bluuebunny/crossref_metadata_2025_split huggingface dataset:
Charging and Discharging Characteristics of Sensible Energy Storage System With Multiple Cylindrical Passages
Authors: Kumar Ravi , Patil Anil Kumar , Kumar Manoj 
Published: June 2021

Abstract
Sensible energy storage systems can be integrated with domestic and industrial systems to fulfill energy needs in the absence of an energy source. The present study experimentally investigates the thermal characteristics of a sensible energy storage system with multiple cylindrical passages during the charging and discharging cycles. Transient temperature distribution, energy storage, energy release, and charging/discharging energy efficiency are evaluated by varying the mass flowrate of air from 0.022 to 0.031 kg/s and inlet air temperature from 45 to 75 °C. The maximum charging energy efficiency of 81.3% was found at 55 °C inlet temperature and 0.031 kg/s of the mass flowrate of air. The maximum discharging energy efficiency is found to be 74.3% corresponding to 45 °C inlet temperature and 0.031 kg/s of the mass flowrate of air.
Quality of systematic reviews supporting the 2017 ACC/AHA and 2018 ESC/ESH guidelines for the management of hypertension
Authors: Kanukula Raju , Dhurjati Rupasvi , Vidyasagar Kota , Rehana Nusrath , Talari Arun , Salam Abdul , Rodgers Anthony , Page Matthew J 
Published: June 2021

ObjectiveTo assess the methodological and reporting quality of systematic reviews (SRs) that informed recommendations in the recent American and European hypertension guidelines.Design and settingsMeta-epidemiological study. We identified SRs that were cited for class I recommendations based on Level of Evidence-A in the 2017 American College of Cardiology/American Heart Association (ACC/AHA) and the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) hypertension guidelines.Main outcome measuresMethodological and reporting quality of the SRs was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) checklist and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, respectively.ResultsA total of 40 SRs was included in the analysis (28 from 2017 ACC/AHA; 22 from 2018 ESC/ESH and 10 were included in both). Based on the AMSTAR-2 assessment, only 7.5% SRs were found to be of high methodological quality, 47.5% were of moderate, each 22.5% were of low and critically low quality. Based on the PRISMA checklist assessment, a mean of 24 items (SD (2.76) were reported appropriately, and only five SRs reported all 27 items appropriately.ConclusionMethodological and reporting quality of SRs were found to vary considerably. Lack of information on the funding source of included studies, use of a protocol, integration of risk of bias assessments while interpreting findings and reporting of excluded studies were major methodological deficiencies.
A network meta-analysis of psychosocial interventions for refugees and asylum seekers with PTSD
Authors: Turrini Giulia , Tedeschi Federico , Cuijpers Pim , Del Giovane Cinzia , Kip Ahlke , Morina Nexhmedin , Nosè Michela , Ostuzzi Giovanni , Purgato Marianna , Ricciardi Chiara , Sijbrandij Marit , Tol Wietse , Barbui Corrado 
Published: June 2021

IntroductionRefugees and asylum seekers are vulnerable to common mental disorders, including post-traumatic stress disorder (PTSD). Using a network meta-analysis (NMA) approach, the present systematic review compared and ranked psychosocial interventions for the treatment of PTSD in adult refugees and asylum seekers.MethodsRandomised studies of psychosocial interventions for adult refugees and asylum seekers with PTSD were systematically identified. PTSD symptoms at postintervention was the primary outcome. Standardised mean differences (SMDs) and ORs were pooled using pairwise and NMA. Study quality was assessed with the Cochrane Risk of Bias (RoB) tool, and certainty of evidence was assessed through the Confidence in Network Meta-Analysis application.ResultsA total of 23 studies with 2308 participants were included. Sixteen studies were conducted in high-income countries, and seven in low-income or middle-income countries. Most studies were at low risk of bias according to the Cochrane RoB tool. NMA on PTSD symptoms showed that cognitive behavioural therapy (CBT) (SMD=−1.41; 95% CI −2.43 to −0.38) and eye movement desensitisation and reprocessing (EMDR) (SMD=−1.30; 95% CI −2.40 to −0.20) were significantly more effective than waitlist (WL). CBT was also associated with a higher decrease in PTSD symptoms than treatment as usual (TAU) (SMD −1.51; 95% CI −2.67 to −0.36). For all other interventions, the difference with WL and TAU was not significant. CBT and EMDR ranked best according to the mean surface under the cumulative ranking. Regarding acceptability, no intervention had less dropouts than inactive interventions.ConclusionCBT and EMDR appeared to have the greatest effects in reducing PTSD symptoms in asylum seekers and refugees. This evidence should be considered in guidelines and implementation packages to facilitate dissemination and uptake in refugee settings.
Reliability of parental assessment of auditory skills in young children: a cross-sectional study in Italian language
Authors: Orzan Eva , Battelino Saba , Ciciriello Elena , Bonifacio Serena , Pellizzoni Sandra , Saksida Amanda 
Published: June 2021

ObjectiveHearing impairments (HIs) that progress or have later onset may have specific effects on language and cognitive development, but are difficult to suspect during routine primary care visits. Family concern regarding hearing is thought to represent an important risk factor requiring audiological examination. Yet it is not clear how successful parents are in recognising the consequences or specific suspect elements of HI in young children. The aim of this study is to verify whether parents of at-risk children recognise the presence of HI through a parental questionnaire that draws attention to auditory skills development and compares them with language and communication skills.DesignObservational study.SettingFrom 2013 to 2019, parents were administered the Questionnaire on Hearing and Communication Abilities before audiological evaluation of their children at a secondary care institute.Participants309 Italian children (1–36 months old) at risk of HI.Primary and secondary outcome measuresQuestionnaire sensitivity in predicting the presence and type of HI.ResultsParents report a decrease in auditory skills for children with sensorineural HI (Χ2(2)=14.4, p=0.003), with an increased concern expressed in 59% compared with 24% in normally hearing children. Both auditory (r=−0.18, p=0.002) and comprehension (r=−0.13, p=0.057) skills weakly but negatively correlated with a diagnosis of HI. On discriminant analysis, the positive predictive value of the questionnaire was 0.78, but with low sensitivity (0.39).ConclusionsParents of children with a verified risk of HI have some capacity to recognise non-typical auditory behaviour. Thus, it is important to assess parental concerns during primary care health visits, and a targeted questionnaire on auditory abilities can complement existing screening procedures. However, given the low sensitivity of the questionnaire, we conclude that for a reliable detection of HIs that progress or have later onset an objective screening tool is always required.
Acute sore throat and Fusobacterium necrophorum in primary healthcare: a systematic review and meta-analysis
Authors: Malmberg Stefan , Petrén Susanna , Gunnarsson Ronny , Hedin Katarina , Sundvall Pär-Daniel 
Published: June 2021

PurposeThe main objective of this review was to describe and quantify the association between Fusobacterium necrophorum (FN) and acute sore throat in primary healthcare (PHC).MethodsIn this systematic review and meta-analysis, we searched Scopus and PubMed for case–control studies reporting the prevalence of FN in patients attending primary care for an uncomplicated acute sore throat as well as in healthy controls. Only studies published in English were considered. Publications were not included if they were case studies, or if they included patients prescribed antibiotics before the throat swab, patients with a concurrent malignant disease, on immunosuppression, having an HIV infection, or patients having another acute infection in addition to a sore throat. Inclusion criteria and methods were specified in advance and published in PROSPERO. The primary outcome was positive etiologic predictive value (P-EPV), quantifying the probability for an association between acute sore throat and findings of FN in the pharynx. For comparison, our secondary outcome was the corresponding P-EPV for group A Streptococcus (GAS).ResultsPubMed and Scopus yielded 258 and 232 studies, respectively. Removing duplicates and screening the abstracts resulted in 53 studies subsequently read in full text. For the four studies of medium to high quality included in the meta-analysis, the cumulative P-EPV regarding FN was 64% (95% CI 33% to 83%). GAS, based on data from the same publications and patients, yielded a positive EPV of 93% (95% CI 83% to 99%).ConclusionsThe results indicate that FN may play a role in PHC patients with an acute sore throat, but the association is much weaker compared with GAS.
Prospective observational cohort study on epidemiology, treatment and outcome of patients with traumatic brain injury (TBI) in German BG hospitals
Authors: Schwenkreis Peter , Gonschorek Andreas , Berg Florian , Meier Ullrich , Rogge Witold , Schmehl Ingo , Kern Bodo Christian , Meisel Hans-Jörg , Wohlfarth Kai , Gross Stefan , Sczesny-Kaiser Matthias , Tegenthoff Martin , Boschert Jürgen , Bruckmoser Ralf , Fürst Andrea , Schaan Marc , Strowitzki Martin , Pingel Andreas , Jägers Lisa Linnea , Rudolf Henrik , Trampisch Hans-Joachim , Lemcke Johannes 
Published: June 2021

ObjectivesSince 2000/2001, no large-scale prospective studies addressing traumatic brain injury (TBI) epidemiology in Germany have been published. Our aim was to look for a possible shift in TBI epidemiology described in other European countries, to look for possible changes in TBI management and to identify predictors of 1-year outcome especially in patients with mild TBI.DesignObservational cohort study.SettingAll patients suffering from a TBI of any degree between 1 October 2014 and 30 September 2015, and who arrived in one of the seven participating BG hospitals within 24 hours after trauma, were included.ParticipantsIn total, 3514 patients were included.Outcome measuresInitial care, acute hospital care and rehabilitation were documented using standardised documentation forms. A standardised telephone interview was conducted 3 and 12 months after TBI in order to obtain information on outcome.ResultsPeaks were identified in males in the early 20s and mid-50s, and in both sexes in the late 70s, with 25% of all patients aged 75 or older. A fall was the most frequent cause of TBI, followed by traffic accidents (especially bicyclists). The number of head CT scans increased, and the number of conventional X-rays of the skull decreased compared with 2000/2001. Besides, more patients were offered rehabilitation than before. Though most TBI were classified as mild, one-third of the patients participating in the telephone interview after 12 months still reported troubles attributed to TBI. Negative predictors in mild TBI were female gender, intracranial bleeding and Glasgow Coma Scale (GCS) 13/14.ConclusionThe observed epidemiologic shift in TBI (ie, elderly patients, more falls, more bicyclists) calls for targeted preventive measures. The heterogeneity behind the diagnosis ‘mild TBI’ emphasises the need for defining subgroups not only based on GCS.
Spiritual distress: symptoms, quality of life and hospital utilisation in home-based palliative care
Authors: Cipta Andre , Turner Bethany , Haupt Eric C , Werch Henry , Reinke Lynn , Mularski Richard A , Nguyen Huong Q 
Published: June 2021

ObjectivesThe purpose of this study was to use a spiritual screening question to quantify the prevalence of spiritual distress (SD) in a large cohort of seriously ill patients at admission to home-based palliative care (HBPC) and to examine the associations between SD with symptom burden, quality of life and hospital-based utilisation up to 6 months after admission to HBPC.MethodsData for this cohort study (n=658) were drawn from a pragmatic comparative-effectiveness trial testing two models of HBPC. At admission to HBPC, SD was measured using a global question (0–10-point scale: none=0; mild=1–4; moderate-to-severe=5+); symptoms and quality of life were measured with the Edmonton Symptom Assessment Scale (ESAS) and PROMIS-10. Hospital utilisation was captured using electronic records and claims. Median regression and proportional hazard competing risk models assessed the association between SD with symptoms and quality of life, and hospital utilisation, respectively.ResultsNearly half of the patients/proxies reported some level of SD. Increasing SD was significantly associated with higher symptom burden (increase of 7–14 points on ESAS) and worse mental well-being (decrease of 2.7 to 4.6 points on PROMIS-10-mental) in adjusted models. Compared with patients/proxies who reported no SD, those with at least some level of SD were not at increased risk for hospital-based utilisation over a median follow-up period of 2 months.ConclusionWhile SD is cross-sectionally associated with worse symptoms and mental well-being, it did not predict downstream hospital-based utilisation. Our results highlight the importance of assessing for and managing SD in patients with serious illness.
Simulated airway drills as a tool to measure and guide improvements in endotracheal intubation preparation in the paediatric emergency department
Authors: Wong Kei U , Gross Isabel , Emerson Beth L , Goldman Michael P 
Published: June 2021

IntroductionEmergent paediatric intubation is an infrequent but high-stakes procedure in the paediatric emergency department (PED). Successful intubations depend on efficient and accurate preparation. The aim of this study was to use airway drills (brief in-situ simulations) to identify gaps in our paediatric endotracheal intubation preparation process, to improve on our process and to demonstrate sustainability of these improvements over time in a new staff cohort.MethodThis was a single-centre, simulation-based improvement study. Baseline simulated airway drills were used to identify barriers in our airway preparation process. Drills were scored for time and accuracy on an iteratively developed 16-item rubric. Interventions were identified and their impact was measured using simulated airway drills. Statistical analysis was performed using unpaired t-tests between the three data collection periods.ResultsTwenty-five simulated airway drills identified gaps in our airway preparation process and served as our baseline performance. The main problem identified was that staff members had difficulty locating essential airway equipment. Therefore, we optimised and implemented a weight-based airway cart. We demonstrated significant improvement and sustainability in the accuracy of obtaining essential airway equipment from baseline to postintervention (62% vs 74%; p=0.014), and postintervention to sustainability periods (74% vs 77%; p=0.573). Similarly, we decreased and sustained the time (in seconds) required to prepare for a paediatric intubation from baseline to postintervention (173 vs 109; p=0.001) and postintervention to sustainability (109 vs 103; p=0.576).ConclusionsSimulated airway drills can be used as a tool to identify process gaps, measure and improve paediatric intubation readiness.
Upper arm length along with mid-upper arm circumference to enhance wasting prevalence estimation and diagnosis: sensitivity and specificity in 6–59-months-old children
Authors: Barro Mouhamed , Baro Mohamed Daouda , Cisse Djibril , Zagre Noel , Ba Thierno , Neff Baro Shanti , Diagana Yacouba 
Published: June 2021

ObjectiveTo evaluate the added value of the use of upper arm length (UAL) along with mid-upper arm circumference (MUAC) to diagnose and estimate the prevalence of wasting in comparison to current WHO standard and other MUAC-based methods.DesignUAL and usual anthropometric measurements were collected during a national cross-sectional nutritional survey. Children were classified into three upper arm length groups (UALGs): UALG1, UALG2 and UALG3 according to the following UAL limits: ≤150, 151–180 and ≥181 mm, respectively. Receiver operating characteristic curves were used to determine the best MUAC cut-off for each group using weight-for-height Z-score (WHZ) as a reference standard. Wasting prevalence, sensitivity and specificity of all diagnostic methods were compared.SettingThis study was conducted in Mauritania.ParticipantsNational representative sample of children from 6 to 59 months old.ResultsIn total, 12 590 children were included in the study. Wasting prevalence was 16.1%, 5.0% and 12.5% when diagnosed by WHZ <−2, MUAC <125 mm and MUAC–UALG methods, respectively. Using the MUAC–UALG method increased the sensitivity for wasting diagnosis from 17.98% with MUAC <125 mm to 39.43% with MUAC–UALG. The specificity decreased from 97.49% with MUAC <125 mm to 92.71% with MUAC–UALG. With MUAC–height Z score and MUAC <138 mm, sensitivity was 26.04% and 69.76% and specificity were 97.40% and 75.64% respectively.ConclusionThis alternative method using MUAC tape to measure UAL increases the wasting diagnosis accuracy and allows for a better estimation of wasting prevalence. This method could be used as a potential alternative method for quick surveys in emergency settings such as Corona virus disease 2019 context.
Electrocardiographic biomarkers to predict atrial fibrillation in sinus rhythm electrocardiograms
Authors: Sanz-García Ancor , Cecconi Alberto , Vera Alberto , Camarasaltas Juan Miguel , Alfonso Fernando , Ortega Guillermo Jose , Jimenez-Borreguero Jesus 
Published: June 2021

ObjectiveEarly prediction of atrial fibrillation (AF) development would improve patient outcomes. We propose a simple and cheap ECG based score to predict AF development.MethodsA cohort of 16 316 patients was analysed. ECG measures provided by the computer-assisted ECG software were used to identify patients. A first group included patients in sinus rhythm who showed an ECG with AF at any time later (n=505). A second group included patients with all their ECGs in sinus rhythm (n=15 811). By using a training set (75% of the cohort) the initial sinus rhythm ECGs of both groups were analysed and a predictive risk score based on a multivariate logistic model was constructed.ResultsA multivariate regression model was constructed with 32 variables showing a predictive value characterised by an area under the curve (AUC) of 0.776 (95% CI: 0.738 to 0.814). The subsequent risk score included the following variables: age, duration of P-wave in aVF, V4 and V5; duration of T-wave in V3, mean QT interval adjusted for heart rate, transverse P-wave clockwise rotation, transverse P-wave terminal angle and transverse QRS complex terminal vector magnitude. Risk score values ranged from 0 (no risk) to 5 (high risk). The predictive validity of the score reached an AUC of 0.764 (95% CI: 0.722 to 0.806) with a global specificity of 61% and a sensitivity of 55%.ConclusionsThe automatic assessment of ECG biomarkers from ECGs in sinus rhythm is able to predict the risk for AF providing a low-cost screening strategy for early detection of this pathology.
Prospective real-world study on the pharmacokinetics of pembrolizumab in patients with solid tumors
Authors: Hurkmans Daan P. , Sassen Sebastiaan D.T. , de Joode Karlijn , Putter Lisanne , Basak Edwin A. , Wijkhuijs Annemarie J.M. , Joerger Markus , Debets Reno , Koch Birgit C.P. , Van der Leest Cor H. , Schreurs Marco W.J. , van der Veldt Astrid A.M. , Aerts Joachim G.J.V. , Mathijssen Ron H.J. , Koolen Stijn L.W. 
Published: June 2021

BackgroundDosing schemes of pembrolizumab (anti-programmed cell death protein 1 monoclonal antibody) are solely based on pharmacokinetic (PK) modelling derived from phase I–III trials. The current study aimed to determine factors affecting PK and its relationship with clinical outcome in the real-world setting.MethodsAdvanced-stage cancer patients, who were treated with pembrolizumab monotherapy (2 mg/kg Q3W or 200 mg flat Q3W), were prospectively included for serial sampling to obtain trough concentrations. A PK model was generated, covariate effects assessed and internally validated by a bootstrap procedure. PK parameters were related to overall survival (OS) and the occurrence of immune-related adverse events (irAEs).Results588 serum samples derived from 122 patients with (non-)small-cell lung cancer ([N]SCLC), malignant pleural mesothelioma (MPM), melanoma and urothelial cell cancer (UCC) were analyzed. Median follow-up was 2.2 years. A one-compartment PK model was generated: body surface area (BSA) and serum albumin had a significant effect on drug clearance (CL; covariate estimate 1.46 and −1.43, respectively), and serum lactate dehydrogenase (LDH) on the distribution volume(Vd; 0.34). A significant inverse CL–OS relationship was determined for NSCLC (HR:1.69; 95%CI1.07–2.68; p=0.024) and MPM (HR: 3.29; 95% CI 1.08 to 10.09; p=0.037), after correction for prognostic factors, which could not confirmed for melanoma (p=0.22) or UCC (p=0.34). No relationship could be determined between CL and grade>3 irAEs (p=0.70).ConclusionsHigh interpatient variability of pembrolizumab PK is determined by BSA and serum albumin (on CL) and LDH (on Vd). A strong inverse CL–OS relationship was demonstrated for NSCLC and MPM, which could not be observed for melanoma and UCC. The findings suggest that personalized dosing should be prospectively explored.