bluuebunny/crossref_metadata_2025_split huggingface dataset:
A convolutional neural‐network‐based pedestrian counting model for various crowded scenes
Authors: Shen Jie , Xiong Xin , Xue Zhiyuan , Bian Yinglong 
Published: May 2019

AbstractPedestrian counting from unconstrained images is an important task in various applications such as resource management, transportation engineering, urban design, and advertising, but it is greatly challenged by some factors such as interocclusion, cross‐scene, scale, and scene perspective distortion. Traditional image‐based methods suffer from them, and the performance of conventional sensor‐based methods such as Kinect and LASER degrades gradually with the increase in pedestrian count and distance from the device to pedestrians. Based on these challenges, this paper proposes a new network model making use of stacked multicolumn convolutional neural networks (CNNs) for pedestrian counting. The human's head features are used to replace the whole body for solving the problem of serious occlusion and choose multicolumn CNNs for dealing with scale and scene perspective distortion. Also, pretrained VGG‐16 is used to generate deeper detailed features and expand the receptive field of the model. Extensive analysis and experiments on current major pedestrian counting datasets show that the proposed network model has considerable advantages in pedestrian counting tasks compared to other state‐of‐the‐art models, and the proposed network model has an improvement effect for the training process. Moreover, the visual differences between the generated density map and ground‐truth density map are visualized and analyzed quantitatively to demonstrate the feasibility of the model.
Quality improvement project to reduce pediatric clear liquid fasting times prior to anesthesia
Authors: Isserman Rebecca , Elliott Elizabeth , Subramanyam Rajeev , Kraus Blair , Sutherland Tori , Madu Chinonyerem , Stricker Paul A. 
Published: May 2019

AbstractBackgroundUnnecessarily long preprocedural fasting can cause suffering and distress for children and their families. Institutional fasting policies are designed to consistently achieve minimum fasting times, often without regard to the extent to which actual fasting times exceed these minimums. Children at our hospital frequently experienced clear liquid fasting times far in excess of required minimums.AimsThe aim of this study was to utilize quality improvement methodology to reduce excess fasting times, with a goal of achieving experienced clear liquid fasting times ≤4 hours for 60% of our patients.MethodsThis quality improvement project was conducted between July 2017 and August 2018. A multidisciplinary team performed a series of Plan‐Do‐Study‐Act cycles focused on children undergoing elective procedures at a large children's hospital. Key drivers for clear liquid fasting times and relevant balancing measures were identified. Data were analyzed using control charts and statistical process control methods.ResultsApproximately 16 000 children were involved in this project. Over the course of the project, the percentage of children with goal clear liquid fasting times improved from the baseline of 20%‐63%, with a change in the mean fasting time from 9 hours to 6 hours. There were no significant effects on balancing measures (case delays/cancellations and clinically significant aspiration events).ConclusionUsing quality improvement methodology, we safely improved the duration of preoperative fasting experienced by our patients. Our results provide additional data supporting the safety of more permissive 1‐hour clear liquid fasting minimums. We suggest other institutions pursue similar efforts to improve patient and family experience.
Novel Experiencer‐Object Verbs and Clitic Doubling
Authors: Alexiadou Artemis , Anagnostopoulou Elena 
Published: May 2019

AbstractThis article discusses novel experiencer‐object verbs (NEOs) and proposes to align their syntax as well as the syntax of nonagentive experiencer‐object verbs to the syntax of verbs undergoing the causative alternation under similar restrictions. We provide support for the view that (i) volitional agents do not occupy the same structural position as nonvolitional causers; (ii) VoiceP creates a phase, that is, a domain of compositional interpretation, and coercion into a psychological reading takes place in the absence of this layer; (iii) clitic doubling can be sensitive to animacy in a structure that lacks Voice and in which the clitic is the reflex of movement; and (iv) the accusative case morphology of experiencers both in eventive experiencer‐object constructions and our NEO constructions is straightforwardly explained as the result of dependent‐case assignment.
Geospatial preparedness: Empirical study of the joint effort to provide geospatial support to disaster response
Authors: San Martin Roberto , Painho Marco 
Published: May 2019

AbstractIn a disaster aftermath in places lacking geospatial preparedness, the United Nations Office for the Coordination of Humanitarian Affairs creates a framework for cooperation with the Coordinated Data Scramble initiative, where Information Management Officers (IMOs) from different organizations work together in supporting the coordination of humanitarian aid. The perspective of these IMOs has been considered to identify the factors influencing the use of GIS in this context. The results show the requirement for a geodata management strategy, including geodata gathering, maintenance, and decision‐making processes based on those geodata. Geodata should be reliable and up‐to‐date. It requires consistent and useful metadata and the possibility of contacting the geodata source. Security and political issues limit information sharing. In this context, OpenStreetMap is often used as a source of information. Therefore, improving OpenStreetMap improves geospatial preparedness. Nevertheless, the use of this open platform highlights issues related to information privacy.
Veterinary ocular microbiome: Lessons learned beyond the culture
Authors: Banks Kayla C. , Ericsson Aaron C. , Reinero Carol R. , Giuliano Elizabeth A. 
Published: May 2019

AbstractOcular pathogens cause many painful and vision‐threatening diseases such as infectious keratitis, uveitis, and endophthalmitis. While virulent pathogens and pathobionts play important roles in disease pathogenesis, the scientific community has long assumed disruption of the ocular surface occurs prior to microbial colonization and subsequent infection. While nonpathogenic bacteria are often detected in corneal and conjunctival cultures from healthy eyes, cultures also frequently fail to yield growth of common ocular pathogens or nonpathogenic bacteria. This prompts the following question: Is the ocular surface populated by a stable microbial population that cannot be detected using standard culture techniques? The study of the microbiome has recently become a widespread focus in physician and veterinary medicine. Research suggests a pivotal symbiotic relationship with these microbes to maintain healthy host tissues, and when altered is associated with various disease states (“dysbiosis”). The microbiota that lives within and on mammalian bodies have long been known to influence health and susceptibility to infection. However, limitations of traditional culture methods have resulted in an incomplete understanding of what many now call the “forgotten organ,” that is, the microbiome. With the introduction of high‐throughput sequencing, physician ophthalmology has recognized an ocular surface with much more diverse microbial communities than suspected based on traditional culture. This article reviews the salient features of the ocular surface microbiome and highlights important future applications following the advent of molecular techniques for microbial identification, including characterizing ocular surface microbiomes in our veterinary species and their potential role in management of infectious and inflammatory ocular diseases.
Postpartum use of oxytocin and volume of placental transfusion: a randomised controlled trial
Authors: Vain Nestor E , Satragno Daniela S , Gordillo Juan Esteban , Fernandez Ariel L , Carrolli Guillermo , Romero Norma P , Prudent Luis M 
Published: May 2019

ObjectiveTo assess whether oxytocin administered before clamping the umbilical cord modifies the volume of placental transfusion.DesignRandomised controlled trial.MethodsMothers of term infants born vigorous by vaginal delivery with informed consent provided in early labour were randomly assigned to oxytocin (10 IU) given intravenously within 15 s of birth (group 1) or after clamping the umbilical cord 3 min after delivery (group 2). Soon after birth, all infants were weighed using a 1 g precision scale and subsequently placed on the mother’s abdomen or chest. At 3 min, in both groups, the cord was clamped and cut, and the weight was again obtained. The primary outcome (volume of placental transfusion) was estimated by the difference in weights.Results144 patients were included. There were no differences in the primary outcome: infants in group 1 (n=70) gained a mean weight of 85.9 g (SD 48.3), and in group 2 (n=74) 86.7 g (SD 49.6) (p=0.92). No differences were found in secondary outcomes, including newborns’ haematocrit and bilirubin concentrations and severe maternal postpartum haemorrhage. On the advice of the Data and Safety Monitoring Committee, the trial was stopped due to futility at 25% of the planned sample size.ConclusionsWhen umbilical cord clamping is delayed for 3 min, term newborn infants born vigorous receive a clinically significant placental transfusion which is not modified by the administration of intravenous oxytocin immediately after birth.Trial registration numberNCT02618499.
Knee osteoarthritis risk is increased 4-6 fold after knee injury – a systematic review and meta-analysis
Authors: Poulsen Erik , Goncalves Glaucia H , Bricca Alessio , Roos Ewa M , Thorlund Jonas B , Juhl Carsten B 
Published: May 2019

ObjectiveTo estimate knee osteoarthritis (OA) risk following anterior cruciate ligament (ACL), meniscus or combined ACL and meniscus injury.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, SPORTDiscus, CINAHL and Web of Science until November 2018.Eligibility criteria for selecting studiesProspective or retrospective studies with at least 2-year follow-up including adults with ACL injury, meniscal injury or combined injuries. Knee OA was defined by radiographs or clinical diagnosis and compared with the contralateral knee or non-injured controls.Study appraisal and synthesisRisk of bias was assessed using the SIGN50 checklist. ORs for developing knee OA were estimated using random effects meta-analysis.Results53 studies totalling ∼1 million participants were included: 185 219 participants with ACL injury, mean age 28 years, 35% females, 98% surgically reconstructed; 83 267 participants with meniscal injury, mean age 38 years, 36% females, 22% confirmed meniscectomy and 73% unknown; 725 362 participants with combined injury, mean age 31 years, 26% females, 80% treated surgically. The OR of developing knee OA were 4.2 (95% CI 2.2 to 8.0; I2=92%), 6.3 (95% CI 3.8 to 10.5; I2=95%) and 6.4 (95% CI 4.9 to 8.3; I2=62%) for patients with ACL injury, meniscal injury and combined injuries, respectively.ConclusionThe odds of developing knee OA following ACL injury are approximately four times higher compared with a non-injured knee. A meniscal injury and a combined injury affecting both the ACL and meniscus are associated with six times higher odds compared with a non-injured knee. Large inconsistency (eg, study design, follow-up period and comparator) and few high-quality studies suggest that future studies may change these estimates.Clinical relevancePatients sustaining a major knee injury have a substantially increased risk of developing knee OA, highlighting the importance of knee injury prevention programmes and secondary prevention strategies to prevent or delay knee OA development.PROSPERO registration number CRD42015016900
Understanding patient preference for physician attire in ambulatory clinics: a cross-sectional observational study
Authors: Zollinger Marc , Houchens Nathan , Chopra Vineet , Clack Lauren , Schreiber Peter Werner , Kuhn Latoya , Snyder Ashley , Saint Sanjay , Petrilli Christopher M , Sax Hugo 
Published: May 2019

ObjectivesWe explored patient perceptions regarding physician attire in different clinical contexts and resultant effects on the physician–patient relationship.SettingThe 900-bed University Hospital Zurich, Switzerland.ParticipantsA convenience sample of patients receiving care in dermatology, infectious diseases and neurology ambulatory clinics of the University Hospital Zurich participated in a paper-based survey.Primary and secondary outcome measuresThe survey instrument was randomised and showed photographs of male or female physicians wearing various forms of attire. On the basis of the respondents’ ratings of how the physician’s attire affected perceptions across five domains (knowledgeable, trustworthy, caring, approachable and comfort with the physician), a composite preference score for attire was calculated as the primary outcome. Secondary outcomes included variation in preferences by respondent characteristics and context in which care was provided.ResultsOf 834 patient respondents (140 in dermatology, 422 in infectious diseases and 272 in neurology), 298 (36%) agreed that physician attire was important. When compared with all available choices, the combination of white scrubs with white coat was rated highest while a business suit ranked lowest. Variation in preferences and opinions for attire were noted relative to respondent demographics and the clinical setting in which the survey was administered. For example, compared with younger patients, respondents ≥65 years of age more often reported that physician dress was both important to them and influenced how happy they were with their care (p=0.047 and p=0.001, respectively).ConclusionsOutpatients at a large Swiss University hospital prefer their physicians to be dressed in white scrubs with white coat. Substantial variation among respondents based on demographics, type of physician and clinical setting were observed. Healthcare systems should consider context of care when defining policies related to dress code.
Assessing testing rates for viral hepatitis B and C by general practitioners in Flanders, Belgium: a registry-based study
Authors: Bielen Rob , Koc Özgür M , Busschots Dana , Robaeys Geert , Aertgeerts Bert , Vaes Bert , Mamouris Pavlos , Mathei Catharina , Goderis Geert , Nevens Frederik 
Published: May 2019

ObjectivesChronic infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) have a major impact on mortality worldwide. Although effective treatments are available for both HBV and HCV infection, <50% of the patients are even diagnosed in Belgium. This study assessed the real-life testing—and diagnosis rate by general practitioners (GPs) in Flanders, Belgium.SettingWe assessed the testing rate for HBV and HCV in 48 primary care practices with electronic medical records linked into one central registry in Flanders, Belgium.ParticipantsThe registry contains data of 440 140 patients over 20 years, which corresponds to 2.2% of the total Flemish population yearly. The primary care practices are distributed across Flanders and the patient population is representative for the distribution of age, gender and socioeconomic status at the community level.ResultsOf 440 140 patients included in the registry, 7892 (1.8%) patients were screened for hepatitis B surface antigen (HBsAg) and 7206 (1.6%) for hepatitis C antibody (HCV Ab) of whom 369 (4.7%) and 163 (2.3%) tested positive, respectively. Of 14 059 patients with chronic liver enzyme elevation, 1112 (7.9%) and 1395 (9.9%) were tested for HBsAg and HCV Ab, respectively. There was no improvement in testing rates over time.ConclusionsThis study demonstrates that real-life testing uptake for viral hepatitis B and C is suboptimal in the general practices in Flanders, even in patients with chronically elevated liver enzymes. As GPs play a crucial role in prevention, diagnosis and linkage to care, efforts and strategies to increase the testing uptake for HBV and HCV are urgently needed.
Parental experiences of end of life care decision-making for children with life-limiting conditions in the paediatric intensive care unit: a qualitative interview study
Authors: Mitchell Sarah , Spry Jenna L , Hill Emma , Coad Jane , Dale Jeremy , Plunkett Adrian 
Published: May 2019

ObjectivesTo provide an in-depth insight into the experience and perceptions of bereaved parents who have experienced end of life care decision-making for children with life-limiting or life-threatening conditions in the paediatric intensive care unit (PICU).DesignAn in-depth qualitative interview study with a sample of parents of children with life-limiting or life-threatening conditions who had died in PICU within the previous 12 months. A thematic analysis was conducted on the interview transcripts.SettingA PICU in a large National Health Service (NHS) tertiary children’s hospital in the West Midlands, UK.Participants17 parents of 11 children who had died in the PICU.ResultsFive interconnected themes were identified related to end of life care decision-making:(1) parents have significant knowledge and experiences that influence the decision-making process.(2) Trusted relationships with healthcare professionals are key to supporting parents making end of life decisions.(3) Verbal and non-verbal communication with healthcare professionals impacts on the family experience.(4) Engaging with end of life care decision-making can be emotionally overwhelming, but becomes possible if parents reach a ‘place of acceptance’.(5) Families perceive benefits to receiving end of life care for their child in a PICU.Conclusions and implicationsThe death of a child is an intensely emotional experience for all involved. This study adds to the limited evidence base related to parental experiences of end of life care decision-making and provides findings that have international relevance, particularly related to place of care and introduction of end of life care discussions. The expertise and previous experience of parents is highly relevant and should be acknowledged. End of life care decision-making is a complex and nuanced process; the information needs and preferences of each family are individual and need to be understood by the professionals involved in their care.
Out-of-hours primary care end of life prescribing: a data linkage study
Authors: Brettell Rachel , Fisher Rebecca , Hunt Helen , Garland Sophie , Lasserson Daniel , Hayward Gail 
Published: May 2019

ObjectivesOut-of-hours (OOH) primary care services are contacted in the last 4 weeks of life by nearly 30% of all patients who die, but OOH palliative prescribing remains poorly understood. Our understanding of prescribing demand has previously been limited by difficulties identifying palliative patients seen OOH. This study examines the volume and type of prescriptions issued by OOH services at the end of life.MethodsA retrospective cohort study was performed by linking a database of Oxfordshire OOH service contacts over a year with national mortality data, identifying patients who died within 30 days of OOH contact. Demographic, service and prescribing data were analysed.ResultsA prescription is issued at 14.2% of contacts in the 30 days prior to death, compared with 29.9% of other contacts. The most common prescriptions were antibiotics (22.2%) and strong opioids (19%). 41.8% of prescriptions are for subcutaneously administered medication. Patients who were prescribed a syringe driver medication made twice as many OOH contacts in the 30 days prior to death compared with those who were not.ConclusionAbsolute and relative prescribing rates are low in the 30 days prior to death. Further research is required to understand what occurs at these non-prescribing end of life contacts to inform how OOH provision can best meet the needs of dying patients. Overall, relatively few patients are prescribed strong opioids or syringe drivers. When a syringe driver medication is prescribed this may help identify patients likely to be in need of further support from the service.
Effects of school environments on student risk-behaviours: evidence from a longitudinal study of secondary schools in England
Authors: Bonell Chris , Beaumont Emma , Dodd Matthew , Elbourne Diana Ruth , Bevilacqua Leonardo , Mathiot Anne , McGowan Jennifer , Sturgess Joanna , Warren Emily , Viner Russell M , Allen Elizabeth 
Published: May 2019

BackgroundThe theory of human functioning and school organisation proposes that schools with rigid ‘boundaries’ (weaker relationships), for example, between staff and students, or learning and broader development, engender weaker student school commitment and sense of belonging, particularly among disadvantaged students, leading to greater involvement in risk-behaviours. Existing studies provide some support but rely on a proxy exposure of ‘value-added education’ and have not explored effects by disadvantage.MethodsWe used longitudinal data from English secondary schools from the control arm of a trial, assessing school-level measures of rigid boundaries, and student commitment and belonging at age 11/12, and student risk-behaviours at age 14/15.ResultsOur direct measures were more strongly associated with risk-behaviours than was value-added education. School-level rigid boundaries were associated with increased alcohol use and bullying. Student belonging was more consistently associated with reduced risk-behaviours than was student commitment. Some school effects were greater for students from disadvantaged subgroups defined in terms of poverty, ethnicity and family structure.ConclusionOur results provide direct support for the theory of human functioning and school organisation and suggest a sense of belonging in school might be particularly protective factor among secondary school students. School effects on risk are generally stronger among disadvantaged students as theorised.Trial registration numberISRCTN10751359
Intraventricular flow patterns during right ventricular apical pacing
Authors: Bianco Francesco , Cicchitti Vincenzo , Bucciarelli Valentina , Chandra Alvin , Di Girolamo Enrico , Pedrizzetti Gianni , Tonti Gianni , Romano Silvio , De Caterina Raffaele , Gallina Sabina 
Published: May 2019

ObjectivesTo assess differences in blood flow momentum (BFM) and kinetic energy (KE) dissipation in a model of cardiac dyssynchrony induced by electrical right ventricular apical (RVA) stimulation compared with spontaneous sinus rhythm.MethodsWe cross-sectionally enrolled 12 consecutive patients (mean age 74±8 years, 60% male, mean left ventricular ejection fraction 58%±6 %), within 48 hours from pacemaker (PMK) implantation. Inclusion criteria were: age>18 years, no PMK-dependency, sinus rhythm with a spontaneous narrow QRS at the ECG, preserved ejection fraction (>50%) and a low percentage of PMK-stimulation (<20%). All the participants underwent a complete echocardiographic evaluation, including left ventricular strain analysis and particle image velocimetry.ResultsCompared with sinus rhythm, BFM shifted from 27±3.3 to 34±7.6° (p=0.016), while RVA-pacing was characterised by a 35% of increment in KE dissipation, during diastole (p=0.043) and 32% during systole (p=0.016). In the same conditions, left ventricle global longitudinal strain (LV GLS) significantly decreased from 17±3.3 to 11%±2.8% (p=0.004) during RVA-stimulation. At the multivariable analysis, BFM and diastolic KE dissipation were significantly associated with LV GLS deterioration (Beta Coeff.=0.54, 95% CI 0.07 to 1.00, p=0.034 and Beta Coeff.=0.29, 95% CI 0.02 to 0.57, p=0.049, respectively).ConclusionsIn RVA-stimulation, BFM impairment and KE dissipation were found to be significantly associated with LV GLS deterioration, when controlling for potential confounders. Such changes may favour the onset of cardiac remodelling and sustain heart failure.