bluuebunny/crossref_metadata_2025_split huggingface dataset:
(Un)warranted variation in local hospital protocols for neonatal referral to the pediatrician: An explorative study in the Netherlands
Authors: Goodarzi Bahareh , Seijmonsbergen‐Schermers Anna , Cronie Doug , van Laerhoven Henriëtte , van den Akker Thomas , van Kaam Anton H. , de Jonge Ank 
Published: November 2022

AbstractBackgroundStudies indicate unwarranted variation in a wide range of neonatal care practices, contributing to preventable morbidity and mortality. Unwarranted variation is the result of complex interactions and multiple determinants. One of the determinants contributing to unwarranted variation in care may be variation in local hospital protocols. The purpose of this study was to examine variation in the content of obstetric and neonatal protocols for six common indications for neonatal referral to the pediatrician: large for gestational age/macrosomia, small for gestational age/fetal growth restriction, meconium‐stained amniotic fluid, vacuum extraction, forceps extraction, and cesarean birth.MethodsWe conducted a nationwide cross‐sectional study examining protocols for neonatal referral to the pediatrician in the obstetric and neonatal departments of all Dutch hospitals. Variation in protocols was analyzed between regions, between neonatal and obstetrics departments located in the same hospital, and within neonatal and obstetrics departments.ResultsThere was considerable variation in protocols between regions, between neonatal and obstetrics departments, and within neonatal and obstetrics departments. The results of this study showed considerable variation in recommendations for type of referral, admission, screening/diagnostic tests, treatment, and discharge. Furthermore, results generally showed lower referral thresholds in neonatal departments compared with obstetric departments, and higher referral thresholds in the eastern region of the Netherlands. We also found variation in local hospital protocols, which could not be explained by population characteristics but which may be explained by varying recommendations in existing national and international guidelines and/or lack of adherence to these guidelines.ConclusionsTo reduce unwarranted variation in local protocols, evidence‐based, multidisciplinary guidelines should be developed in the Netherlands. Further research addressing knowledge gaps is needed to inform these guidelines. Attention should be paid to the implementation of evidence, and only where evidence is lacking or inconclusive should agreements be based on multidisciplinary consensus. Where protocols deviate from evidence‐based guidelines because of specific local circumstances, clearer, more transparent justifications should be made. Uniformity in guidance will offer clear standards for care evaluation and provide opportunities to reduce inappropriate care.
Business Risk Management Program and risk‐balancing in Ontario hog sector: An empirical analysis
Authors: Sarker Rakhal , Phan Truc , Lee Yu Na , Weersink Alfons 
Published: November 2022

AbstractBusiness risk management (BRM) has been an important focus of Canadian agricultural policy in the New Millennium. Safety net payments received by farmers can alter their investment portfolio and lead to risk‐balancing behavior in agriculture. Risk‐balancing is an unintended consequence of the farm safety net program and has a direct implication for future growth and sustainability of farm business. Does risk‐balancing exist in Ontario agriculture? This question is addressed in this paper using data for the hog sector in Ontario. While safety net programs were designed to address Business Risk (BR) for all farms, our empirical results indicate that CAIS/AgriStability payments reduced BR for small, medium, and large farms. The results from our fixed effect panel regression analysis demonstrate that there is a significant risk‐balancing behavior among medium hog farms in Ontario. Our results also reveal that the presence of risk‐balancing behavior in Ontario hog sector does not pose any problem for future growth of the hog sector or the long‐term sustainability of the farm safety net program.
Development and implementation of an aspiration pneumonia cause investigation algorithm
Authors: Yoshimatsu Yuki , Tobino Kazunori , Ortega Omar , Oda Hiroyuki , Ota Hiroaki , Kawabata Takafumi , Hiramatsu Yuri , Murakami Yosuke , Clavé Pere 
Published: November 2022

AbstractThe diagnostic criteria of aspiration pneumonia have not been established, and it remains an underdiagnosed entity. Diagnosis and cause investigation is essential in improving the management of aspiration pneumonia. The Japanese Respiratory Society Guidelines for the Management of Pneumonia in Adults (JRS Guidelines) show a list of risk factors for aspiration pneumonia. We developed an algorithm to aid physicians in evaluating these possible underlying factors and guide their management with a focus on aspiration pneumonia. The algorithm was developed based on the JRS Guidelines. The algorithm suggested dysphagia screening, pneumococcal and influenza vaccination, and other preventative measures for pneumonia. The algorithm was implemented in the acute setting of a general hospital among older patients admitted with pneumonia. Their outcomes were compared with a historical control group constituting similar patients from the previous year. Forty patients with pneumonia were assessed with the algorithm group, and 44 patients were included in the control group. In the algorithm group, significantly more cases (95.0% vs. 15.9%, p < 0.01) underwent early screening for a swallowing disorder. Two patients in the algorithm group were diagnosed with a new condition causing aspiration pneumonia, as opposed to none in the control group. Drugs with a potential risk for aspiration were identified and discontinued in 27.5% of the patients in the algorithm group and 4.5% in the control group. In conclusion, an aspiration pneumonia cause investigation algorithm translating the JRS guideline approach into practice enhanced the rate of swallow screening and preventative measures for aspiration.
Effects of the egg incubation environment on turtle carapace development
Authors: Cordero Gerardo A. , Birk Katie , Ruane Sara , Dinkelacker Stephen A. , Janzen Fredric J. 
Published: November 2022

AbstractDeveloping organisms are often exposed to fluctuating environments that destabilize tissue‐scale processes and induce abnormal phenotypes. This might be common in species that lay eggs in the external environment and with little parental care, such as many reptiles. In turtles, morphological development has provided striking examples of abnormal phenotypic patterns, though the influence of the environment remains unclear. To this end, we compared fluctuating asymmetry, as a proxy for developmental instability, in turtle hatchlings incubated in controlled laboratory and unstable natural conditions. Wild and laboratory hatchlings featured similar proportions of supernumerary scales (scutes) on the dorsal shell (carapace). Such abnormal scutes likely elevated shape asymmetry, which was highest in natural nests. Moreover, we tested the hypothesis that hot and dry environments cause abnormal scute formation by subjecting eggs to a range of hydric and thermal laboratory incubation regimes. Shape asymmetry was similar in hatchlings incubated at five constant temperatures (26–30°C). A hot (30°C) and severely Dry substrate yielded smaller hatchlings but scutes were not overtly affected. Our study suggests that changing nest environments contribute to fluctuating asymmetry in egg‐laying reptiles, while clarifying the conditions at which turtle shell development remains buffered from the external environment.
Love and evaluative conflict
Authors: Tillman Jeremiah 
Published: November 2022

AbstractLovers often disagree. We may reject the specific goals our loved ones pursue or the broad values they hold. Some philosophers suggest that such evaluative conflict makes romantic love in its ideal form deficient. I argue that this is mistaken. On the contrary, our ideal of love holds that we can love people for “who they are” (as we say), even as we profoundly disagree with them. My argument draws on intuitive cases from screwball comedy about love amid conflict, love across political party lines, as well as “forbidden” love across religions and cultures. At a deeper level, I sketch an ideal of love I call intimate independence and argue that this ideal is (a) fully compatible with any evaluative conflict, (b) embedded in our ordinary attitudes toward mature love between equals, and (c) an ideal worth achieving. As long as intimate independence is a compelling ideal, deep conflict will not seem like an obstacle to true love. The ideal reminds us that love can bring together people with radically different points of view, and that to insist on shared ends or values is thus to miss a part of the meaning and power of love.
Data‐driven approach to design fatigue‐resistant notched structures
Authors: Wang Qingbo , Gao Chao , Berto Filippo 
Published: November 2022

AbstractFatigue is the most common failure mode for engineering materials in various industrial applications. Generally, designing new products and components based on typical deterministic fatigue design approaches is slow and expensive. Although numerous investigations have been carried on this topic over decades, there still lacks a robust and efficient method to design a super‐fatigue‐resistant and testless structure. In this investigation, a novel data‐driven approach based on the deep learning algorithm is applied on designing a fatigue‐resistant notched structure under different loading via numerical simulations and deep learning. The notches with various shapes are designed by employing the same material. Then finite element (FE) simulations are performed to obtain the mechanical behaviors of notched structures under different loading conditions. The deep learning algorithm is applied to predict mechanical behaviors of unknown notched structures based on input training set of simple notched geometries and relative lower computational cost. It is demonstrated that deep learning on the fatigue‐resistant structure is a promising approach of fatigue design. This work offers an alternative design strategy of fatigue‐resistant structure and cost‐effective solution to accelerate the design of engineering components under different loading conditions.
Telephone follow‐up on treatment and patient satisfaction at a Danish tertiary headache center: A prospective study
Authors: Carlsen Louise Ninett , Bendtsen Lars , Jensen Rigmor Højland , Schytz Henrik Winther 
Published: November 2022

AbstractObjectiveWe investigated whether telephone follow‐up consultations could lead to appropriate adjustment of treatments and a higher degree of patient satisfaction among patients with migraine and tension‐type headache (TTH).BackgroundMigraine and TTH are disabling headache forms requiring optimized treatment.MethodsIn a prospective, non‐randomized, quality control study with controls comparing telephone‐interview intervention (TeII) with business‐as‐usual (BAU) treatment, we included newly referred patients with migraine and/or TTH. The TeII group was contacted by telephone by healthcare professionals at 8 and 16 weeks after the first visit addressing headache treatment. Electronic questionnaires were sent to all participants before the first visit and after 6 months. Predefined outcomes were number of patients with change in preventive and acute medication; change in headache frequency; migraine frequency; scores from the eight‐item Headache Under‐Response to Treatment (HURT‐8) questionnaire, Insomnia Severity Index (ISI), and Hospital Anxiety and Depression Scale (HADS); and patient satisfaction after 6 months.ResultsFrom May 2020 to April 2021, there were 230 patients enrolled in the TeII program, whereof 96 patients were included in the analysis. For the BAU group, 91 patients with similar sex and age distribution were identified via medical‐record reviews in the same period. More patients in the TeII group than in the BAU group had a change in acute medication (27/96 [28%] vs. five of 91 [6%], p < 0.001) and preventive medication (28/96 [29%] vs. 12/91 [13%], p = 0.006). Headache days per month decreased in the TeII group (−4.6, 95% confidence interval [CI] −6.5 to −2.7; p = 0.001) and the BAU group (−2.5, 95% CI −4.6 to −0.4; p = 0.018), without significant difference between the groups (p = 0.080). There was no difference in migraine frequency between the groups (TeII: 1.0 day, 95% CI, −1.3 to 1.0; BAU: 1.0 day, 95% CI, −2.5 to 0.5; p = 0.718) or HURT‐8 score (TeII: 10.5, 95% CI 9.5–11.5; BAU: 13.0, 95% CI 11.7–14.2; p = 0.053). There were no changes in the ISI score (TeII: 1.0, interquartile range [IQR] 6; p = 0.152; BAU: 0.5, IQR 4.5; p = 0.824), HADS‐Anxiety score (TeII: −5, IQR 5.3; p = 0.186; BAU: 1.0, IQR 4.0; p = 0.445), or HADS‐Depression score (TeII: 0.0, IQR 3.0; p = 0.163; BAU: 0.0, IQR 2.0; p = 0.303) in any of the groups. There was a higher degree of patient satisfaction in the TeII group compared with the BAU group in treatment (median [IQR] score 4 [3–5] vs. 3 [3–4], p < 0.001), headache improvement (median [IQR] 3 [2–4] vs. 2 [1–3], p = 0.002), the headache program (median [IQR] 4 [3–5] vs. 3 [3–4], p < 0.001), and information (median [IQR] 4 [3–5] vs. 3 [3–4], p = 0.005).ConclusionPatients with migraine and/or TTH benefit from a telephone follow‐up approach within the first 6 months of their treatment course in terms of more efficient treatment and higher patient satisfaction.
Bibliometric analysis of COVID‐19 publications shows the importance of telemedicine and equitable access to the internet during the pandemic and beyond
Authors: Samadbeik Mahnaz , Bastani Peivand , Fatehi Farhad 
Published: November 2022

AbstractBackgroundPandemics highlight the increasing role of information and communications technology for improving access to health care. This study aimed to present a bibliometric analysis of the concept of digital divide reported in the published articles concerning the coronavirus disease 2019 (COVID‐19) pandemic.MethodsTo conduct this bibliometric analysis of research topics and trends, we used VOSviewer software. We developed a search strategy to retrieve peer‐reviewed publications related to ‘digital divide in the COVID‐19 era' from the Scopus database.ResultsIn total, 241 publications on the topic of digital divide and COVID‐19 were retrieved from Scopus database between 2020 and 2021. The analysis of keywords co‐occurrence of research topics revealed four main clusters including: ‘telemedicine’, ‘Internet access and Internet use’, ‘e‐learning’ and ‘epidemiology’. Seven characteristic categories were examined in these research topics, including: sociodemographic, economic, social, cultural, personal, material and motivational.Conclusion‘Telemedicine’ and ‘Internet access and Internet use’ as the largest clusters are connected to topics addressing inequalities in online health care access. Thus, policymakers should develop or modify policies in more egalitarian Internet access for all community members not only during a pandemic like the COVID‐19 but also at regular times.
Fostemsavir and ethinyl estradiol drug interaction: Clinical recommendations for co‐administration
Authors: Nwokolo Nneka , Post Elana , Mageau A. Savannah , Shah Rimi , Magee Mindy , Mannino Frank , Ackerman Peter , Clark Andrew , Moore Katy 
Published: November 2022

AbstractObjectivesFostemsavir, a prodrug of temsavir, is indicated for heavily treatment‐experienced adults with multidrug‐resistant HIV‐1 infection, antiretroviral (ARV) intolerance, or safety considerations. Understanding drug–drug interactions (DDIs) is important in individuals taking fostemsavir with hormonal contraceptives or menopausal or gender‐affirming hormonal therapies.MethodsEffect of temsavir (active moiety) on the pharmacokinetics of ethinyl estradiol (EE) and norethindrone (NET) was evaluated in an open‐label, single‐sequence, four‐cycle, four‐treatment study in 26 healthy female participants (study 206279, NCT02480881). Relevant ARV–contraceptive interaction studies and guideline recommendations were reviewed; that information was then applied to other contraceptive methods and hormone‐based therapies to predict the impact of fostemsavir co‐administration.ResultsTemsavir increased EE concentrations by 40% and had no effect on NET concentrations. Fostemsavir co‐administration with hormone therapy is not expected to impact hormone treatment efficacy. Fostemsavir did not impact progestin; therefore, progestin‐only and non‐hormonal contraceptives will not be impacted by fostemsavir. Recommendations for co‐administration of fostemsavir and hormonal contraceptives or menopausal or gender‐affirming hormone therapies are based upon known and predicted DDIs, ensuring adequate hormonal concentrations to maintain the target effect.ConclusionsApplying the results of Study 206279 and other relevant ARV–contraceptive studies, we recommend that when co‐administering fostemsavir with combined oral contraceptives (COCs) and other oestrogen‐based therapies, EE dose should not exceed 30 μg or equivalent, and caution is advised in the case of individuals with risk factors for thromboembolic events. Other oestrogen‐based therapies may be co‐administered with fostemsavir, with monitoring of oestrogen concentrations and appropriate dose adjustments. No impact of fostemsavir on COC efficacy is expected.
A new type of Sr(Zr0.2Hf0.2Ce0.2Yb0.2Me0.2)O3−x (Me = Y, Gd) high‐entropy ceramics used in thermal barrier coatings
Authors: Zhan Hao , Ma Wen , Han Xinxin , Liang Weicheng , Hao Jiajing , Dong Hongying , Bai Yu , Liu Hongxia , Meng Xiangfeng 
Published: November 2022

AbstractSeeking for new ceramics with excellent thermophysical properties as thermal barrier coatings candidate materials has become a hot research field. In this study, Sr(Zr0.2Hf0.2Ce0.2Yb0.2Me0.2)O3−x high‐entropy ceramic powders were successfully synthesized by the method of solid‐state reaction, and the ceramics with single phase were prepared by pressureless sintering at 1600°C. The phase composition, microstructure, element distribution, high‐temperature thermal stability, and thermophysical properties of the ceramics were studied. The results showed that Sr(Zr0.2Hf0.2Ce0.2Yb0.2Me0.2)O3−x ceramics were composed of SrZrO3 phase and the second phase of AB2O4 spinel (i.e., SrY2O4 and SrGd2O4). The content of the second phase was gradually increased after heat treatment at 1400°C, which significantly improved the thermophysical and mechanical properties of the ceramics. The microhardness and fracture toughness of the ceramics were improved compared with that of SrZrO3. The thermal conductivities of Sr(Zr0.2Hf0.2Ce0.2Yb0.2Me0.2)O3−x (Me = Y, Gd) ceramics were 1.30 and 1.28 W m−1 K−1 at 1000°C, which were about 35% and 40% lower than that of SrZrO3 (1.96 W m−1 K−1) and yttria‐stabilized zirconia (2.12 W m−1 K−1), respectively. The thermal expansion coefficients of Sr(Zr0.2Hf0.2Ce0.2Yb0.2Me0.2)O3−x (Me = Y, Gd) ceramics were 12.8 × 10−6 and 14.1 × 10−6 K−1 at 1300°C, respectively, which was more closer to the superalloys compared with SrZrO3 ceramic (11.0 × 10−6 K−1).
Inhibitory effect of Zanthoxylum bungeanum maxim. and Capsicum annuum L. on the activities of pancreatic lipase and α‐amylase
Authors: Lu Yunhao , Peng Qing , He Qiang 
Published: November 2022

SummaryZanthoxylum bungeanum maxim. (ZBM) and Capsicum annuum L. (CAL) are popular condiments in China. In this study, the inhibition of pancreatic lipase and α‐amylase by ZBM and CAL extracts, as well as catechin, rutin, hydroxy‐α‐sanshool (from ZBM extract) and capsaicin (from CAL extract), was determined. The half maximal inhibitory concentration (IC50) values of ZBM extract, CAL extract, rutin, hydroxy‐α‐sanshool and capsaicin against pancreatic lipase were 82.1, 533.5, 583.8, 565.7 and 62.4 μg mL−1, respectively, while that against α‐amylase were 125.6, 1167.2, 213.2195.6 and 163.2 μg mL−1, respectively. Catechin had no detectible inhibition on the two enzymes even at 4 mg mL−1. The combination of hydroxy‐α‐sanshool and capsaicin against the two enzymes showed similar inhibition trends to that of ZBM and CAL extracts (synergism at low concentrations but antagonism at high concentrations), suggesting the two compounds were closely associated with the functions of the crude extracts. The results obtained from the in vitro digestion were similar but with a lower inhibition rate. Kinetic studies revealed that ZBM extract, hydroxy‐α‐sanshool and capsaicin showed mixed‐type inhibition for pancreatic lipase and α‐amylase. Molecular modelling suggested capsaicin had a higher affinity to the two enzymes, with glide scores of −8.18 and −7.87 kcal mol−1, respectively.
Adenosine signalling in T‐cell activation favours development of IL‐17 positive cells with suppressive properties
Authors: Leikeim Lisa , Li Hui , An Liying , Sticht Carsten , Krämer Bernhard K. , Yard Benito , Leipe Jan , Kälsch Anna‐Isabelle 
Published: November 2022

AbstractEvidence suggests that the anti‐inflammatory nucleoside adenosine can shape immune responses by shifting the regulatory (Treg)/helper (Th17) T‐cell balance in favour of Treg. Since this observation is based on in vivo and in vitro studies mostly confined to murine models, we comprehensively analysed effects of adenosine on human T‐cells. Proliferation, phenotype and cytokine production of stimulated T‐cells were assessed by flow cytometry, multiplex assay and ELISA, gene expression profiling was determined by microarray. We found that the pan‐adenosine agonist 5′‐N‐ethylcarboxamidoadenosine (NECA) skews human CD3+ T‐cell responses towards non‐inflammatory Th17 cells. Addition of NECA during T‐cell activation increased the development of IL‐17+ cells with a CD4+ RORγt+ phenotype and enhanced CD161 and CD196 surface expression. Remarkably, these Th17 cells displayed non‐inflammatory cytokine and gene expression profiles including reduced Th1/Th17 transdifferentiation, a stem cell‐like molecular signature and induced surface expression of the adenosine‐producing ectoenzymes CD39 and CD73. Thus, T‐cells cultured under Th17‐inducing conditions together with NECA were capable of suppressing responder T‐cells. Finally, genome‐wide gene expression profiling revealed metabolic quiescence previously associated with non‐pathogenic Th17 cells in response to adenosine signalling. Our data suggest that adenosine induces non‐inflammatory Th17 cells in human T‐cell differentiation, potentially through regulation of metabolic pathways.
Capital‐flow volatility in emerging markets: A panel GARCH approach
Authors: Kaya Ahmet Ihsan , Erden Lutfi 
Published: November 2022

AbstractThis study analyzes the role of push–pull factors on the level, volatility and comovement of capital flows in emerging markets (EMs). Taking the commonality of capital flows into account, we employ the panel Generalized Autoregressive Conditional Heteroscedasticity model developed by Cermeño and Grier for 16 EMs. This method not only accounts for country‐specific heterogeneity and cross‐section dependence but also allows the examination of the sources of the level, volatility and comovement of capital flows in a single step. The results show that domestic factors explain two‐thirds of the variation in net capital‐flow volatility. While both global and domestic factors, with the prominent ones being global risks and domestic economic growth, influence the comovement, their impacts somewhat vary by the types of capital flows.