bluuebunny/crossref_metadata_2025_split huggingface dataset:
CD8+ T‐cell predominance in autoimmune glial fibrillary acidic protein astrocytopathy
Authors: Yuan Zhongmin , Li Huilu , Huang Lu , Fu Congcong , Chen Yaotang , Zhi Cheng , Qiu Wei , Long Youming 
Published: February 2021

AbstractBackground and objectiveWe aimed to report the pathological features of T lymphocytes in autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy (GFAP‐A).MethodsA retrospective pathological analysis of patients with GFAP‐A was performed.ResultsEight patients with GFAP‐immunoglobulin G (IgG) and pathological data were included. Their biopsy findings were similar, and all showed marked lymphocytic infiltration in the white matter, with perivascular predominance. The lymphocytic infiltration was predominantly composed of CD8+ T lymphocytes rather than CD4+ T lymphocytes, except in one patient who had overlapping positive myelin oligodendrocyte glycoprotein‐IgG. Unlike CD4+ T cells, CD8+ T cells were frequently observed adjacent to dystrophic neurons and astrocytes. There was also diffuse infiltration by CD68+ and CD163+ macrophages. CD8+ astrocytes were identified in two samples, but no CD4+ astrocytes were observed.ConclusionsA predominance of CD8+ T cells may be an important pathological and diagnostic feature in GFAP‐A.
Nursing interventions for pressure injury prevention among critically ill patients: A systematic review
Authors: Alshahrani Bassam , Sim Jenny , Middleton Rebekkah 
Published: February 2021

AbstractAimTo systemically synthesise the evidence on the most effective nursing interventions to prevent pressure injuries among critical care patients.BackgroundAlthough pressure injury (PI) prevention is a focus of nursing care in critical care units, hospital‐acquired pressure injuries continue to occur in these settings.DesignA systematic review of literature guided by the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) and Synthesis without meta‐analysis (SWiM) guidelines.MethodsFour electronic databases were searched for relevant studies. Included studies were screened and then critically appraised using the appropriate Joanna Briggs Institute appraisal tool. Data were analysed and reported using a narrative synthesis.ResultsThe review included 14 studies. Randomised controlled trials, quasi‐experimental, case series and cross‐sectional studies were included. The review identified four broad categories of interventions that are the most effective for preventing pressure injuries: (a) PI prevention bundles, (b) repositioning and the use of surface support, (c) prevention of medical device‐related pressure injuries and (d) access to expertise. All the included studies reported a reduction in pressure injuries following the interventions; however, the strength of the evidence was rated from moderate to very low.ConclusionsNurses are well qualified to lead in the prevention of pressure injuries in critical care units. Every critically ill patient requires interventions to prevent pressure injuries, and the prevention of PIs should be considered a complex intervention. Nurses must plan and implement evidence‐based care to prevent all types of pressure injuries, including medical device‐related pressure injuries. Education and training programmes for nurses on PI prevention are important for prevention of pressure injuries.Relevance to clinical practiceNursing interventions should consist of evidence‐based ‘bundles’ and be adapted to patients’ needs. To prevent pressure injuries among critically ill patients, nurses must be competent and highly educated and ensure fundamental strategies are routinely implemented to improve mobility and offload pressure.
The value of information and support; Experiences among patients with prostate cancer
Authors: Aunan Siv Tove , Wallgren Gry Ciekals , Hansen Britt Sætre 
Published: February 2021

AbstractAims and objectivesTo explore and analyse prostate cancer survivors` experiences and critical reflections of information received during their cancer trajectory.BackgroundProstate cancer is one of the most prevalent cancers in men worldwide. Treatment causes side effects such as urinary incontinence, bowel changes and erection problems influencing sex life and manhood. Cancer pathways are designed to give patients and their relatives a predictable and as stress‐free as possible treatment trajectory and minimise waiting time.DesignQualitative, explorative research design.MethodsFocus groups with 16 prostate cancer survivors after having participated in an educational programme. The COREQ checklist was followed to ensure rigour in the study.ResultsThe main theme, ‘Help me stay in control’, and three subthemes, ‘To be met with interest and support, enough knowledge to understand what is happening and a plan to build the new life on’, emerged from qualitative analysis and highlighted the participants’ need for information and support, specially scheduled at critical times in the treatment trajectory: the diagnostic phase, the treatment phase and the life after treatment. They also highlighted the need for empathy and interest from healthcare professionals and highlighted the need for arenas to discuss vulnerable topics. Contact with peers was perceived as supportive and encouraging.ConclusionHealthcare professionals must support prostate cancer survivors with empathy, interest and information tailored to their needs in three different phases. Continuity in information flow may increase trust and satisfaction among the prostate cancer survivors.Relevance to clinical practicePCa patients’ need for information varied at critical times in their treatment trajectory. HCP should meet them with empathy and interest to be able to tailor their need for information and support.
Prevalence of NAFLD, MAFLD and associated advanced fibrosis in the contemporary United States population
Authors: Ciardullo Stefano , Perseghin Gianluca 
Published: February 2021

AbstractData are limited on the epidemiological implications of the recent change in terminology from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction‐associated fatty liver disease (MAFLD). We therefore performed a cross‐sectional study of adults recruited in the 2017‐2018 National Health and Nutrition Examination Survey, a representative sample of the general US population. The prevalence of NAFLD and MAFLD based on controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) obtained through vibration‐controlled transient elastography (VCTE) were 37.1% (95% CI 34.0‐40.4) and 39.1% (95% CI 36.3‐42.1), respectively, with higher rates among Hispanic individuals. Agreement between the two definitions was high (Cohen's κ 0.92). Patients with NAFLD and MAFLD also showed similar risk of advanced liver fibrosis (7.5% and 7.4% respectively). Our results suggest that the recent change in diagnostic criteria did not affect the prevalence of the condition in the general United States population.
With a frown or a smile: How leader affective states spark the leader‐follower reciprocal exchange process
Authors: Bartels Amy L. , Nahrgang Jennifer D. , Sessions Hudson , Wilson Kelly Schwind , Wu Lusi , Law‐Penrose Jared 
Published: February 2021

AbstractDespite evidence that affect shapes perceptions of workplace relationships, the role of affect in the reciprocal exchange process of leader–member exchange (LMX) theory is often overlooked. We argue that this is likely due to a continued focus on global assessments of LMX quality, rather than examination of the reciprocal, interlocked actions and reactions that take place daily between members of the dyad. A leader's affective state may indeed spark this reciprocal exchange process on a daily level and ultimately shape the state of the leader–follower relationship. In this study, we integrate LMX theory and emotions‐as‐social‐information (EASI) theory to examine how the leader's negative and positive affective states uniquely contribute to the reciprocal exchange process. In doing so, we advance understanding of the distinction of state LMX as well as the unique process for leader's negative affective state within the reciprocal exchange process. Using a 15‐day experience sampling methodology study of 76 leader–follower dyads, we find that a leader's positive and negative affective states transmit effects along the affective and inferential paths posited in EASI theory to influence follower performance on a daily basis. Interestingly, a leader's positive affective state is stronger along the affective path and a leader's negative affective state is stronger along the inferential path. We also find that leaders reciprocate the daily shift in follower performance with OCBI directed toward the follower. Finally, as expected, the reciprocal exchange process alters state LMX (leader rated).
A Need to Revise Human Exposure Limits for Ultraviolet UV‐C Radiation†
Authors: Sliney David H. , Stuck Bruce E. 
Published: February 2021

AbstractThe COVID‐19 pandemic has greatly heightened interest in ultraviolet germicidal irradiation (UVGI) as an important intervention strategy to disinfect air in medical treatment facilities and public indoor spaces. However, a major drawback of UVGI is the challenge posed by assuring safe installation of potentially hazardous short‐wavelength (UV‐C) ultraviolet lamps. Questions have arisen regarding what appear to be unusually conservative exposure limit values in the UV‐C spectral band between 180 and 280 nm. We review the bases for the current limits and proposes some adjustments that would provide separate limits for the eye and the skin at wavelengths less than 300 nm and to increase both skin and eye limits in the UV‐C below 250 nm.
Defining Cyber Security and Cyber Security Risk within a Multidisciplinary Context using Expert Elicitation
Authors: Cains Mariana G. , Flora Liberty , Taber Danica , King Zoe , Henshel Diane S. 
Published: February 2021

AbstractIt is important to have and use standardized terminology and develop a comprehensive common understanding of what is meant by cyber security and cyber security risk given the multidisciplinary nature of cyber security and the pervasiveness of cyber security concerns throughout society. Using expert elicitation methods, collaborating cyber researchers from multiple disciplines and two sectors (academia, government–military) were individually interviewed and asked to define cyber security and cyber security risk. Data‐driven thematic analysis was used to identify the most salient themes within each definition, sector, and cyber expert group as a whole with results compared to current standards definitions. Network analysis was employed to visualize the interconnection of salient themes within and across sectors and disciplines. When examined as a whole group, “context‐driven,” “resilient system functionality,” and “maintenance of CIA (confidentiality, integrity, availability)” were the most salient themes and influential network nodes for the definition of cyber security, while “impacts of CIA vulnerabilities,” “probabilities of outcomes,” and “context‐driven” were the most salient themes for cyber security risk. We used this expert elicitation process to develop comprehensive definitions of cyber security (cybersecurity) and cyber security risk that encompass the contextual frameworks of all the disciplines represented in the collaboration and explicitly incorporates human factors as significant cyber security risk factors.
Clinical characteristics and predictors of mortality in patients with melioidosis: the Kapit experience
Authors: Toh Valerie , Tee Sui Poh , Lee Shen‐Han 
Published: February 2021

AbstractObjectivesMelioidosis, caused by Burkholderia pseudomallei, is prevalent in rural areas of Malaysia. The aim of this study is to delineate the epidemiology and predictors of mortality from melioidosis in Kapit district, Sarawak.MethodsFor this retrospective study of patients with culture‐confirmed melioidosis admitted to Kapit Hospital, Sarawak, Malaysia, between July 2016 and July 2019, epidemiological, clinical and microbiological data were obtained. Univariate and multivariate logistic regression analyses were used to determine predictors of mortality.ResultsSeventy three patients met inclusion criteria. Diabetes mellitus (28.8%) and hypertension (27.4%) were primary co‐morbidities. Clinical spectrum of melioidosis ranged from bacteraemia (64.4%), pneumonia (61.6%) and internal organ abscesses (49.3%) to localised soft tissue (21.9%) and joint abscesses (6.9%). Mortality rate was 12.3%. Bacteraemia and pneumonia were significantly associated with septic shock, whereas patients with soft tissue abscesses tended to present with a milder form of melioidosis without septic shock. Septic shock, mechanical ventilation, intensive care unit admission, serum urea, creatinine, bicarbonate, albumin and aspartate transaminase were all significantly associated with increased mortality on univariate analysis (all P < 0.05). Multivariate analysis revealed that low serum bicarbonate (P = 0.004, OR 0.64, 95% CI 0.48‐0.87) and albumin (P = 0.031, OR 0.73, 95% CI 0.54–0.97) could be associated with a higher mortality.ConclusionMelioidosis remains a fatal infection and commonly presents with septic shock, in the form of bacteraemia and pneumonia. Two routine clinical parameters, serum bicarbonate and serum albumin, may have important prognostic implications in septicaemic melioidosis.
On the Basis for Stumble Recovery Strategy Selection in Healthy Adults
Authors: Eveld Maura E. , King Shane T. , Vailati Leo G. , Zelik Karl E. , Goldfarb Michael 
Published: February 2021

Abstract
Healthy adults employ one of three primary strategies to recover from stumble perturbations—elevating, lowering, or delayed lowering. The basis upon which each recovery strategy is selected is not known. Though strategy selection is often associated with swing percentage at which the perturbation occurs, swing percentage does not fully predict strategy selection; it is not a physical quantity; and it is not strictly a real-time measurement. The objective of this work is to better describe the basis of strategy selection in healthy individuals during stumble events, and in particular to identify a set of real-time measurable, physical quantities that better predict stumble recovery strategy selection, relative to swing percentage. To do this, data from a prior seven-participant stumble experiment were reanalyzed. A set of biomechanical measurements at/after the perturbation were taken and considered in a two-stage classification structure to find the set of measurements (i.e., features) that best explained the strategy selection process. For Stage 1 (decision between initially elevating or lowering of the leg), the proposed model correctly predicted 99.0% of the strategies used, compared to 93.6% with swing percentage. For Stage 2 (decision between elevating or delayed lowering of the leg), the model correctly predicted 94.0% of the strategies used, compared to 85.6% with swing percentage. This model uses dynamic factors of the human body to predict strategy with substantially improved accuracy relative to swing percentage, giving potential insight into human physiology as well as potentially better informing the design of fall-prevention interventions.
Micro Solder Joint Reliability and Warpage Investigations of Extremely Thin Double-Layered Stacked-Chip Packaging
Authors: Lee Chang-Chun , Kao Kuo-Shu , Liu Hou-Chun , Hsieh Chia-Ping , Chang Tao-Chih 
Published: February 2021

Abstract
To overcome the limited operational speed for nanoscaled transistors, scaling electronic devices to small and thin packaging and high-density arrangements have become the technological mainstream in designing versatile packaging architectures. Among these, a promising candidate is a three-dimensional integrated circuit (3D-IC) package due to its excellent capability of heterogeneous integration. However, sequential reliability is a troublesome concern given the complex packaging structure, especially for the assembly of microsolder joints. To address this issue, we propose a double-layered, thin stacked chip package under the application of temperature cycling load. The packaging warpage and creep impact of SnAg microsolder joints on their fatigue lifespan are examined separately. Nonlinear material/geometry finite element analysis (FEA) is used on important designed factors, including the elastic modulus of underfill, chip thickness, and the radius and pitch of through silicon via (TSV). The simulated results indicate that the best fatigue lifetime of SnAg microsolder joint can be achieved at 10 μm of each chip thickness, 230 μm and 5 μm for TSV pitch and radius within the examined designed extent. Moreover, a hard underfill material requires consideration when the mounted chips thicken. Consequently, reliability significantly improves by dispersing thermomechanical stress/strain of the SnAg microjoints to neighboring underfill and related packaging components, especially for large TSV array spacing.
Custom Three-Dimensional-Printed CPAP Mask Development, Preliminary Comfort and Fit Evaluation
Authors: Ma Zhichao , Hyde Philip , Drinnan Michael , Munguia Javier 
Published: February 2021

Abstract
Obstructive sleep apnea (OSA) is an acute breathing disorder, which causes soft tissue inside the throat to collapse, thus blocking the airways while sleeping. This syndrome is usually treated by the supply of pressurized air delivered by a pump, which is connected to the patient via mouth and/or nose using a mask as an interface. While most of the literature on OSA is focused on the pressure pump and the therapy conditions (pressure, humidity, velocity, etc.) there has been an increased interest in the mask/interface as a key contributing factor to the treatment's effectiveness. Mask-related issues such as skin damage, allergic reactions, or air leaking due to poor fit can deter OSA patients from following this treatment. This study presents a preliminary evaluation of customized mask designs, which are tailored to specific wearer's facial contours. The development process includes the use of three-dimensional scanning/modeling/printing as an integrated workflow. Individual facial features have been digitally acquired and used to generate a custom device, which conforms to predefined facial landmarks of interest, which delimit the mask contour. A trial study was undertaken by recruiting two healthy volunteers for the fit and comfort evaluation of custom mask designs using a randomized fit test with a series of three-dimensional (3D) printed versus commercial standard mask. Results indicate that custom masks exhibit a higher level of comfort compared to conventional continuous positive airway pressure (CPAP) masks particularly on fit, contact pressure and comfort.
Axisymmetric Thermal Stresses of a Piezoelectric Poroelastic Circular Solid Plate
Authors: Abjadi Ali , Jabbari Mohsen , Khorshidvand Ahmad Reza 
Published: February 2021

Abstract
This paper presents the steady-state thermoelasticity solution for a circular solid plate is made of an undrained porous piezoelectric hexagonal material symmetry of class 6 mm. The porosities of the plate vary through the thickness; thus, material properties, except Poisson's ratio, are assumed as exponential functions of axial variable z in cylindrical coordinates. Having axisymmetric general form, external thermal and electrical loads are acted on the plate and the piezothermoelastic behavior of the plate is investigated. Using a full analytical method based on Bessel Fourier's series and separation of variables, the governing partial differential equations are derived. A formulation is given for the displacements, electric potential, thermal stresses, and electric displacements resulting from prescribed the general form of thermal, mechanical, and electric boundary conditions. Finally, the application of the derived formulas is illustrated by an example for a cadmium selenide solid, the results of which are presented graphically. Also, the effects of material property indexes, the porosity, and Skempton coefficients are discussed on the displacements, thermal stresses, electrical potential function, and electric displacements.
Thermal Analysis of a Solar Hybrid Dehydrator Designed for Uniform Multi-Product Drying
Authors: Munir Anjum , Mahmood Farhat , Amjad Waseem , Ahmad Syed Amjad 
Published: February 2021

Abstract
Thermal analysis was performed for a vertical cabinet solar hybrid dryer having a salient feature of the perforated sheet along its entire height to achieve uniform drying. The dryer was integrated with a solar collector and gas burner for a hybrid heating source. Experiments were performed using tomato at 55 °C with solar, gas, and dual (solar-gas) heating sources. Energy analysis showed that rates of energy utilization were found in ranges of 2.7–12.5 kW (dual), 3–13 kW (gas), and 2.9–12 kW (solar), and energy ratios were 13–56% (dual), 14–58% (gas), and 12–50% (solar). Exergy analysis showed that exergy losses were 2.1–5.0 kJ/kg (dual), 2.1–5.3 kJ/kg (gas), and 1.5–4.2 kJ/kg (solar) while exergy efficiencies found 33–70% (dual), 30–75% (gas), and 20–69% (solar). Based on higher values of exergetic factor and improvement potential rate (IP), it was found that optimization of heating source especially those consisting solar collector and heat exchanger (IP 1.93 kW) is required. The specific energies for the removal of product moisture and to dry the product were found 2.42, 2.72, 2.58 MJ/kg of water and 18.8, 21.2, 20.15 MJ/kg dried product for drying processes conducted under solar, gas, and dual (solar-gas) heating sources, respectively. For design optimization, a complete algorithm has been prepared for complete drying systems in terms of available energy and losses.
Analysis of Thermal Creep Effects on Fluid Flow and Heat Transfer in a Microchannel Gas Heating
Authors: Ramadan K. M. , Kamil Mohammed , Tlili I. , Qisieh O. 
Published: February 2021

Abstract
Thermal creep effects on fluid flow and heat transfer in a microchannel gas flow at low velocities are studied numerically. The continuity and Navier–Stokes equations in vorticity–stream function form, coupled with the energy equation, are solved, considering the thermal creep effect due to the longitudinal temperature gradient along the channel wall in addition to the combined effects of viscous dissipation, pressure work, axial conduction, shear work, and nonequilibrium conditions at the gas–wall interface. The governing equations are also solved without thermal creep, and comparisons between the two solutions are presented to evaluate the thermal creep effect on the flow field in the slip flow regime at relatively low Reynolds numbers. The results presented show that the thermal creep effect on both velocity and temperature fields become more significant as the Reynolds number decreases. Thermal creep effect on the velocity field also extends a longer distance downstream the channel as the Reynolds number decreases, hence increasing the hydrodynamics entrance length. Thermal creep can cause high positive velocity gradients at the upper channel wall for gas heating and hence reverse the flow rotation in the fluid layers adjacent to the wall. Thermal creep also results in a higher gas temperature in the developing region and higher heat exchange between the fluid and the channel wall in the entrance region. Thermal creep effect on heat exchange between the gas and the channel wall becomes more significant as the Knudsen number decreases.