bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical impact of vancomycin‐resistant enterococci colonization in nonliver solid organ transplantation and its implications for infection control strategies: A single‐center, 10‐year retrospective study
Authors: McFarlane Alexandra C. , Kabbani Dima , Bakal Jeffrey A. , Smith Stephanie W. 
Published: October 2021

AbstractBackgroundVancomycin‐resistant enterococci (VRE) colonization in nonliver solid organ transplantation (SOT) is poorly defined. Infection control management of these patients is influenced by the association of VRE with adverse outcomes in liver transplantation. This study examines the frequency and clinical impact of VRE colonization specifically on nonliver SOT patients and discusses implications for nosocomial VRE control.MethodsWe retrospectively reviewed all nonliver SOT patients at a single transplant center from 2005 to 2015. We determined colonization rates in the peritransplant period and the rate of VRE infections. The association between VRE colonization with 90‐day mortality and other clinical outcomes was examined.ResultsThere were 1786 nonliver SOTs from 2005 to 2015, with 81 (4.6%) colonized with VRE in the peritransplantation period. The colonization prevalence varied by organ type: 45 of 423 lung (10.6%), 12 of 352 heart (3.4%), one of 18 heart–lung (5.6%), 20 of 884 kidney (2.3%), three of 63 kidney–pancreas (4.8%), zero of 11 pancreas, zero of five small bowel, and zero of 11 multivisceral. Peritransplant VRE colonization was not associated with 90‐day mortality odds ratio = 2.35 (95% CI = 0.53, 10.29) and adjusted odds ratio = 1.52 (95% CI = 0.34, 6.88). In the multivariable logistic regression, there was no association with mortality at 1 year or 5 years, hospital length of stay, rehospitalization, or days alive out of hospital. There were 14 inpatient VRE infections up to 1 year after transplantation.ConclusionNonliver SOT patients have lower rates of VRE colonization than liver SOT, and colonization was not associated with increased adverse clinical outcomes. Although infection control strategies for VRE in hospital remain controversial, nonliver SOT should be considered among typical hospitalized patients when designing strategies for prevention.
How did we reform our out of control massive transfusion protocol program?
Authors: Adkins Brian D. , Libby Theresa A. , Mayberry Marlene M. , Brady Thomas W. , Halls Justin B. , Corbett Stephanie Mallow , Schoeny Joseph , Shields Eric P. , Chowdhury Jahan , Kinsinger‐Stickel Amanda N. , Wehrli Gay , Jaeger Nicholas R. , Robertson Matthew P. , Butler Kathy M. , Lowson Stuart M. , Calland James Forrest , Gorham James D. 
Published: October 2021

AbstractBackgroundThe massive transfusion protocol (MTP) is designed to quickly provide blood products at a fixed ratio for the exsanguinating patient. At our academic medical center, the frequency of MTP activation increased over 10‐fold between 2008 and 2015, putting inordinate stress on our transfusion service.Study design and methodsGathering a large number of relevant stakeholders, we performed a multidisciplinary root cause analysis (RCA) in response to the acute clinical need to reform our MTP.ResultsThrough the RCA, we identified four principal opportunities for improvement (OFI) associated with our MTP: education, stewardship, process improvement, and communication. Through the deployment of new approaches to each of these OFI, we reduced MTP activations, blood product waste, and transfusion service technologist stress.ConclusionThe MTP is amenable to improvement, and, although time intensive, the RCA process yields significant favorable effects: improving communication with colleagues, reducing stress within the transfusion service, and improving resource utilization. Activation of the MTP at our institution is now more aligned with its primary purpose: rapidly providing large quantities of blood products to exsanguinating patients.
Weed control and community composition in living mulch systems
Authors: Westbrook Anna S. , Bhaskar Vinay , DiTommaso Antonio 
Published: October 2021

AbstractA living mulch is a cover crop grown during the growing season of a main (cash) crop. Living mulches may reduce soil erosion and nitrate leaching more effectively than bare ground or non‐living mulches. Living mulches can also make substantial contributions to non‐chemical or diversified weed management programmes. However, living mulches sometimes fail to suppress weeds, or they succeed at the cost of main crop yield. Seeking to understand these divergent outcomes, we survey the effects of living mulches on weeds in temperate field and vegetable crops. Primary purposes of this review include (a) outlining mechanisms of weed control by living mulches, (b) identifying major sources of variation in weed control outcomes, and (c) highlighting knowledge gaps. The effects of living mulches on weeds are largely (but not exclusively) via competition and typically strongest when living mulch vigour is high at sensitive stages of weed life cycles. Best management practices depend on living mulch, main crop, and weed community characteristics. Living mulches often have different effects on different weed species, which may have far‐reaching consequences for weed diversity and community composition. Future research on long‐term changes to weed communities will clarify how and when living mulches should be adopted to increase agroecosystem biodiversity and promote sustainability.
Valsartan nano‐filaments alter mitochondrial energetics and promote faster healing in diabetic rat wounds
Authors: Nidadavolu Lolita S. , Stern David , Lin Ran , Wang Yuzhu , Li Yi , Wu Yuqiong , Marin Sela , Antonio Marjorie J. , Yenokyan Gayane , Boronina Tatiana , Cole Robert , Foster D. Brian , Talbot Conover , Jedrych Jaroslaw , Smith Barbara , Rini David , Le Anne , Cui Honggang , Walston Jeremy D. , Abadir Peter M. 
Published: October 2021

AbstractChronic wounds are a common and debilitating condition associated with aging populations that impact more than 6.5 million patients in the United States. We have previously demonstrated the efficacy of daily topical 1% valsartan in treating wounds in diabetic mouse and pig models. Despite these promising results, there remains a need to develop an extended‐release formulation that would reduce patient burden by decreasing the frequency of daily applications. Here, we used nanotechnology to self‐assemble valsartan amphiphiles into a filamentous structure (val‐filaments) that would serve as a scaffold in wound beds and allow for steady, localised and tunable release of valsartan amphiphiles over 24 days. Two topical treatments of this peptide‐based hydrogel on full‐thickness wounds in Zucker Diabetic Fatty rats resulted in faster rates of wound closure. By day 23, all val‐filament treated wounds were completely closed, as compared to one wound closed in the placebo group. Mechanistically, we observed enrichment of proteins involved in cell adhesion and energetics pathways, downregulation of Tgf‐β signalling pathway mediators (pSmad2, pSmad3 and Smad4) and increased mitochondrial metabolic pathway intermediates. This study demonstrates the successful synthesis of a sustained‐release valsartan filament hydrogel, its impact on mitochondrial energetics and efficacy in treating diabetic wounds.
Experimental and Modeling Uncertainty Considerations for Determining the First Item Ignited in a Compartment Using a Bayesian Method
Authors: Cabrera J. M. , Moser R. D. , Ezekoye O. A. 
Published: October 2021

Abstract
Fire scene reconstruction and determining the fire evolution (i.e., item-to-item ignition events) using the postfire compartment is an extremely difficult task because of the time-integrated nature of the observed damages. Bayesian methods are ideal for making inferences amongst hypotheses given observations and are able to naturally incorporate uncertainties. A Bayesian methodology for determining probabilities to items that may have initiated the fire in a compartment from damage signatures is developed. Exercise of this methodology requires uncertainty quantification of these damage signatures. A simple compartment configuration was used to quantify the uncertainty in damage predictions by firedynamicssimulator (fds) and, a compartment evolution program, jt-risk as compared to experimentally derived damage signatures. Surrogate sensors spaced within the compartment use heat flux data collected over the course of the simulations to inform damage models. Experimental repeatability showed up to 4% uncertainty in damage signatures between replicates. Uncertainties for fds and jt-risk ranged from 12% up to 32% when compared to experimental damages. Separately, the evolution physics of a simple three-fuel-package problem with surrogate damage sensors were characterized in a compartment using experimental data, fds, and jt-risk predictions. A simple ignition model was used for each of the fuel packages. The Bayesian methodology was exercised using the damage signatures collected, cycling through each of the three fuel packages, and combined with the previously quantified uncertainties. Only reconstruction using experimental data was able to confidently predict the true hypothesis from the three scenarios.
A Suction Cup With Tunable Stiffness Based on Shape Memory Alloy
Authors: Zhou Weimian , Wang Xiaojie , Wu Xuan 
Published: October 2021

Abstract
This paper presents the design and testing of a bioinspired compliant suction cup with tunable elastic stiffness using shape memory alloy (SMA). We embedded SMA wires into a compliant suction cup for stiffness tuning. When the voltage is input, it increases the stiffness of the suction cup body and helps prevent deformation. Further, a bending moment is applied to the suction cup lip in contact with the surface, which reduces the probability of gas leakage as well as the risk of adsorption failure. In the experiment, suction cups with and without embedded SMA are tested respectively. The maximum pull-off forces and adsorption time are measured via an MTS tester, and the pressure values induced by SMA’s tuning effect on the cup lip are recorded by membrane sensors. Results show that under the same preloading forces, the adsorption force is almost identical, while the adsorption maintaining time of the suction cup with embedded SMA is increased by 365% at the maximum compared with that without SMA. The force generated by the bending moment applied to the lip increases by 360% at the maximum when the SMA is activated. The strain of the sample embedded with SMA is 186% less than that of the sample made of pure soft material at 20kPa stress. The results indicate that the embedded SMA can help increase the stiffness, reduce the deformation of the suction cup body, and enhance adsorption maintenance ability.
Evaluation of the exploration prospect and risk of marine gas shale, southern China: A case study of Wufeng-Longmaxi shales in the Jiaoshiba area and Niutitang shales in the Cen’gong area
Authors: Gou Qiyang , Xu Shang , Hao Fang , Lu Yangbo , Shu Zhiguo , Lu Yongchao , Wang Zhengkai , Wang Yufan 
Published: October 2021

Abstract
The Wufeng-Longmaxi shales and the Niutitang shales are the most important organic-rich marine shales in southern China. To fully understand the significant difference in drilling results between the two sets of shales, the accumulation conditions of shale gas were systematically compared. The Niutitang shales have a superior material base of hydrocarbon generation for higher total organic carbon than the Wufeng-Longmaxi shales. Due to the influence of hydrothermal activities and carbonization of organic matter, however, the porosity, pore volume, pore size, and pore connectivity of Niutitang shales is obviously lower than that of Wufeng-Longmaxi shales. The natural fractures of Wufeng-Longmaxi shales are dominated by horizontal bedding fractures, and most of them are filled by calcite. By contrast, the high dip-angle fractures are more developed in the Niutitang shales. Especially, these fractures remain open in stages during the process of serious uplift and denudation movements. Thus, the seal conditions of the Niutitang shales are poor, which is further not conducive to the enrichment of shale gas. Our work also suggests that the exploration and development of highly over matured marine shales in southern China should follow the principle of “high to find low, and strong to find weak.”
Clinical outcomes in COVID-19 and cirrhosis: a systematic review and meta-analysis of observational studies
Authors: Middleton Paul , Hsu Catherine , Lythgoe Mark P 
Published: October 2021

BackgroundCOVID-19 continues to pose a significant healthcare challenge throughout the world. Comorbidities including diabetes and hypertension are associated with a significantly higher mortality risk. However, the effect of cirrhosis on COVID-19 outcomes has yet to be systematically assessed.ObjectivesTo assess the reported clinical outcomes of patients with cirrhosis who develop COVID-19 infection.Design/MethodPubMed and EMBASE databases were searched for studies included up to 3 February 2021. All English language primary research articles that reported clinical outcomes in patients with cirrhosis and COVID-19 were included. The study was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The risk of bias was assessed using the Quality In Prognostic Score (QUIPS) risk-of-bias assessment instrument for prognostic factor studies template. Meta-analysis was performed using Cochrane RevMan V.5.4 software using a random effects model.Results63 studies were identified reporting clinical outcomes in patients with cirrhosis and concomitant COVID-19. Meta-analysis of cohort studies which report a non-cirrhotic comparator yielded a pooled mortality OR of 2.48 (95% CI: 2.02 to 3.04). Analysis of a subgroup of studies reporting OR for mortality in hospitalised patients adjusted for significant confounders found a pooled adjusted OR 1.81 (CI: 1.36 to 2.42).ConclusionCirrhosis is associated with an increased risk of all-cause mortality in COVID-19 infection compared to non-cirrhotic patients. Patients with cirrhosis should be considered for targeted public health interventions to prevent COVID-19 infection, such as shielding and prioritisation of vaccination.
Determinants of adolescents’ perceptions on access to healthcare services in the Kingdom of Saudi Arabia: Jeeluna national survey findings
Authors: Najjar Shahenaz , Saade Mayssa , Abdalla Sahar , AlBuhairan Fadia 
Published: October 2021

ObjectivesThe study aimed at identifying the determinants of adolescents’ access to healthcare services.SettingIntermediate and secondary schools across all 13 regions in the Kingdom of Saudi Arabia (KSA) from 2011 to 2012 through the Jeeluna national school-based survey.ParticipantsIntermediate and secondary school students participated in the study. A multistage, cluster, random sampling technique was used. Participants responded to a self-administered questionnaire that addressed several domains.Main outcome measureAdolescents’ perception of access to healthcare services.ResultsTwenty-five per cent of participants reported difficulty in accessing healthcare. Women, early (younger) adolescents and adolescents with three siblings were less likely to report difficulty in accessing healthcare than men, late (older) adolescents and those with fewer than three siblings. Adolescents from low-income families and those with either mental or physical illness were more likely to report difficulty in accessing healthcare than adolescents from higher income families and those without mental or physical illnesses.ConclusionsDisparities in access to care exist between certain subpopulations of adolescents. Efforts are needed to support enhancing access and making it more equitable. Training for healthcare professionals and targeted health policies are necessary to improve adolescents’ access to health services in the KSA.Trial registration numberRC08-092; King Abdullah International Medical Research Centre.
Prevalence and outcomes of twin pregnancies in Botswana: a national birth outcomes surveillance study
Authors: Isaacson Arielle , Diseko Modiegi , Mayondi Gloria , Mabuta Judith , Davey Sonya , Mmalane Mompati , Makhema Joseph , Jacobson Denise L , Luckett Rebecca , Shapiro Roger L , Zash Rebecca 
Published: October 2021

ObjectivesThis study aims to evaluate the prevalence and outcome of twin pregnancies in Botswana.SettingThe Tsepamo Study conducted birth outcomes surveillance at 8 government-run hospitals (~45% of all births in Botswana) from August 2014 to June 2018 and expanded to 18 hospitals (~70% of all births in Botswana) from July 2018 to March 2019.ParticipantsData were collected for all live-born and stillborn in-hospital deliveries with a gestational age (GA) greater than 24 weeks. This analysis included 117 593 singleton and 3718 twin infants (1859 sets (1.6%)) born to 119 477 women between August 2014 and March 2019 and excluded 73 higher order multiples (23 sets of triplets and 1 set of quadruplets).Outcomes measuredOur primary outcomes were preterm delivery (<37 weeks GA), very preterm delivery (<32 weeks GA) and stillbirth (APGAR (Appearance, Pulse, Grimace, Activity, Respiration) score of 0, 0, 0).ResultsWomen with twin pregnancies had a similar median number of antenatal care visits (9 vs 10), but were more likely to deliver in a tertiary centre (54.8% vs 45.1%, p<0.001) and more likely to have a cesarean-section (54.6% vs 22.0%, p<0.001) than women with singletons. Compared with singletons, twin pregnancies had a higher risk of preterm delivery (<37 weeks GA) (47.6% vs 16.7%, adjusted risk ratio (aRR) 2.8, 95% CI 2.7 to 2.9) and very preterm delivery (<32 weeks) (11.8% vs 4.0%, aRR 3.0 95% CI 2.6 to 3.4). Among all twin pregnancies, 128 (6.9%) had at least one stillborn infant compared with 2845 (2.4%) stillbirths among singletons (aRR 2.8, 95% CI 2.3 to 3.3).ConclusionAdverse birth outcomes are common among twins in Botswana, and are often severe. Interventions that allow for earlier identification of twin gestation and improved antenatal management of twin pregnancies may improve infant and child survival.
Impact of income and eating speed on new-onset diabetes among men: a retrospective cohort study
Authors: Ishihara Reiko , Babazono Akira , Liu Ning , Yamao Reiko 
Published: October 2021

ObjectiveTo examine the impact of income and eating speed on new-onset diabetes among men.DesignThis was a retrospective cohort study.SettingWe used the administrative claims and health check-up data for fiscal years 2010–2015 obtained from the Fukuoka branch of the Japan Health Insurance Association.ParticipantsParticipants were 15 474 non-diabetic male employees, aged between 40 and 74 years. They were categorised based on their eating speeds (ie, fast, normal and non-fast).Primary and secondary outcome measuresTo calculate the OR of the development of diabetes, we created generalised linear regression models with diabetes onset as the dependent variable and eating speed and income as covariates and calculated corresponding 95% CI values. The analyses were performed after adjusting the data for age, obesity and comorbidities.ResultsOf the total participants, 620 developed diabetes during the 5-year study period. A univariate analysis using the generalised linear regression model revealed that eating fast (OR: 1.35, 95% CI 1.17 to 1.55) and having a low income wereincome (OR: 1.47, 95% CI 1.24 to 1.74) were significantly associated with the onset of diabetes. After adjusting for age, obesity and comorbidities, both eating fast (OR: 1.17, 95% CI 1.02 to 1.35) and having a low income (OR: 1.24, 95% CI 1.03 to 1.50) were recognised as independent risk factors for diabetes onset.ConclusionsThe study revealed that eating fast and having a low income were independent risk factors, leading to the development of diabetes. While it is difficult to address income differences, it may be possible to address the factors that contribute to income differences to manage diabetes appropriately and at low healthcare costs. However, eating speed can be controlled. Hence, the provision of education and coaching on dietary habits, including eating speed, may be effective in preventing diabetes onset.
Seroprevalence and associated factors of maternal cytomegalovirus in Southern Ethiopia: a cross-sectional study
Authors: Zenebe Mengistu Hailemariam , Mekonnen Zeleke , Loha Eskindir , Padalko Elizaveta 
Published: October 2021

ObjectivesThe aim of this study was to assess the seroprevalence and associated factors of cytomegalovirus (CMV) among pregnant women in Southern Ethiopia.DesignCross-sectional study.SettingThe study was conducted in Hawassa University comprehensive and specialised hospital. Hawassa, Southern Ethiopia.ParticipantsA total of 600 consecutive pregnant women attending the delivery ward were recruited for the study from August to October 2020.Outcome measuresThe study assessed the rate of maternal anti-CMV IgG and IgM antibodies. The association of obstetric history, sociodemographic and behavioural characteristics with seropositivity of CMV was also evaluated based on the collected data using structured questioners.ResultsSeropositivity for CMV IgM antibodies was 8.2% (49/600) (95% CI 6% to 10.5%), whereas the CMV IgG was 88.7% (532/600), (95% CI 89.5% to 94.0%). Seroprevalence of CMV IgM was higher in women of older age, currently unmarried, having nursery schooled children and with any of the detected curable sexually transmitted infections, while seroprevalence of CMV IgG was significantly associated only with women having nursery schooled children. Seroprevalence was not significantly associated with previous adverse pregnancy outcome, gravidity, being a child daycare occupant mother and newborn birth weight.ConclusionIn the present study, we identified a high rate of CMV IgM and CMV IgG seroprevalence among pregnant women in Southern Ethiopia. Given that there is no existing CMV diagnosis, special attention should be designed to pregnant women in parallel to the existing antenatal care facility. Besides, training healthcare professionals will support awareness conception among pregnant women concerning the sequels of CMV infection during pregnancy.