bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exergy Transfer and Irreversibility of Metal Foams Filled in a Vertical Channel
Authors: Kiran Kumar K. , Kotresha Banjara , Naik Kishan 
Published: April 2023

Abstract
The aim of this work is to unveil the exergy transfer and overall thermal performance of the metal foams partially filled in varying thicknesses in the vertical channel. The numerical examination performed in this study consists of a heater cum plate assembly which is sited at the core of the vertical channel and the heat transfer from the plates is augmented by placing metal foams with high heat conducting capacities on either side of the channel. The uniqueness of the current investigation is to determine the optimum filling rate in various thicknesses of the channel with respect to overall thermal performance along with exergy transfer. Four different partial filling rates are considered in each thickness of the channel to find the optimum exergy transfer. The integrated Darcy Extended Forchheimer and local thermal non-equilibrium models are used for predicting the flow and heat transfer features via metal foam porous medium. The methodology implemented in this study is affirmed by validating the findings with the literature. The flow and heat transfer, along with exergy and irreversibility parameters are presented and discussed. Results showed that higher working limits permitted by exergy (WLPERe) are obtained for lesser metal foam filling rate as well as for higher metal foam thicknesses for all the cases examined in the study.
Embedded Microfluidic Cooling in Aluminum Nitride HTCC Substrate for High-Power Radio Frequency Chip Array
Authors: Ma Yupu , Wei Tao , Qian Jiyu , Peng Jian 
Published: April 2023

Abstract
Radio frequency (RF) electronics are developing toward high power, high integration, and high-power density, resulting in a continuous increase in heat flux. The traditional high-power RF package, which is usually composed of aluminum nitride (AlN) substrate, aluminum silicon housing shell, and aluminum alloy cold plate, exhibits poor heat dissipation ability and high thickness due to excessive interfaces and a long thermal conduction path. In this paper, aimed at improving heat dissipation ability and reducing the thickness of RF electronics, the microchannel was transferred from the cold plate to the AlN high-temperature co-fired ceramic (HTCC) substrate which plays the role of electrical connection, structural support, and liquid cooling cold plate. The embedded AlN microchannel cooler was firstly designed. Then, a prototype of the AlN substrate with 64 simulated chip arrays and microchannels was fabricated and the thermal performance was evaluated using an experimental setup. Finally, the thermal performances of the proposed and traditional cooler were compared using a CFD simulation. The results indicated that the proposed embedded cooling structure could enhance the heat-flux dissipation ability by 61% and reduce the packaging thickness by 40% compared with the traditional cooling structure.
Mapping evidence on the acceptability of human papillomavirus self-sampling for cervical cancer screening among women in sub-Saharan Africa: a scoping review
Authors: Dzobo Mathias , Dzinamarira Tafadzwa , Maluleke Kuhlula , Jaya Ziningi Nobuhle , Kgarosi Kabelo , Mashamba-Thompson Tivani Phosa 
Published: April 2023

ObjectivesThe objective of this scoping review was to map evidence on the acceptability of self-sampling for human papillomavirus testing (HPVSS) for cervical cancer screening among women in the sub-Saharan Africa region.DesignScoping review.MethodsUsing Arksey and O’Malley’s framework, we searched Scopus, PubMed, Medline Ovid, Cochrane and Web of Science databases for evidence on the acceptability of HPVSS among women aged 25 years and older published between January 2011 and July 2021. We included studies that reported evidence on the acceptability of HPVSS for cervical cancer screening. Review articles and protocols were excluded. We also searched for evidence from grey literature sources such as dissertations/theses, conference proceedings, websites of international organisations such as WHO and relevant government reports. Two reviewers independently performed the extraction using a pre-designed Excel spreadsheet and emerging themes were narratively summarised.ResultsThe initial search retrieved 1018 articles. Of these, 19 articles were eligible and included in the review. The following themes emerged from the included articles: acceptability of HPVSS; lack of self-efficacy to perform HPVSS, complications when performing HPVSS, preferences for provider sampling or assistance; setting of HPVSS; HPVSS by vulnerable populations.ConclusionEvidence shows that HPVSS is highly acceptable for cervical cancer screening in sub-Saharan Africa. Further research exploring the acceptability of HPVSS among women residing in rural areas is required, as well as studies to determine women’s preferences for HPVSS intervention including the preferred type of sampling devices. Knowledge on the acceptability and preferences for HPVSS is important in designing women-centred interventions that have the potential to increase screening coverage and participation in cervical cancer screening programmes.
Physician benzodiazepine self-use prior to and during the COVID-19 pandemic in Ontario, Canada: a population-level cohort study
Authors: Myran Daniel , Milani Christina , Pugliese Michael , Hensel Jennifer M , Sood Manish , Kendall Claire E , Kendzerska Tetyana , Tanuseputro Peter 
Published: April 2023

ObjectivesThe aim of this study was to investigate physician benzodiazepine (BZD) self-use pre-COVID-19 pandemic and to examine changes in BZD self-use during the first year of the pandemic.DesignPopulation-based retrospective cohort study using linked routinely collected administrative health data comparing the first year of the pandemic to the period before the pandemic.SettingProvince of Ontario, Canada between March 2016 and March 2021.ParticipantsInterventionOnset of the COVID-19 pandemic in March 2020.Outcomes measuresThe primary outcome measure was the receipt of one or more prescriptions for BZD, which was captured via the Narcotics Monitoring System.ResultsIn a cohort of 30 798 physicians (mean age 42, 47.8% women), we found that during the year before the pandemic, 4.4% of physicians had 1 or more BZD prescriptions. Older physicians (6.8% aged 50+ years), female physicians (5.1%) and physicians with a prior mental health (MH) diagnosis (12.4%) were more likely than younger (3.7% aged <50 years), male physicians (3.8%) and physicians without a prior MH diagnosis (2.9%) to have received 1 or more BZD prescriptions. The first year of the COVID-19 pandemic was associated with a 10.5% decrease (adjusted OR (aOR) 0.85, 95% CI: 0.80 to 0.91) in the number of physicians with 1 or more BZD prescriptions compared with the year before the pandemic. Female physicians were less likely to reduce BZD self-use (aORfemale=0.90, 95% CI: 0.83 to 0.98) compared with male physicians (aORmale=0.79, 95% CI: 0.72 to 0.87, pinteraction=0.046 during the pandemic. Physicians presenting with an incident MH visit had higher odds of filling a BZD prescription during COVID-19 compared with the prior year.ConclusionsPhysicians’ BZD prescriptions decreased during the first year of the COVID-19 pandemic in Ontario, Canada. These findings suggest that previously reported increases in mental distress and MH visits among physicians during the pandemic did not lead to greater self-use of BZDs.
Diagnostic accuracy of clinical diagnostic scoring systems for childhood tuberculosis: a systematic review and meta-analysis protocol
Authors: Kakinda Michael , Olum Ronald , Baluku Joseph Baruch , Bongomin Felix 
Published: April 2023

IntroductionDiagnosis of childhood tuberculosis (TB) poses several challenges. Therefore, clinical signs and symptoms, radiological studies, laboratory examinations, point-based scoring systems or diagnostic algorithms have been developed to improve diagnostic yields in this population. However, there are limited data on the diagnostic test accuracy of paediatric TB scoring systems. Therefore, this systematic review and meta-analysis aims to synthesise the available evidence on the diagnostic accuracy of childhood TB diagnostic scoring systems.Methods and analysisThis protocol describes a systematic review, developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses of Diagnostic Test Accuracy. We will conduct a comprehensive literature search for relevant articles in the following databases: PubMed, CINAHL, Embase, Scopus and Cochrane Databases. The eligibility criteria for studies will be formulated based on the Participants (Population), Index Test, Comparator Test and Target Condition criteria for the review question. The index test will be defined as any attempt to diagnose childhood TB using either a scoring system or a diagnostic algorithm, whereas a composite reference standard will be used as a reference standard. This will include any attempt to confirm diagnosis of TB. Where bacteriological confirmation is not obtained and there are at least two of the following features: chest radiograph consistent with TB, immunological evidence ofMycobacterium tuberculosisinfection and/or positive response to TB treatment will also be considered. The QUADAS-2 Tool will be used to assess the quality of the studies. The diagnostic accuracy measures (ie, sensitivity, specificity, negative predictive and positive predictive values) will be pooled with the random-effects or fixed-effects models, as appropriate. All statistical analyses will be performed using the Review Manager V.5.4.Ethics and disseminationThis research is exempt from ethics approval given that this is a protocol for a systematic review, which uses published data. The findings from this review will be disseminated through peer-reviewed publications and scientific conferences.PROSPERO registration numberCRD42022367049.
Effectiveness of telerehabilitation and home-based falls prevention programs for community-dwelling older adults: a systematic review and meta-analysis protocol
Authors: Leung Karen K , Carr Frances M , Kennedy Megan , Russell Matthew J , Sari Zainab , Triscott Jean AC , Korownyk Christina 
Published: April 2023

IntroductionFalls among older adults are associated with adverse sequelae including fractures, chronic pain and disability, which can lead to loss of independence and increased risks of nursing home admissions. The COVID-19 pandemic has significantly increased the uptake of telehealth, but the effectiveness of virtual, home-based fall prevention programmes is not clearly known. We aim to synthesise the trials on telerehabilitation and home-based falls prevention programmes to determine their effectiveness in reducing falls and adverse outcomes, as well as to describe the safety risks associated with telerehabilitation.Methods and analysisThis protocol was developed using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Database searches from inception to August 2022 will be conducted without language restrictions of MEDLINE, EMBASE, Ovid HealthSTAR, CINAHL, SPORTDiscus, Physiotherapy EvidenceDatabase (PEDro) and the Cochrane Library. Grey literature including major geriatrics conference proceedings will be reviewed. Using Covidence software, two independent reviewers will in duplicate determine the eligibility of randomised controlled trials (RCTs). Eligible RCTs will compare telerehabilitation and home-based fall prevention programmes to usual care among community-dwelling older adults and will report at least one efficacy outcome: falls, fractures, hospitalisations, mortality or quality of life; or at least one safety outcome: pain, myalgias, dyspnoea, syncope or fatigue. Secondary outcomes include functional performance in activities of daily living, balance and endurance. Risk of bias will be assessed using the Cochrane Collaboration tool. DerSimonian-Laird random effects models will be used for the meta-analysis. Heterogeneity will be assessed using the I2statistic and Cochran’s Q statistic. We will assess publication bias using the Egger’s test. Prespecified subgroup analyses and univariate meta-regression will be used.Ethics and disseminationEthics approval is not required. The results will be disseminated through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42022356759.
Predominance of non-Candida albicansspecies oral colonisation among patients on anticancer therapy: findings from a cross-sectional study in Tanzania
Authors: Kibwana Upendo Ozeniel , Manyahi Joel , Kamori Doreen , Mushi Martha , Mwandigha Ambele M , Majigo Mtebe 
Published: April 2023

ObjectivesThis study aimed to determine the oral carriage prevalence ofCandidaspecies and identify factors associated with the carriage ofCandidaspecies among patients with cancer on treatment.DesignA hospital-based cross-sectional study.SettingThe study was conducted at a tertiary-level cancer hospital Ocean Road Cancer Institute (ORCI), Dar es Salaam, Tanzania.ParticipantsWe enrolled 196 participants who consented to join the study. Oral swabs were collected from all participants and inoculated onto Sabouraud dextrose agar supplemented with 50 mg/mL gentamicin and 50 mg/mL chloramphenicol, and chromogenic agar for phenotypic identification ofCandidaspecies.Primary outcomeThe study reported the high prevalence of oral carriage ofCandidaspecies among patients with cancer on treatment at the tertiary-level cancer hospital in Dar es Salaam, Tanzania.ResultsA total of 196 participants were enrolled in the study. The overall oral carriage ofCandidaspecies was 37.8% (74/196). The prevalence was higher among patients undergoing chemotherapy and radiotherapy (44.4%) than those in monotherapy (13.3% chemotherapy, 20% radiotherapy).Candida kruseiwas the most common isolated species, 48.6% (36/74). Head and neck (adjusted OR (aOR) 15.09, 95% CI 3.05 to 74.59, p=0.00), gastrointestinal (aOR 14.14, 95% CI 2.25 to 88.63, p=0.00) malignancies and diabetes (aOR 3.18, 95% CI 1.03 to 9.77, p=0.04) were factors independently associated with oral carriage ofCandidaspecies.ConclusionThe oral carriage ofCandidaspecies among patients with cancer receiving treatment at ORCI is high, mainly due toC. kruseispecies. This is alarming sinceC. kruseihas intrinsic resistance to fluconazole, a common antifungal agent used to manage adult fungal infections. Therefore, efforts should be put into conducting regular check-ups for such opportunistic pathogens as they can lead to subsequent infections. Furthermore, studies conducted to determine the antifungal profile of the causative agents are warranted since different causative agents might have different profiles.
Country learning on maintaining quality essential health services during COVID-19 in Timor-Leste: a qualitative analysis
Authors: Kleine-Bingham Melissa B , Rangel Gregorio , Sarakbi Diana , Kelleher Treasa , Mensah Abrampah Nana Afriyie , Neilson Matthew , Bodson Oriane , White Philippa , Bothra Vinay , M de Carvalho Helder , da C A Pinto Feliciano , Babar Syed Shamsuzzoha 
Published: April 2023

ObjectiveThis case study examines the enabling factors, strengths, challenges and lessons learnt from Timor-Leste (TLS) as it sought to maintain quality essential health services (EHS) during the COVID-19 pandemic.DesignA qualitative case study triangulated information from 22 documents, 44 key informant interviews and 6 focus group discussions. The framework method was used to thematically examine the factors impacting quality EHS in TLS.SettingNational, municipal, facility levels in Baucau, Dili and Ermera municipalities in TLS.ResultsBased on the TLS National Health Statistics Reports, a reduction in outpatient, emergency department and primary care service delivery visits was observed in 2020 when compared with 2019. However, in contrast, maternal child health services simultaneously improved in the areas of skilled birth attendants, prenatal coverage and vitamin A distribution, for example. From the thematic analysis, five themes emerged as contributing to or impeding the maintenance of quality EHS including (1) high-level strategy for maintaining quality EHS, (2) measurement for quality and factors affecting service utilisation, (3) challenges in implementation of quality activities across the three levels of the health system, (4) the impact of quality improvement leadership in health facilities during COVID-19 and (5) learning systems for maintaining quality EHS now and for the future.ConclusionThe maintenance of quality EHS is critical to mitigate adverse health effects from the COVID-19 pandemic. When quality health services are delivered prior to and maintained during public health emergencies, they build trust within the health system and promote healthcare-seeking behaviour. Planning for quality as part of emergency preparedness can facilitate a high standard of care by ensuring health services continue to provide a safe environment, reduce harm, improve clinical care and engage patients, facilities and communities.
Integrating social support into interventions among the elderly in nursing homes: a scoping review
Authors: Behrendt Daniel , Spieker Sybille , Sumngern Chommanard , Wendschuh Vanessa 
Published: April 2023

ObjectivesThis study aimed to understand the evidence related to integration of social support into interventions, to identify literature gaps related to social support interventions, and to clarify dimensions of supportive functions, outcomes, and providers among the elderly in nursing homes.DesignThis scoping review followed the approach by Arksey and O’Malley. The Mixed Methods Appraisal Tool V.2018 was used for quality assessment of the studies.Data sourcesSearches were conducted of the PubMed, ScienceDirect, Public Library of Science, SocioHub, Wiley Online Library and PsycINFO databases for publications from 2010 to 2021.Eligibility criteria for selecting studiesWe searched for primary studies and heterogeneous study designs published in English. Eligible studies took place in nursing and care homes and had study populations of elderly adults (older adults, geriatrics, ageing, seniors, older people and those aged 60 years and older).Data extraction and synthesisA data extraction form based on Joanna Briggs Institute’s recommendations for scoping reviews was used. Two reviewers independently extracted data and performed quality assessment of the studies. Then, extracted data and quality assessment reports were discussed by all authors.ResultsThirty-one eligible studies were included in this review. 54.8% of the studies provided interventions for cognitively impaired residents. The top-three outcomes were neuropsychiatric symptoms, physical function and quality of life, respectively. The interventions were performed by nursing home staff (83.9%), other persons with specific qualifications (58.1%) and health volunteers (6.5%). Most studies (90.3%) depicted the integration of emotional and instrumental supportive functions into interventions.ConclusionThe appropriate dimensions of supportive function, mainly emotional and instrumental support, are important to integrate into the social care of elderly people living in nursing homes.
Effect of instrument type and one-handed versus two-handed grips on force application during simulated instrument-assisted soft tissue mobilisation
Authors: Martonick Nickolai JP , North Kyle , Reeves Ashley , McGowan Craig , Baker Russell T 
Published: April 2023

ObjectiveThe purpose of this study was to examine whether the forces used by trained clinicians during a simulated instrument-assisted soft tissue mobilisation (IASTM) treatment varied across five different instruments during one-handed and two-handed IASTM grips.MethodsNine athletic trainers who previously completed IASTM training and used the technique in professional practice were included in the study. A skin simulant was attached to a force plate and used to evaluate force production during a simulated IASTM treatment scenario. Peak (Fpeak) and mean (Fmean) forces were recorded for both one-handed and two-handed grips for each participant across the five instruments. Data were analysed using separate 2 (grip type) × 5 (IASTM instrument) repeated measures analysis of variance for both Fpeakand Fmean.ResultsData for Fpeakdemonstrated a significant main effect for grip type (F(1, 8)=46.39, p<0.001,ηp2=0.34), instrument (F(4, 32)=4.61, p=0.005,ηp2=0.06) and interaction (F(2, 16)=10.23, p=0.001,ηp2=0.07). For Fmean, there was also a statistically significant main effect for grip type (F(1, 8)=60.47, p<0.001,ηp2=0.32), instrument (F(4, 32)=4.03, p=0.009,ηp2=0.06) and interaction (F(2, 19)=7.92, p=0.002,ηp2=0.06).ConclusionsClinicians produced greater IASTM forces when applying a two-handed grip than a one-handed grip. Instrument weight may matter less than instrument shape, size and bevelling for influencing force production as instrument length appears to influence force production when using one-handed or two-handed grips. Although the effects of IASTM force variation on patient outcomes remains unknown, these findings may be considered by clinicians when making instrument and grip choices.
Population pharmacokinetic and safety analysis of ropivacaine used for erector spinae plane blocks
Authors: Schwenk Eric S , Lam Edwin , Abulfathi Ahmed A , Schmidt Stephan , Gebhart Anthony , Witzeling Scott D , Mohamod Dalmar , Sarna Rohan R , Roy Akshay B , Zhao Joy L , Kaushal Gagan , Rochani Ankit , Baratta Jaime L , Viscusi Eugene R 
Published: April 2023

IntroductionErector spinae plane blocks have become popular for thoracic surgery. Despite a theoretically favorable safety profile, intercostal spread occurs and systemic toxicity is possible. Pharmacokinetic data are needed to guide safe dosing.MethodsFifteen patients undergoing thoracic surgery received continuous erector spinae plane blocks with ropivacaine 150 mg followed by subsequent boluses of 40 mg every 6 hours and infusion of 2 mg/hour. Arterial blood samples were obtained over 12 hours and analyzed using non-linear mixed effects modeling, which allowed for conducting simulations of clinically relevant dosing scenarios. The primary outcome was the Cmaxof ropivacaine in erector spinae plane blocks.ResultsThe mean age was 66 years, mean weight was 77.5 kg, and mean ideal body weight was 60 kg. The mean Cmaxwas 2.5 ±1.1 mg/L, which occurred at a median time of 10 (7–47) min after initial injection. Five patients developed potentially toxic ropivacaine levels but did not experience neurological symptoms. Another patient reported transient neurological toxicity symptoms. Our data suggested that using a maximum ropivacaine dose of 2.5 mg/kg based on ideal body weight would have prevented all toxicity events. Simulation predicted that reducing the initial dose to 75 mg with the same subsequent intermittent bolus dosing would decrease the risk of toxic levels to <1%.ConclusionLocal anesthetic systemic toxicity can occur with erector spinae plane blocks and administration of large, fixed doses of ropivacaine should be avoided, especially in patients with low ideal body weights. Weight-based ropivacaine dosing could reduce toxicity risk.Trial registration numberNCT04807504; clinicaltrials.gov.