bluuebunny/crossref_metadata_2025_split huggingface dataset:
Forecasting Track Geometry Degradation Using GPR Based Ballast Condition
Authors: Zarembski Allan M. , Palese Joseph W. , Nguyen Mike 
Published: June 2022

Abstract
The ability to predict track geometry degradation is of critical importance in planning of track maintenance operations. This paper presents results of an FRA sponsored study on the relationship between track geometry degradation and ballast condition as measured by Ground Penetrating Radar (GPR). The study examined six different sites on a major Class 1 freight Railroad, with a range of ballast conditions and tie types, and developed a relationship between the rate of degradation of key track geometry parameters, profile (surface), and cross-level, as a function of two GPR measured ballast parameters: Ballast Fouling Index and Fouling Depth Layer (depth of clean ballast layer). The study sites included both fouled and clean ballast conditions that were monitored for track geometry on a very frequent basis (every two to four weeks) and also experienced multiple GPR measurements during that same period. Data analytic techniques were applied to this large data set to develop a relationship between rate of geometry degradation and ballast fouling condition and depth of ballast. The results showed a statistically significant relationship between high rates of geometry degradation and poor subsurface conditions as defined by the GPR parameters. A predictive model was developed to project and forecast geometry degradation as a function of ballast conditions.
Smart Switch: The Application of Fiber Optic Continuous Strain Sensing to the Railroad Turnouts
Authors: Smith Frank J. , Ghofrani Faeze 
Published: June 2022

Abstract
This paper discusses the application of Fiber Optic-based Continuous Strain Sensing (FOCSS) to Switches (a.k.a. railroad turnouts) and presents the resulting benefits. The FOCSS technology allows effective rail break detection to all parts of the switch and reliable point position detection in a secure environment.
The building blocks of community health systems: a systems framework for the design, implementation and evaluation of iCCM programs and community-based interventions
Authors: Karim Aliya , de Savigny Don , Awor Phyllis , Cobos Muñoz Daniel , Mäusezahl Daniel , Kitoto Tshefu Antoinette , Ngaima Jean Serge , Enebeli Ugo , Isiguzo Chinwoke , Nsona Humphreys , Ogbonnaya Ikechi , Ngoy Pascal , Alegbeleye Ayo 
Published: June 2022

IntroductionAlmost all sub-Saharan African countries have adopted some form of integrated community case management (iCCM) to reduce child mortality, a strategy targeting common childhood diseases in hard-to-reach communities. These programs are complex, maintain diverse implementation typologies and involve many components that can influence the potential success of a program or its ability to effectively perform at scale. While tools and methods exist to support the design and implementation of iCCM and measure its progress, these may not holistically consider some of its key components, which can include program structure, setting context and the interplay between community, human resources, program inputs and health system processes.MethodsWe propose a Global South-driven, systems-based framework that aims to capture these different elements and expand on the fundamental domains of iCCM program implementation. We conducted a content analysis developing a code frame based on iCCM literature, a review of policy documents and discussions with key informants. The framework development was guided by a combination of health systems conceptual frameworks and iCCM indices.ResultsThe resulting framework yielded 10 thematic domains comprising 106 categories. These are complemented by a catalogue of critical questions that program designers, implementers and evaluators can ask at various stages of program development to stimulate meaningful discussion and explore the potential implications of implementation in decentralised settings.ConclusionThe iCCM Systems Framework proposed here aims to complement existing intervention benchmarks and indicators by expanding the scope and depth of the thematic components that comprise it. Its elements can also be adapted for other complex community interventions. While not exhaustive, the framework is intended to highlight the many forces involved in iCCM to help managers better harmonise the organisation and evaluation of their programs and examine their interactions within the larger health system.
Risk profiles of frequent outpatients among public assistance recipients in Japan: a retrospective cohort study using a classification and regression trees algorithm
Authors: Nishioka Daisuke , Kino Shiho , Ueno Keiko , Kondo Naoki 
Published: June 2022

ObjectivesAlthough several individual risk factors of frequent outpatient attendance (FOA) have previously been reported, identifying a specific risk profile is needed to provide effective intervention for impoverished citizens with complex biopsychosocial needs. We aimed to identify potential risk profiles of FOA among public assistance recipients in Japan by using classification and regression trees (CART) and discussed the possibilities of applying the CART to policypractice as compared with the results of conventional regression analyses.DesignWe conducted a retrospective cohort study.SettingWe used secondary data from the public assistance databases of six municipalities in Japan.ParticipantsThe study population included all adults on public assistance in April 2016, observed until March 2017. We obtained the data of 15 739 people on public assistance. During the observational period, 435 recipients (2.7%) experienced FOA.Outcome measureWe dichotomised a cumulative incidence of FOA during the study period into a binary variable of exhibiting FOA or not. We adopted the definition of FOA by the Ministry of Health, Labour, and Welfare: visiting the same medical institution more than 15 days a month.ResultsThe results of the CART showed that an employed subpopulation with mental disabilities exhibited the highest risk of FOA (incidence proportion: 16.7%). Meanwhile, multiple Poisson regression showed that the adjusted incidence ratio of being unemployed (vs employed) was 1.71 (95% CI 1.13 to 2.59).ConclusionsUsing the CART model, we could identify specific risk profiles that could have been overlooked when considering only the risk factors obtained from regression analysis. Public health activities can be provided effectively by focusing on risk factors and the risk profiles.
Protocol for a systematic review on routine use of antibiotics for infants less than 6 months of age with growth failure/faltering
Authors: Imdad Aamer , Chen Fanny F , François Melissa , Tanner-Smith Emily , Smith Abigail , Tsistinas Olivia J , Das Jai K , Bhutta Zulfiqar Ahmed 
Published: June 2022

IntroductionAntibiotics have been used as an adjunct in treating children with severe acute malnutrition 6–59 months of age; however, the data for infants less than 6 months are scarce. The WHO recently started guideline development for preventing and treating wasting, including growth failure/faltering in infants less than 6 months. This systematic review commissioned by WHO aims to synthesise evidence from current literature on the effectiveness of antibiotics for infants less than 6 months of age with growth failure/faltering.Methods and analysisWe will conduct a systematic review and meta-analysis for studies that assessed the effect of antibiotics in the treatment of infants with growth faltering. We will search multiple electronic databases. We will include randomised control trials and non-randomised studies with a control arm. The study population is infants less than 6 months of age with growth failure. The intervention group will be infants who received no antibiotics or antibiotics other than recommended in 2013 guidelines by WHO to treat severe acute malnutrition in children. The comparison group will be infants who received antibiotics according to the 2013 guideline by WHO. We will consider the following outcomes: mortality, clinical deterioration, antimicrobial resistance, recovery from comorbidity, adverse events, markers of intestinal inflammation, markers of systemic inflammation, hospital-acquired infections, non-response. We will use the meta-analysis to pool the studies where applicable. We will use the Grading of Recommendations Assessment, Development, and Evaluation approach to reporting the overall evidence quality for an outcome.Ethics and disseminationThis is a systematic review and will not involve contact with a human subject. The findings of this review will be published in a peer-review journal and will guide the WHO’s recommendation for the use of antibiotics in infants less than 6 months of age with growth failure.PROSPERO registration numberCRD42021277073.
Gross and applied anatomy pedagogical approaches in occupational therapy education: protocol for a scoping review
Authors: Dove Erica , Hennessy Kelly , Kirou-Mauro Athena , Aitkens Lorna , Duncan Andrea , Agur Anne , Ho Emily S 
Published: June 2022

IntroductionHistorically, dissection is considered the ‘gold standard’ for teaching foundational anatomy to student occupational therapists. However, many programmes no longer have access to gross anatomy laboratory resources, as it is considered too costly. To address this limitation, applied anatomy instructors have developed innovative novel approaches to teach gross and applied anatomy to student occupational therapists, including live/surface anatomy, medical imaging, and more recently, computer-aided instruction. The types of different anatomy pedagogical approaches used and their impact on learning outcomes in occupational therapy education are unclear. The purpose of this scoping review is to map the types of musculoskeletal gross and applied anatomy pedagogical approaches used in occupational therapy curricula.Methods and analysisUsing Arksey and O’Malley’s (2005) six-stage scoping review framework, approximately 304 different search combinations will be searched across five electronic library databases (ie, MEDLINE, Embase, CINAHL, AMED and ERIC) from their inception to December 2021, in addition to conducting consultation exercises with relevant stakeholders. After title/abstract and full-text screening, included articles will be charted, collated and summarised.Ethics and disseminationThis study will not involve human or animal subjects. Therefore, research ethics approval is not required. The proposed scoping review will help the research, institutional and clinical rehabilitation communities to better understand the types of musculoskeletal gross and applied anatomy pedagogical approaches used to foster, build and promote musculoskeletal foundational knowledge in occupational therapy education. This could potentially inform the future physical medicine course curricula in occupational therapy programmes. The findings of this review will be disseminated to occupational therapy instructors, occupational therapists, researchers and organisations offering occupational therapy programmes (eg, Universities).
Using nasal sprays to prevent respiratory tract infections: a qualitative study of online consumer reviews and primary care patient interviews
Authors: Williamson Sian , Dennison Laura , Greenwell Kate , Denison-Day James , Mowbray Fiona , Richards-Hall Samantha , Smith Deb , Bradbury Katherine , Ainsworth Ben , Little Paul , Geraghty Adam W A , Yardley Lucy 
Published: June 2022

ObjectivesNasal sprays could be a promising approach to preventing respiratory tract infections (RTIs). This study explored lay people’s perceptions and experiences of using nasal sprays to prevent RTIs to identify barriers and facilitators to their adoption and continued use.DesignQualitative research. Study 1 thematically analysed online consumer reviews of an RTI prevention nasal spray. Study 2 interviewed patients about their reactions to and experiences of a digital intervention that promotes and supports nasal spray use for RTI prevention (reactively: at ‘first signs’ of infection and preventatively: following possible/probable exposure to infection). Interview transcripts were analysed using thematic analysis.SettingPrimary care, UK.Participants407 online customer reviews. 13 purposively recruited primary care patients who had experienced recurrent infections and/or had risk factors for severe infections.ResultsBoth studies identified various factors that might influence nasal spray use including: high motivation to avoid RTIs, particularly during the COVID-19 pandemic; fatalistic views about RTIs; beliefs about alternative prevention methods; the importance of personal recommendation; perceived complexity and familiarity of nasal sprays; personal experiences of spray success or failure; tolerable and off-putting side effects; concerns about medicines; and the nose as unpleasant and unhygienic.ConclusionsPeople who suffer disruptive, frequent or severe RTIs or who are vulnerable to RTIs are interested in using a nasal spray for prevention. They also have doubts and concerns and may encounter problems. Some of these may be reduced or eliminated by providing nasal spray users with information and advice that addresses these concerns or helps people overcome difficulties.
Study protocol for using a smartphone application to investigate speech biomarkers of Parkinson’s disease and other synucleinopathies: SMARTSPEECH
Authors: Kouba Tomáš , Illner Vojtěch , Rusz Jan 
Published: June 2022

IntroductionEarly identification of Parkinson’s disease (PD) in its prodromal stage has fundamental implications for the future development of neuroprotective therapies. However, no sufficiently accurate biomarkers of prodromal PD are currently available to facilitate early identification. The vocal assessment of patients with isolated rapid eye movement sleep behaviour disorder (iRBD) and PD appears to have intriguing potential as a diagnostic and progressive biomarker of PD and related synucleinopathies.Methods and analysisSpeech patterns in the spontaneous speech of iRBD, early PD and control participants’ voice calls will be collected from data acquired via a developed smartphone application over a period of 2 years. A significant increase in several aspects of PD-related speech disorders is expected, and is anticipated to reflect the underlying neurodegeneration processes.Ethics and disseminationThe study has been approved by the Ethics Committee of the General University Hospital in Prague, Czech Republic and all the participants will provide written, informed consent prior to their inclusion in the research. The application satisfies the General Data Protection Regulation law requirements of the European Union. The study findings will be published in peer-reviewed journals and presented at international scientific conferences.
Factors associated with, and variations in, COVID-19 hospital death rates in England’s first two waves: observational study
Authors: Bottle Alex , Faitna Puji , Brett Stephen , Aylin Paul 
Published: June 2022

ObjectivesTo assess patient-level and hospital-level predictors of death and variation in death rates following admission for COVID-19 in England’s first two waves after accounting for random variation. To quantify the correlation between hospitals’ first and second wave death rates.DesignObservational study using administrative data.SettingAcute non-specialist hospitals in England.ParticipantsAll patients admitted with a primary diagnosis of COVID-19.Primary and secondary outcomesIn-hospital death.ResultsHospital Episode Statistics (HES) data were extracted for all acute hospitals in England for COVID-19 admissions from March 2020 to March 2021. In wave 1 (March to July 2020), there were 74 484 admissions and 21 883 deaths (crude rate 29.4%); in wave 2 (August 2020 to March 2021), there were 165 642 admissions and 36 040 deaths (21.8%). Wave 2 patients were younger, with more hypertension and obesity but lower rates of other comorbidities. Mortality improved for all ages; in wave 2, it peaked in December 2020 at 24.2% (lower than wave 1’s peak) but halved by March 2021. In multiple multilevel modelling combining HES with hospital-level data from Situational Reports, wave 2 and wave 1 variables significantly associated with death were mostly the same. The median odds ratio for wave 1 was just 1.05 and for wave 2 was 1.07. At 99.8% control limits, 3% of hospitals were high and 7% were low funnel plot outliers in wave 1; these figures were 9% and 12% for wave 2. Four hospitals were (low) outliers in both waves. The correlation between hospitals’ adjusted mortality rates between waves was 0.45 (p<0.0001). Length of stay was similar in each wave.ConclusionsEngland’s first two COVID-19 waves were similar regarding predictors and moderate interhospital variation. Despite the challenges, variation in death rates and length of stay between hospitals was modest and might be accounted for by unobserved patient factors.
Determinants of subjective well-being among migrant and local elderly in China: a cross-sectional study
Authors: Yuxi Liu , Ingviya Thammasin , Sangthong Rassamee , Wan Chonghua 
Published: June 2022

ObjectivesThe study aimed to examine the association between individual and community levels in relation to subjective well-being (SWB) among the migrant and local elderly. It particularly focuses on the extent to which and the ways in which the residential environment of migrant and local elderly influences their SWB.DesignA cross-sectional study.SettingOur study was conducted in Dongguan City, China.ParticipantsTwo groups of elderly (aged >60 years), including migrants and local residents, were recruited. A total of 470 migrants and 422 local residents participated in this study.Main outcome measuresSWB was assessed by the Memorial University of Newfoundland Scale of Happiness.ResultsThe community-level health facility density had a positive association with SWB (B=0.38, p<0.01), whereas the financial facility density had a negative association (B=−0.42, p<0.01). The density of health and financial facilities affected the local elderly more than the migrant elderly. Social cohesion is an aspect of the social environment of the community that influenced elders’ SWB (B=0.72, p<0.001).ConclusionsThe primary determinants of SWB for both the migrant and local elderly included individual, societal and environmental factors.
Perceptions of medical doctors living in Ethiopia about physician migration: a qualitative study
Authors: Sedeta Ephrem Tadele , Abicho Temesgen Beyene , Jobre Bilain Yilma 
Published: June 2022

ObjectivesMigration of physicians is one of the most pressing global health problems of our time with the greatest implications in sub-Saharan African countries. Although other studies have explored and produced important quantitative data about the impact of medical migration in the health sector of Ethiopia, the motive behind Ethiopian physician migration have been explored less thoroughly. This article explores the perceptions of a group of physicians about the complicated and continuously evolving driving forces of physician migration in Ethiopia.DesignQualitative study using in-depth, virtual semistructured interviews.ParticipantsUsing purposive sampling, 12 physicians participated.SettingSkype interviews with 12 participants working in Tikur Anbessa Specialised Hospital in Addis Ababa, Ethiopia.ResultsFour themes emerged reflecting the perceptions of Ethiopian medical doctors on the driving forces of physician migration: (1) Economic push and pull factors; (2) Professional push and pull factors; (3) Social and Political push and pull factors and (4) Medical migration governance.ConclusionThe emigration of Ethiopian physicians is made after weighing the push and pull factors. Push factors are more crucial than pull factors, and financial reasons play the leading role. Junior physician unemployment, politicisation of hospital administration, and poor medical migration governance are growing problems. Junior physician unemployment is a recent phenomenon in Ethiopia and with a potential to be a leading push factor if appropriate intervention is not taken. The findings of this study are worrying and urge for comprehensive solutions to be devised by policy-makers to deal with physician migration in Ethiopia.
Efficacy and safety of subcutaneous clonidine for refractory symptoms in palliative medicine: a retrospective study
Authors: Howard Paul , Curtin John 
Published: June 2022

ObjectivesTo investigate the efficacy and safety of subcutaneous clonidine for refractory symptoms in the palliative setting.MethodsA retrospective chart review of the use of subcutaneous clonidine in a single palliative care centre. We reviewed the use of clonidine since it was introduced in our locality 2½ years ago. All clinical notes, medication administration records and infusion monitoring documentation were examined to ascertain therapeutic aim, efficacy and tolerability.ResultsSubcutaneous clonidine was administered to 113 patients. Recipients were generally frail (median Karnofsky Score 20%) and in the last weeks of life (median survival 6 days). The the most common indications were opioid poorly responsive pain (59), agitation refractory to antipsychotics and/or benzodiazepines (18) or both (35). Symptoms appeared to improve in the majority (85/113, 75%). Some (36, 32%) required no further medication changes once clonidine was commenced. Clonidine appeared well tolerated although blood pressure was not monitored in the majority, in line with our practice to discontinue such observations in those who are nursed in bed and receiving symptom-focused care.ConclusionsSubcutaneous administration of clonidine appears to be a promising alternative option for refractory symptoms in the last weeks of life. We suggest some possible next steps for further research.
Nucleosynthesis in multinucleon transfer reactions
Authors: Heinz S. , Devaraja H. M. 
Published: June 2022

AbstractHow does one populate still vacant areas on the chart of nuclides? Mainly on the neutron-rich side several thousand further isotopes are expected to exist, including most of the nuclei along the astrophysical r-process path. The standard nucleosynthesis reactions, which are fragmentation, fission and fusion, are reaching their limits. Therefore, other pathways to exotic nuclei are needed. Years ago, the idea arose to revive multinucleon transfer reactions to progress toward the neutron-rich side of heavy and superheavy nuclei. Meanwhile, this option is investigated in nuclear physics labs worldwide. Beside new studies of transfer product kinematics and cross-sections, the development of suitable separation and detection techniques for heavy transfer products is ongoing. But how promising are these new advances? So far achieved results allow us to get an impression on the potential which multinucleon transfer reactions provide for nucleosynthesis.