bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of aortic cannulation depth on air emboli transport during cardiopulmonary bypass: A computational study
Authors: Ho Raymond , McDonald Charles , Pauls Jo P , Li Zhiyong 
Published: May 2022

Introduction Varying the insertion depth of the aortic cannula during cardiopulmonary bypass (CPB) has been investigated as a strategy to mitigate cerebral emboli, yet its effectiveness associated with CPB flow is not fully understood. We compared different arterial cannula insertion depths and pump flow influencing air microemboli entering the aortic arch branch arteries (AABA). Methods A computational approach used a patient-specific aorta model to evaluate four cannula locations at (1) proximal arch, (2) mid arch, (3) distal arch, and (4) descending aorta. We injected 0.1 mm microemboli (N=720) at 2 and 5 L/min and assessed the embolic load and the particle averaged transit times ( entering the AABA. Results Location 4 had the lowest embolic load (2 L/min: N= 63) and (5 L/min: N= 54) compared to locations 1 to 3 in the range of (N= 118 to 116 at 2 L/min:) and (N= 92 to 146 at 5 L/min). There was no significant difference between 2 L/min and 5 L/min (p = 0.31), despite 5 L/min attaining a lower mean (±standard deviation) than 2 L/min (38.0±23.4 vs 44.5±21.1), respectively. Progressing from location 1 to 4, increased 3.11s -7.40 s at 2 L/min and 1.81s -4.18s at 5 L/min. Conclusion It was demonstrated that the elongated cannula insertion length resulted in lower embolic loads, particularly at a higher flow rate. The numerical results suggest that CPB management could combine active flow variation with improving cannula performance and provide a foundation for a future experimental and clinical investigation to reduce surgical cerebral air microemboli.
Wrinkling suppression in thin membranes using designed geometrical features
Authors: Nazzal Mohammad , Alkhader Maen , Agha Akshat , Abu‐Farha Fadi , Ali Zain , AlDamaty Waleed 
Published: May 2022

The rapidly increasing use of thin membranes; especially in the fabrication of flexible electronics, has motivated investigating the wrinkling behavior of these membranes. Wrinkling has an undesirable effect since wrinkles degrade the surface accuracy of structures incorporating thin membranes. This work introduces and evaluates an approach based on including optimized geometric features in thin membranes to suppress their wrinkling behavior. The ability of the optimized geometric features to suppress wrinkling in a 25 μm thick polyimide membrane subjected to uniaxial stretching is investigated computationally and experimentally in this work. A finite element model is developed to predict the wrinkling behavior of the membrane. An experimental setup equipped with 3D digital image correlation system is used to determine the wrinkles pattern, amplitude, and wavelength. Symmetric circular holes are introduced in the membrane to redistribute the stress field, eliminate the fluctuation in the minor principal stress in the membrane, and suppress wrinkles. The location and size of the circular holes are determined by coupling the Non-Linear Programming by Quadratic Largrangian technique and finite element simulations. An optimal design is obtained and the experimental results show that the optimally designed holes effectively suppressed the wrinkling behavior.
Changes in Work Status, Couple Adjustment, and Recovery Capital: Secondary Analysis of Data From a Congruence Couple Therapy Randomized Controlled Trial
Authors: Lee Bonnie K , Ofori Dei Samuel M 
Published: May 2022

Purpose: Employment and family/social relationships are 2 of the highest priorities among those in substance use recovery. This study examined the relationship of work status with couple adjustment and other recovery capital treatment outcomes among symptomatic alcohol, substance use, and gambling participants ( N = 38) using data collected in a randomized trial comparing a systemic Congruence Couple Therapy (CCT) and individual-based Treatment-as-Usual (TAU). Method: Change scores and associations between work status and couple adjustment together with 8 other recovery outcome variables at post-treatment (5 months from baseline) and follow-up (8 months from baseline) in TAU ( n = 17) and CCT ( n = 21) were analyzed. Results: Number of those working increased with both CCT and TAU but without reaching significance in either CCT (Cochran’s Q = 5.429, P = .066) or TAU (Cochran’s Q = 2.800, P = .247). Relative to those not working in the combined sample, those working showed significantly improved scores in post-treatment and follow-up in addictive symptoms, couple adjustment, psychiatric symptoms, depression, and life stress. Separating the CCT and TAU groups, similar trend was found in the CCT group but was inconsistent in the TAU group. Conclusion: Significantly greater improvement in addictive symptoms and recovery capital of couple adjustment, mental health, and life stress was found in the working vs not-working group. Compared to individual-based TAU, exploratory findings indicate that the systemic treatment of CCT showed a clearer and more consistent difference in improved working days, addictive symptoms and recovery capital. Replication with larger samples is needed to generalize these results.
Detection and Determination of Staphylococcus aureus in Camel Milk and Associated Factors in Fedis, Eastern Hararghe, Ethiopia
Authors: Tasse Ibsa , Mengistu Dechasa Adare , Belina Dinaol , Girma Sisay 
Published: May 2022

Background: Camel milk is the key food for pastoralists in the arid and semi-arid areas of the eastern lowlands of Ethiopia. Unless it is handled under good hygienic conditions, milk can be a good medium for bacterial growth and can lead to foodborne diseases caused by various pathogenic microorganisms, such as Staphylococcus aureus. The current study was aimed to determine the prevalence of Staphylococcus aureus in raw camel milk and associated factors in Fedis, Eastern Ethiopia. Methods: A cross-sectional study was conducted from December 2, 2018 to May 26, 2019 in Fedis, Eastern Hararghe, Ethiopia. The questionnaire was used to determine the hygienic practices of camel milkers and sellers. Laboratory analysis was conducted to determine the level of Staphylococcus aureus. A total of 156 (78 from households and 78 from selling sites) milk samples were collected randomly from selected camel herd owners and selling sites for the isolation and enumeration of Staphylococcus aureus. Data analysis was carried out using SPSS software version 22.0. Finally, Chi-square and Fisher’s exact tests were used to analyze the data. A P-value of .05 was considered as the cut-off point for statistical significance. Results: A total of 156 samples, including 78 samples of raw milk from the households and 78 samples from the market were purchased to determine Staphylococcus aureus. Out of 156 samples, Staphylococcus aureus was detected in 60 (38.5%) samples, of which 27 (34.6%) and 33 (42.3%) were among those collected from household and market, respectively. The overall mean Staphylococcus aureus count was 4.83 log CFU/mL, with household and market samples accounted for 2.76 and 5.08 log CFU/mL, respectively. Furthermore, 23 (38.3%) of the samples were contaminated with Staphylococcus aureus beyond the recommended level (4-5 log CFU/mL). There was a statistically significant association ( P-value of <.05) between the prevalence of Staphylococcus aureus and other variables such as age of the camel, parity, lactation stages, and sources of milk. Conclusion: More than one-third of milk samples were contaminated with Staphylococcus aureus at levels higher than the maximum permitted level. The findings of the current study suggests that there is a potential risk of foodborne infection and intoxication. Therefore, implementation of adequate hygiene and safety practices is very important to prevent the consumption of contaminated fruit juices, which leads to foodborne illness.
Fifteen years with patient choice and free establishment in Swedish primary healthcare: what do we know?
Authors: Fredriksson Mio , Isaksson David 
Published: May 2022

Background: In 2007, a reform of Swedish primary healthcare began when some regions implemented enhanced patient choice in combination with free establishment for private providers. Although heavily debated, in 2010 it became mandatory for all regions to implement this choice system. Aim: The aim of this article was to review all published research articles related to the primary healthcare choice reform in Sweden, to investigate what has been published about the reform and summarise its first 15 years. Methods: A scoping review was performed to cover the breadth of research on the reform. Searches were made in Scopus, Web of Science and PubMed for articles published between 2007 and 2021, resulting in 217 unique articles. In total, 52 articles were included. Results: The articles were summarised and presented in relation to six overarching themes: arguments about the primary healthcare choice reform; governance and financial reimbursements; choice of provider and use of information; effects on equity and access; effects on quality; and differences between private and public primary healthcare centres. Conclusions: The articles show that the reform has led to an increase in access to primary healthcare, but most studies indicate that the increase is inequitably distributed in terms of socioeconomy and geographical location. The effects on quality are unclear but several studies show that the mechanisms supposed to lead to quality improvements do not work as intended. Furthermore, from a population health perspective, it is time to discuss how such a responsibility can be reintegrated into primary healthcare and function with the choice system.
Access and Utilization of Asthma Medications Among Patients Who Receive Care in Federally Qualified Health Centers
Authors: Ali Asma M. , Gaglioti Anne H. , Stone Rebecca H. , Crawford Natalie D. , Dobbin Kevin K. , Guglani Lokesh , Young Henry N. 
Published: May 2022

Objectives: To describe access to and use of prescription asthma medications, and to assess factors associated with asthma exacerbation, healthcare utilization, and health status among asthma patients treated at Federally Qualified Health Centers. Methods: This is a retrospective cross-sectional study. We analyzed data from the 2014 National Health Center Patient Survey. This data is publicly available from the Health Resources and Services Administration. Data was collected from patients receiving face-to-face care from health centers funded under Section 330 of the Public Health Service Act. Data from patients was collected between October 8, 2014, and April 17, 2015. We included adult participants who reported having a diagnosis of asthma and confirmed that they still have asthma. Association between explanatory variables (access to prescription medications and use of asthma controller medications) and outcome variables (asthma exacerbations, asthma hospitalizations or emergency department visits, and self-rated health) was assessed using multivariable regression analyses while adjusting for demographics. Results: A total of 919 participants with asthma were included. Approximately 32% of the participants experienced delays in getting prescription medications, 26% were unable to get them, 60% experienced an asthma exacerbation last year, 48% rated their health as fair/poor, and 19% visited a hospital or an emergency department last year. Multivariable results showed that participants who were currently taking controller medications were more likely to have experienced an asthma exacerbation (OR = 4.02; 95% CI 1.91 to 8.45; P < .01), or visited a hospital or an emergency department (OR = 3.07; 95% CI 1.39 to 6.73; P < .01) in the last year compared with those who had never taken controller medications. Experiencing difficulties in accessing asthma medications was associated with lower self-rated health ([Formula: see text] = −.51; 95% CI −0.94 to −0.08; P = .02). Conclusions: Future interventions should seek to improve asthma patient care and health outcomes using innovative strategies that act at multiple levels of the healthcare system (eg, individual, interpersonal, community levels).
Extensive eczema herpeticum in a previously well child
Authors: Almoalem Manal , AlAlhareth Ibrahim , Alomer Hussa , Almarri Azzam , Alyami Awadh , Hamzah Rakan , Albalawi Othub , Alnoaimi Salwa 
Published: May 2022

Abstract
Background
Eczema herpeticum, also known as Kaposi varicelliform eruption, is a potentially life-threatening disseminated cutaneous viral infection. In the majority of cases, this condition develops as a complication in patients with atopic dermatitis. However, it may arise in a wide spectrum of pre-existing skin conditions, including psoriasis, seborrheic dermatitis, contact dermatitis, cutaneous T cell lymphoma, pemphigus vulgaris, and others.

Case presentation
We present the case of a 2-year-old boy who was brought to the emergency department because of a high-grade fever and rash. The fever started 2 days before his presentation, and its maximum measurement was 39.6°C. The following day, the patient developed numerous painful, pruritic vesiculopustular eruptions, and oozing involving the lips, rendering the patient unable to tolerate oral feeding. The patient was seen by the dermatology team who diagnosed the child as having eczema herpeticum. The patient was commenced on antiviral and empirical antibiotic therapy in the form of intravenous acyclovir and cephalexin along with topical fusidic acid and panthenol. The patient showed clinical improvement with resolution of the fever and partial involution of the rash 2 days following the administration of the antimicrobial therapy.

Conclusion
Eczema herpeticum is a rare clinical entity that can result in significant morbidity. The case highlights the importance of considering the diagnosis of eczema herpeticum in the appropriate clinical settings, even in patients who were not known to have any prior skin disorder.
Clinical characteristics and mortality associated with COVID-19 at high altitude: a cohort of 5161 patients in Bogotá, Colombia
Authors: Rodriguez Lima David Rene , Pinzón Rondón Ángela María , Rubio Ramos Cristhian , Pinilla Rojas Darío Isaías , Niño Orrego Maria José , Díaz Quiroz Mateo Andrés , Molano-González Nicolás , Ceballos Quintero Jorge Enrique , Arroyo Santos Alex Francisco , Ruiz Sternberg Ángela María 
Published: May 2022

Abstract
Background
There are few data on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) in cities over 1000 m above sea level (masl).

Objectives
To describe the clinical characteristics and mortality of patients with COVID-19 treated at a high complexity hospital in Bogotá, Colombia, at 2640 masl.

Methods
This was an observational study of a cohort including 5161 patients with confirmed COVID-19 infection from 19 March 2020 to 30 April 2021. Demographic data, laboratory values, comorbidities, oxygenation indices, and clinical outcomes were collected. Data were compared between survivors and nonsurvivors. An independent predictive model was performed for mortality and invasive mechanical ventilation (IMV) using classification and regression trees (CART).

Results
The median cohort age was 66 years (interquartile range (IQR) 53–77), with 1305 patients dying (25%) and 3856 surviving (75%). The intensive care unit (ICU) received 1223 patients (24%). Of 898 patients who received IMV, 613 (68%) of them perished. The ratio of partial pressure arterial oxygen (PaO2) to fraction inspired oxygen (FiO2), or the P/F ratio, upon ICU admission was 105 (IQR 77–146) and 137 (IQR 91–199) in the deceased and survivors, respectively. The CART model showed that the need for IMV, age greater than 79 years, ratio of oxygen saturation (SaO2) to FiO2, or the S/F ratio, less than 259, and lactate dehydrogenase (LDH) greater than 617 U/L at admission were associated with a greater probability of death.

Conclusion
Among more than 5000 patients with COVID-19 treated in our hospital, mortality at hospital discharge was 25%. Older age, low S/F ratio, and high LDH at admission were predictors of mortality.
Combined use of specific length amplified fragment sequencing (SLAF-seq) and bulked segregant analysis (BSA) for rapid identification of genes influencing fiber content of hemp (Cannabis sativa L.)
Authors: Zhao Yue , Sun Yufeng , Cao Kun , Zhang Xiaoyan , Bian Jing , Han Chengwei , Jiang Ying , Xu Lei , Wang Xiaonan 
Published: May 2022

AbstractHemp (Cannabis sativa L.), an ancient crop, is a significant source of high-quality fiber that primarily caters to the textile industry worldwide. Fiber content is a crucial quantitative trait for evaluating fiber yield in hemp. Understanding the genetic mechanisms involved in hemp breeding is essential for improving yield. In this study, we developed 660 F1 plants from a cross between Jindao-15 (high fiber content fiber-use variety) and Fire No.1 (low fiber content fiber-use variety), and thirty plants each with high and low fiber content were selected from 305 monoecious plants of this population according to 5%-10% of population size for quantitative traits. The DNA from these plants was extracted to establish two bulk DNA pools and then subjected to the restriction digestion by the enzymes RsaI and HaeIII to obtain 314–364 bp digestion fragments and subjected to sequencing using specific length amplified fragment sequencing (SLAF-seq). Finally, we successfully developed 368,404 SLAF tags, which led to the detection of 25,133 high-quality SNPs. Combing with the resequencing results of parents, the SNPs of mixed pools were then subjected to the SNP-Index correlation algorithm, which revealed four candidate regions related to fiber content traits on Chromosome 1, with a length of 8.68 Mb and containing 389 annotated genes. The annotation information and the comparison results identified 15 genes that were highly likely to modulate the fiber content of hemp. Further, qPCR validation identified six genes (LOC115705530, LOC115705875, LOC115704794, LOC115705371, LOC115705688 and LOC115707511) that were highly positively correlated with influencing the hemp fiber content. These genes were involved in the transcription regulation, auxin and water transportion, one carbon and sugar metabolism. And non-synnoumous mutation SNPs which may play vital role in influencing the fiber content were detected in LOC115705875, LOC115704794, LOC115705688 and LOC115707511. Thus, our study highlights the importance of the combined use of SLAF-Seq and Bulked Segregant analysis (BSA) to locate genes related to hemp fiber content rapidly. Hence, our study provides novel mechanistic inputs for the fast identification of genes related to important agronomic traits of hemp and other crops catering to the textile industry.
Functional characterization and comparison of lycopene epsilon-cyclase genes in Nicotiana tabacum
Authors: Song Weina , Wei Fang , Gao Shuwen , Dong Chen , Hao Jianfeng , Jin Lifeng , Li Feng , Wei Pan , Guo Jinggong , Wang Ran 
Published: May 2022

Abstract
Background
Lycopene epsilon-cyclase (ε-LCY) is a key enzyme in the carotenoid biosynthetic pathway (CBP) of higher plants. In previous work, we cloned two Ntε-LCY genes from allotetraploid tobacco (Nicotiana tabacum), Ntε-LCY2 and Ntε-LCY1, and demonstrated the overall effect of Ntε-LCY genes on carotenoid biosynthesis and stress resistance. However, their genetic and functional characteristics require further research in polyploid plants.

Results
Here, we used CRISPR/Cas9 to obtain Ntε-LCY2 and Ntε-LCY1 mutants in allotetraploid N.tabacum K326. Ntε-LCY2 and Ntε-LCY1 had similar promoter cis-acting elements, including light-responsive elements. The Ntε-LCY genes were expressed in roots, stems, leaves, flowers, and young fruit, and their highest expression levels were found in leaves. Ntε-LCY2 and Ntε-LCY1 genes responded differently to normal light and high light stress. Both the Ntε-LCY2 and the Ntε-LCY1 mutants had a more rapid leaf growth rate, especially ntε-lcy2-1. The expression levels of CBP genes were increased in the ntε-lcy mutants, and their total carotenoid content was higher. Under both normal light and high light stress, the ntε-lcy mutants had higher photosynthetic capacities and heat dissipation levels than the wild type, and this was especially true of ntε-lcy2-1. The reactive oxygen species content was lower in leaves of the ntε-lcy mutants.

Conclusion
In summary, the expression patterns and biological functions of the Ntε-LCY genes Ntε-LCY1 and Ntε-LCY2 differed in several respects. The mutation of Ntε-LCY2 was associated with a greater increase in the content of chlorophyll and various carotenoid components, and it enhanced the stress resistance of tobacco plants under high light.
Recurrent heart failure hospitalizations increase the risk of mortality in heart failure patients with atrial fibrillation and type 2 diabetes mellitus in the United Kingdom: a retrospective analysis of Clinical Practice Research Datalink database
Authors: Lahoz Raquel , Fagan Ailís , McSharry Martin , Proudfoot Clare , Corda Stefano , Studer Rachel 
Published: May 2022

Abstract
Background
Heart failure (HF) is a global illness and is a leading cause of hospitalizations. Recurrent HF hospitalization (HFH) is associated with increased risk of cardiovascular (CV) and all-cause mortality, thereby burdening the health system. Type 2 diabetes mellitus (T2DM) and atrial fibrillation (AF) are two important comorbidities in patients living with HF. This study aims to assess the association between recurrent HFHs with CV and all-cause mortality in patients living with HF and having AF and/or T2DM.

Methods
This study was conducted using primary care data from the Clinical Practice Research Datalink database with linkage to hospital data and mortality data. Adults living with HF and with at least 1 HFH were identified from January 2010 to December 2014. Patients were grouped based on the number of recurrent HFHs. During follow-up, all-cause mortality or CV mortality for the HF population with AF and T2DM was recorded.

Results
Overall, 32.9% of 2344 T2DM patients and 28.2% of 4585 AF patients had at least 1 recurrent HFH. The patients were relatively elderly and were predominantly male. The mean number of all-cause hospitalizations in HF patients having T2DM and AF, with ≥ 1 recurrent HFH were significantly higher than patients without recurrent HFH. The annualized mortality rates in CV mortality as the primary cause and for all-cause mortality and increased with recurrent HFHs, in T2DM and AF patients. The risk of CV mortality as primary cause and all cause morality were 5.39 and 3.19 times higher in T2DM patients with 3 recurrent HFHs versus no recurrent HFH. Similarly, the risk of CV mortality as primary cause and all cause morality was 5.98 and 4.3 times higher in AF patients with 3 recurrent HFHs versus those with no recurrent HFH.

Conclusions
Recurrent HFHs are strongly associated with CV mortality and all-cause mortality in HF patients with TD2M or AF. The hospitalization rate highlights the need for treatment and disease management, which will improve the course of the disease and help patients stay out of hospital.