bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of restrictions to visiting in paediatric intensive care during the COVID‐19 pandemic
Authors: Wray Jo , Ndokera Rufaro , Pierce Christine M. , Oldham Geralyn 
Published: January 2023

AbstractBackgroundRestrictions to hospital visiting were mandated during the COVID‐19 pandemic, with variability in the degree of restriction imposed. At times, paediatric intensive care units (ICU) restricted visiting to one parent/carer. Views of parents/carers and ICU staff about changes in the visiting policy are not well understood.Study DesignThis is a Service evaluation involving questionnaire survey incorporating rating scales and free‐text comments. Inner‐city specialist children's hospital. Parents/carers of children on ICU between December 2020–March 2021 and staff who were working on ICU during May–June 2021. Parents and staff on ICU were invited to complete a questionnaire focusing on their experience of being or working on ICU. Quantitative data were analysed descriptively and free‐text comments were thematically analysed.ResultsCompleted questionnaires were received from 81/103 (79%) parents/carers and 217/550 (39%) staff. The majority of parents (n = 60;77%) and staff (n = 191;89%) understood the need for the one‐parent visiting policy but acknowledged it was a source of considerable stress. More staff than parents agreed it was appropriate other relatives/friends visiting was not permitted (Z = 3.715;p < .001). There was no association between parents' satisfaction with their child's care and views about the visiting policy. However, staff were more likely to report an impact on their ability to deliver family centred care if they disagreed with the policy.ConclusionThe COVID‐19 visiting policy had a clear impact on parents and staff. In the event of any future threat to open‐access visiting to children in hospital, the potentially damaging effect on children, parents, and staff must be considered.Relevance to Clinical PracticeVisiting policies need to take account of parents being partners in their child's care, rather than purely visitors to the unit where their child is being cared for. Visiting for two carers should always be facilitated, including during a crisis such as a pandemic.
Psychometric properties of the simplified Chinese version of Kihon Checklist in the Chinese older people
Authors: Wang Qun , Tao An , Zhang Yao , Li Xilin , Lin Qiuru , Liu Fang , Li Hong , Qiu Xichenhui 
Published: January 2023

AbstractBackgroundThe 25‐item Kihon Checklist (KCL) is a comprehensive screening tool for identifying frail older people who are at risk of becoming dependent. It has been widely used in different countries and revealed good validity and reliability.ObjectivesThe KCL was translated into Simplified Chinese (KCL‐SC) in 2019. The study aims to evaluate the psychometric properties of the KCL‐SC.MethodsThe study employed a cross‐sectional study design and recruited 258 community‐dwelling older people in Shenzhen, China. The reliability of internal consistency, split‐half reliability and 2‐week test–retest reliability were evaluated. An expert panel examined the content validity. Concurrent validity of KCL‐SC was evaluated by its correlation with the other measure of frailty (FRAIL Scale, FS), activities of daily living (ADL, Katz index of independence in ADL) and depressive mood (5‐item Geriatric Depression Scale, GDS‐5). Construct validity was examined by exploratory factor analysis. Criteria validity in discriminating different frailty status (with FS as criteria) were evaluated with the receiver‐operating characteristic curves (ROC).ResultsThe Cronbach's α was 0.827; split‐half reliability coefficient was 0.737; and test–retest reliability was 0.974. The content validity index was 0.960. The KCL‐SC and dimensions were significantly correlated with the scores of FS, Katz ADL and GDS‐5 (p < 0.05). Seven factors were recognised in the exploratory factor analysis and explained 56.36% of the total variances. The areas under the ROC in discriminating frail/nonfrail, frail/prefrail and prefrail/robust were 0.925, 0.880 and 0.758, respectively. The cut‐off values for identifying prefrailty and frailty were 11 and 5, respectively.ConclusionsThe KCL‐SC revealed satisfactory psychometric properties in identifying frailty among the Chinese community‐dwelling older people.
Iron status and burden of anemia in children with recessive dystrophic epidermolysis bullosa
Authors: Tarango Cristina , Quinn Charles T. , Augsburger Bret , Lucky Anne W. 
Published: January 2023

AbstractBackground and ObjectivesTo describe the prevalence, severity, and management of anemia in a cohort of children with recessive dystrophic epidermolysis bullosa (RDEB) and to highlight the use of soluble transferrin receptor (sTfR) to diagnose iron deficiency in this chronic inflammatory state.MethodsWe studied a cohort of 114 patients with RDEB followed at a pediatric hospital‐based Epidermolysis Bullosa Center from 2010 to 2020; data were prospectively tracked in a comprehensive clinical database that captured all visits, laboratory tests, iron infusions, and transfusions. The primary outcome was occurrence of anemia, which was assessed by age and sex, with and without transfusion support. Secondary outcomes included iron status using a combination of ferritin and sTfR levels, the cumulative incidence of parenteral iron therapy and transfusions, and survival.ResultsIn RDEB, anemia begins in the first year of life and becomes more frequent and severe with age. The prevalence of iron deficiency anemia (IDA) estimated by ferritin was 33.6% (37/110), but the sTfR/log10‐ferritin ratio indicated a 1.5‐fold higher true prevalence of IDA of 50.6% (41/81). 53.5% (61/114) received parenteral iron infusions, transfusions, or both. Higher ferritin was associated with earlier mortality.ConclusionsIndividuals with RDEB have a high burden of anemia (IDA and anemia of inflammation) that requires frequent medical interventions. The sTfR/log10‐ferritin ratio improves the detection of iron deficiency in the context of inflammation and guides therapy.
The effect of the Mindfulness‐Based Stress Reduction program on the level of perceived stress and geriatric depression in older adults: a randomised controlled study
Authors: Kabataş Yıldız Mükerrem , Orak Oya Sevcan 
Published: January 2023

BackgroundThis study aims to reveal the effect of the Mindfulness‐Based Stress Reduction (MBSR) program on the perceived stress and geriatric depression levels of older adults.MethodsThe data of this randomised controlled experimental study were obtained from older adults living in a nursing home in Turkey, between May and November, 2021. The target population consisted of 54 older adults living in the specified nursing home, and the sample consisted of 48 older adults who met the inclusion criteria (n = 24 intervention group, n = 24 control group). The MBSR program was applied to the older adults in the intervention group. Data were collected using the Personal Information Form, the Perceived Stress Scale, and the Geriatric Depression Scale‐Short Form.ResultsIt was revealed that the MBSR program led to a 54.7% decrease in the perceived stress total scores of the participants, and a 49.9% and 49.8% decrease in the sub‐dimensions of perceived insufficient self‐efficacy and perceived stress/distress, respectively. It was also found that the program reduced geriatric depression scores by 14.1% and created a significant effect (P < 0.05).ConclusionsIt can be concluded that the MBSR program is an effective method in reducing the perceived stress and geriatric depression levels of older adults. This effect has been maintained 1 month after the completion of the program.
In-Plane Quasi-Static Crushing Behaviors of a Novel Reentrant Combined-Wall Honeycomb
Authors: Zhou Yang , Pan Yi , Gao Qiang , Sun Beibei 
Published: January 2023

Abstract
The innovative design of microstructure topology is of great significance to improve the energy absorption performance of honeycombs. In this paper, by embedding a hexagonal substructure in each inclined wall of the traditional reentrant (RE) honeycomb, a novel auxetic honeycomb, called reentrant combined-wall (RCW) honeycomb, is developed for improving energy absorption. Combining the experimental methods, numerical simulations, and analytical analyses, we systematically studied the in-plane quasi-static behaviors of the proposed honeycomb structure. It can be found that the deformation of the RCW honeycomb has a transitional stage, which makes a significant stress enhancement. During the crushing process, the Poisson’s ratio of the RCW honeycomb keeps negative and is lower than that of the RE honeycomb. Besides, numerical and analytical analyses show that the stress-strain response of the RCW honeycomb has a good designability. Further, the analysis of specific energy absorption (SEA) is also performed, in which the RCW honeycomb shows a significant superiority over the RE honeycomb, with the SEA value almost twice that of the latter. Therefore, it can be concluded that the proposed novel structure has tangible improvements in the crushing strength, auxetic performance, and energy absorption, which deserves more attention in future work.
On Practical Aspects of Variational Consistency in Contact Dynamics
Authors: Recuero Antonio , Lindsay Alexander 
Published: January 2023

Abstract
Usage of contact mechanics methodologies is a pervasive modeling requirement in dynamic simulations. While for some trivial problems, solutions taken from analytical geometry are available, use of a finite element framework is common to achieve formulation generality. This work explores two dynamic contact formulations: one based on the traditional node-to-segment (NTS) approach, and a variationally consistent segment-to-segment (STS) mortar formulation. The NTS formulation employed here enforces the constraints kinematically (i.e., the interpenetration is enforced to the solver tolerance), whereas the mortar approach uses Lagrange multipliers to enforce the contact constraints. Both approaches are implemented in the open-source finite element framework Multiphysics Object-Oriented Simulation Environment (MOOSE). The results highlight two relevant contact-interface-related dynamic phenomena in finite element simulations. First, stabilization of contact constraints is discussed, taking into account the evolution of the total energy in a benchmark problem. Second, the influence of finite element discretization on both of the aforementioned contact formulations is analyzed by exercising a large-deformation example with continuous relative sliding. Variationally consistent contact approaches such as the mortar formulation lead to improved energy preservation and avoid spurious excitation of the system's frequencies. This is especially relevant in settings where inertia and vibrations are of importance.
Plumbing the depths of magma crystallization using 176Lu/177Hf in zircon as a pressure proxy
Authors: Moreira Hugo , Buzenchi Anda , Hawkesworth Chris J. , Dhuime Bruno 
Published: January 2023

AbstractExtensional tectonics are marked by shallow magma crystallization depths, whereas compressional tectonics are associated with deeper crystallization depths. This implies that variations in crystallization depths can be used to track changes in Earth’s dominant tectonic regimes through time. We therefore developed a new “pressure of crystallization” proxy based on the variation of the 176Lu/177Hf ratio in zircon. This ratio is controlled by zircon fractionation and residual garnet, and it can be used to monitor the evolution of a crystallizing magma ascending within the crust. The secular evolution of the 176Lu/177Hf ratio in zircon is characterized by cyclical oscillations that are broadly in tune with the δ18O record in zircon and with periods of continental collision and supercontinent amalgamation. The apparent mean depth of crystallization of zircon-bearing igneous rocks has decreased with time over the last ~3.0 b.y. This can be linked to shallowing of the primary crystallization depths and/or to the effect of time-integrated erosion in the geologic record. Prior to ca. 3.0 Ga, crystallization depth maxima and oscillations in apparent depth are less clear, perhaps suggesting that the nature of tectonic interactions was different in the Mesoarchean and earlier.
Distribution and causes of blindness and severe visual impairment in children at a tertiary referral centre in Rwanda
Authors: El-Khoury Sylvain , Strittmatter Sophia , Tuyisabe Theophile , Preussner Paul-Rolf , Abdelmassih Youssef 
Published: January 2023

AimTo determine the prevalence and the causes of severe visual impairment and blindness (SVI/BL) in children at a tertiary referral centre in Rwanda.MethodsIn this retrospective study, files of all patients <18 years presenting during the year 2019 at the Kabgayi Eye Unit in Rwanda with SVI/BL (presenting visual acuity of <6/60 Snellen or lack of preferential looking behaviour) in at least one eye were analysed for age, sex, laterality, province of origin and cause of SVI/BL. Causes were categorised according to WHO standard classification.ResultsOut of 3939 children presenting to the clinic, 428 (10.9%) had SVI/BL in at least one eye. 165 (4.2%) patients had bilateral and 263 (6.7%) had unilateral condition. Of patients with BL/SVI, 36.7% were below the age of 6 years. In bilateral BL/SVI, the main causes were cataract (18%), refractive error (18%), keratoconus (13%), congenital eye anomaly (9%), glaucoma (8%), cortical blindness (8%) and retinoblastoma (6%). In unilateral BL/SVI it was trauma (46%), cataract (8%), keratoconus (8%), infectious corneal disease (7%) and retinoblastoma (7%). In preschool children, retinopathy of prematurity accounted for 7% of bilateral BL/SVI. Avoidable BL/SVI accounted for 87% of all cases.ConclusionThe high number of avoidable causes for SVI/BL may be reduced through several cost-effective ways.
Clinical characteristics of mpox infection in individuals who received a first dose of modified vaccinia Ankara immunisation
Authors: Agunbiade Simisola , Burton Felicity , Muirhead Jessica , Whitlock Gary George , Girometti Nicolò 
Published: January 2023

IntroductionA key part of the response to the mpox (monkeypox) epidemic has been the vaccination campaign targeted at gay, bisexual and other men who have sex with men (GBM), including people living with HIV (PLWH).MethodsWe undertook a single-site, retrospective analysis of individuals who received a single dose of modified vaccinia Ankara (MVA-BN) prior to the onset of mpox symptoms. Demographics, clinical characteristics and patient management were analysed.ResultsOf 10 068 individuals who received a first dose of the MVA-BN vaccination, 15 (0.15%) developed mpox subsequently. All individuals identified were GBM with 12/15 (80%) on Pre-exposure prophylaxis (PrEP) and 3/15 (20%) PLWH. Median time from MVA-BN inoculum to mpox symptoms was 4 days (IQR 3–9), systemic symptoms and supportive medical treatment required were common (11/15 patients, 73%) and all had localising skin lesions. One individual required hospitalisation.ConclusionsAlthough clinical presentation was similar to unvaccinated cohorts, we observed low numbers of mpox cases following a first dose of MVA-BN vaccination. Larger, multicentric studies are needed to further evaluate vaccination failure and immunity duration.
Influence of Genomic Landscape on Cancer Immunotherapy for Newly Diagnosed Ovarian Cancer: Biomarker Analyses from the IMagyn050 Randomized Clinical Trial
Authors: Landen Charles N. , Molinero Luciana , Hamidi Habib , Sehouli Jalid , Miller Austin , Moore Kathleen N. , Taskiran Cagatay , Bookman Michael , Lindemann Kristina , Anderson Charles , Berger Regina , Myers Tashanna , Beiner Mario , Reid Thomas , Van Nieuwenhuysen Els , Green Andrew , Okamoto Aikou , Aghajanian Carol , Thaker Premal H. , Blank Stephanie V. , Khor Victor K. , Chang Ching-Wei , Lin Yvonne G. , Pignata Sandro 
Published: January 2023

Abstract

Purpose:
To explore whether patients with BRCA1/2-mutated or homologous recombination deficient (HRD) ovarian cancers benefitted from atezolizumab in the phase III IMagyn050 (NCT03038100) trial.

Patients and Methods:
Patients with newly diagnosed ovarian cancer were randomized to either atezolizumab or placebo with standard chemotherapy and bevacizumab. Programmed death-ligand 1 (PD-L1) status of tumor-infiltrating immune cells (IC) was determined centrally (VENTANA SP142 assay). Genomic alterations, including deleterious BRCA1/2 alterations, genomic loss of heterozygosity (gLOH), tumor mutation burden (TMB), and microsatellite instability (MSI), were evaluated using the FoundationOne assay. HRD was defined as gLOH ≥ 16%, regardless of BRCA1/2 mutation status. Potential associations between progression-free survival (PFS) and genomic biomarkers were evaluated using standard correlation analyses and log-rank of Kaplan–Meier estimates.

Results:
Among biomarker-evaluable samples, 22% (234/1,050) harbored BRCA1/2 mutations and 46% (446/980) were HRD. Median TMB was low irrespective of BRCA1/2 or HRD. Only 3% (29/1,024) had TMB ≥10 mut/Mb, and 0.3% (3/1,022) were MSI-high. PFS was better in BRCA2-mutated versus BRCA2–non-mutated tumors and in HRD versus proficient tumors. PD-L1 positivity (≥1% expression on ICs) was associated with HRD but not BRCA1/2 mutations. PFS was not improved by adding atezolizumab in BRCA2-mutated or HRD tumors; there was a trend toward enhanced PFS with atezolizumab in BRCA1-mutated tumors.

Conclusions:
Most ovarian tumors have low TMB despite BRCA1/2 mutations or HRD. Neither BRCA1/2 mutation nor HRD predicted enhanced benefit from atezolizumab. This is the first randomized double-blind trial in ovarian cancer demonstrating that genomic instability triggered by BRCA1/2 mutation or HRD is not associated with improved sensitivity to immune checkpoint inhibitors.
See related commentary by Al-Rawi et al., p. 1645
Pleomorphic Ventricular Tachycardia in Dilated Cardiomyopathy Predicts Ventricular Tachycardia Recurrence After Ablation Independent From Cardiac Function: Comparison With Patients With Ischemic Heart Disease
Authors: Kimura Yoshitaka , de Riva Marta , Ebert Micaela , Glashan Claire , Wijnmaalen Adrianus P. , Piers Sebastiaan R. , Dekkers Olaf M. , Trines Serge A. , Zeppenfeld Katja 
Published: January 2023

Background:
In dilated cardiomyopathy (DCM), outcome after catheter ablation of ventricular tachycardia (VT) is modest, compared with ischemic heart disease (IHD). Pleomorphic VT (PL-VT) has been associated with fibrotic remodeling and end-stage heart failure in IHD. The prognostic role of PL-VT in DCM is unknown.

Methods:
Consecutive IHD (2009–2016) or DCM (2008–2018) patients undergoing ablation for monomorphic VT were included. PL-VT was defined as ≥1 spontaneous change of the 12-lead VT-morphology during the same induced VT episode. Patients were followed for VT recurrence and mortality.

Results:

A total of 247 patients (86% men; 63±13 years; IHD n=152; DCM n=95) underwent ablation for monomorphic VT. PL-VT was observed in 22 and 29 patients with IHD and DCM, respectively (14% versus 31%,
P
=0.003). In IHD, PL-VT was associated with lower LVEF (28±9% versus 34±12%,
P
=0.02) and only observed in those with LVEF<40%. In contrast, in DCM, PL-VT was not related to LVEF and induced in 27% of patients with LVEF>40%. During a median follow-up of 30 months, 79 (32%) patients died (IHD 48; DCM 31;
P
=0.88) and 120 (49%) had VT recurrence (IHD 59; DCM 61;
P
<0.001). PL-VT was associated with mortality in IHD but not in DCM. In IHD, VT recurrence was independently associated with LVEF, number of induced VTs, and procedural noncomplete success. Of note, in DCM, PL-VT (HR, 2.62 [95% CI, 1.47–4.69]), pathogenic mutation (HR, 2.13 [95% CI, 1.16–3.91]), and anteroseptal VT substrate (HR, 1.75 [95% CI, 1.00–3.07]) independently predicted VT recurrence.

Conclusions:
In IHD, PL-VT was associated with low LVEF and mortality. In DCM, PL-VT was not associated with mortality but a predictor of VT recurrence independent from LVEF. PL-VT in DCM may indicate a specific arrhythmic substrate difficult to control by current ablation techniques.
Chronic Kidney Disease Induces Proarrhythmic Remodeling
Authors: King Benjamin M.N. , Mintz Shana , Lin Xianming , Morley Gregory E. , Schlamp Florencia , Khodadadi-Jamayran Alireza , Fishman Glenn I. 
Published: January 2023

Background:
Patients with chronic kidney disease (CKD) are at increased risk of developing cardiac arrhythmogenesis and sudden cardiac death; however, the basis for this association is incompletely known.

Methods:
Here, using murine models of CKD, we examined interactions between kidney disease progression and structural, electrophysiological, and molecular cardiac remodeling.

Results:
C57BL/6 mice with adenine supplemented in their diet developed progressive CKD. Electrocardiographically, CKD mice developed significant QT prolongation and episodes of bradycardia. Optical mapping of isolated-perfused hearts using voltage-sensitive dyes revealed significant prolongation of action potential duration with no change in epicardial conduction velocity. Patch-clamp studies of isolated ventricular cardiomyocytes revealed changes in sodium and potassium currents consistent with action potential duration prolongation. Global transcriptional profiling identified dysregulated expression of cellular stress response proteins RBM3 (RNA-binding motif protein 3) and CIRP (cold-inducible RNA-binding protein) that may underlay the ion channel remodeling. Unexpectedly, we found that female sex is a protective factor in the progression of CKD and its cardiac sequelae.

Conclusions:
Our data provide novel insights into the association between CKD and pathologic proarrhythmic cardiac remodeling. Cardiac cellular stress response pathways represent potential targets for pharmacologic intervention for CKD-induced heart rhythm disorders.
The Emergence of Argument Structure in Artificial Languages
Authors: Bosc Tom , Vincent Pascal 
Published: January 2023

Abstract
Computational approaches to the study of language emergence can help us understand how natural languages are shaped by cognitive and sociocultural factors. Previous work focused on tasks where agents refer to a single entity. In contrast, we study how agents predicate, that is, how they express that some relation holds between several entities. We introduce a setup where agents talk about a variable number of entities that can be partially observed by the listener. In the presence of a least-effort pressure, they tend to discuss only entities that are not observed by the listener. Thus we can obtain artificial phrases that denote a single entity, as well as artificial sentences that denote several entities. In natural languages, if we ignore the verb, phrases are usually concatenated, either in a specific order or by adding case markers to form sentences. Our setup allows us to quantify how much this holds in emergent languages using a metric we call concatenability. We also measure transitivity, which quantifies the importance of word order. We demonstrate the usefulness of this new setup and metrics for studying factors that influence argument structure. We compare agents having access to input representations structured into pre-segmented objects with properties, versus unstructured representations. Our results indicate that the awareness of object structure yields a more natural sentence organization.