bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Telemedicine and the COVID-19 Pandemic on Medical Trainees' Usage of the Electronic Health Record in the Outpatient Setting
Authors: Mani Kyle , Canarick Jay , Ruan Elise , Liu Jianyou , Kitsis Elizabeth , Jariwala Sunit P. 
Published: February 2023

Abstract
Objectives This study aimed to (1) determine the impact of COVID-19 (coronavirus disease 2019) and the corresponding increase in use of telemedicine on volume, efficiency, and burden of electronic health record (EHR) usage by residents and fellows; and (2) to compare these metrics with those of attending physicians.
Methods We analyzed 11 metrics from Epic's Signal database of outpatient physician user logs for active residents/fellows at our institution across three 1-month time periods: August 2019 (prepandemic/pre-telehealth), May 2020 (mid-pandemic/post-telehealth implementation), and July 2020 (follow-up period) and compared these metrics between trainees and attending physicians. We also assessed how the metrics varied for medical trainees in primary care as compared with subspecialties.
Results Analysis of 141 residents/fellows and 495 attendings showed that after telehealth implementation, overall patient volume, Time in In Basket per day, Time outside of 7 a.m. to 7 p.m., and Time in notes decreased significantly compared with the pre-telehealth period. Female residents, fellows, and attendings had a lower same day note closure rate before and during the post-telehealth implementation period and spent greater time working outside of 7 a.m. to 7 p.m. compared with male residents, fellows, and attendings (p < 0.01) compared with the pre-telehealth period. Attending physicians had a greater patient volume, spent more time, and were more efficient in the EHR compared with trainees (p < 0.01) in both the post-telehealth and follow-up periods as compared with the pre-telehealth period.
Conclusion The dramatic change in clinical operations during the pandemic serves as an inflection point to study changes in physician practice patterns in the EHR. We observed that (1) female physicians closed fewer notes the same day and spent more time in the EHR outside of normal working hours compared with male physicians, and (2) attending physicians had higher patient volumes and also higher efficiency in the EHR compared with resident physicians.
Mothers' Experiences of Tandem Breastfeeding: A Phenomenological Study
Authors: Aker Menekşe N. , Gönenç Ilknur M. , Er Korucu Aslı , Çakırer Çalbayram Nazan 
Published: February 2023

Objective Despite many benefits of tandem breastfeeding, mothers stop breastfeeding their older babies early during pregnancy due to inadequate knowledge and support. This study was conducted to determine the tandem breastfeeding experiences of mothers.
Study Design A phenomenological design was used in this study. The data of the study were collected between January and August 2018. In-depth, individual, open-ended interviews were carried out for data collection. A personal information form and a semi-structured in-depth interview form were used to collect data. It was conducted with 13 women who were tandem breastfeeding, 9 of whom had given birth and 4 of whom were pregnant.
Results The data obtained from the interviews with mothers who were tandem breastfeeding were classified into nine themes, namely: metaphors, feelings, benefits, myths, facilitators, pathways to tandem breastfeeding, fears and worries, difficulties, and obstacles. Mothers experienced many benefits of tandem breastfeeding for maternal and infant health. In addition, although there was no evidence in the literature regarding the harms of tandem breastfeeding, they encountered many myths about it. These myths increased their concerns about this type of breastfeeding. Mothers could not get enough information and support from health care professionals, and this was reported as a challenging experience of tandem breastfeeding.
Conclusion Despite many positive experiences, mothers who tandem breastfeed may also face various difficulties. They need a breastfeeding-friendly environment and support from family and health professionals to cope with these challenges.
Key Points
Management of Locally Advanced Unresectable or Metastatic Urothelial Carcinoma: Expert Opinion from an Indian Panel via Delphi Consensus Method
Authors: Rajappa Senthil , Raja T. , Desai Chirag , Joshi Amit , Dattatreya Palanki Satya , Agarwal Mohit , Sud Rahul , Ramesh Anita , Vaid A. K. , Talwar Vineet , Rauthan Amit , Kaushal Ashish , Mohapatra Prabrajya , Kapoor Akhil 
Published: February 2023

Introduction Currently, there are no guidelines for the management of locally advanced unresectable or metastatic urothelial carcinoma (mUC) from an Indian perspective. There is a lack of consensus on the utility of treatment options in first-line (1L) and second-line (2L) settings, especially in cisplatin- and platinum-unfit mUC patient subgroups.
Objective This articles aims to develop evidence-based practical consensus recommendations for the management of mUC in Indian settings.
Methods Modified Delphi consensus methodology was considered to arrive at a consensus. An expert scientific committee of 15 medical oncologists from India constituted the panel. Twelve clinically relevant questions were grouped into five categories for presentation and discussion: (1) cisplatin and platinum ineligibility criteria; (2) programmed death ligand 1 and fibroblast growth factor receptor (FGFR) testing in mUC patients; (3) treatment options in 1L settings; (4) role of switch maintenance; and (5) treatment options in 2L. Statements that reached high (≥ 80%) and moderate (60–79%) levels of consensus in the first round (electronic survey) did not undergo the second Delphi round. The questions that received a low level of consensus (< 60%) were discussed during the virtual meeting.
Results Renal impairment (creatinine clearance [CrCl] < 60 mL/min) and New York Heart Association class 3 heart failure are important assessment criteria for determining cisplatin ineligibility. Patients are unfit for any platinum-based chemotherapy in case of Eastern Cooperative Oncology Group performance status> 3 or severe renal impairment (CrCl < 30 mL/min). Gemcitabine and platinum with cisplatin over carboplatin were preferred in 1L settings. In patients unfit for cisplatin-based regimens, carboplatin–gemcitabine chemotherapy was preferred over immunotherapy (atezolizumab or pembrolizumab). Selected patients who are platinum ineligible may be considered for immunotherapy. Post-induction chemotherapy, those who do not progress may be strongly considered for avelumab maintenance. Experts recommended erdafitinib in FGFR-positive mUC patients in 2L settings. In FGFR-negative patients, immunotherapy (pembrolizumab, nivolumab, or avelumab) may be preferred over chemotherapy (paclitaxel, docetaxel, or vinflunine). Enfortumab vedotin and sacituzumab govitecan may be considered for further lines of therapy.
Conclusion Expert panel consensus will offer expert guidance to oncologists/clinicians on the management of mUC in Indian settings.
Key Points
Decompressive Craniectomy in Pediatric Traumatic Brain Injury: A Retrospective Cohort Study
Authors: Yew Wan Xin , Lee Jan Hau , Dang Hongxing , Low Sharon Yin Yee , Sri Dewi Dianna , Chong Shu-Ling 
Published: February 2023

AbstractDecompressive craniectomy (DC) in children with traumatic brain injury (TBI) and refractory raised intracranial pressure (ICP) remains controversial. We aimed to describe the clinical and operative characteristics of children with moderate to severe TBI who underwent DC, and compare outcomes with those who had medical therapy. We performed a retrospective observational cohort study on children < 16 years of age with moderate to severe TBI (Glasgow coma scale [GCS] ≤13) who underwent DC in two pediatric centers in Singapore and China between 2014 and 2017, and compared their outcomes with children who underwent medical treatment, among participating centers of the Pediatric Acute and Critical Care Medicine Asian Network. We defined poor functional outcomes as moderate, severe disability, vegetative or comatose state, or mortality, using the Pediatric Cerebral Performance Category scale. We performed multivariable logistic regression to identify predictors for poor functional outcomes. We analyzed 18 children who underwent DC with 214 who had medical therapy. A greater proportion of children with DC (14, 77.8%) experienced poor functional outcomes, compared with those with medical therapy (87, 41.2%, p = 0.003). Children who underwent DC had fewer median 14-day intensive care unit (ICU)-free days (2.5 days, interquartile range [IQR]: 0.0–5.8 vs. 8.0 days, IQR: 0.0–11.0, p = 0.033), median 28-day hospital-free days (0 day, IQR: 0.0–3.5 vs. 11.0 days, IQR: 0.0–21.0, p = 0.002) and 14-day mechanical ventilation-free days (6.5 days, IQR: 0.0–12.3 vs. 11.0 days, IQR: 3.0–14.0, p = 0.011). After accounting for age, sex, GCS, cerebral edema, uncal herniation, nonaccidental injury, and need for intubation, there was no significant association between DC and poor functional outcomes (adjusted odds ratio: 1.59, 95% confidence interval: 0.35–7.24, p = 0.548). Children with DC had severe injuries, and prolonged hospital and ICU stays. Future studies are needed to understand the effectiveness of DC on children with TBI.
Apparatus for measurement of thermoelectric properties of a single leg under large temperature differences
Authors: Naithani H. , Ziolkowski P. , Dasgupta T. 
Published: February 2023

Thermoelectric (TE) devices operate under large temperature differences, but material property measurements are typically accomplished under small temperature differences. Because of the issues associated with forming proper contact between the test sample and the electrodes and the control of heat flux, there are very few reports on large temperature difference measurements. Therefore, practically relevant performance parameters of a device, namely, power output and efficiency, are estimated by temperature averaging of material properties, whose accuracy is rarely validated by experimental investigations. To overcome these issues, we report an apparatus that has been designed and assembled to measure the TE properties—Seebeck coefficient, electrical conductivity, thermal conductivity, and power output and efficiency of a single thermoelectric material sample over large temperature gradients. The sample holder—a unique feature of this design—lowers the contact resistance between the sample and the electrodes, allowing for more accurate estimates of the sample’s properties. Measurements were performed under constant temperature differences ranging from 50 to 300 K with the hot side reaching 673 K on a metallized Mg2Si0.3Sn0.7 leg synthesized in the laboratory. To simulate practical operating conditions of a continuously loaded generator, continuous current flow measurements were also performed under large temperature differences. The temperature-averaged TE properties from standard low temperature difference measurements and the experimental TE properties agree with each other, indicating that the designed setup is reliable for measuring various thermoelectric generator properties of single TE legs when subjected to temperature gradients between 50 and 300 K.
Angiopoietin-like protein 4/8 complex-mediated plasmin generation leads to cleavage of the complex and restoration of LPL activity
Authors: Zhen Eugene Y. , Chen Yan Q. , Russell Anna M. , Ehsani Mariam , Siegel Robert W. , Qian Yuewei , Konrad Robert J. 
Published: February 2023

Triglyceride (TG) metabolism is highly regulated by angiopoietin-like protein (ANGPTL) family members [Y. Q. Chen
et al.
,
J. Lipid Res.
61
, 1203–1220 (2020)]. During feeding, ANGPTL8 forms complexes with the fibrinogen-like domain-containing protein ANGPTL4 in adipose tissue to decrease ANGPTL3/8- and ANGPTL4-mediated lipoprotein lipase (LPL)-inhibitory activity and promote TG hydrolysis and fatty acid (FA) uptake. The ANGPTL4/8 complex, however, tightly binds LPL and partially inhibits it in vitro. To try to reconcile the in vivo and in vitro data on ANGPTL4/8, we aimed to find novel binding partners of ANGPTL4/8. To that end, we performed pulldown experiments and found that ANGPTL4/8 bound both tissue plasminogen activator (tPA) and plasminogen, the precursor of the fibrinolytic enzyme plasmin. Remarkably, ANGPTL4/8 enhanced tPA activation of plasminogen to generate plasmin in a manner like that observed with fibrin, while minimal plasmin generation was observed with ANGPTL4 alone. The addition of tPA and plasminogen to LPL-bound ANGPTL4/8 caused rapid, complete ANGPTL4/8 cleavage and increased LPL activity. Restoration of LPL activity in the presence of ANGPTL4/8 was also achieved with plasmin but was blocked when catalytically inactive plasminogen (S760A) was added to tPA or when plasminogen activator inhibitor-1 was added to tPA + plasminogen, indicating that conversion of plasminogen to plasmin was essential. Together, these results suggest that LPL-bound ANGPTL4/8 mimics fibrin to recruit tPA and plasminogen to generate plasmin, which then cleaves ANGPTL4/8, enabling LPL activity to be increased. Our observations thus reveal a unique link between the ANGPTL4/8 complex and plasmin generation.
Assessment of large critical electric field in ultra-wide bandgap p-type spinel ZnGa2O4
Authors: Chi Zeyu , Tchelidze Tamar , Sartel Corinne , Gamsakhurdashvili Tsotne , Madaci Ismail , Yamano Hayate , Sallet Vincent , Dumont Yves , Pérez-Tomás Amador , Medjdoub Farid , Chikoidze Ekaterine 
Published: February 2023

Abstract
The spinel zinc gallate ZnGa2O4 stands out among the emerging ultra-wide bandgap (∼5 eV) semiconductors as the ternary complex oxide with the widest gap where bipolar conductivity has been demonstrated. For power and energy electronics, a fundamental property of the material is its critical electric field (

E

CR

) although, for ZnGa2O4, is yet unknown. In this work, highly resistive p-type ZnGa2O4 thin films on sapphire and Si substrates were grown by metal organic chemical vapor deposition to determine both, the remote acceptor concentration and vertical breakdown voltage. Hall Effect measurements confirmed a low carrier concentration at room temperature of ∼1011 cm−3. From vertical metal-semiconductor-metal structures the average E
CR has been estimated to be of at least 5.3 MV cm−1, which already is significantly larger than the one of SiC and GaN.
Electronic structure and layer-dependent magnetic order of a new high-mobility layered antiferromagnet KMnBi
Authors: Yang Yichen , Lu Hengzhe , Yuan Jian , Liu Zhengtai , Jiang Zhicheng , Huang Zhe , Ding Jianyang , Liu Jiayu , Cho Soohyun , Liu Jishan , Liu Zhonghao , Guo Yanfeng , Zheng Yi , Shen Dawei 
Published: February 2023

Abstract
Room-temperature two-dimensional antiferromagnetic (AFM) materials are highly desirable for various device applications. In this letter, we report the low-energy electronic structure of KMnBi measured by angle-resolved photoemission spectroscopy, which confirms an AFM ground state with the valence band maximum located at −100 meV below the Fermi level and small hole effective masses associated with the sharp band dispersion. Using complementary Raman, atomic force microscope and electric transport measurement, we systematically study the evolution of electric transport characteristics of micro-mechanically exfoliated KMnBi with varied flake thicknesses, which all consistently reveal the existence of a probable AFM ground state down to the quintuple-layer regime. The AFM phase transition temperature ranges from 220 K to 275 K, depending on the thickness. Our results suggest that with proper device encapsulation, multilayer KMnBi is indeed a promising 2D AFM platform for testing various theoretical proposals for device applications.
Effect of polydispersity in concentrated magnetorheological fluids
Authors: Manuel Júlio Gabriel de Falco , Bombard Antonio José Faria , Weeks Eric R 
Published: February 2023

Abstract
Magnetorheological fluids (MRF) are smart materials of increasing interest due to their great versatility in mechanical and mechatronic systems. As main rheological features, MRFs must present low viscosity in the absence of magnetic field (0.1–1.0 Pa.s) and high yield stress (50–100 kPa) when magnetized, in order to optimize the magnetorheological effect. Such properties, in turn, are directly influenced by the composition, volume fraction, size, and size distribution (polydispersity) of the particles, the latter being an important piece in the improvement of these main properties. In this context, the present work aims to analyze, through experiments and simulations, the influence of polydispersity on the maximum packing fraction, on the yield stress under field (on-state) and on the plastic viscosity in the absence of field (off-state) of concentrated MRF (φ = 48.5 vol.%). Three blends of carbonyl iron powder (CIP) in polyalphaolefin oil were prepared. These blends have the same mode, but different polydispersity indexes (α), ranging from 0.46 to 1.44. Separate simulations show that the random close packing fraction increases from about 68% to 80% as the polydispersity indexes increase over this range. The on-state yield stress, in turn, is raised from 30 ± 0.5 kPa to 42 ± 2 kPa (B ≈ 0.57 T) and the off-state plastic viscosity, is reduced from 4.8 Pa.s to 0.5 Pa.s. Widening the size distributions, as is well known in the literature, increases packing efficiency and reduces the viscosity of concentrated dispersions, but beyond that, it proved to be a viable way to increase the magnetorheological effect of concentrated MRF. The Brouwers model, which considers the void fraction in suspensions of particles with lognormal distribution, was proposed as a possible hypothesis to explain the increase in yield stress under magnetic field.
Nonlinear-optical microscopy of asymmetric-shaped nanoantennas
Authors: Mamonov Evgeniy A , Kolmychek Irina A , Maydykovskiy Anton I , Gusev Nikita S , Skorokhodov Evgeny V , Gusev Sergey A , Temiryazeva Marina P , Murzina Tatiana V 
Published: February 2023

Abstract
Arrays of metal nanostructures have attracted much interest due to their unique potential as optical nanoantennas and nanosensors. Here we use the second harmonic generation (SHG) microscopy technique for the studies of the nonlinear optical (NLO) response of cobalt nanoparticles of triangular and trapezoid shapes separated from a Py/Si3N4 film by a 1.5 nm thick MgO spacer. We demonstrate that the nonsymmetric elongated shape of planar nanoparticles along with the strong light localization effects result in the enhancement of the NLO response, including SHG and two-photon fluorescence. We also demonstrate that the efficiency of the SHG in nanoparticles is rather sensitive to the polarization of the incident laser beam, the visibility of the nanostructures in the nonlinear microscopy images being the highest for the linear polarization of the laser beam.
Investigation of optical constants of Al2O3 films in the spectral range 0.2 - 0.8 microns
Authors: Kotlikov E N , Lavrovskaya N P , Miloushev I K , Tenev T K 
Published: February 2023

Abstract
We determine optical constants of Al2O3 films deposited by electron beam evaporation on a quartz substrate in the spectrum range 0.2-0.8 microns. Refractive index and extinction coefficient are determined by a spectrophotometric method using the reflection and transmission spectra. An original method of correction of the spectra of the films is used taking into account the absorption. The refractive index is determined from absorption-free spectra, and the extinction coefficient is determined from absorption spectra in the specified spectral region.
On the classical critical behavior of the specific heat capacity of a model of structural phase transitions with a long-range interaction
Authors: Pisanova E S 
Published: February 2023

Abstract
The critical specific heat capacity c of a d-dimensional model describing structural phase transitions in an anharmonic crystal with a long-range interaction (decreasing at large distances r as r
−d−σ
, 0 < σ ≤ 2) is studied near the classical critical point Tc
. At temperatures T > Tc
and for dimensions σ < d < 2σ (σ and 2σ are the lower and the upper critical dimensions, respectively) the critical specific heat capacity is obtained in the form c ≈ 1 − Dεαs

, where D > 0 and αs
< 0 depend only on the ratio d/σ, and ε = T/Tc
−1 is a measure of the deviation from the critical point. For three fixed values of the ratio d/σ the dependence c ≈ c(ε) is graphically presented. It is shown that at all temperatures T ≤ Tc
the specific heat capacity retains its maximum value, c
max = 1. The critical exponent αs
, obtained here, coincides with that of the known mean spherical model, while c
max is different for the two models.
Graphene Oxide Induced Sub-structures of Bi-tilted Smectic CG in Dimer Liquid Crystals
Authors: Katranchev B , Petrov M , Naradikian H , Rafailov P M , Todorov N D 
Published: February 2023

Abstract
A nanocomposite built of the hydrogen-bonded (HB) dimer liquid crystal 4-heptyloxybenzoic acid (7OBA) and Graphene oxide (GO) exhibiting a cascade of phase transitions and phases not typical for pristine 7OBA, was investigated by optical polarization microtexture analysis and Raman spectroscopy. We use the 7OBA/GO nanocomposite beacause of the effective functionalizing properties of GO to study the generation and development of the ferroelectric smectic CG phase in its bi-tilted configuration. For the appearance of the CG phase with its substructures we propose an explanation based on the HB formation between 7OBA dimers in closed and open conformations and the GO sheets, aided by the π–π interaction with graphene hexagons which are free from functional groups. We propose molecular and macroscopic models for the substructures CGcl and CGln and indicate their triclinic C1 symmetry, characterized by a polar vector directed oblique to the layers. This confirms that the bi-tilted CG and its substructures are ferroelectric in the bulk similarly to solid ferroelectrics, thus showing potential as material for controllable photonic functional devices.
Thickness dependence of optical properties of thin multilayer Ag/Bi structures and their surface plasmon-enhanced photoluminescence capability
Authors: Katrova V , Atanasova A , Todorov R , Hristova-Vasileva T , Strijkova V 
Published: February 2023

Abstract
Preparation technology, optical properties and surface-enhanced photoluminescence features of thin Ag/Bi layers with different ratios of the chemical elements are subject of present work. Coatings with different number of Ag/Bi stacks were tested in order to determine the minimum number of sublayers required to achieve epsilon-near-zero properties (ENZ). The results for the complex permittivity showed that the Ag/Bi films possess epsilon-near-zero properties in a wide spectral range of 1.3-6 eV. It was established that the most promising material for photoluminescence signal amplification is the four stacked Ag50:Bi50 thin layer.