bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burnout symptoms and workplace satisfaction among veterinary emergency care providers
Authors: Holowaychuk Marie K. , Lamb Kenneth E. 
Published: January 2023

AbstractObjectivesTo measure symptoms of burnout among veterinary emergency care providers (VECPs), determine how burnout symptoms among VECPs compare to human emergency care providers, and identify what demographic and workplace variables are associated with these symptoms.DesignCross‐sectional study using an online survey and convenience sampling.SubjectsA total of 1204 VECPs including mostly veterinarians and technicians.InterventionsAn online questionnaire using the Maslach Burnout Inventory and Areas of Worklife Survey was distributed between May and July 2018 via an email list and social media. VECPs working less than part‐time (<20 h/week) and incomplete survey responses were excluded.Measurements and Main ResultsVECPs had higher total emotional exhaustion and depersonalization scores and lower total personal accomplishment scores compared to emergency department human healthcare professionals (P < 0.001). Subsets of VECPs with the highest burnout symptom scores included females, residents, those working in private or corporate referral hospitals, and those with off‐shift duties. Workplace variables positively associated with burnout symptom scores among these groups typically included perceptions of an unmanageable workload, lack of control over work, little reward (recognition) for work, or an unfair allocation of resources at work. Conversely, VECPs working >20 years and those married or with children at home had lower burnout symptom scores. Workplace variables negatively associated with burnout symptom scores among respondents included perceptions of having a manageable workload, control over work, reward for work, or a fair allocation of resources at work. Multivariable analysis revealed that the variable most positively associated with emotional exhaustion and depersonalization was workload, whereas reward was most positively associated with personal accomplishment (P < 0.001).ConclusionsBurnout symptom scores are higher among VECPs compared to human emergency department teams. Targeting workplace variables such as workload and reward is warranted in future studies to determine strategies for reducing burnout among VECPs.
Behavior of Gas–Solid Two-Phase Flow in a Backward Facing Step - Effect of Interparticle Collisions
Authors: Senapati Santosh Kumar 
Published: January 2023

Abstract
This article presents a computational investigation of the dilute gas–solid flow's loss coefficient and reattachment length in a horizontally placed backward-facing step. The article's primary objective is to study the effect of the interparticle collision and three significant parameters, namely, inlet solid-phase volume fraction (αs=0.002, 0.005), particle size (dp = 70 μm and 200 μm), and solid-particle density (ρs = 1500 kg/m3 and 3000 kg/m3). The numerical procedure uses the Eulerian–Eulerian approach in conjunction with the Kinetic theory of Granular flow and the four-way coupling approach. The outcomes show that the loss coefficient and the reattachment length increase as the interparticle collision intensifies with the system. Moreover, these parameters show higher values with small particle sizes and higher solid-phase volume fractions. The reattachment length is higher with less dense solid particles and higher with heavier solid particles.
Attention-Enhanced Multimodal Learning for Conceptual Design Evaluations
Authors: Song Binyang , Miller Scarlett , Ahmed Faez 
Published: January 2023

Abstract
Conceptual design evaluation is an indispensable component of innovation in the early stage of engineering design. Properly assessing the effectiveness of conceptual design requires a rigorous evaluation of the outputs. Traditional methods to evaluate conceptual designs are slow, expensive, and difficult to scale because they rely on human expert input. An alternative approach is to use computational methods to evaluate design concepts. However, most existing methods have limited utility because they are constrained to unimodal design representations (e.g., texts or sketches). To overcome these limitations, we propose an attention-enhanced multimodal learning (AEMML)-based machine learning (ML) model to predict five design metrics: drawing quality, uniqueness, elegance, usefulness, and creativity. The proposed model utilizes knowledge from large external datasets through transfer learning (TL), simultaneously processes text and sketch data from early-phase concepts, and effectively fuses the multimodal information through a mutual cross-attention mechanism. To study the efficacy of multimodal learning (MML) and attention-based information fusion, we compare (1) a baseline MML model and the unimodal models and (2) the attention-enhanced models with baseline models in terms of their explanatory power for the variability of the design metrics. The results show that MML improves the model explanatory power by 0.05–0.12 and the mutual cross-attention mechanism further increases the explanatory power of the approach by 0.05–0.09, leading to the highest explanatory power of 0.44 for drawing quality, 0.60 for uniqueness, 0.45 for elegance, 0.43 for usefulness, and 0.32 for creativity. Our findings highlight the benefit of using multimodal representations for design metric assessment.
Thermoeconomic Analysis of Novel Vapor Compression-Absorption Multi-Target-Temperature Cascade Refrigeration System
Authors: Mishra Shubham Kumar , Sharma Ajay , Verma Ashutosh Kumar , Yadav Laxmikant 
Published: January 2023

Abstract
To fulfill the requirement of multi-refrigeration temperature, multi-target-temperature techniques are increasing research interests for industrial and commercial applications. Taking forward the previous research keeping in mind the electric power saving, a novel vapor compression-absorption multi-target-temperature cascade (VCAMTTS) system is proposed, in which NH3-H2O pair is used as vapor absorption section in the high-temperature circuit whereas two out of three refrigerant R717, R410A, and R134a are used in two lower circuits results in three possible configurations as NH3-H2O/R717 + R410A, NH3-H2O/R410A + R134a, and NH3-H2O/R134a + R717. This detailed analysis is based on the selection of the best configuration, investigating these on every aspect of energy, exergy, and economy (EEE). The whole investigation revolves around the parameters such as coefficient of performance (COP), exergy efficiency, and their sensitivity due to change of evaporator temperature and refrigerating capacity distribution ratio, exergy-economic factor, and product cost rate. Based on its best thermodynamic and thermal-economic performance, NH3-H2O/R410A + R134a (NHRARa) system can be a better option for multi-target-temperature refrigeration applications. Further, from the thermoeconomic analysis the optimum COP, exergy efficiency, and minimum cost obtained are about 0.3378, 8.29%, and 24.19 $/h, respectively.
Identifying Risk Profiles for Nonadherence to the 24-Hour Movement Guidelines for Children and Youth 6 Months Into the COVID-19 Pandemic
Authors: Guerrero Michelle D. , Moore Sarah , Faulkner Guy , Roberts Karen C. , Mitra Raktim , Vanderloo Leigh M. , Rhodes Ryan E. , Tremblay Mark S. 
Published: January 2023

Purpose: The purposes of the current study were to identify risk profiles for nonadherence among children and youth (5–17 y) at the 6-month mark of the COVID-19 pandemic and to discuss similarities and differences between risk profiles identified in the current study and those identified at the 1-month mark of the pandemic. Methods: Data were part of a nationally representative sample of 1143 parents (Mage = 43.07 y, SD = 8.16) of children and youth (5–17 y) living in Canada. Survey data were collected in October 2020. Results: Results showed that 3.8% met all movement behavior recommendations, 16.2% met the physical activity recommendation, 27% met the screen time recommendation, and 63.8% met the sleep recommendation. Characteristics associated with nonadherence to all movement behaviors included low parental perceived capability to restrict screen time and decreased overall time spent outdoors. Characteristics associated with nonadherence to the physical activity and screen time recommendations included youth (12–17 y), low parental perceived capability to restrict screen time, decreased time spent outdoors, and increased screen time. Conclusion: Results emphasized the importance of parental perceived capability to restrict screen time and children’s and youth’s outdoor time and showed that pandemic-related factors have impacted children and youth differently.
Convergent genomics of longevity in rockfishes highlights the genetics of human life span variation
Authors: Treaster Stephen , Deelen Joris , Daane Jacob M. , Murabito Joanne , Karasik David , Harris Matthew P. 
Published: January 2023

Longevity is a defining, heritable trait that varies dramatically between species. To resolve the genetic regulation of this trait, we have mined genomic variation in rockfishes, which range in longevity from 11 to over 205 years. Multiple shifts in rockfish longevity have occurred independently and in a short evolutionary time frame, thus empowering convergence analyses. Our analyses reveal a common network of genes under convergent evolution, encompassing established aging regulators such as insulin signaling, yet also identify flavonoid (aryl-hydrocarbon) metabolism as a pathway modulating longevity. The selective pressures on these pathways indicate the ancestral state of rockfishes was long lived and that the changes in short-lived lineages are adaptive. These pathways were also used to explore genome-wide association studies of human longevity, identifying the aryl-hydrocarbon metabolism pathway to be significantly associated with human survival to the 99th percentile. This evolutionary intersection defines and cross-validates a previously unappreciated genetic architecture that associates with the evolution of longevity across vertebrates.
Exploring the effectiveness of a cascading mentorship model in developing CanMEDS competencies in postgraduate medical education: a qualitative interview study among resident mentors at a medical school in Canada
Authors: Guo Tina , Chowdhury Mushfika , Rasouli Rahna , Patel Mitesh 
Published: January 2023

ObjectivesThe CanMEDS framework, an educational framework for physicians used in Canada, defined competencies that physicians require to meet patients’ needs, all of which can be cultivated through mentorship activities. The Advocacy Mentorship Initiative (AMI) at the University of Toronto used a cascading mentorship model (CMM), whereby resident mentors (RMs) mentored undergraduate medical student mentors (MSMs), who in turn mentored youth raised in at-risk environments. Both RMs and MSMs were mentored by the AMI programme lead, a staff psychiatrist, with expertise in child and adolescent psychiatry. The research question of this study was as follows: What were the merits of using a CMM in enhancing the knowledge, competencies and residency experiences of RMs in AMI?DesignQualitative interview study.Setting and participantsRMs involved in AMI from January 2017 to December 2020 were invited to participate in the study. A total of 11 RMs agreed to participate.MethodsInterviews were conducted to canvas participants about how AMI impacted them, and these were recorded, transcribed and anonymised. Braun and Clarke’s approach to thematic analysis was used to identify ‘subthemes’ and ‘themes’.ResultsEleven RMs participated in the study. A major theme identified was how AMI enhanced the medical learner experience by augmenting the educational experience of MSMs, strengthening RMs’ values and attitudes, and strengthening RMs’ knowledge and competencies. The second theme captured was the effective facets of a mentorship programme in AMI, including the CMM, and collaborative and inclusive relationships between mentors and mentees.ConclusionsRMs identified that the CMM of AMI cultivated CanMEDS competencies in medical learners; deepened medical learners’ understanding of social determinants of health; and offered a bidirectional approach to teaching and learning between MSMs and RMs. MSMs and RMs also learnt from the staff psychiatrist.
Effectiveness of continuous subcutaneous insulin infusion versus multiple daily injections on glycaemic control among older adults with type 2 diabetes: protocol for systematic review and meta-analysis
Authors: Yang Bei , Han Lin , Wang Yin , Cheng Kangyao 
Published: January 2023

IntroductionInsulin therapy plays an irreplaceable role in glycaemic control among older adults with type 2 diabetes mellitus (T2DM) and can be administered by either multiple daily injections (MDI) of insulin or by a continuous subcutaneous insulin infusion (CSII) pump. Many clinical trials have compared the effects of CSII pumps and MDI in various diabetic populations, but there has been no systematic review and meta-analysis focusing on older adults with T2DM. This study aims to determine whether the CSII pump is associated with better glycaemic control relative to the MDI in older adults with T2DM.Methods and analysisPubMed, Medline, Cochrane Library, Web of Science core collection, China National Knowledge Infrastructure (CNKI), Wan Fang Database, Chinese Science and Technology Journal Database (VIP) and Chinese Biomedical Literature Database (SinoMed) will be searched from inception to December 2021. Only randomised controlled trials will be included, and the language of the selected studies will be restricted to English and Chinese. Two researchers will independently screen the studies, extract data, assess the risk of bias and evaluate the quality of evidence. Any disagreement will be resolved by consensus or by a third researcher. Data analysis and synthesis will be conducted using RevMan V.5.3. Subgroup analysis, sensitivity analysis and publication bias assessment will be performed, as necessary.Ethics and disseminationAs this study will not contain personal information, ethical approval will not be required. The results of the study will be published in a peer-reviewed journal or at relevant conference.PROSPERO registration numberCRD42021283729.
Mental health of pregnant and postpartum women during the third wave of the COVID-19 pandemic: a European cross-sectional study
Authors: Tauqeer Fatima , Ceulemans Michael , Gerbier Eva , Passier Anneke , Oliver Alison , Foulon Veerle , Panchaud Alice , Lupattelli Angela , Nordeng Hedvig 
Published: January 2023

ObjectiveTo describe the mental health of perinatal women in five European countries during the third pandemic wave and identify risk factors related to depressive and anxiety symptoms.DesignA cross-sectional, online survey-based study.SettingBelgium, Norway, Switzerland, the Netherlands and the UK, 10 June 2021–22 August 2021.ParticipantsPregnant and up to 3 months postpartum women, older than 18 years of age.Primary outcome measureThe Edinburgh Depression Scale (EDS) and the Generalised Anxiety Disorder scale (GAD-7) were used to assess mental health status. Univariate and multivariate generalised linear models were performed to identify factors associated with poor mental health.Results5210 women participated (including 3411 pregnant and 1799 postpartum women). The prevalence of major depressive symptoms (EDS ≥13) was 16.1% in the pregnancy group and 17.0% in the postpartum . Moderate to severe generalised anxiety symptoms (GAD ≥10) were found among 17.3% of the pregnant and 17.7% of the postpartum women. Risk factors associated with poor mental health included having a pre-existing mental illness, a chronic somatic illness, having had COVID-19 or its symptoms, smoking, unplanned pregnancy and country of residence. Among COVID-19 restrictive measures specific to perinatal care, pregnant and postpartum women were most anxious about not having their partner present at the time of delivery, that their partner had to leave the hospital early and to be separated from their newborn after the delivery.ConclusionApproximately one in six pregnant or postpartum women reported major depression or anxiety symptoms during the third wave of the pandemic. These findings suggest a continued need to monitor depression and anxiety in pregnancy and postpartum populations throughout and in the wake of the pandemic. Tailored support and counselling are essential to reduce the burden of the pandemic on perinatal and infant mental health.
Effectiveness of cerebellar vermis intermittent theta-burst stimulation in improving trunk control and balance function for patients with subacute stroke: a randomised controlled trial protocol
Authors: Chen Yi , Su Wei , Gui Chen-Fan , Guo Qi-Fan , Tan Hui-Xin , He Lin , Jiang Han-Hong , Wei Qing-Chuan , Gao Qiang 
Published: January 2023

IntroductionBalance impairments frequently occur after stroke. Achieving effective core trunk stability is the key to improving balance ability. However, there is still a lack of advanced well-defined rehabilitation protocols for balance improvement in patients with stroke. Intermittent theta-burst stimulation (iTBS) is a non-invasive brain activity modulation strategy that can produce long-term potentiation. The cerebellar vermis is a fundamental structure involved in balance and motor control. However, no study has demonstrated the therapeutic effect and potential mechanism of cerebellar vermis iTBS on balance after stroke.Methods and analysisThis study will be a prospective single-centre double-blind randomised controlled clinical trial with a 3-week intervention and 3-week follow-up. Eligible participants will be randomly allocated to the experimental group or the control group in a 1:1 ratio. After routine conventional physical therapy, patients in the experimental group will receive cerebellar vermis iTBS, whereas patients in the control group will receive sham stimulation. The overall intervention period will be 5 days a week for 3 consecutive weeks. The outcomes will be measured at baseline (T0), 3 weeks postintervention (T1) and at the 3-week follow-up (T2). The primary outcomes are Berg Balance Scale and Trunk Impairment Scale scores. The secondary outcomes are balance test scores via the Balance Master system, muscle activation of the trunk and lower limbs via the surface electromyography recordings, cerebral cortex oxygen concentrations measured via the resting-state functional near-infrared spectroscopy, Fugl-Meyer Assessment of Lower Extremity and Barthel index scores.Ethics and disseminationThis study was approved by the West China Hospital Clinical Trials and Biomedical Ethics Committee of Sichuan University. All participants will sign the informed consent form voluntarily. The results of this study will be published in peer-reviewed journals and disseminated at academic conferences.Trial registration numberChiCTR2200065369.
Preclinical optimization of a GPC2-targeting CAR T-cell therapy for neuroblastoma
Authors: Sun Ming , Cao Yingying , Okada Reona , Reyes-González Jeyshka M , Stack Hannah G , Qin Haiying , Li Nan , Seibert Charlie , Kelly Michael C , Ruppin Eytan , Ho Mitchell , Thiele Carol J , Nguyen Rosa 
Published: January 2023

BackgroundAlthough most patients with newly diagnosed high-risk neuroblastoma (NB) achieve remission after initial therapy, more than 50% experience late relapses caused by minimal residual disease (MRD) and succumb to their cancer. Therapeutic strategies to target MRD may benefit these children. We developed a new chimeric antigen receptor (CAR) targeting glypican-2 (GPC2) and conducted iterative preclinical engineering of the CAR structure to maximize its anti-tumor efficacy before clinical translation.MethodsWe evaluated different GPC2-CAR constructs by measuring the CAR activity in vitro. NOD-SCID mice engrafted orthotopically with human NB cell lines or patient-derived xenografts and treated with human CAR T cells served as in vivo models. Mechanistic studies were performed using single-cell RNA-sequencing.ResultsApplying stringent in vitro assays and orthotopic in vivo NB models, we demonstrated that our single-chain variable fragment, CT3, integrated into a CAR vector with a CD28 hinge, CD28 transmembrane, and 4-1BB co-stimulatory domain (CT3.28H.BBζ) elicits the best preclinical anti-NB activity compared with other tested CAR constructs. This enhanced activity was associated with an enrichment of CD8+effector T cells in the tumor-microenvironment and upregulation of several effector molecules such asGNLY,GZMB,ZNF683, andHMGN2. Finally, we also showed that the CT3.28H.BBζ CAR we developed was more potent than a recently clinically tested GD2-targeted CAR to control NB growth in vivo.ConclusionGiven the robust preclinical activity of CT3.28H.BBζ, these results form a promising basis for further clinical testing in children with NB.
Hydroxychloroquine daily dose, hydroxychloroquine blood levels and the risk of flares in patients with systemic lupus erythematosus
Authors: Fasano Serena , Messiniti Valentina , Iudici Michele , Coscia Melania Alessia , Ciccia Francesco 
Published: January 2023

BackgroundRecent guidelines for SLE recommend using a hydroxychloroquine (HCQ) dose less than 5.0 mg/kg/day to reduce the risk of retinopathy. To determine if this dose reduction would have an impact on the clinical course of SLE, we compared flare incidence in a cohort of patients with SLE treated with two different oral HCQ dosages (≤5 mg/kg/day or >5 mg/kg/day). As a secondary analysis, we compared HCQ blood levels between the two different oral dosages, and evaluated the frequency of non-adherence in patients with SLE treated with HCQ.MethodsWe identified a cohort of patients with SLE taking HCQ for at least 6 months and followed for 24 months. At study entry and 6 months later, a blood venous sample was taken to measure HCQ blood levels by liquid chromatography. Incidence of new SLE flares after recruitment was put in relation to daily HCQ dose and mean HCQ blood levels. Cox regression analysis served to identify factors associated with SLE flares.Results83 patients were enrolled. We observed 11 (16%) flares that developed in mean 14.8 months of follow-up. The difference in terms of flare rate and mean HCQ blood levels between the two oral dosages was not statistically significant. There was a trend (p=0.08) for high HCQ dose being associated with a lower flare rate. At Cox analysis, higher HCQ blood levels and older age at baseline were protective against flare occurrence, while concomitant immunosuppressant therapy showed significant positive association. HCQ blood levels did not correlate with prescribed HCQ dose.ConclusionPatients with low oral HCQ dosage tend to have more flares, although the difference was not statistically significant. Higher HCQ blood levels were protective against flare occurrence. The risks and benefits must be balanced in choosing HCQ dose.