bluuebunny/crossref_metadata_2025_split huggingface dataset:
Has variable access to health care during the COVID‐19 pandemic impacted the severity of paediatric diabetic ketoacidosis?
Authors: Fathi Alireza , Levine Glenn K , Hicks Rebecca , Morphew Tricia , Babbitt Christopher J 
Published: June 2022

Abstract
Previous studies have indicated that paediatric patients with type 1 diabetes mellitus are presenting with more severe diabetic ketoacidosis (DKA) during the COVID‐19 pandemic. This study was performed to determine the effect that access to health care had on DKA severity and outcomes in children and young people (CYP) with new‐onset diabetes mellitus.This is a retrospective cohort analysis comparing pre‐pandemic and pandemic patients admitted to a 30‐bed paediatric intensive care unit (PICU) in the United States with DKA. A database query identified patients and clinical data were extracted and analysed. Additionally, phone interviews focusing on challenges with health care access during the COVID‐19 pandemic were performed with the parents of CYP admitted during the pandemic.A total of 50 pre‐pandemic and 43 pandemic patients met inclusion criteria and were included in the analysis. Pandemic patients had more severe acidosis (pH 7.10 versus 7.17), a longer duration of insulin infusion (19 versus 15 hours) and increased PICU length of stay (1 versus 0.75 days, all p < 0.05) than pre‐pandemic patients. Patients whose families felt the pandemic affected their child's ability to see a physician had a longer PICU length of stay (1.5 versus 0.9 days, p = 0.004) and a trend towards a lower pH (7.01 versus 7.13, p = 0.106). Patients with a social vulnerability index ≥0.75 were less likely to see a physician before coming to the hospital (p = 0.017).In conclusion, CYP with new‐onset type 1 diabetes who were admitted with DKA during the COVID‐19 pandemic had more severe acidosis and a longer PICU stay. Variable access to health care during the COVID‐19 pandemic may be contributing to this. Copyright © 2022 John Wiley & Sons.
Mental health impact ofCOVID‐19 pandemic on therapists at an inpatient rehabilitation facility
Authors: Jow Steven , Doshi Saumil , Desale Sameer , Malmut Laura 
Published: June 2022

AbstractBackgroundHealthcare workers have faced extraordinary work‐related stress in the face of the COVID‐19 pandemic. Physical therapy, occupational therapy, and speech‐language pathology providers at inpatient rehabilitation facilities may represent a distinct at‐risk subgroup for work‐related stress during the pandemic due to the usual nature of their job duties, including close physical contact and extended treatment times.ObjectiveTo evaluate the impact of the COVID‐19 pandemic on work‐related stress and occurrence of depression and anxiety in physical therapists, occupational therapists, and speech‐language pathologists during the first surge of COVID‐19 hospitalizations.DesignCross‐sectional survey.SettingAcademic, freestanding inpatient rehabilitation facility.ParticipantsSurvey responses were collected from 38 therapists.InterventionA 26‐item electronic questionnaire containing a mix of multiple‐choice and open‐ended questions.Main Outcome MeasuresPositive screens for depression or anxiety as measured by the Patient Health Questionnaire‐9 (PHQ‐9) and the General Anxiety Disorder 7‐item (GAD‐7) scale, respectively.ResultsSeven individuals (19%) scored at or above the clinically significant cutoff of 10 on each the PHQ‐9 and GAD‐7, corresponding to increased risk for depression and anxiety. Therapists younger than 30 years old had significantly higher GAD‐7 scores compared to therapists between 30‐39 years old (p < .05). Occupational stress was attributed to a number of causes including concerns for health and safety, unpredictable changes in hospital protocols and work assignments, acquisition of additional work duties, concerns about the ability to provide high‐quality patient care in a restricted environment, and the psychological toll of caring for patients with or recovering from COVID‐19.ConclusionThis cross‐sectional survey highlights the impact of the COVID‐19 pandemic on occupational stress and mental health of therapists working at an inpatient rehabilitation facility during the first surge of COVID‐19 hospitalizations. This research may help institutions identify at‐risk individuals who may benefit from support and guide policy changes to resolve potentially modifiable factors at a systems level.
Hidden Sectors from Multiple Line Bundles for the B−L$B-L$ MSSM
Authors: Ashmore Anthony , Dumitru Sebastian , Ovrut Burt A. 
Published: June 2022

AbstractWe give a formalism for constructing hidden sector bundles as extensions of sums of line bundles in heterotic M‐theory. Although this construction is generic, we present it within the context of the specific Schoen threefold that leads to the physically realistic MSSM model. We discuss the embedding of the line bundles, the existence of the extension bundle, and a number of necessary conditions for the resulting bundle to be slope‐stable and thus supersymmetric. An explicit example is presented, where two line bundles are embedded into the factor of the maximal subgroup of the hidden sector E8 gauge group, and then enhanced to a non‐Abelian bundle by extension. For this example, there are in fact six inequivalent extension branches, significantly generalizing that space of solutions compared with hidden sectors constructed from a single line bundle.
Incremental nonlinear stability analysis of stochastic systems perturbed by Lévy noise
Authors: Han SooJean , Chung Soon‐Jo 
Published: June 2022

AbstractWe present a theoretical framework for characterizing incremental stability of nonlinear stochastic systems perturbed by either compound Poisson shot noise or finite‐measure Lévy noise. For each noise type, we compare trajectories of the perturbed system with distinct noise sample paths against trajectories of the nominal, unperturbed system. We show that for a finite number of jumps arising from the noise process, the mean‐squared error between the trajectories exponentially converge toward a bounded error ball across a finite interval of time under practical boundedness assumptions. The convergence rate for shot noise systems is the same as the exponentially stable nominal system, but with a tradeoff between the parameters of the shot noise process and the size of the error ball. The convergence rate and the error ball for the Lévy noise system are shown to be nearly direct sums of the respective quantities for the shot and white noise systems separately, a result which is analogous to the Lévy–Khintchine theorem. We demonstrate both empirical and analytical computation of the error ball using several numerical examples, and illustrate how varying the parameters of the system affect the tightness of the bound.
Application of viable system model in diagnosing defects and problems of the credit supply chain network in the Iranian banking industry
Authors: Jabbarzadeh Eissa , Teimoury Ebrahim , Shavvalpour Saeed 
Published: June 2022

AbstractThe present study attempts to study the credit supply process in the Iranian banking industry by using the viable system model (VSM) to identify its vulnerabilities and improve the financing system. The method used in this study consists of three steps: (a) identification of system, (b) diagnosis of system and (c) control of information flow, communication channels and frequent errors. In this research, 37 credit experts from 17 different bank branches were interviewed about the process of granting facilities, and SPSS 23 was used to examine research objectives through the Delphi method. The results show that the structure of Iran's credit supply chain network suffers from such problems as deviation in the appropriate use of allocated credit resources, structural faults of the banking system and lack of administrative health, high bureaucracy, directed facilities, etc. In the end, some suggestions are provided for redesign and optimization of the credit supply network.
The antagonistic effect of melatonin onTBBPA‐induced apoptosis and necroptosis viaPTEN/PI3K/AKTsignaling pathway in swine testis cells
Authors: Sun Kexin , Wang Xu , Zhang Xinyu , Shi Xu , Gong Duqiang 
Published: June 2022

AbstractTetrabromobisphenol A (TBBPA) is a widely used industrial brominated flame retardant, which can endanger animal and human health, including cytotoxicity, endocrine disruption, reproductive toxicity and so on. Melatonin (MT) is a noteworthy free radical scavenger and an antioxidant to alleviate oxidative stress. To investigate the cytotoxic of TBBPA on swine testis cells (ST cells), as well as the antagonistic effect of MT, we established TBBPA exposure and MT antagonistic models, used flow cytometry and AO/EB staining methods to detect apoptosis and necroptosis, used DCFH‐DA method to examine the content of reactive oxygen species (ROS) and investigated the expression of associated genes using RT‐PCR and Western blot. According to our findings, TBBPA exposure induced cell death in ST cells. TBBPA increased ROS levels, thus increasing PTEN expression and decreasing PI3K and AKT expression. Apoptosis‐related factors (Caspase‐3, Bax, Cyt‐c, and Caspase‐9) and necroptosis‐related factors (RIPK1, RIPK3, and MLKL) were considerably elevated, in addition to the reduced expression of BCL‐2 and Caspase‐8. We also found that MT inhibited apoptosis and necroptosis in TBBPA‐induced ST cells and effectively resolved the abnormal expression of related signaling pathways. In summary, the above results indicate that MT alleviates the disorder of PTEN/PI3K/AKT signaling pathway via inhibiting ROS overproduction, thereby mitigating apoptosis and necroptosis caused by TBBPA. This research provides a theoretical basis for further understanding of the toxicity of TBBPA and the detoxification of MT against environmental toxics.
In silico exploration of amyloid‐related imaging abnormalities in the gantenerumab open‐label extension trials using a semi‐mechanistic model
Authors: Aldea Roxana , Grimm Hans Peter , Gieschke Ronald , Hofmann Carsten , Lott Dominik , Bullain Szofia , Delmar Paul , Klein Gregory , Lyons Marco , Piazza Fabrizio , Carare Roxana O. , Mazer Norman A. 
Published: June 2022

AbstractIntroductionAmyloid‐related imaging abnormalities with edema/effusion (ARIA‐E) are commonly observed with anti‐amyloid therapies in Alzheimer's disease. We developed a semi‐mechanistic, in silico model to understand the time course of ARIA‐E and its dose dependency.MethodsDynamic and statistical analyses of data from 112 individuals that experienced ARIA‐E in the open‐label extension of SCarlet RoAD (a study of gantenerumab in participants with prodromal Alzheimer's disease) and Marguerite RoAD (as study of Gantenerumab in participants with mild Alzheimer's disease) studies were used for model building. Gantenerumab pharmacokinetics, local amyloid removal, disturbance and repair of the vascular wall, and ARIA‐E magnitude were represented in the novel vascular wall disturbance (VWD) model of ARIA‐E.ResultsThe modeled individual‐level profiles provided a good representation of the observed pharmacokinetics and time course of ARIA‐E magnitude. ARIA‐E dynamics were shown to depend on the interplay between drug‐mediated amyloid removal and intrinsic vascular repair processes.DiscussionUpon further refinement and validation, the VWD model could inform strategies for dosing and ARIA monitoring in individuals with an ARIA‐E history.
Integrated Alzheimer's Disease Rating Scale: Clinically meaningful change estimates
Authors: Wessels Alette M. , Rentz Dorene M. , Case Michael , Lauzon Steve , Sims John R. 
Published: June 2022

AbstractIntroductionThe Integrated Alzheimer's Disease Rating Scale (iADRS) has been used to detect differences in disease progression in early Alzheimer's disease (AD). The objectives of this study were to enhance understanding of iADRS point changes within the context of clinical trials, and to establish a minimal clinically important difference (MCID) on the iADRS.MethodsData from AMARANTH and EXPEDITION3 were analyzed using various approaches, including anchor‐based, distribution‐based, regression analyses, and cumulative distribution function (CDF) plots. Three potential anchors were examined, including the Clinical Dementia Rating—Sum of Boxes, Mini‐Mental State Examination, and Functional Activities Questionnaire. Triangulation of all results was used to determine the MCID for participants with mild cognitive impairment (MCI) due to AD and AD with mild dementia.ResultsAll three anchors met criteria for “sufficiently associated” (|r| = 0.4–0.7). Cumulatively, results from anchor‐based and distribution‐based results converged to suggest an iADRS MCID of 5 points for MCI due to AD and 9 points for AD with mild dementia. Regression analyses and CDF plots supported these values.DiscussionThese findings suggest the iADRS can be used in clinical trials to detect a clinically meaningful outcome of AD progression.
‘We're gonna end up scared to do anything’: A qualitative exploration of how client complaints are experienced by UK veterinary practitioners
Authors: Gibson Julie , White Kate , Mossop Liz , Oxtoby Catherine , Brennan Marnie 
Published: June 2022

AbstractBackgroundUK veterinary practitioners are reported to be fearful of client complaints, but their experiences have not been formally captured. Understanding how complaints impact veterinary practitioners is key to mitigating detrimental consequences.MethodsA qualitative exploration of how UK veterinary practitioners experience and respond to adverse events was conducted. Data were collected via focus groups and interviews, which were transcribed and simultaneously analysed. Coding and theme development were inductive rather than restricted by preconceived theories.ResultsTwelve focus groups and 15 individual interviews took place. One theme identified focused on the impact of client complaints. Practitioners experienced unintentional distraction and disengagement from clinical work, as well as employing defensive strategies as a direct result of complaints. The vexatious nature of some complainants was highlighted, along with concerns about practice and regulatory complaint management, lack of appropriate support, discriminatory behaviours and the influence of ‘trial by media’.ConclusionsClient complaints present a threat to practitioner mental health and workforce sustainability, as well as having implications for patient safety. Mitigating these effects is a complex and multifaceted undertaking, but fairness, transparency and timeliness of practice and regulatory complaint investigation must be prioritised, along with provision of tailored support for those facing complaints.
Indigenous legume fodder trees and shrubs with emphasis on land use and agroecological zones: Identification, diversity, and distribution in semi‐humid condition of southern Ethiopia
Authors: Abraham Getachew , Kechero Yisehak , Andualem Dereje , Dingamo Temesgen 
Published: June 2022

AbstractBackgroundFodder trees and shrubs are among the strategic feed resources that complement the dry season feed supply in the tropics. They are an integral element of the farming system incorporated into different land uses and deliver multiple functions, even though their diversity relies on various anthropogenic, physiographic, and agroecological factors.ObjectiveThe study aimed to identify indigenous legume fodder trees and shrubs (ILFTS) and estimate their diversity in terms of land use and agroecological zones in southern Ethiopia's Gamo landscape.MethodRespondent households were selected using a stratified multistage sampling procedure. Information about the ILFTS was gathered through key informant interviews conducted in each agro‐ecological zone. A total of 273 households from three agro‐ecological zones were selected and interviewed using a semi‐structured questionnaire to assess ILFTS. The information acquired by the questionnaire survey was complemented with a focus group discussion held with 10 respondents in each agro‐ecological zone. Herbarium samples were collected for each of the species for identification and confirmation of the botanical names. Sixty randomly selected sampling plots of each with a dimension of 20 m × 20 m were created, and inventories of ILFTS species were performed and recorded on species inventory sheets. The Shannon–Wiener diversity index (H) was used to determine the species diversity.ResultThe study identified 21 ILFTS that have been an integral constituent of the land uses recognised for their multiple functions in all agroecological zones. The mean species richness and diversity indices of the ILFTS differed significantly with land use and agroecological zones, where the lowland area closure exhibited the highest, and the highland homesteads and highland grazing land revealed the least.ConclusionFarmers’ indigenous knowledge and previous experience determined the species richness and diversity of ILFTS in farmlands and homesteads; however, the level of exploitation or protection was the reason for variation in area closure and grazing lands.
Stable Isotope Signatures of Wood, its Constituents and Methods of Cellulose Extraction
Authors: Helle Gerhard , Pauly Maren , Heinrich Ingo , Schollän Karina , Balanzategui Daniel , Schürheck Lucas 
Published: June 2022

AbstractIn this chapter, we give some basic information on the chemical and isotopic properties of wood constituents and describe their relative contribution to the isotopic signature of wood. Based on these considerations we review studies that have compared stable isotope signals of wood with those of corresponding cellulose. We exemplify how relationships of wood-based tree-ring stable isotope sequences with climate can be affected by varying proportions of wood constituents like cellulose, lignin and extractives. A majority of benchmarking studies suggests that cellulose extraction may not be necessary. However, based upon existing research, a general statement cannot be made on the necessity of cellulose extraction. Changes in wood composition can particularly influence environmental signal strength during periods of low isotope variability. Cellulose extraction removes any effects from changing wood composition. We present the three established chemical approaches of extraction, outline how to test the purity of isolated cellulose and present user-friendly efficient experimental setups allowing to simultaneously process hundreds of samples in one batch. Further, we briefly address the analysis of stable isotopes of lignin methoxyl groups because of easy sample preparation and its potential additional value for studies on fossil wood.
Factorization for azimuthal asymmetries in SIDIS at next-to-leading power
Authors: Ebert Markus A. , Gao Anjie , Stewart Iain W. 
Published: June 2022

Abstract
Differential measurements of the semi-inclusive deep inelastic scattering (SIDIS) process with polarized beams provide important information on the three-dimensional structure of hadrons. Among the various observables are azimuthal asymmetries that start at subleading power, and which give access to novel transverse momentum dependent distributions (TMDs). Theoretical predictions for these distributions are currently based on the parton model rather than a rigorous factorization based analysis. Working under the assumption that leading power Glauber interactions do not spoil factorization at this order, we use the Soft Collinear Effective Theory to derive a complete factorization formula for power suppressed hard scattering effects in SIDIS. This yields generalized definitions of the TMDs that depend on two longitudinal momentum fractions (one of them only relevant beyond tree level), and a complete proof that only the same leading power soft function appears and can be absorbed into the TMD distributions at this order. We also show that perturbative corrections can be accounted for with only one new hard coefficient. Factorization formulae are given for all spin dependent structure functions which start at next-to-leading power. Prospects for improved subleading power predictions that include resummation are discussed.
Are there ALPs in the asymptotically safe landscape?
Authors: de Brito Gustavo P. , Eichhorn Astrid , Lino dos Santos Rafael R. 
Published: June 2022

Abstract
We investigate axion-like particles (ALPs) in the context of asymptotically safe gravity-matter systems. The ALP-photon interaction, which facilitates experimental searches for ALPs, is a dimension-5-operator. Quantum fluctuations of gravity lower its scaling dimension, and the ALP-photon coupling can become asymptotically free or even asymptotically safe. However, quantum fluctuations of gravity need to be strong to overcome the canonical scaling and this strong-gravity regime is in tension with the weak-gravity bound in asymptotic safety. Thus, we tentatively conclude that fundamental ALPs can likely not be accommodated in asymptotically safe gravity-matter systems. In turn, an experimental discovery of an ALP would thus shed valuable light on the quantum nature of gravity.
Increasing grades of frontal deformities in knee osteoarthritis are not associated with ligamentous ankle instabilities
Authors: Graef F. , Rühling M. , Gwinner C. , Hommel H. , Tsitsilonis S. , Perka C. 
Published: June 2022

Abstract
Purpose
Varus or valgus deformities in knee osteoarthritis may have a crucial impact on ankle subtalar range of motion (ROM) and ligamentous stability. The purpose of this study was to assess whether the grade of ankle eversion and inversion rotation stability was influenced by frontal deformities of the knee joint.

Methods
Patients who were planned to undergo total knee arthroplasty (TKA) were prospectively included in this study. Patients were examined radiologically (mechanical tibiofemoral angle (mTFA), hindfoot alignment view angle (HAVA), anterior distal tibia angle (ADTA)) and clinically (ROM of the knee and ankle joint, foot function index, knee osteoarthritis outcome score). Ankle stability was assessed using an ankle arthrometer (AA) to test inversion/eversion (ie) rotation and anterior/posterior (ap) displacement stability of the ankle joint. Correlations were calculated using Pearson’s coefficient, and differences between two independent groups of nonparametric data were calculated using a two-sided Wilcoxon signed rank test.

Results
Eighty-two (varus n = 52, valgus n = 30) patients were included. The preoperative mTFA significantly correlated with the HAVA (Pearson’s correlation = − 0.72, p < 0.001). Laxity testing of the ankle demonstrated that in both varus and valgus knee osteoarthritis, higher grades of mTFA did not correlate with the inversion or eversion capacity of the ankle joint. The ADTA significantly correlated with the posterior displacement of the ankle joint (cor = 0.24, p = 0.049).

Conclusions
This study could not confirm that higher degrees of frontal knee deformities in osteoarthritis were associated with increasing grades of ligamentous ankle instabilities or a reduced ROM of the subtalar joint.

Level of evidence
II.