bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonlinear dynamics, coexistence of attractors and microcontroller implementation of a modified Helmholtz Jerk oscillator
Authors: Fangnon R , Kamdoum Tamba Victor , Miwadinou C H , Monwanou A V , Chabi Orou J B 
Published: July 2023

AbstractIn this work, we converted a two-dimensional modified Helmholtz oscillator into a three-dimensional modified Helmholtz jerk oscillator. The study of the stability of the fixed points is made and by using the theorem of Hopf, the condition of existence of the bifurcation of Hopf is sought. By numerical simulations relating to the diagrams of the basin of parameters, attraction, bifurcation, the Lyapunov exponents and the phase portrait, the global dynamics as well as the coexistence of the attractors of the system are analyzed. This study revealed that the considered modified Jerk Helmholtz oscillator can generate Hopf bifurcation, bistable limit cycles, coexistence of chaotic and periodic attractors for appropriate choices of system parameter values. The microcontroller based implementation of the modified Jerk Helmholtz oscillator is proposed to experimentally verify the obtained analytical and numerical results. Finally, to control the amplitude of the Lyapunov attractor and exponent, we added two new parameters in the modified Helmholtz jerk oscillator.
Reduction of pyocyanin synthesis and antibiotic resistance in Pseudomonas aeruginosa by low concentration ethanol
Authors: Jiang Shijie , Deng Yunfeng , Long Zhijian , Liu Peng , Hong Jing , Wei Tingzhou , Zhang Yu , Sun Shanshan , Zhuo Shaoyuan , Shang Liguo 
Published: July 2023

Abstract
Pseudomonas aeruginosa is a common bacteria that may cause a wide range of severe illnesses in humans. One of the nonantibiotic therapies, antivirulence factor therapy, has attracted ongoing interest. Screening for and investigating bacterial virulence factor inhibitors is critical for the development of antivirulence factor treatments. Pyocyanin is P. aeruginosa’s distinctive pigment, and it plays a key role in infection. The impact of low concentration ethanol on pyocyanin production was investigated in this research. Pyocyanin production was found both subjectively and quantitatively. The effects of ethanol on the expression of pyocyanin production genes were studied using qRT-PCR and western blotting. The findings demonstrated that low concentrations of ethanol (as little as 0.1%) greatly suppressed pyocyanin production without affecting P. aeruginosa growth. The degree of inhibition increased as the ethanol contentration rose. Ethanol inhibits the expression of genes involved in pyocyanin production. This inhibitory impact was mostly seen at the protein level. Further research revealed that ethanol increased the expression of the post-transcriptional regulator RsmA, which inhibits pyocyanin production. Given the favorable relationship between pyocyanin production and antibiotic resistance, the impact of low concentration ethanol on various antibiotics was investigated. Ethanol lowered antibiotic resistance in P. aeruginosa, presumably by inhibiting pyocyanin.
Engaging Nigerian Older Persons in Neighborhood Environment Assessment for Physical Activity Participation: A Citizen Science Project
Authors: Odeyemi Emmanuel , Chesser Stephanie , King Abby C , Porter Michelle M 
Published: July 2023

Abstract

Background and Objectives
Global organizations are advocating that older persons’ voices should guide communities in age-friendly design. An important aspect of age friendliness to enable daily function and health is ensuring that physical activity can occur, regardless of age, within local neighborhoods.

Research Design and Methods
This study used a specific citizen science approach, Our Voice, to engage a sample (N = 13) of older adults (60 or older) in Festac Town, Nigeria. The citizen scientists’ roles were to assess and identify how different aspects of the neighborhood environment act as supports or barriers to their physical activity participation. They were individually enabled using a tablet-based mobile application called the Stanford Healthy Neighborhood Discovery Tool to record a total of 156 geocoded photos and 151 commentaries of neighborhood environmental features that facilitate or hinder physical activity in and around their neighborhoods. In a guided process, the following occurred: collaborative discussions of findings with other citizen scientists to determine common targets, setting of priority targets for change, and brainstorming strategies and solutions.

Results
Facilitators of physical activity included: pedestrian and traffic facilities (e.g., traffic lights, walkways); green areas and parks; multigenerational community features (e.g., programs/facilities); opportunities for social connection (e.g., neighborhood associations, churches); safety of destinations and services; and public toilets. Barriers to physical activity included: hazardous walkways/traffic; noise pollution; refuse, selling of public parks; crime (e.g., kidnapping, criminal hideouts); no safe drinking water; and ageism. The priorities for changes were social connectivity; improved pedestrian and traffic facilities; and green and beautiful environments.

Discussion and Implications
In this study, both physical and social aspects of the environment were deemed important for older Nigerians to enable physical activity in their local community. This approach has a promise for age-friendly initiatives seeking local changes by meaningfully engaging older adults.
Association of red blood cell distribution width with hospital admission and in-hospital mortality across all-cause adult emergency department visits
Authors: Hong Woo Suk , Rudas Akos , Bell Elijah J , Chiang Jeffrey N 
Published: July 2023

Abstract

Objectives
To test the association between the initial red blood cell distribution width (RDW) value in the emergency department (ED) and hospital admission and, among those admitted, in-hospital mortality.

Materials and Methods
We perform a retrospective analysis of 210 930 adult ED visits with complete blood count results from March 2013 to February 2022. Primary outcomes were hospital admission and in-hospital mortality. Variables for each visit included demographics, comorbidities, vital signs, basic metabolic panel, complete blood count, and final diagnosis. The association of each outcome with the initial RDW value was calculated across 3 age groups (&lt;45, 45–65, and &gt;65) as well as across 374 diagnosis categories. Logistic regression (LR) and XGBoost models using all variables excluding final diagnoses were built to test whether RDW was a highly weighted and informative predictor for each outcome. Finally, simplified models using only age, sex, and vital signs were built to test whether RDW had additive predictive value.

Results
Compared to that of discharged visits (mean [SD]: 13.8 [2.03]), RDW was significantly elevated in visits that resulted in admission (15.1 [2.72]) and, among admissions, those resulting in intensive care unit stay (15.3 [2.88]) and/or death (16.8 [3.25]). This relationship held across age groups as well as across various diagnosis categories. An RDW &gt;16 achieved 90% specificity for hospital admission, while an RDW &gt;18.5 achieved 90% specificity for in-hospital mortality. LR achieved a test area under the curve (AUC) of 0.77 (95% confidence interval [CI] 0.77–0.78) for hospital admission and 0.85 (95% CI 0.81–0.88) for in-hospital mortality, while XGBoost achieved a test AUC of 0.90 (95% CI 0.89–0.90) for hospital admission and 0.96 (95% CI 0.94–0.97) for in-hospital mortality. RDW had high scaled weights and information gain for both outcomes and had additive value in simplified models predicting hospital admission.

Discussion
Elevated RDW, previously associated with mortality in myocardial infarction, pulmonary embolism, heart failure, sepsis, and COVID-19, is associated with hospital admission and in-hospital mortality across all-cause adult ED visits. Used alone, elevated RDW may be a specific, but not sensitive, test for both outcomes, with multivariate LR and XGBoost models showing significantly improved test characteristics.

Conclusions
RDW, a component of the complete blood count panel routinely ordered as the initial workup for the undifferentiated patient, may be a generalizable biomarker for acuity in the ED.
An evaluation of the quality of Annona muricata leaf products
Authors: Jocelin Chan Wai-Jo , Harnett Joanna E , Meroni Alexandra , McLachlan Andrew J , Hanrahan Jane R 
Published: July 2023

Abstract

Objectives
Annona muricata, also known as graviola, is traditionally used for the treatment of a range of disorders including cancer. Interest in A. muricata use has increased in recent years. This study investigated the quality and safety of a selection of commercially available A. muricata leaf products.

Methods
Seven commercially available products were purchased via online shopping sites. Each product was assessed for quality indicators including weight variation, quantification of the bioactive constituent annonacin, presence of annonaceous acetogenins and contaminants. The samples were evaluated by thin-layer chromatography, high-performance liquid chromatography, liquid chromatography–mass spectroscopy, low-resolution mass spectrometry and nuclear magnetic resonance spectroscopy. Microbial analysis was carried out in accordance with the British Pharmacopoeia. Heavy metals were analysed by inductive coupled plasma mass spectrometry.

Key findings
Of the seven products analysed, one product contained less than half of the content stated on the label. The labelled dosage recommendation varied between products. There was a high variation in annonacin concentration (1.05–3.09 mg/g) and the presence of annonaceous acetogenins. One of the products was found to have a total aerobic microbial count above the United States Pharmacopoeia limit.

Conclusions
The variation in the indicators of quality and safety of commercially available A. muricata leaf products tested have implications for clinicians and people living with cancer who use these herbal products.
Multitarget therapy with a corticosteroid, cyclosporine and mycophenolate mofetil for idiopathic membranous nephropathy: a prospective randomized controlled trial
Authors: Duan Yajuan , Bai Yu , Guo Weikang , Wang Liyan , Dai Wendi , Guo Wang , Huang Hongdong , Liu Wenhu , Diao Zongli 
Published: July 2023

ABSTRACT

Background
The effectiveness of multitarget combination therapy with a corticosteroid, cyclosporine and mycophenolate mofetil for idiopathic membranous nephropathy (IMN) is unclear. In the present study, we aimed to compare the efficacy and safety of multitarget therapy with a cyclical corticosteroid–cyclophosphamide regimen in patients with IMN.

Methods
This was a single-centre, prospective, randomized, controlled trial. We randomly assigned patients with IMN to receive multitarget therapy (a combination of prednisone, cyclosporine and mycophenolate mofetil) or 6-month cyclical treatment with a corticosteroid and cyclophosphamide. The study patients were followed up for 12 months. The primary outcome was a composite of complete or partial remissions at 12 months. Adverse events were also assessed.

Results
The study cohort comprised 78 patients, 39 of whom received multitarget therapy and the other 39 cyclical alternating treatment with a corticosteroid and cyclophosphamide. At 12 months, 31 of 39 patients (79%) in the multitarget therapy group and 34 of 39 (87%) in the corticosteroid–cyclophosphamide group had achieved complete or partial remissions (relative risk 0.93; 95% confidence interval 0.72–1.21; P = .85; log-rank test). The prevalence of adverse events was significantly lower in the multitarget therapy group than in the corticosteroid–cyclophosphamide group [46% (18 of 39) vs 74% (29 of 39); P &lt; .05].

Conclusions
Multitarget therapy for IMN patients is noninferior to cyclical alternating treatment with corticosteroid and cyclophosphamide in inducing proteinuria remission and has a better safety profile than the corticosteroid–cyclophosphamide combination.
Charitable giving and intermediation: a principal agent problem with hidden prices
Authors: Chlaß Nadine , Gangadharan Lata , Jones Kristy 
Published: July 2023

AbstractDonations are often made through charitable intermediaries that can fund themselves from these same donations. After intermediation, only a fraction of the amount donated may reach the intended beneficiary. The price of charitable output is therefore higher after intermediation than if donors donated directly toward the end cause. At the same time, this price is hidden from donors since they cannot verify how much intermediaries pass on. We show that while donors reduce their donation in intermediation itself, and also reduce their donation because they expect the price of charitable output to increase, both reactions are either fully or partly compensated by their ethical preferences for the recipient’s rights. Charitable output, therefore, can be a Giffen-good.
Acquiring Land from Traditional Communities: Bottlenecks, Misallocation and Second-Best Considerations
Authors: Ghatak Maitreesh , Mookherjee Dilip 
Published: July 2023

Abstract
We discuss reasons why traditional rural communities may be reluctant to voluntarily relinquish their access to land despite being compensated at market prices, thereby limiting the scope for reallocating land to more productive uses in agriculture or urban development. Owing to financial market imperfections, insurance and collateral benefits of land ownership imply that welfare-optimal land allocations may not maximize productive efficiency, even if distributive or environmental considerations are ignored. We provide some suggestive evidence and discuss implications for land acquisition policy.
Utilising trusts in Swiss divorces?
Authors: Suter Claudia , Korradi Anja 
Published: July 2023

Abstract
What do trusts and divorces have in common? They are expensive. One might thus wonder why the two should be combined. Admittedly, establishing a trust is not a realistic option for most divorcing couples. For some (wealthy) spouses, however, a trust could provide a number of economic and other benefits worth considering. This article points out the benefits of using a trust in the context of a Swiss divorce and sets out the framework for its permissibility. For this, we assess the potential and constraints of Swiss marital and divorce agreements as well as the scope of review exercised by Swiss divorce courts.
Bladder Temperature During Neonatal Targeted Temperature Management
Authors: Buccione Emanuele , Chiavaroli Valentina , Scarponcini Fornaro Davide , Toracchio Erica , Cicioni Paola , Rasero Laura , Bambi Stefano , Di Valerio Susanna 
Published: July 2023

Background:
Neonatal encephalopathy is a clinical condition of altered neurological function in the first days of life. Targeted temperature management (TTM) is a validated approach to mitigate neurologic sequelae. Current literature suggests using rectal or esophageal site to assess temperature during TTM, but few studies focused on the best and the less invasive site to evaluate the temperature. This case report describes the performance of the bladder temperature monitoring during TTM.

Clinical Findings:
A female newborn was born at 39 weeks' gestational age plus 4 days. At delivery, the newborn was in cardiorespiratory arrest.

Primary Diagnosis:
After performing cardiopulmonary resuscitation and neurological examination, a hypoxic–ischemic encephalopathy was diagnosed.

Interventions:
After about 2 hours from birth, the newborn underwent TTM.

Outcomes:
A total of 4642 measurements of rectal temperature and 4520 measurements of bladder temperature were collected. Agreement between the 2 sites was statistically significant with a mean difference of 0.064°C ± 0.219 (95% confidence interval, −0.364 to 0.494); F = 47.044; and P value of less than .001. Furthermore, difference between rectal and bladder sites was not influenced by patient's urine output (F = 0.092, P = .762).

Practice Recommendations:
Bladder temperature seems to have a good reliability and not to be inferior to the other assessment site currently used. Using bladder catheter with temperature sensor could reduce the number of devices, ensure safer stabilization, and decrease treatment downtime.
Epinephrine Dosing Use During Extracorporeal Cardiopulmonary Resuscitation: Single-Center Retrospective Cohort*
Authors: Kucher Nicholas M. , Marquez Alexandra M. , Guerguerian Anne-Marie , Moga Michael-Alice , Vargas-Gutierrez Mariella , Todd Mark , Honjo Osami , Haller Christoph , Goco Geraldine , Floh Alejandro A. 
Published: July 2023

OBJECTIVES:
During pediatric cardiac arrest, contemporary guidelines recommend dosing epinephrine at regular intervals, including in patients requiring extracorporeal membrane oxygenation (ECMO). The impact of epinephrine-induced vasoconstriction on systemic afterload and venoarterial ECMO support is not well-defined.

DESIGN:
Nested retrospective observational study within a single center. The primary exposure was time from last dose of epinephrine to initiation of ECMO flow; secondary exposures included cumulative epinephrine dose and arrest time. Systemic afterload was assessed by mean arterial pressure and use of systemic vasodilator therapy; ECMO pump flow and Vasoactive-Inotrope Score (VIS) were used as measures of ECMO support. Clearance of lactate was followed post-cannulation as a marker of systemic perfusion.

SETTING:
PICU and cardiac ICU in a quaternary-care center.

PATIENTS:
Patients 0–18 years old who required ECMO cannulation during resuscitation over the 6 years, 2014–2020. Patients were excluded if ECMO was initiated before cardiac arrest or if the resuscitation record was incomplete.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
A total of 92 events in 87 patients, with 69 events having complete data for analysis. The median (interquartile range) of total epinephrine dosing was 65 mcg/kg (37–101 mcg/kg), with the last dose given 6 minutes (2–16 min) before the initiation of ECMO flows. Shorter interval between last epinephrine dose and ECMO initiation was associated with increased use of vasodilators within 6 hours of ECMO (p = 0.05), but not with mean arterial pressure after 1 hour of support (estimate, –0.34; p = 0.06). No other associations were identified between epinephrine delivery and mean arterial blood pressure, vasodilator use, pump speed, VIS, or lactate clearance.

CONCLUSIONS:
There is limited evidence to support the idea that regular dosing of epinephrine during cardiac arrest is associated with increased in afterload after ECMO cannulation. Additional studies are needed to validate findings against ECMO flows and clinically relevant outcomes.
Beta-HCG levels and ovarian ultrasonography results among non-pregnant women of reproductive age in Port Harcourt, Nigeria
Authors: Agonsi Celine Chibuzo , Anacletus Francis , Aluko Joel , Eleke Chinemerem , Samuel Joy 
Published: July 2023

AbstractBackgroundCertain ovarian cancers previously more common in postmenopausal women are now increasingly observed in women of reproductive age. The research on using β-HCG as a diagnostic biomarker for ovarian cancer in women of reproductive age is ongoing. This particular study assessed the level of serum β-HCG in non-pregnant women of reproductive age and determined its potential association with suspicious ovarian ultrasonography results in Port Harcourt, Nigeria.Material and methodsThis study utilized a descriptive-analytic design on a quota sample of 224 diagnostic case notes of women aged 18-40 years obtained from eight diagnostic centres. Data collection involved a data extraction form. Data analysis employed descriptive statistics, Chi-square, Fisher’s exact test, and Odds Ratio at 95% confidence and 5% significance levels.ResultsAbout 5.8% of the participants exhibited detectable levels of serum β-HCG above 5 IU/L (World Health Organization reference) at a mean concentration of 5.87 (±1.75) IU/L. About 4.0% of the participants had suspicious ovarian lesions identified through ultrasonography. Participants with elevated serum β-HCG levels above the WHO reference were 59 times more likely to have suspicious ovarian lesions, with an odds ratio of 59.4 (95%CI: 12.3–287.8, p = 0.001). There was a significant association between serum β-HCG level and age (p = 0.041) as well as parity (p < 0.001).ConclusionsThis study demonstrated that Serum β-HCG levels above the WHO reference were associated with suspicious ovarian lesions. Non-pregnant women should undergo serum β-HCG testing at least yearly to facilitate the early detection of ovarian anomalies.
Validation of Utstein-Based score to predict Return Of Spontaneous Circulation (UB-ROSC) in patients with out-of-hospital cardiac arrest
Authors: Caputo Maria Luce , Baldi Enrico , Burkart Roman , Wilmes André , Cresta Ruggero , Benvenuti Claudio , Cianella Roberto , Primi Roberto , Currao Alessia , Bendotti Sara , Compagnoni Sara , Gentile Francesca Romana , Anselmi Luciano , Savastano Simone , Klersy Catherine , Auricchio Angelo 
Published: July 2023

ABSTRACTBackgroundPrediction of probability of return of spontaneous circulation (ROSC) during out-of-hospital cardiac arrest (OHCA) is one of the biggest challenge in resuscitation science. The Utstein Based-ROSC (UB-ROSC) score has been developed to predict ROSC in OHCA’s victims. Aim of the study was to validate UB-ROSC score using two large Utstein-based OHCA registries: the SWiss REgistry of Cardiac Arrest (SWISSRECA) and the Lombardia Cardiac Arrest Registry (Lombardia CARe), northern Italy.MethodsConsecutive OHCA of any etiology occurring between January 1st, 2019 and December 31stand registered in 2 large national registries were included in a prospectively designed validation study. For model validation, a model area under the ROC curve (AUC ROC) for discrimination, using 10-fold cross-validation was computed. The score was plotted against the survival to hospital admission.Results14,715 patients were included in the study. A sustained ROSC was obtained in 3,151 patients (21%). Overall, UB-ROSC model showed a good discrimination (AUC 0.72, 95% CI 0.71-0.73). Shape of risk predicted by the model was almost linear and the model resulted well calibrated. In the low likelihood subgroup of UB-ROSC, only 9% of patients achieved a ROSC. This proportion raised to 35% for UB-ROSC score between −18 and 12 (OR 5.3, 95% CI 2.9-9.4, P<0.001). Finally, in 85% of patients with UB-ROSC values of more than or equal to 13 a ROSC was obtained (OR 52.1, 95%CI 15.6-173.0, P <0.001).ConclusionsUB-ROSC score may represent a reliable tool to predict ROSC probability. Its application may help the decision-making process providing a realistic stratification of probability of ROSC achievement.Clinical perspectivesWhat is new?-UB-ROSC is the unique Utstein-based score designed to help EMS staff to stratify patient’s probability of ROSC before treating the patient.-In this validation study, UB-ROSC score was verified in a cohort of more than 14,000 OHCA and confirmed a very high power in discrimination of ROSC probability-The score is very user-friendly and may be considered a helpful tool for EMS in the decision-making process when approaching OHCA victims.What are the clinical implications?-Sudden cardiac death is the leading causes of death worldwide and substantially contribute to loss of health and excess health system costs.-Development and validation of models to stratify probability of survival are increasingly necessary in the decision-making process, particularly in a pre-hospital setting, to offer a realistic expectation of survival and eventually to terminate resuscitation attempts.