bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systolic third sound associated with systolic anterior motion of the mitral valve in cats with obstructive hypertrophic cardiomyopathy
Authors: Saponaro Vittorio , Mey Clémence , Vonfeld Irène , Chamagne Antoine , Alvarado Maria‐Paz , Cadoré Jean‐luc , Chetboul Valérie , Desquilbet Loïc 
Published: July 2023

AbstractBackgroundThird heart sounds in cats frequently are associated with hypertrophic cardiomyopathy (HCM) but their exact characterization and timing within the cardiac cycle remains unknown.ObjectivesCharacterize third heart sounds in cats by phonocardiography and test the ability of 3 observers with different levels of experience and training to recognize third systolic heart sounds in cats.AnimalsFifty client‐owned cats of different breeds presented for heart screening.MethodsCats were prospectively assessed using an electronic stethoscope (with digital recording) and then underwent full conventional echocardiographic examination. Audio recordings were blindly assessed in a random order by 3 observers: the cardiologist who collected clinical data, as well as a trained and an untrained junior veterinarian. Cohen's kappa coefficients were calculated to quantify agreement between the opinion of each observer and the echocardiography results (considered the gold standard).ResultsTwenty cats had a third systolic sound on phonocardiography and an obstructive HCM phenotype with systolic anterior motion of the mitral valve (SAM) on echocardiography. Agreement with echocardiography was very good for the experienced cardiologist, substantial for the trained junior veterinarian, and poor for the untrained junior veterinarian (kappa of 0.92, 0,64, and 0.08, respectively).Conclusions and Clinical ImportanceWe describe here a new auscultatory abnormality in cats with obstructive HCM. It could help a trained non‐cardiologist veterinarian in suspecting obstructive HCM in cats based on auscultation only.
An exploratory international survey of the assessments and interventions used by occupational therapists and physiotherapists during the hospitalization of people with Guillain‐Barré syndrome
Authors: Houlahan Madeline , Gintings Nicole , Burdon Madeline , Ashby Samantha 
Published: July 2023

AbstractGuillain‐Barré syndrome is a rare neurological condition. Although some people make a substantial functional recovery, almost half require intensive rehabilitation. Data were collected using a cross‐sectional survey which investigated the assessments and interventions used by occupational therapists and physiotherapists for people with Guillain‐Barré syndrome. Seventy valid responses were received from 10 countries. The survey highlighted four factors about current practice: (i) practitioners did not identify the use of formal clinical guidelines or protocols for Guillain‐Barré Syndrome treatment of the upper limb; (ii) a range of standardized and non‐standardized assessment and goal‐setting tools are utilized; (iii) interventions include passive and active range of motion exercises, and the prescription of upper limb/hand splints; and (iv) interdisciplinary practice is common in the intensive care unit and during acute phases of Guillain‐Barré syndrome, whereas discipline‐specific work is more common during rehabilitation. A range of goal‐setting and assessment tools are used by occupational therapists and physiotherapists during the hospitalization of people with Guillain‐Barré syndrome. The type and duration of interventions vary and may reflect the lack of international protocols for Guillain‐Barré syndrome rehabilitation.
Unique presentation of late‐onsetPneumocystis pneumonia in a pediatric kidney transplant recipient
Authors: Grewal Manpreet , Srivastava Ruma , Ang Jocelyn Y. , Salimnia Hossein , Jain Amrish 
Published: July 2023

AbstractBackgroundRestrictive lung disease leading to abnormal lung function in kidney transplant recipients is commonly associated with noninfectious complications or medications used for post‐transplant immunosuppression. Herein, we report an interesting case of pediatric kidney transplant recipient with weight loss and abnormal spirometry who was diagnosed to have late‐onset Pneumocystis pneumonia.Case ReportA 17‐year‐old male patient with a history of allergic rhinitis, mild persistent asthma, and deceased donor kidney transplant, performed 18 months prior, presented for routine evaluation of his asthma to the pulmonology clinic. He was clinically asymptomatic except for a weight loss of 8 kg over 6‐month period prior to presentation. Patient's spirometry was suggestive of a restrictive pattern and further investigation using a high‐resolution computed tomography (HRCT) of the chest showed bilateral diffuse ground‐glass reticulonodular opacities with subpleural sparing suggestive of interstitial pneumonitis. A bronchoscopy with bronchoalveolar lavage revealed organisms consistent with Pneumocystis jirovecii on gomori‐methenamine‐silver (GMS) staining. Beta‐d‐glucan testing in serum revealed a level of >500 pg/mL (normal 0‐59 pg/mL) further supportive of Pneumocystis jirovecii infection. Patient was treated with a 6‐week course of trimethoprim‐sulfamethoxazole. His weight loss and beta‐d‐glucan levels improved over a course of 6 months, and he continues to be on trimethoprim‐sulfamethoxazole prophylaxis.ConclusionLate‐onset Pneumocystis jirovecii infection in kidney transplant recipients can have an atypical presentation. Treating physicians should consider PJP in the differential diagnosis of unexplained weight loss in pediatric kidney transplant recipients, especially those receiving a large cumulative burden of immunosuppression.
The impact of COVID‐19 on American Society for Public Administration's scholar and practitioner membership
Authors: Knox Claire Connolly , Moloney Kim , Entress Rebecca M. , Thornton Tonya E. , Jeong Bok Gyo , Bernier Nathalie 
Published: July 2023

AbstractThe novel coronavirus, or SARS‐CoV‐2, which caused COVID‐19, emerged in China in December 2019 and by March 2020 had rapidly spread becoming a global pandemic. The pandemic tested nearly every aspect of the public sector including efforts to respond to, recover from, and mitigate its impacts. This Viewpoint explores COVID‐19 impact on US‐based public administration scholars and practitioners. The results of a survey conducted for members of the American Society for Public Administration showed that respondents grappled with issues involving institutional trust, organizational inequity and capacity, group‐based inequity, health measures, shifts in academic practice, and challenges arising from intergovernmentalism. We conclude with recommendations for future research.
A mixed‐methods analysis of stereotypical female librarian representation in memes
Authors: Neville Jennifer 
Published: July 2023

AbstractThis essay is a mixed‐methods analysis of stereotypical female librarian representation in memes.BackgroundLibrarianship has been a female‐dominated field since the 19th century. Because of the influx of women, the field has been seen as feminized, which means that it was seen in a negative light and less important than other jobs. Feminization led to two predominant female librarian stereotypes: the spinster librarian and the sexy librarian. Under the pretext of humor, internet memes of stereotypical librarians are damaging to women in librarianship.ObjectiveThe purpose of this essay was to explore how female librarians were stereotypically represented in memes and why they were characterized thusly.MethodsQuantitative information concerning how female librarians were represented in memes was compiled through a content analysis, entered into the input form, and tallied using Microsoft Excel. The extent of the representation was also measured through quantitative means by assessing the number of available memes. Finally, the reasons why female librarians were represented as such was explored using a feminist theory framework.ResultsThe memes from the sample stressed certain traits of female librarians such as tight clothing, rigid postures, and stern expressions. The images framed these traits as the most important qualities of female librarians. The sexy librarian stereotype was much more common than the spinster. More importantly, perhaps, was the crossover of representation, which created a new version that blended the spinster and sexy librarian trope. Images must be read in terms of the context; the images in the memes showed mainly objectification and gender stereotyping.ConclusionThe memes from the research sample demonstrated that there was still a significant amount of stereotyping and perpetuation of the feminization of librarianship. Representing female librarians in such a way indicated that her contributions were marginal, that she was only in the library to be objectified. The humorous text of the memes acted as an attempt to make light of the stereotyped imagery, but instead of being ironic and or intellectual, it served to propagate the stereotype. By treating female librarians in this manner, feminization of the profession continued and was maintained in the meme world.
Overestimation of fibrinogen concentration in cryoprecipitate by repeated freeze–thawing with long thawing period as used in the Clauss method
Authors: Tanaka Yumi , Matsumoto Takeshi , Kadoya Kanae , Shimokaria Yuji , Tawara Isao , Katayama Naoyuki , Ohishi Kohshi 
Published: July 2023

AbstractBackgroundCryoprecipitate (CRY) is widely used for treating acquired hypofibrinogenemia. During our study to determine an optimal preparation method, we noticed that the measurement of fibrinogen concentration in CRY had a risk of overestimation. We analyzed this condition and mechanism.Study Design and MethodsCRY was prepared from fresh frozen plasma (FFP) under four conditions: A, 30 h thawing time, 2 cycles; B, 24 h thawing time, 2 cycles; C, 30 h thawing time, 1 cycle; and D, 24 h thawing time, 1 cycle. Then, fibrinogen concentrations in CRY and cryosupernatant (CS) were measured by the Clauss method.ResultsPurification (CRY/CRY+CS) and recovery (CRY/FFP) rates in CRY prepared under 2‐cycle conditions were higher than those under 1 cycle. However, recovery rates often exceeded 100%, particularly in the case of CRY prepared under A condition, and fibrinogen concentrations calculated by direct measurement were higher than those indirectly calculated from FFP and CS, suggesting an overestimation of fibrinogen values. The level of soluble fibrin monomer complex was considerably higher in CRY prepared under A than under D condition, indicating that CRY adopted a hypercoagulated state. We further found that repeated thawing/freezing increased fibrinogen values as measured by the Clauss method while mechanical vortexing did not.DiscussionOur findings suggest that direct assessment of fibrinogen contents in CRY prepared by repeated freeze–thawing with a longer thawing period presents a higher risk of overestimation. For the purpose of quality control, we propose an alternative method to indirectly estimate fibrinogen concentrations in CRY from those of CS and FFP.
Exergoeconomics of a Solar-Assisted Double-Effect Absorption Cogeneration System Integrated With a Cold Thermal Energy Storage System
Authors: Alghamdi Abdulmajeed , Sherif S. A. 
Published: July 2023

Abstract
The cogeneration system described in this paper is constructed based on a solar-assisted double-effect absorption cogeneration cycle with an adjustable cooling-to-power ratio. As a proposed technique to benefit from the ability to adjust the cooling-to-power ratio, this system is integrated with a cold thermal energy storage system. The procedure described here will be applied to a combined cooling and power system with a thermal energy storage capability for a large medical center in Jeddah, Saudi Arabia. Through an exergoeconomic analysis of the integrated system on a typical summer day in Jeddah, we found that the integrated system could fulfill the cooling and power demands of the medical center under study with an exergetic efficiency of 53.97%. From an economics perspective, the integrated system was found to deliver cooling and power with average unit costs of 222.89 $/GJ and 17.06 $/GJ, respectively. These costs were found to be lower than the unit costs of the respective cooling and power costs delivered to the medical center if they were obtained from an electrically-driven vapor compression system and the electric grid, respectively. For the case study investigated, it has been found that using the integrated system is a desirable approach due to the system’s lower unit costs as well as its relatively short payback period. Additionally, it has been found that although cogeneration systems constructed based on the double-effect combined cooling and power cycle have higher exergy destruction and capital investment rates, they have a lower unit cost for the produced exergy in comparison with those of cogeneration systems constructed based on a single-effect combined cooling and power cycle.
Sweat conductivity diagnostic accuracy for cystic fibrosis: a systematic review and meta-analysis
Authors: Zhang Linjie , Nomiyama Seiko , Bedran Renata Marcos , Alvim Cristina Gonçalves , Ribeiro José Dirceu , Camargos Paulo 
Published: July 2023

ObjectiveWe conducted a systematic review and meta‐analysis of diagnostic test accuracy studies to summarise the properties of sweat conductivity (SC) to rule in/out cystic fibrosis (CF).Data sourceWe searched PubMed, Embase, Web of Science, Google Scholar, SciELO and LILACS up to 13 March 2023.Study selectionWe selected prospective and retrospective diagnostic test accuracy studies which compared SC, measured through two well-established and commercially available devices, that is, Nanoduct or Sweat-Chek Analyser, to quantitative measurement of sweat chloride.Main outcome measuresPooled sensitivity, specificity, positive likelihood ratio (+LR) and negative likelihood ratio (−LR), and their corresponding 95% CIs.Data extraction and synthesisThe Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies guidelines were followed. Data were extracted by one reviewer and checked by another. The hierarchical summary receiver operating characteristics model was used to estimate diagnostic test accuracy.ResultsTen studies involving 8286 participants were included. The pooled estimates of sensitivity, specificity, +LR and −LR were 0.97 (95% CI 0.94 to 0.98), 0.99 (95% CI 0.98 to 0.99), 171 (95% CI 58 to 500) and 0.02 (95% CI 0.01 to 0.05), respectively. Sensitivity analyses did not reveal a substantial impact of study-level factors on the results, such as study quality, cut-off values for a positive test, study sample size and participant age group. The quality of evidence was considered moderate.ConclusionSC demonstrated excellent diagnostic performance. In addition, its accuracy parameters suggest its role as an alternative to the sweat test for CF diagnosis.PROSPERO registration numberCRD42022284504.
EarlySupervisedIncrementalResistanceTraining (ESpIRiT) following cardiac surgery via a median sternotomy: a study protocol of a multicentre randomised controlled trial
Authors: Md Ali Nur Ayub , El-Ansary Doa , Abdul Rahman Mohd Ramzisham , Ahmad Suriah , Royse Colin , Huat Chong Tze , Muhammad Nor Mohamad Arif , Dillon Jeswant , Royse Alistair , Haron Hairulfaizi , Ismail Muhamad Ishamudin , Abdul Manaf Mohd Rizal , Katijjahbe Md Ali 
Published: July 2023

IntroductionThere is no consistency in current practice pertaining to the prescription and progression of upper limb resistance exercise following cardiac surgery via median sternotomy. The aim of this study is to investigate whether less restrictive sternal precautions with the addition of early-supervised resistance training exercise improves upper limb function and facilitates recovery following median sternotomy.Methods and analysisThis is double-blind randomised controlled trial, with parallel group, concealed allocation, blinding of patients and assessors, and intention-to-treat analysis. 240 adult participants who had median sternotomy from eight hospitals in Malaysia will be recruited. Sample size calculations were based on the unsupported upper limb test. All participants will be randomised to receive either standard or early supervised incremental resistance training. The primary outcomes are upper limb function and pain. The secondary outcomes will be functional capacity, multidomain recovery (physical and psychological), length of hospital stay, incidence of respiratory complications and quality of life. Descriptive statistics will be used to summarise data. Data will be analysed using the intention-to-treat principle. The primary hypothesis will be examined by evaluating the change from baseline to the 4-week postoperative time point in the intervention arm compared with the usual care arm. For all tests to be conducted, a p value of <0.05 (two tailed) will be considered statistically significant, and CIs will be reported. The trial is currently recruiting participants.Ethics and disseminationThe study was approved by a central ethical committee as well as the local Research Ethics Boards of the participating sites (UKM:JEP-2019-654; Ministry of Health: NMMR-50763; National Heart Centre: IJNREC/501/2021). Approval to start was given prior to the recruitment of participants commencing at any sites. Process evaluation findings will be published in peer-reviewed journals and presented at relevant academic conferences.Trial registration numberInternational Standard Randomised Controlled Trials Number (ISRCTN17842822).
Evaluations of statistical methods for outlier detection when benchmarking in clinical registries: a systematic review
Authors: Hansen Jessy , Ahern Susannah , Earnest Arul 
Published: July 2023

ObjectivesBenchmarking is common in clinical registries to support the improvement of health outcomes by identifying underperforming clinician or health service providers. Despite the rise in clinical registries and interest in publicly reporting benchmarking results, appropriate methods for benchmarking and outlier detection within clinical registries are not well established, and the current application of methods is inconsistent. The aim of this review was to determine the current statistical methods of outlier detection that have been evaluated in the context of clinical registry benchmarking.DesignA systematic search for studies evaluating the performance of methods to detect outliers when benchmarking in clinical registries was conducted in five databases: EMBASE, ProQuest, Scopus, Web of Science and Google Scholar. A modified healthcare modelling evaluation tool was used to assess quality; data extracted from each study were summarised and presented in a narrative synthesis.ResultsNineteen studies evaluating a variety of statistical methods in 20 clinical registries were included. The majority of studies conducted application studies comparing outliers without statistical performance assessment (79%), while only few studies used simulations to conduct more rigorous evaluations (21%). A common comparison was between random effects and fixed effects regression, which provided mixed results. Registry population coverage, provider case volume minimum and missing data handling were all poorly reported.ConclusionsThe optimal methods for detecting outliers when benchmarking clinical registry data remains unclear, and the use of different models may provide vastly different results. Further research is needed to address the unresolved methodological considerations and evaluate methods across a range of registry conditions.PROSPERO registration numberCRD42022296520.
External validation of a clinical prediction tool for the use of manual therapy for patients with temporomandibular disorders: a protocol for a prospective observational study
Authors: Asquini Giacomo , Devecchi Valter , Edoardo Bianchi Andrea , Borromeo Giulia , Tessera Paola , Falla Deborah 
Published: July 2023

IntroductionClinical guidelines recommend conservative treatment for the management of temporomandibular disorders (TMD), and manual therapy directed to temporomandibular structures is commonly applied to reduce pain and improve function. In a recent prospective study, we developed a clinical prediction tool based on an array of predictors to identify people with TMD who are likely to experience significant pain relief and functional improvements following a programme of manual therapies (MTP) applied to temporomandibular structures. The purpose of this study is to externally validate in a different sample (temporal validation) the prediction model obtained in the initial study.Methods/analysisThis observational prospective study will recruit a cohort of 120 adults with TMD from a Dental Hospital in Italy. The intervention will be an MTP consisting of four sessions (once per week) of manual therapy applied to temporomandibular structures. Candidate predictors included in the predictive model will be pain intensity during mouth opening, treatment expectations, number of pain locations, central sensitisation, TMD pain duration and maximal mouth opening. Outcome measures (i.e., pain intensity, functional improvement) will be collected before starting the MTP, after the last session and after 1 month (2 months from baseline). A reduction of pain intensity by at least 30% will be considered a good outcome. External validity of the prediction model will be evaluated after the last session by measuring its calibration, discrimination and overall fit. Additionally, the performance of the model will be evaluated considering the clinical outcomes collected 1 month after the last MTP session.Ethics and disseminationEthical approval was obtained from the Ethics Committee of the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Italy. The results will be submitted for publication in a peer-reviewed journal, and the prediction model will be implemented in a web-based calculator to facilitate its use by clinicians.Trial registration numberNCT03990662.