bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID‐19 vulnerabilities are intensified by declining human serum albumin levels
Authors: Johnson Andrew S. , Winlow William 
Published: July 2021

What is the topic of this review?
Human serum albumin (HSA) a common factor in COVID‐19 vulnerabilities.

What advances does it highlight?
Understanding of HSA capacity, and systemic vulnerabilities to COVID‐19. Raising HSA in COVID‐19 patients may alleviate systemic injury caused by diminished native HSA binding. A change in fluid therapy administration into the portal system of the liver is proposed to safely raise HSA levels.
AbstractThe specific nature of the vulnerabilities to COVID‐19 are an intrinsic part of COVID‐19 infection in many patients. This paper proposes that vulnerabilities to COVID‐19 may be intensified by a decrease in human serum albumin (HSA) as a ligand carrier for nutrients. A mechanism for COVID‐19 vulnerabilities is evident from consideration of ligand carriers such as HSA as intermediaries. We hypothesise that low levels of pool HSA binding, caused for whatever reason, affect the performance of albumin as a carrier protein reducing the availability of nutrients. Hypoalbuminaemia (low HSA) has been implicated as an indicator of COVID‐19 and long‐COVID‐19. The levels of HSA directly affect the immune system and vulnerabilities to age, diabetes and obesity in COVID‐19. Any slight reduction in available HSA has profound effects on ligand concentrations in the small capillaries where damage occurs in COVID‐19. The clinical implication is that attempts should be made to return HSA to clinical levels to compensate for the additional ligands caused by infection (SARS‐CoV‐2 virions, antibodies and cellular breakdown products). Therapeutic albumin is usually given peripherally, and usual preparations are unbound to ligands, but we suggest that a clinical trial of HSA therapy via the hepatic portal vein should be considered.
Boiling Heat Transfer Characteristics of Rotary Hollow Cylinders With In-Line and Staggered Multiple Arrays of Water Jets
Authors: Jahedi Mohammad , Moshfegh Bahram 
Published: July 2021

Abstract
Transient heat transfer studies of quenching rotary hollow cylinders with in-line and staggered multiple arrays of jets have been carried out experimentally. The study involves three hollow cylinders (Do/d = 12–24) with rotation speed 10–50 rpm, quenched by subcooled water jets (ΔTsub = 50–80 K) with jet flow rate 2.7–10.9 L/min. The increase in area-averaged and maximum heat flux over quenching surface (Af) has been observed in the studied multiple arrays with constant Qtotal compared to previous studies. Investigation of radial temperature distribution at stagnation point of jet reveals that the footprint of configuration of 4-row array is highlighted in radial distances near the outer surface and vanishes further down toward the inner surface. The influence of the main quenching parameters on local average surface heat flux at stagnation point is addressed in all the boiling regimes where the result indicates jet flow rate provides strongest effect in all the boiling regimes. Effectiveness of magnitude of maximum heat flux in the boiling curve for the studied parameters is reported. The result of spatial and temporal heat flux by radial conduction in the solid presents projection depth of cyclic variation of surface heat flux in the radial axis as it disappears near inner surface of hollow cylinder. In addition, correlations are proposed for area-averaged Nusselt number as well as average and maximum local heat flux at stagnation point of jet for the in-line and staggered multiple arrays.
Development and Functional Testing of an Unloading Concept for Knee Osteoarthritis Patients: A Pilot Study
Authors: Stoltze Jonas S. , Pallari Jari , Eskandari Behrokh , Oliveira Anderson S. C. , Pirscoveanu Cristina I. , Rasmussen John , Andersen Michael S. 
Published: July 2021

Abstract
This paper presents a knee brace design that applies an extension moment to unload the muscles in stance phase during gait, and thereby the knee, as alternative to conventional valgus braces for knee osteoarthritis patients. The concept was tested on one healthy subject during normal gait with a prototype, which was designed to activate and deactivate in order to apply the extension moment in the stance phase only and hereby avoid any interference during the swing phase. Electromyography measurements and musculoskeletal models were used to evaluate the brace effects on muscle activation and knee compressive forces, respectively. Simulations predicted an ideal reduction of up to 36%, whereas experimental tests revealed a reduction of up to 24% with the current prototype. The prototype brace also reduced the knee joint force impulse up to 9% and electromyography (EMG) peak signal of the vasti muscles with up to 19%. Due to these reductions on a healthy subject, this bracing approach seems promising for reducing knee loads during normal gait. However, further clinical experiments on knee osteoarthritis patients are required to evaluate the effect on both pain and disease progression.
Mental Health in Times of the COVID-19 Pandemic: Exploring the Impact on Well-Being Across the Athlete-Collegiate Career
Authors: Schary David P. , Lundqvist Carolina 
Published: July 2021

In reaction to the COVID-19 pandemic, restrictive policies altered student-athletes’ academic and athletic life. Sparse research has investigated the pandemic’s effect on student-athlete mental health in terms of both negative (e.g., depression, anxiety) and positive (e.g., well-being, quality of life) dimensions. This study explored the effect of the COVID-19 pandemic on well-being and quality of life among National Collegiate Athletic Association Division I student-athletes at different stages of their collegiate career. Ninety-nine student-athletes (Mage = 19.7 years, SD = 1.5) completed assessments on their mental health. Regression analysis revealed experiences directly related to COVID-19 did not affect general well-being or quality of life, but anxiety, depression, and significant insomnia did. Social well-being was lower for student-athletes closer to graduation (e.g., juniors, seniors), independent of reported anxiety and depression levels. These findings highlight the importance of psychosocial support, particularly in times of crisis, and indicate that tailored support might be beneficial at later stages of the collegiate years.
Improving triage for children with comorbidity using the ED-PEWS: an observational study
Authors: Zachariasse Joany M , Espina Pinky Rose , Borensztajn Dorine M , Nieboer Daan , Maconochie Ian K , Steyerberg Ewout W , van der Lei Johan , Greber-Platzer Susanne , Moll Henriette A 
Published: July 2021

ObjectiveTo assess the value of the Emergency Department–Pediatric Early Warning Score (ED-PEWS) for triage of children with comorbidity.DesignSecondary analysis of a prospective cohort.Setting and patients53 829 consecutive ED visits of children <16 years in three European hospitals (Netherlands, UK and Austria) participating in the TrIAGE (Triage Improvements Across General Emergency departments) project in different periods (2012–2015).InterventionED-PEWS, a score consisting of age and six physiological parameters.Main outcome measureA three-category reference standard as proxy for true patient urgency. We assessed discrimination and calibration of the ED-PEWS for children with comorbidity (complex and non-complex) and without comorbidity. In addition, we evaluated the value of adding the ED-PEWS to the routinely used Manchester Triage System (MTS).Results5053 (9%) children had underlying non-complex morbidity and 5537 (10%) had complex comorbidity. The c-statistic for identification of high-urgency patients was 0.86 (95% prediction interval 0.84–0.88) for children without comorbidity, 0.87 (0.82–0.92) for non-complex and 0.86 (0.84–0.88) for complex comorbidity. For high and intermediate urgency, the c-statistic was 0.63 (0.62–0.63), 0.63 (0.61–0.65) and 0.63 (0.55–0.73) respectively. Sensitivity was slightly higher for children with comorbidity (0.73–0.75 vs 0.70) at the cost of a lower specificity (0.86–0.87 vs 0.92). Calibration was largely similar. Adding the ED-PEWS to the MTS for children with comorbidity improved performance, except in the setting with few high-urgency patients.ConclusionsThe ED-PEWS has a similar performance in children with and without comorbidity. Adding the ED-PEWS to the MTS for children with comorbidity improves triage, except in the setting with few high-urgency patients.
Peer mentorship to improve self-management of hip and knee osteoarthritis: a randomised feasibility trial
Authors: Anderson Anna M , Lavender Elizabeth C , Dusabe-Richards Esther , Mebrahtu Teumzghi F , McGowan Linda , Conaghan Philip G , Kingsbury Sarah R , Richardson Gerry , Antcliff Deborah , McHugh Gretl A 
Published: July 2021

ObjectiveTo determine the feasibility of conducting a randomised controlled trial (RCT) of a peer mentorship intervention to improve self-management of osteoarthritis (OA).DesignSix-month parallel group non-blinded randomised feasibility trial.SettingOne secondary care and one primary care UK National Health Service Trust.ParticipantsFifty adults aged ≥55 years old with hip and/or knee OA.InterventionsParticipants were allocated 1:1 to the intervention or control group using an online randomisation service. Intervention group participants received usual care (information resources) and up to eight community-based self-management support sessions delivered by a peer mentor (trained volunteer with hip and/or knee OA). Control group participants received usual care only.Outcome measuresKey feasibility outcomes were participant and peer mentor recruitment and attrition, intervention completion and the sample size required for a definitive RCT. Based on these feasibility outcomes, four success criteria for proceeding to a definitive RCT were prespecified. Patient-reported outcomes were collected via questionnaires at baseline, 8 weeks and 6 months.ResultsNinety-six individuals were screened, 65 were eligible and 50 were randomised (25 per group). Of the 24 participants who commenced the intervention, 20 completed it. Four participants did not complete the 6-month questionnaire. Twenty-one individuals were eligible for the peer mentor role, 15 were trained and 5 withdrew prior to being matched with a participant. No intervention-related harms occurred. Allowing for 20% attrition, the sample size required for a definitive RCT was calculated as 170 participants. The intervention group showed improvements in self-management compared with the control group.ConclusionsThe feasibility outcomes achieved the prespecified criteria for proceeding to an RCT. The exploratory analyses suggest peer mentorship may improve OA self-management. An RCT of the OA peer mentorship intervention is therefore warranted with minor modifications to the intervention and trial procedures.Trial registration numberISRCTN:50675542.
Non-invasive, vagus nerve stimulation to reduce ileus after colorectal surgery: protocol for a feasibility trial with nested mechanistic studies
Authors: Chapman Stephen J , Naylor Maureen , Czoski Murray Carolyn J , Tolan Damian , Stocken Deborah D , Jayne David G 
Published: July 2021

IntroductionIleus is a common and distressing condition characterised by gut dysfunction after surgery. While a number of interventions have aimed to curtail its impact on patients and healthcare systems, ileus is still an unmet challenge. Electrical stimulation of the vagus nerve is a promising new treatment due to its role in modulating the neuro-immune axis through a novel anti-inflammatory reflex. The protocol for a feasibility study of non-invasive vagus nerve stimulation (nVNS), and a programme of mechanistic and qualitative studies, is described.Methods and analysisThis is a participant-blinded, parallel-group, randomised, sham-controlled feasibility trial (IDEAL Stage 2b) of self-administered nVNS. One hundred forty patients planned for elective, minimally invasive, colorectal surgery will be randomised to four schedules of nVNS before and after surgery. Feasibility outcomes include assessments of recruitment and attrition, adequacy of blinding and compliance to the intervention. Clinical outcomes include bowel function and length of hospital stay. A series of mechanistic substudies exploring the impact of nVNS on inflammation and bowel motility will inform the design of the final stimulation schedule. Semistructured interviews with participants will explore experiences and perceptions of the intervention, while interviews with patients who decline participation will explore barriers to recruitment.Ethics and disseminationThe protocol has been approved by the Tyne and Wear South National Health Service (NHS) Research Ethics Committee (19/NE/0217) on 2 July 2019. Feasibility, mechanistic and qualitative findings will be disseminated to national and international partners through peer-reviewed publications, academic conferences, social media channels and stakeholder engagement activities. The findings will build a case for or against progression to a definitive randomised assessment as well as informing key elements of study design.Trial registration numberISRCTN62033341.
External validation of simplified out-of-hospital cardiac arrest and cardiac arrest hospital prognosis scores in a Japanese population: a multicentre retrospective cohort study
Authors: Shibahashi Keita , Sugiyama Kazuhiro , Kuwahara Yusuke , Ishida Takuto , Sakurai Atsushi , Kitamura Nobuya , Tagami Takashi , Nakada Taka-aki , Takeda Munekazu , Hamabe Yuichi 
Published: July 2021

BackgroundThe novel simplified out-of-hospital cardiac arrest (sOHCA) and simplified cardiac arrest hospital prognosis (sCAHP) scores used for prognostication of hospitalised patients have not been externally validated. Therefore, this study aimed to externally validate the sOHCA and sCAHP scores in a Japanese population.MethodsWe retrospectively analysed data from a prospectively maintained Japanese database (January 2012 to March 2013). We identified adult patients who had been resuscitated and hospitalised after intrinsic out-of-hospital cardiac arrest (OHCA) (n=2428, age ≥18 years). We validated the sOHCA and sCAHP scores with reference to the original scores in predicting 1-month unfavourable neurological outcomes (cerebral performance categories 3–5) based on the discrimination and calibration measures of area under the receiver operating characteristic curves (AUCs) and a Hosmer-Lemeshow goodness-of-fit test with a calibration plot, respectively.ResultsIn total, 1985/2484 (82%) patients had a 1-month unfavourable neurological outcome. The original OHCA, sOHCA, original cardiac arrest hospital prognosis (CAHP) and sCAHP scores were available for 855/2428 (35%), 1359/2428 (56%), 1130/2428 (47%) and 1834/2428 (76%) patients, respectively. The AUCs of simplified scores did not differ significantly from those of the original scores, whereas the AUC of the sCAHP score was significantly higher than that of the sOHCA score (0.88 vs 0.81, p<0.001). The goodness of fit was poor in the sOHCA score (ν=8, χ2=19.1 and Hosmer-Lemeshow test: p=0.014) but not in the sCAHP score (ν=8, χ2=13.5 and Hosmer-Lemeshow test: p=0.10).ConclusionThe performances of the original and simplified OHCA and CAHP scores in predicting neurological outcomes in successfully resuscitated OHCA patients were acceptable. With the highest availability, similar discrimination and good calibration, the sCAHP score has promising potential for clinical implementation, although further validation studies to evaluate its clinical acceptance are necessary.
What became of the ‘eyes and the ears’?: exploring the challenges to reporting poor quality of care among trainee medical staff
Authors: Berry Philip 
Published: July 2021

ABSTRACTThe importance of trainee medical staff in alerting Trusts to patient safety risks and low-quality care was established by the Francis Report, yet many remain hesitant about speaking up. Known barriers include lack of feedback, sceptical attitudes to the likelihood of change and fear of consequences. The author explores other factors including moral orientation in the workplace, role modelling by senior clinicians, discontinuity, ‘normalisation of deviance’, human reactions to burnout/moral injury, loyalty and the spectrum of motivation. The issues of absent feedback and fear are discussed in detail. Challenges met by those receiving reports are also described, such as how to collate soft intelligence, putting concerns into context (the ‘bigger picture’) and stewardship of resources. Initiatives to encourage reporting of trainees’ concerns such as speak up guardians, ‘Speak Up for Safety’ campaign and simulation training are described. A proposal to embed proactive intelligence-gathering arrangements is presented.
Randomized comparison between pericapsular nerve group (PENG) block and suprainguinal fascia iliaca block for total hip arthroplasty
Authors: Aliste Julián , Layera Sebastián , Bravo Daniela , Jara Álvaro , Muñoz Gonzalo , Barrientos Cristián , Wulf Rodrigo , Brañez Julián , Finlayson Roderick J , Tran De Q 
Published: July 2021

BackgroundThis randomized trial compared ultrasound-guided pericapsular nerve group block and suprainguinal fascia iliaca block in patients undergoing primary total hip arthroplasty. We selected the postoperative incidence of quadriceps motor block (defined as paresis or paralysis of knee extension) at 6 hours as the primary outcome. We hypothesized that, compared with suprainguinal fascia iliaca block, pericapsular nerve group block would decrease its occurrence from 70% to 20%.MethodsForty patients undergoing primary total hip arthroplasty under spinal anesthesia were randomly allocated to receive a pericapsular nerve group block (n=20) using 20 mL of adrenalized levobupivacaine 0.50%, or a suprainguinal fascia iliaca block (n=20) using 40 mL of adrenalized levobupivacaine 0.25%. After the performance of the block, a blinded observer recorded pain scores at 3, 6, 12, 18, 24, 36, and 48 hours; cumulative breakthrough morphine consumption at 24 and 48 hours; opioid-related side effects; ability to perform physiotherapy at 24 and 48 hours; as well as length of stay. Furthermore, the blinded observer also carried out sensory assessment (of the anterior, lateral, and medial aspects of the mid-thigh) and motor assessment (knee extension and hip adduction) at 3, 6, and 24 hours.ResultsCompared with suprainguinal fascia iliaca block, pericapsular nerve group block resulted in a lower incidence of quadriceps motor block at 3 hours (45% vs 90%; p<0.001) and 6 hours (25% vs 85%; p<0.001). Furthermore, pericapsular nerve group block also provided better preservation of hip adduction at 3 hours (p=0.023) as well as decreased sensory block of the anterior, lateral, and medial thighs at all measurement intervals (all p≤0.014). No clinically significant intergroup differences were found in terms of postoperative pain scores, cumulative opioid consumption at 24 and 48 hours, ability to perform physiotherapy, opioid-related side effects, and length of hospital stay.ConclusionFor primary total hip arthroplasty, pericapsular nerve group block results in better preservation of motor function than suprainguinal fascia iliaca block. Additional investigation is required to elucidate the optimal local anesthetic volume for motor-sparing pericapsular nerve group block and to compare the latter with alternate motor-sparing strategies such as periarticular local anesthetic infiltration.Trial registration numberNCT04402450.
Development and pilot testing of the Nutrition Attitudes and Knowledge Questionnaire to measure changes of child nutrition knowledge related to the Canada’s Food Guide
Authors: Franco-Arellano Beatriz , Brown Jacqueline M. , Froome Hannah M. , LeSage Ann , Arcand JoAnne 
Published: July 2021

Foodbot Factory is a serious game developed to teach children about the 2019 Canada’s Food Guide (CFG) healthy eating principles. Because no measurement tools existed to assess changes in children’s knowledge of the CFG, the Nutrition Attitudes and Knowledge (NAK) questionnaire was developed for this purpose. The NAK is based on the 2019 CFG nutrition content and aligned with the Foodbot Factory modules (Drinks, Whole Grain foods, Vegetables and Fruit, Protein foods). Seven experts assessed face and content validity of the draft NAK questionnaire. Three sections were deemed valid, while the remaining 2 required minor revisions. The NAK was pilot tested for changes in nutrition attitudes and knowledge among children aged 9–10 years-old (n = 23), who answered the NAK questionnaire before and after using Foodbot Factory. Significant increases were found in overall nutrition knowledge, and knowledge of Whole Grain foods, Vegetables and Fruit and Protein foods. Knowledge of Drinks and nutrition attitudes remained unchanged. The NAK showed a moderate reliability when tested among a group of children (n = 23). While the NAK questionnaire is a promising tool for assessing changes nutrition knowledge related to the 2019 CFG guidelines in children, further research is required to test construct validity of this instrument. Novelty: The Nutrition Attitudes and Knowledge (NAK) questionnaire was developed by educators and dietitians. The NAK underwent face and content validity assessments and was pilot tested among children. The NAK questionnaire is a potential tool to detect changes in children’s knowledge of the 2019 Canada’s Food Guide.
Ruppeiner geometry and thermodynamic phase transition of the black hole in massive gravity
Authors: Wu Bin , Wang Chao , Xu Zhen-Ming , Yang Wen-Li 
Published: July 2021

AbstractThe phase transition and thermodynamic geometry of a 4-dimensional AdS topological charged black hole in de Rham, Gabadadze and Tolley (dRGT) massive gravity have been studied. After introducing a normalized thermodynamic scalar curvature, it is speculated that its value is related to the interaction between the underlying black hole molecules if the black hole molecules exist. We show that there does exist a crucial parameter given in terms of the topology, charge, and massive parameters of the black hole, which characterizes the thermodynamic properties of the black hole. It is found that when the parameter is positive, the singlet large black hole phase does not exist for sufficient low temperature and there is a weak repulsive interaction dominating for the small black hole which is similar to the Reissner–Nordström AdS black hole; when the parameter is negative, an additional phase region describing large black holes also implies a dominant repulsive interaction. These constitute the distinguishable features of dRGT massive topological black hole from those of the Reissner–Nordström AdS black hole as well as the Van der Waals fluid system.
Unifying dark matter and dark energy with non-canonical scalars
Authors: Mishra Swagat S. , Sahni Varun 
Published: July 2021

AbstractNon-canonical scalar fields with the Lagrangian $${{\mathcal {L}}} = X^\alpha - V(\phi )$$

L
=

X
α

-
V

(
ϕ
)

, possess the attractive property that the speed of sound, $$c_s^{2} = (2\,\alpha - 1)^{-1}$$

c
s
2

=

(
2

α
-
1
)

-
1

, can be exceedingly small for large values of $$\alpha $$
α
. This allows a non-canonical field to cluster and behave like warm/cold dark matter on small scales. We derive a general condition on the potential in order to facilitate the kinetic term $$X^\alpha $$

X
α

to play the role of dark matter, while the potential term $$V(\phi )$$

V
(
ϕ
)

playing the role of dark energy at late times. We demonstrate that simple potentials including $$V= V_0\coth ^2{\phi }$$

V
=

V
0

coth
2

ϕ

and a Starobinsky-type potential can unify dark matter and dark energy. Cascading dark energy, in which the potential cascades to lower values in a series of discrete steps, can also work as a unified model.