bluuebunny/crossref_metadata_2025_split huggingface dataset:
60% Reduction of reoperations and complications for elderly patients with hip fracture through the implementation of a six-item improvement programme
Authors: Lian Tom , Brandrud Aleidis , Mariero Lars , Nordsletten Lars , Figved Wender 
Published: July 2022

IntroductionHip fractures are common, serious and costly fractures in the elderly population. Several guidelines seeking to ensure best practice have been introduced. Although our institution complied with national guidelines for early surgery of hip fractures, no assessment of other evidence-based measures existed. We wanted to assess, test, implement and measure the impact of a quality improvement (QI) programme consisting of key elements proven to be important in the treatment of hip fractures.MethodsWe formed a multidisciplinary QI team, consisting of several specialists in different fields. The QI team assessed multiple possible process measures for inclusion in the programme and selected six measurable interventions for implementation: early surgery, correct administration of prophylactic antibiotics, surgery using proven methods and expertise, a multidisciplinary patient pathway and secondary fracture prevention. The improvement process was monitored by a statistical process control chart (SPC). Complications, reoperations and mortality were compared before (n=293) and after (n=182) the intervention.ResultsThe SPC analyses indicated increasing adherence with all interventions throughout the improvement programme, and sustainability 7 years later. The last four periods showed a stable adherence above 90%. We found 60% reduction in major complications after the implementation of the improvement programme, from 19.1% to 7.7% (HR: 0.38 (95% CI: 0.23 to 0.61, p=0.0007). The need for reoperations due to complications fell from 12.6% to 4.9% (HR: 0.37 (95% CI: 0.21 to 0.67, p=0.0054). We did not find a difference in post-operative mortality after the implementation of the QI programme (HR: 0.95 (95% CI: 0.74 to 1.2, p=0.645).ConclusionOur multiprofessional improvement programme achieved almost full adherence within 2 years and was sustainable 7 years later. The quality and safety of the care process were improved and led to a substantial and sustainable decrease in complications and reoperations.
Nearly half of patients with chronic tendinopathy may have a neuropathic pain component, with significant differences seen between different tendon sites: a prospective cohort of more than 300 patients
Authors: Wheeler Patrick C 
Published: July 2022

ObjectivesIdentifying the prevalence of neuropathic pain components in patients with chronic tendinopathy conditions using the Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) questionnaire.MethodsPatients with chronic tendinopathy and ‘tendon-like’ conditions treated within a single hospital outpatient clinic specialising in tendinopathy were identified. Pain scores, plus global function patient-reported outcome measures (5-Level version of EuroQol-5 Dimension and Musculoskeletal Health Questionnaire (MSK-HQ)), were completed and compared with the S-LANSS questionnaireResults341 suitable patients with chronic tendinopathy and potentially similar conditions were identified. Numbers: lateral elbow tendinopathy (39), greater trochanteric pain syndrome (GTPS; 112), patellar tendinopathy (11), non-insertional Achilles tendinopathy (40), insertional Achilles tendinopathy (39), plantar fasciopathy (100). 68% were female, with a mean age of 54.0±11.3 years and a mean symptom duration of 38.1±33.7 months.There was a mean S-LANSS score of 11.4±6.4. Overall, 47% of patients scored 12 or greater points on S-LANSS, indicating the possible presence of neuropathic pain. The highest proportion was in patients with plantar fasciopathy (61%), the lowest in those with GTPS (33%). Weak correlations were found between the S-LANSS score and MSK-HQ score, the numerical rating scale (0–10) values for ‘average pain’ and for ‘worst pain’, but not with the MSK-HQ %health value.ConclusionS-LANSS identified nearly half of patients with chronic tendinopathy as possibly having a neuropathic pain component. This is of unclear clinical significance but worth further study to see if/how this may relate to treatment outcomes. These results are from a single hospital clinic dealing with patients with chronic tendinopathy, without a control group or those with shorter symptom duration. However, this reinforces the probability of neuropathic pain components in at least some patients with chronic tendinopathy.
THE FEASIBILITY OF CONSTRUCTING A PORCINE TESCHOVIRUS INFECTIOUS cDNA CLONE TAGGED WITH iLOV FLUORESCENT PROTEIN RESCUED AS A VISIBLE MARKER VIRUS
Authors: Tsai Tung-Hsuan , Chang Chia-Yi , Wang Fun-In 
Published: July 2022

Viral vectors serve as promising tools for the development of novel multivalent or multipathogen vaccines. Poliovirus (of the family Picornaviridae) vectors offer the advantages of small genome size, ease of manipulation, inherent stability in the intestinal tract, and induction of potent mucosal immunity through oral administration. Porcine teschovirus (PTV), also belonging to Picornaviridae, generally causes asymptomatic infections in pigs. PTV’s wide tissue tropism suggests that it can act as a potential vector for vaccine development; however, no infectious PTV cDNA clone has been reported yet. In this study, infectious PTV cDNA was cloned and recombinant porcine teschovirus (rPTV) was constructed with a unique XhoI site introduced into 2A, as well as substitution of the G–H loop sequence “RNNQIPQDF” of VP1 by an 8-histidine marker which helps to differentiate it from the parental PTV. Subsequently, the coding sequence of a small fluorescent protein, iLOV, was incorporated into the XhoI site to rescue the recombinant rPTV-iLOV virus, allowing for direct visualization of the viral infection. These rescued viruses were replication-competent and antigenically identical to the parental virus, but showed attenuation due to an impaired self-cleaving function caused by the insertion of iLOV into the 2A protease site, as assessed by a double reporter expressing system. This rescued recombinant virus shows potential for the development of attenuated vaccines with few safety concerns and may serve as an important tool to visually study virus–cell interactions.
C-PAK: Correcting and Completing Variable-Length Prefix-Based Abbreviated Keystrokes
Authors: Li Tianshi , Quinn Philip , Zhai Shumin 
Published: July 2022

Improving keystroke savings is a long-term goal of text input research. We present a study into the design space of an abbreviated style of text input called
C-PAK
(Correcting and completing variable-length Prefix-based Abbreviated Keystrokes) for text entry on mobile devices. Given a variable length and potentially inaccurate input string (e.g., “li g t m”), C-PAK aims to expand it into a complete phrase (e.g., “looks good to me”). We develop a C-PAK prototype keyboard,
PhraseWriter
, based on a current state-of-the-art mobile keyboard consisting of 1.3 million
n
-grams and 164,000 words. Using computational simulations on a large dataset of realistic input text, we found that, in comparison to conventional single-word suggestions, PhraseWriter improves the maximum keystroke savings rate by 6.7% (from 46.3% to 49.4,), reduces the word error rate by 14.7%, and is particularly advantageous for common phrases. We conducted a lab study of novice user behavior and performance which found that users could quickly utilize the C-PAK style abbreviations implemented in PhraseWriter, achieving a higher keystroke savings rate than forward suggestions (25% vs. 16%). Furthermore, they intuitively and successfully abbreviated more with common phrases. However, users had a lower overall text entry rate due to their limited experience with the system (28.5 words per minute vs. 37.7). We outline future technical directions to improve C-PAK over the PhraseWriter baseline, and further opportunities to study the perceptual, cognitive, and physical action trade-offs that underlie the learning curve of C-PAK systems.
(Digital Presentation) Pre-Lithiation of Silicon Anodes By Thermal Evaporation of Lithium for Boosting Energy Density of Lithium Ion Cells
Authors: Adhitama Egy , Brandao Frederico Dias , Dienwiebel Iris , Bela Marlena Maria , Gomez Martin Aurora , Javed Atif , Stan Marian , Winter Martin , Placke Tobias 
Published: July 2022

Lithium ion batteries (LIBs) do not only dominate the small format battery market for portable electronic devices, but have also been successfully implemented as the technology of choice for electric vehicles. However, for successful consumer acceptance and broad market penetration of electric vehicles, further improvements of LIBs in terms of energy density and cost along are required. The practically usable energy density of LIB cells is reduced by parasitic side reactions including electrolyte decomposition and formation of the “solid electrolyte interphase” (SEI) at the surface of the anode, as this process is related to the consumption of active lithium. Especially high-capacity silicon-based anodes suffer from ongoing lithium loss and rapid capacity fading.
Pre-lithiation is considered as a highly appealing technique to compensate for active lithium losses and, therefore, to increase the practical energy density. A critical parameter for a pre-lithiation strategy is to establish a technique for achieving lithiation of the active storage material at the most uniform lateral and in-depth distributions possible. Despite extensive exploration of various pre-lithiation techniques, controlling the lithium amount precisely while keeping an even lithium distribution remains challenging.
Here, we report the thermal evaporation of lithium metal as a novel pre-lithiation technique for silicon anodes that allows both, i.e., a precise control of the degree of pre-lithiation and a homogeneous deposition at the electrode surface. Silicon | Lithium metal interface and SEI characterization show that this approach enables the preserved Li to be consumed for the formation of a pre-formed SEI and creates moderate mechanical cracks by volume changes. The highly uniform Li on thin-film Si is beneficial for increasing capacity retention and significantly suppressing active lithium losses. The phase changes are evaluated and the terms dry-state and wet-state pre-lithiation (without/with electrolyte) are revisited. Finally, a series of electrochemical methods are also validated to allow a direct correlation of active lithium losses with the pre-formed SEI formation and improved electrochemical performance of silicon anodes.

Figure 1
IL27 Signaling Serves as an Immunologic Checkpoint for Innate Cytotoxic Cells to Promote Hepatocellular Carcinoma
Authors: Aghayev Turan , Mazitova Aleksandra M. , Fang Jennifer R. , Peshkova Iuliia O. , Rausch Matthew , Hung Manhsin , White Kerry F. , Masia Ricard , Titerina Elizaveta K. , Fatkhullina Aliia R. , Cousineau Isabelle , Turcotte Simon , Zhigarev Dmitry , Marchenko Anastasiia , Khoziainova Svetlana , Makhov Petr , Tan Yin Fei , Kossenkov Andrew V. , Wiest David L. , Stagg John , Wang Xin Wei , Campbell Kerry S. , Dzutsev Amiran K. , Trinchieri Giorgio , Hill Jonathan A. , Grivennikov Sergei I. , Koltsova Ekaterina K. 
Published: July 2022

Abstract

Although inflammatory mechanisms driving hepatocellular carcinoma (HCC) have been proposed, the regulators of anticancer immunity in HCC remain poorly understood. We found that IL27 receptor (IL27R) signaling promotes HCC development in vivo. High IL27EBI3 cytokine or IL27RA expression correlated with poor prognosis for patients with HCC. Loss of IL27R suppressed HCC in vivo in two different models of hepatocarcinogenesis. Mechanistically, IL27R sig­naling within the tumor microenvironment restrains the cytotoxicity of innate cytotoxic lymphocytes. IL27R ablation enhanced their accumulation and activation, whereas depletion or functional impairment of innate cytotoxic cells abrogated the effect of IL27R disruption. Pharmacologic neutralization of IL27 signaling increased infiltration of innate cytotoxic lymphocytes with upregulated cytotoxic molecules and reduced HCC development. Our data reveal an unexpected role of IL27R signaling as an immunologic checkpoint regulating innate cytotoxic lymphocytes and promoting HCC of different etiologies, thus indicating a therapeutic potential for IL27 pathway blockade in HCC.

Significance:
HCC, the most common form of liver cancer, is characterized by a poor survival rate and limited treatment options. The discovery of a novel IL27-dependent mechanism controlling anticancer cytotoxic immune response will pave the road for new treatment options for this devastating disease.
This article is highlighted in the In This Issue feature, p. 1825
Single-Cell Sequencing Reveals Trajectory of Tumor-Infiltrating Lymphocyte States in Pancreatic Cancer
Authors: Schalck Aislyn , Sakellariou-Thompson Donastas , Forget Marie-Andrée , Sei Emi , Hughes Tara G. , Reuben Alexandre , Bai Shanshan , Hu Min , Kumar Tapsi , Hurd Mark W. , Katz Matthew H.G. , Tzeng Ching-Wei D. , Pant Shubham , Javle Milind , Fogelman David R. , Maitra Anirban , Haymaker Cara L. , Kim Michael P. , Navin Nicholas E. , Bernatchez Chantale 
Published: July 2022

Abstract

Pancreatic ductal adenocarcinoma (PDAC) has few effective treatments. Immunotherapy, an attractive alternative strategy, remains challenging with the lack of knowledge on the tumor-infiltrating lymphocyte (TIL) landscape in PDAC. To generate a reference of T-cell subpopulations, we profiled 80,000 T cells from 57 PDAC samples, 22 uninvolved/normal samples, and cultured TIL using single-cell transcriptomic and T-cell receptor analysis. These data revealed 20 cell states and heterogeneous distributions of TIL populations. The CD8+ TIL contained a putative transitional GZMK+ population based on T-cell receptor clonotype sharing, and cell-state trajectory analysis showed similarity to a GZMB+PRF1+ cytotoxic and a CXCL13+ dysfunctional population. Statistical analysis suggested that certain TIL states, such as dysfunctional and inhibitory populations, often occurred together. Finally, analysis of cultured TIL revealed that high-frequency clones from effector populations were preferentially expanded. These data provide a framework for understanding the PDAC TIL landscape for future TIL use in immunotherapy for PDAC.

Significance:
To improve the efficacy of immunotherapy in PDAC, there is a great need to understand the PDAC TIL landscape. This study represents a reference of PDAC TIL subpopulations and their relationships and provides a foundation upon which to base future immunotherapeutic efforts.
This article is highlighted in the In This Issue feature, p. 2221
Machine Learning–Derived Severe Weather Probabilities from a Warn-on-Forecast System
Authors: Clark Adam J. , Loken Eric D. 
Published: July 2022

Abstract
Severe weather probabilities are derived from the Warn-on-Forecast System (WoFS) run by NOAA’s National Severe Storms Laboratory (NSSL) during spring 2018 using the random forest (RF) machine learning algorithm. Recent work has shown this method generates skillful and reliable forecasts when applied to convection-allowing model ensembles for the “Day 1” time range (i.e., 12–36-h lead times), but it has been tested in only one other study for lead times relevant to WoFS (e.g., 0–6 h). Thus, in this paper, various sets of WoFS predictors, which include both environment and storm-based fields, are input into a RF algorithm and trained using the occurrence of severe weather reports within 39 km of a point to produce severe weather probabilities at 0–3-h lead times. We analyze the skill and reliability of these forecasts, sensitivity to different sets of predictors, and avenues for further improvements. The RF algorithm produced very skillful and reliable severe weather probabilities and significantly outperformed baseline probabilities calculated by finding the best performing updraft helicity (UH) threshold and smoothing parameter. Experiments where different sets of predictors were used to derive RF probabilities revealed 1) storm attribute fields contributed significantly more skill than environmental fields, 2) 2–5 km AGL UH and maximum updraft speed were the best performing storm attribute fields, 3) the most skillful ensemble summary metric was a smoothed mean, and 4) the most skillful forecasts were obtained when smoothed UH from individual ensemble members were used as predictors.
Conservative therapy significantly reduces patients’ chronic venous disease symptoms: A Caribbean insight into the VEIN Act Program
Authors: Dialsingh Isaac , Mohammed Saeed Rashaad , Medford Rei Sebastian , Budhoo Emerson , White-Gittens Ian , Maharaj Dale 
Published: July 2022

Objectives We sought to determine the baseline demographic and clinical characteristics of patients with Chronic Venous Disease (CVD) across the Caribbean, and to evaluate patients’ compliance to conservative therapy and the effectiveness of such therapy in reducing patients’ CVD symptoms. Method Patients were enrolled into the VEIN Act Program, and their demographic data, CVD symptoms (and their intensity) and CEAP C-classification was recorded at the first visit. Patients were prescribed conservative therapy, and symptom intensity and patient compliance and satisfaction evaluated at a follow-up visit. Results We enrolled 193 patients into the study, most of which (76%) were female, between 39–78 years (80%) and within the C2-C4a classes (56.1%). Pain (61.1%) and heaviness (58.5%) were the most common symptoms. Patient compliance to the prescribed treatment was relatively high for all modalities (>75%) and most patients (92.1%) were at least somewhat satisfied with their treatment. Conclusions Patient compliance to conservative therapy for management of CVD is high across the Caribbean, and such therapy is effective in reducing intensity of CVD symptoms.
Evaluation of Loop Diuretic Dosing Following Sodium-Glucose Cotransporter 2 Inhibitor Initiation in Patients With Heart Failure
Authors: Trudeau Brooke M. , Allen Larry A. , Billups Sarah J. , Saseen Joseph J. , Pearson Scott M. 
Published: July 2022

Introduction: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have demonstrated cardiovascular benefits in patients with heart failure, many of which take loop diuretics. There are no evidence-based recommendations identifying which patients may require loop diuretic dose decreases or how to adjust loop diuretic doses when SGLT2is are initiated. Objectives: The main objective of this study was to investigate the frequency and degree of adjustments in loop diuretic doses after SGLT2i initiation in patients with heart failure. Methods: In this retrospective evaluation, patients seen in the UCHealth system with a diagnosis of heart failure who were prescribed a loop diuretic before initiation of SGLT2i were identified. We described loop diuretic dose changes at the time of SGLT2i initiation, at 6 months after initiation, and at 1 year after initiation. We also described de-escalation of maintenance medications that can contribute to hypotension at these time points. Data were evaluated using descriptive statistics. Results: A total of 100 patients were included. Loop diuretic dose was reduced empirically upon SGLT2i initiation in 2.0% of patients. Reduction of loop diuretic dose within the first 6 months of starting an SGLT2i occurred in 8.0% of patients. From baseline to 12 months after starting SGLT2i therapy, 14.0% of patients had loop diuretic dose reduction. Conclusions: Most of our patients with HF did not have change in loop diuretic dose after initiation of an SGLT2i. In patients who did have loop diuretic dose reduction, most occurred within 6 months after starting SGLT2i therapy rather than empirically at time of initiation.
CFD modelling on flow field characteristics of engine cooling water jacket and its cooling performance improvement based on coolant transport path analysis method
Authors: Tan Libin , Yuan Yuejin , Huang Can 
Published: July 2022

Reasonable coolant flow distribution and its heat transfer coefficient (HTC) distribution are of great significance to the cooling performance of water-cooled engine. Therefore, the present paper proposes a coolant transport path analysis method aiming at analyzing coolant velocity distribution and optimizing the coolant flow characteristics of water jacket based on Computational Fluid Dynamics (CFD), with particular emphasis on the assessment of coolant flow velocity distributions of high-temperature area of engine head water jacket. First, the coolant flow characteristics of a single-cylinder water jacket is investigated and it is found that coolant velocity of exhaust bridge is less than 1.5 m/s and the HTC distribution of water jacket under three flow conditions of 15 L/min, 25 L/min and 35 L/min have a small area reaching 5000 W/(m2∙K). Some areas have no coolant flow and the mass flowrate distribution of each gasket hole is unreasonable, proving that original water jacket structure has some shortcomings and need to be optimized. Based on coolant transport analysis, an improved design of the single cylinder water jacket is proposed and HTC distribution of improved water jacket meet cooling requirements that HTC in high heat load area are above 5000 W/(m2∙K). The coolant transport path analysis method for optimizing coolant flow characteristics of water jacket proves to be an effective way through successful application and remarkable achievement in the other single-cylinder water jacket and two-cylinder water jacket that coolant flow distribution become more reasonable and coolant velocity of high-temperature areas are bigger than 1.5 m/s.
Prediction of the Invasiveness of Ground-Glass Nodules in Lung Adenocarcinoma by Radiomics Analysis Using High-Resolution Computed Tomography Imaging
Authors: Zhang Tianqi , Li Xiuling , Liu Jianhua 
Published: July 2022

Background Pure ground-glass nodules (pGGNs) have been considered inert tumors due to their biological behavior; however, their prognosis is not completely consistent because of differences in internal pathological component. The aim of this study was to explore whether radiomics can be used to identify the invasiveness of pGGNs. Methods The retrospective study received the relevant ethical approval. After postoperative pathological confirmation, sixty-five patients with lung adenocarcinoma pGGNs (≤30 mm) were enrolled in this study from January 2015 to October 2018. All the cases were randomly divided into training and test groups in a 7:3 ratio. In total, 385 radiomics features were obtained from HRCT images, and then least absolute shrinkage and selection operator (LASSO) logistic regression was applied to the training group to obtain optimal features to distinguish the invasion degree of lesions. The diagnostic efficiency of the radiomics model was estimated by the area under the curve (AUC) of the receiver operating curve (ROC), and verified by the test group. Results The optimal features (“GLCMEntropy_angle135_offset1” and “Sphericity”) were selected after applying the LASSO regression to develop the proposed radiomics model. This prediction model exhibited good differentiation between pre-invasive and invasive lesions. The AUC for the test group was 0.824 (95%CI: 0.599-1.000), indicating that the radiomics model has some prediction ability. Conclusion The HRCT radiomics features can discriminate pre-invasive from invasive lung adenocarcinoma pGGNs. This non-invasive method can provide more information for surgeons before operation, and can also predict the prognosis of patients to some extent.