bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous Versus Bolus Thermodilution‐Derived Coronary Flow Reserve and Microvascular Resistance Reserve and Their Association With Angina and Quality of Life in Patients With Angina and Nonobstructive Coronaries: A Head‐to‐Head Comparison
Authors: Jansen Tijn P. J. , de Vos Annemiek , Paradies Valeria , Dimitriu‐Leen Aukelien , Crooijmans Caïa , Elias‐Smale Suzette , Rodwell Laura , Maas Angela H. E. M. , Smits Pieter C. , Pijls Nico , van Royen Niels , Damman Peter 
Published: August 2023

Background
Coronary flow reserve (CFR) and microvascular resistance reserve (MRR) are physiological parameters to assess coronary microvascular dysfunction. CFR and MRR can be assessed using bolus or continuous thermodilution, and the correlation between these methods has not been clarified. Furthermore, their association with angina and quality of life is unknown.

Methods and Results

In total, 246 consecutive patients with angina and nonobstructive coronary arteries from the multicenter Netherlands Registry of Invasive Coronary Vasomotor Function Testing (NL‐CFT) were investigated. The 36‐item Short Form Health Survey Quality of Life and Seattle Angina questionnaires were completed by 153 patients before the invasive measurements. CFR and MRR were measured consecutively with bolus and continuous thermodilution. Mean continuous thermodilution‐derived coronary flow reserve (CFR
abs
) was significantly lower than mean bolus thermodilution‐derived coronary flow reserve (CFR
bolus
) (2.6±1.0 versus 3.5±1.8;
P
<0.001), with a modest correlation (
ρ
=0.305;
P
<0.001). Mean continuous thermodilution‐derived microvascular resistance reserve (MRR
abs
) was also significantly lower than mean bolus thermodilution‐derived MRR (MRR
bolus
) (3.1±1.1 versus 4.2±2.5;
P
<0.001), with a weak correlation (
ρ
=0.280;
P
<0.001). CFR
bolus
and MRR
bolus
showed no correlation with any of the angina and quality of life domains, whereas CFR
abs
and MRR
abs
showed a significant correlation with physical limitation (
P
=0.005,
P
=0.009, respectively) and health (
P
=0.026,
P
=0.012). In a subanalysis in patients in whom spasm was excluded, the correlation further improved (MRR
abs
versus physical limitation:
ρ
=0.363;
P
=0.041, MRR
abs
versus physical health:
ρ
=0.482;
P
=0.004). No association with angina frequency and stability was found.

Conclusions

Absolute flow measurements using continuous thermodilution to calculate CFR
abs
and MRR
abs
weakly correlate with, and are lower than, the surrogates CFR
bolus
and MRR
bolus
. Absolute flow parameters showed a relationship with physical complaints. No relationship with angina frequency and stability was found.
Assimilation of GOES-16 ABI All-Sky Radiance Observations in RRFS Using EnVar: Methodology, System Development, and Impacts for a Severe Convective Event
Authors: Degelia Samuel K. , Wang Xuguang , Wang Yongming , Johnson Aaron 
Published: August 2023

Abstract
The Advanced Baseline Imager (ABI) aboard the GOES-16 and GOES-17 satellites provides high-resolution observations of cloud structures that could be highly beneficial for convective-scale DA. However, only clear-air radiance observations are typically assimilated at operational centers due to a variety of problems associated with cloudy radiance data. As such, many questions remain about how to best assimilate all-sky radiance data, especially when using hybrid DA systems such as EnVar wherein a nonlinear observation operator can lead to cost function gradient imbalance and slow minimization. Here, we develop new methods for assimilating all-sky radiance observations in EnVar using the novel Rapid Refresh Forecasting System (RRFS) that utilizes the Finite-Volume Cubed-Sphere (FV3) model. We first modify the EnVar solver by directly including brightness temperature (Tb) as a state variable. This modification improves the balance of the cost function gradient and speeds up minimization. Including Tb as a state variable also improves the model fit to observations and increases forecast skill compared to utilizing a standard state vector configuration. We also evaluate the impact of assimilating ABI all-sky radiances in RRFS for a severe convective event in the central Great Plains. Assimilating the radiance observations results in better spinup of a tornadic supercell. These data also aid in suppressing spurious convection by reducing the snow hydrometeor content near the tropopause and weakening spurious anvil clouds. The all-sky radiance observations pair well with reflectivity observations that remove primarily liquid hydrometeors (i.e., rain) closer to the surface. Additionally, the benefits of assimilating the ABI observations continue into the forecast period, especially for localized convective events.
Effect of solution-blown nanofibrous web on quasi-static punch shear test results and quasi-static indentation behavior of carbon fiber-reinforced epoxy matrix composites
Authors: Ayten Ali Imran , Polat Yusuf , Sahbaz Mehmet , Seyhan Aybeniz 
Published: August 2023

This study investigated the effects of the nanofiber interlayer in carbon fiber-reinforced epoxy matrix composites on quasi-static loading behaviors such as quasi-static punch shear (QS-PST), quasi-static indentation (QSI), and short-beam shear (SBS) loading. The solution-blowing technique was used to produce polyamide-6 (PA6) nanofiber with 1 g/m2 areal density. A 2×2 twill weave carbon fiber fabric with an areal density of 200 g/m2 was covered with solution-blown nanofibers. The vacuum-assisted resin transfer molding (VARTM) method was used to manufacture nanofiber interlayered composites and non-interlayered composites. QS-PS experiments were conducted at three different span to punch ratios (SPR), namely 1.1, 2, and 4. The PA6 nanofiber had a synergetic effect on the composite structure. In the QS-PST experiments, it increased the amount of work achieved by the specimen at rates of 29.5%, 13.5%, and 5.66% for SPR 1.1, 2, and 4, respectively while it provided increases in the maximum force at rates of 15.3%, 15%, and 5.7%, respectively. Additionally, the PA6 nanofiber contributed to the composite material properties determined based on the QSI test including the maximum force, punch crush strength, crush stiffness, and through-thickness modulus at rates of 7.5%, 7.56%, 2.72%, and 5.76%, respectively. Finally, an increase at a rate of 11.43% was determined in the SBS strength of the nanofiber interlayered composite, while it showed an increase in maximum force observed during the SBS experiment at a rate of 12.28%. The enhancements of mechanical properties of structural composites make them more reliable for high technology applications like aerospace, and automotive.
Clinical Features and a Prediction Nomogram for Prognosis in Children with Escherichia coli Meningitis
Authors: Zhang Lingyu , Li Wenjie , Peng Xiaoling , Jiang Li , Hu Yue 
Published: August 2023

Background We aimed to build a prediction nomogram for early prediction of poor prognosis in children with Escherichia coli meningitis and analyzed the course of treatment and discharge criteria. Methods Eighty-seven pediatric patients with E coli meningitis were retrospectively recruited from the Children's Hospital of Chongqing Medical University between June 2012 and November 2021. Univariate analysis and binary logistic analysis were used to evaluate the risk factors, and the prediction model was built. Results E coli meningitis is more common in children <3 months old in our study (86.2%). Common complications were subdural effusion (39.1%), followed by hydrocephalus (13.8%) and repeated convulsions (12.6%). The mortality rate and sequelae rate of E coli meningitis in children was ∼10.9% and ∼6.3%, respectively. Univariate analysis showed that 13 clinical indicators were associated with poor prognosis of E coli meningitis in children. In binary logistic analysis, risk factors were seizures ( P = .032) and the last cerebrospinal fluid glucose content before discharge ( P = .002). A graphical nomogram was designed. The area under the receiver operating characteristic curve was 0.913. The Hosmer-Lemeshow test showed that the model was a good fit ( P = .648). Internal validation proved the reliability of the prediction nomogram. Conclusions E coli meningitis is more common in children <3 months old in our study. The rate of complications and sequelae are high. The prediction nomogram could be used to assess the risk of poor prognosis in children with E coli meningitis by clinicians.
Megaloblastic Anemia in Bardet-Biedl Syndrome: A Rare Case Report
Authors: Hassan Subtain , Khan Qaisar Ali , Saravanan Priyadharshini , Iram Sumaira , Rohail Samia , Belay Naod F , Afzal Muhammad , Hadi Faiza Amatul , Pande Harshawardhan 
Published: August 2023

Background: Bardet-Biedl syndrome (BBS) also known as Laurence-Moon-Bardet-Biedl syndrome one of the rarely reported genetic disorder characterized by an intellectual disability, limb, kidney abnormalities, obesity, and Rod-cone dystrophy. Other associated condition includes diabetes mellitus, hypertension, hypogonadism, facial dysmorphism, and congenital heart defects. This case highlights megaloblastic anemia associated with BBS. Case presentation: A 16-year-old female patient who had a moon face, truncal obesity, polydactyly, low IQ, and visual impairment presented with the complaint of shortness of breath and easy fatiguability. She had bilateral retinal pigmentosa in her eyes and her laboratory evaluation and bone marrow biopsy revealed megaloblastic anemia secondary to vitamin B12 deficiency. She received injectable vitamin B12, folate, and red cell contrate transfusion. Her symptoms improved and she was discharged with oral medication. Conclusion: Megaloblastic anemia in BBS is rarely reported, further research is needed to find the exact cause that is necessary for proper management and better outcome.
Medical social worker support for elderly patients in a tertiary care hospital in Japan
Authors: Nakao Shunichiro , Fukumori Yuji , Takahashi Yumi , Ogura Hiroshi , Oda Jun 
Published: August 2023

Summary When elderly patients are admitted to a hospital, they may require support from medical social workers during hospitalization. This study examined the association between patient characteristics and support provided by medical social workers in applications for social welfare benefits during hospitalization. We conducted a retrospective observational study of patients aged 65 years or older between October 2018 and September 2021 who had involvement by a medical social worker during their hospitalization at a tertiary care hospital in Japan. We evaluated associations between background factors and support in applying for social welfare benefits by medical social workers using logistic regression analysis. Findings Among 485 eligible patients, 79 (16.3%) received support from a medical social worker in an application for social welfare benefits. Early elderly age (65–74 years) and living alone were independently associated with receiving support from medical social workers (adjusted odds ratio [OR] 1.98, 95% confidence interval [CI] 1.16–3.37, P = .012; 3.86, 95% CI 2.26–6.62, P < .001, respectively), regardless of sex, activities of daily living before admission, and presence of a regular doctor. Application The findings suggest that early elderly individuals who live alone may not be able to utilize the available welfare benefits and not have adequate support from family members when admitted to a tertiary care hospital, even if they have adequate activities of daily living and a regular doctor. Early intervention to improve social vulnerability may be required for early elderly individuals who live alone.
Could Spatial Awareness Affect Situation Awareness: A Conceptual Examination
Authors: Yekita Hamed , Pati Debajyoti , Hamilton D. Kirk 
Published: August 2023

Purpose: The purpose of this study was to explore the relationship between situation awareness (SA) and the physical environment in patient rooms through building a conceptual model. Background: Nurses work in very complicated and dynamic environments where having high levels of SA could be critical for their performance. Studies have also shown that nurses’ awareness of the physical environment and patient room is a part of their awareness of dynamic situations in which nurses’ spatial awareness may play a role in SA. Despite literature outlining the importance of SA, there is a lack of studies exploring the relationship between the two. Method: A literature review was conducted for the study from nursing and psychology databases. Thirty-three articles, books, and dissertations from a scoping review were included for in-depth review. Results: An in-depth review of the harvested literature indicated that there is in fact a relationship between these two phenomena. Founded on Endsley’s model of SA, the literature review in this study offers a conceptual model that articulates a plausible causal pathway between the physical environment and SA. Conclusions: There are a lot of studies focusing on SA and various aspects of it related to nursing, but almost none mention the physical environment and its impact on SA. The current inquiry suggests that spatial awareness plays a prominent role in SA.
Use of focused computerized cognitive training (Neuroflex) to improve symptoms in women with persistent chemotherapy-related cognitive impairment
Authors: Vega Jennifer N. , Newhouse Paul A. , Conley Alexander C. , Szymkowicz Sarah M. , Gong Xuewen , Cote Sarah , Mayer Ingrid , Taylor Warren D. , Morimoto Sarah Shizuko 
Published: August 2023

Purpose Chemotherapy-related cognitive impairment (CRCI) is a distressing and increasingly recognized long-term sequela reported by breast cancer patients following cancer treatment. There is an urgent but unmet clinical need for treatments that improve CRCI. In this context, we proposed the use of a novel cognitive enhancement strategy called Neuroflex to target CRCI experienced by breast cancer survivors. Methods The primary aim of this pilot study was to evaluate the feasibility and acceptability of Neuroflex, a novel digital cognitive enhancement strategy, in breast and gynecologic cancer survivors with CRCI. Secondary analyses focused on whether improvements in performance on Neuroflex were associated with improvement in subjective cognitive complaints and objective cognitive performance measures. Results Participants ( N = 21) completed an average of 7.42 hours of Neuroflex training per week, an average of 44.5 (±1.01) hours total, and had a 100% completion rate. Participants exhibited significant improvement in self-reported cognitive function as well as significant improvement on tasks of verbal learning and memory and auditory working memory. Participants also exhibited improvement in mood, as well as improvement on a disability assessment. Conclusions Results demonstrate feasibility and that breast cancer survivors are capable of completing a lengthy and challenging cognitive training program. Secondly, Neuroflex may confer specific cognitive benefits to both self-reported and objective performance. Results strongly support further investigation of Neuroflex in a larger controlled trial to establish efficacy for CRCI symptoms. Further studies may also result in optimization of this digital intervention for women with CRCI.
Chronic disease IMPACT (chronic disease early detection and improved management in primary care project): An Australian stepped wedge cluster randomised trial
Authors: Jones Julia L , Simons Koen , Manski-Nankervis Jo-Anne , Lumsden Natalie G , Fernando Sanduni , de Courten Maximilian P , Cox Nicholas , Hamblin Peter Shane , Janus Edward D , Nelson Craig L 
Published: August 2023

Background Interrelated chronic vascular diseases (chronic kidney disease (CKD), type 2 diabetes (T2D) and cardiovascular disease (CVD)) are common with high morbidity and mortality. This study aimed to assess if an electronic-technology-based quality improvement intervention in primary care could improve detection and management of people with and at risk of these diseases. Methods Stepped-wedge trial with practices randomised to commence intervention in one of five 16-week periods. Intervention included (1) electronic-technology tool extracting data from general practice electronic medical records and generating graphs and lists for audit; (2) education regarding chronic disease and the electronic-technology tool; (3) assistance with quality improvement audit plan development, benchmarking, monitoring and support. De-identified data analysis using R 3.5.1 conducted using Bayesian generalised linear mixed model with practice and time-specific random intercepts. Results At baseline, eight included practices had 37,946 active patients (attending practice ≥3 times within 2 years) aged ≥18 years. Intervention was associated with increased OR (95% CI) for: kidney health checks (estimated glomerular filtration rate, urine albumin:creatinine ratio (uACR) and blood pressure) in those at risk 1.34 (1.26–1.42); coded diagnosis of CKD 1.18 (1.09–1.27); T2D diagnostic testing (fasting glucose or HbA1c) in those at risk 1.15 (1.08–1.23); uACR in patients with T2D 1.78 (1.56–2.05). Documented eye checks within recommended frequency in patients with T2D decreased 0.85 (0.77–0.96). There were no significant changes in other assessed variables. Conclusions This electronic-technology-based intervention in primary care has potential to help translate guidelines into practice but requires further refining to achieve widespread improvements across the interrelated chronic vascular diseases.
Fixed Functional Appliance Therapy With and Without Skeletal Anchorage in Class II Malocclusion: A Systematic Review of Randomized Controlled Trials
Authors: Rajamanickam Preethi , Sundari K. K. Shantha 
Published: August 2023

Background:For its synergistic effects in producing skeletal changes as well as to lessen the proclination of the lower incisors, which is a common negative result of mandibular advancement, fixed functional appliances with skeletal anchorage have recently been used.Aim:Objective was to evaluate the skeletal and dentoalveolar effects with fixed functional appliances with and without skeletal anchorage.Methods:Electronic database search and manual search were performed up to 2021, April in four databases namely The Cochrane Library, PubMed, Lilac, and Google Scholar. RCTs that employed the use of fixed functional appliances in Class II malocclusion with and without skeletal anchoring were collected. Two co-authors independently extracted the data, and a pre-designed template was followed during the data extraction process. Data including inclusion and exclusion criteria; study design, the year of publication; age and gender of the patients; type of fixed functional device; stage of skeletal maturation; size and site of mini-implant or miniplate placement, amount of force applied in grams or Newtons; method of study outcome assessment (2D or 3D); and follow up were collected. The skeletal and dentoalveolar parameters were extracted.Results:The risk of bias was evaluated, and the SMD and 95% confidence intervals (CIs) were also calculated. Four RCTs were evaluated for qualitative and quantitative analysis. The review involved data of 179 Class II individuals. The results of a random-effects meta-analysis showed that the SNB differed significantly from the control group (SMD = 0.50 (95% CI –1.55 to –0.10)). No significant differences noted between the two groups in terms of lower incisor inclination and mandibular length changes [SMD = –0.04 (95% CI −2.06 to 1.98) and –1.33 (95% CI −3.28 to 0.62), respectively]. The studies under this were not able to provide enough data to draw any conclusions about the effects of using skeletal anchorage with FFA.Conclusion:According to the evidence that is currently available, using FFA coupled with skeletal anchorage does not appear to have any superior skeletal effects than those without skeletal anchorage.
Connecting and Attuning Mental Health Care for Adolescent Patients: The Role of Presence Practice
Authors: Chukwuere Precious Chibuike 
Published: August 2023

Introduction The healthcare system over the years has witnessed evolvement and transformation in the care pattern, including in the mental healthcare system. This has seen a considerable and commendable improvement in patient care. This article aims to demonstrate the need for “presence practice” and practical implications thereof, in the care of adolescents with mental health illnesses and to further demonstrate the need for connecting and attuning mental health care for good care and positive nurse and patient outcomes. The developmental stage of adolescents is characterized by various psychosocial changes. At the same time, the emergence of numerous mental health conditions is prevalent at the adolescent stage, contributing to the disease burden among this age group. Understandably, the prevalence of mental health illnesses in adolescents could be associated with their vulnerability and the result of the interaction of numerous biopsychosocial factors in the lives of the individuals, asserting influences on their development and mental health such as family challenges, the stress associated with schooling, relationship issues, and abuse. Method This article follows a quality improvement method where the author took time to nonsystematically explain existing literature on presence practice and its practical implication and further practically demonstrated the need for and how to facilitate connecting and attuning mental health care for good care and positive nurse and patient outcomes. Result Presence practice should be adopted by mental health nurses to foster the establishment of relational care with mental health care users, such as adolescents with mental illness, and to help mitigate relapse. Being open-minded and preparing their minds to be receptive and present during care should be part of nurses effective presence practice. Conclusion The article concludes that mental health nurses, as frontline caregivers, should always endeavor to connect and attune care to the needs of the adolescents receiving mental health care to foster positive outcomes.