations in key metabolic enzymes lead to the production of the oncometabolite 2-hydroxyglutarate, which promotes leukemogenesis through a block in normal myeloid differentiation. Since this discovery, selective oral inhibitors of mutant IDH1 and IDH2 have subsequently been developed and are now approved as single agent therapy, based on clinical efficacy observed within the original first-in-human trials. The investigation of IDH inhibitors in combination with standard therapies such as azacytidine, with intensive chemotherapy, and with other small molecule targeted therapies in rational combinations are currently under evaluation to further improve upon clinical efficacy.
Minimal residual disease assessment by multiparameter flow cytometry in transplant-eligible myeloma in the EMN02/HOVON 95 MM trial
Authors: Oliva Stefania , Bruinink Davine Hofste op , Rihova Lucie , D’Agostino Mattia , Pantani Lucia , Capra Andrea , van der Holt Bronno , Troia Rossella , Petrucci Maria Teresa , Villanova Tania , Vsianska Pavla , Jugooa Romana , Brandt-Hagens Claudia , Gilestro Milena , Offidani Massimo , Ribolla Rossella , Galli Monica , Hajek Roman , Gay Francesca , Cavo Michele , Omedé Paola , van der Velden Vincent H. J. , Boccadoro Mario , Sonneveld Pieter 
Published: June 2021

AbstractMinimal residual disease (MRD) by multiparameter flow cytometry (MFC) is the most effective tool to define a deep response in multiple myeloma (MM). We conducted an MRD correlative study of the EMN02/HO95 MM phase III trial in newly diagnosed MM patients achieving a suspected complete response before maintenance and every 6 months during maintenance. Patients received high-dose melphalan (HDM) versus bortezomib-melphalan-prednisone (VMP) intensification, followed by bortezomib-lenalidomide-dexamethasone (VRd) versus no consolidation, and lenalidomide maintenance. Bone marrow (BM) samples were processed in three European laboratories, applying EuroFlow-based MFC protocols (eight colors, two tubes) with 10−4−10−5 sensitivity. At enrollment in the MRD correlative study, 76% (244/321) of patients were MRD-negative. In the intention-to-treat analysis, after a median follow-up of 75 months, 5-year progression-free survival was 66% in MRD-negative versus 31% in MRD-positive patients (HR 0.39; p < 0.001), 5-year overall survival was 86% versus 69%, respectively (HR 0.41; p < 0.001). MRD negativity was associated with reduced risk of progression or death in all subgroups, including ISS-III (HR 0.37) and high-risk fluorescence in situ hybridization (FISH) patients (HR 0.38;). In the 1-year maintenance MRD population, 42% of MRD-positive patients at pre-maintenance became MRD-negative after lenalidomide exposure. In conclusion, MRD by MFC is a strong prognostic factor. Lenalidomide maintenance further improved MRD-negativity rate.