bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paramedics’ Perceptions of Job Demands and Resources in Finnish Emergency Medical Services: A Qualitative Study
Authors: Ericsson Christoffer R , Lindström Veronica , Rudman Ann , Nordquist Hilla 
Published: June 2022

Abstract
Background: Paramedics’ fatigue is rising. Stress factors show increased risk for burnout, fatigue, leaving the profession, decreased performance and risk for patient safety. Meanwhile, paramedics’ strong community of practice, autonomy and a sense of professional respect are important factors in forming psychological resilience. We aimed to explore Finnish paramedics’ perceptions of job demands and resources. Methods: Our study design was descriptive, inductive with a constructivist approach. Using reflexive thematic analysis, we analyse open-ended questions, from a web-based survey and essays written by Finnish paramedic masters-degree students. The study followed the STROBE checklist.Results: We identified paramedics’ job demands as stress from a high workload, environmental factors and emotional burden. Performance expectations and a sense of inadequacy were further noted, as well as an organizational culture of hardiness, presenting lack of support and sense of inequality. Paramedics’ job resources were pressure management strategies, which were expressed as positive coping mechanisms, agency to affect workload and professional self-actualization, expressed as psychologically safe work community, professional pride and internal drive to professional development. Conclusions: Finnish paramedics exhibit resources and demands related to uncertainty and emotional burden as well as cultural hardiness and psychological safety in communities. Patient or Public Contribution: This study was done based on survey data collected and analysed by the authors. No patient or public contribution was utilized for this study.
Effect of concurrent beta-blocker use in patients receiving immune checkpoint inhibitors for advanced solid tumors
Authors: Mellgard George , Patel Vaibhav G. , Zhong Xiaobo , Joshi Himanshu , Qin Qian , Wang Bo , Parikh Anish , Jun Tomi , Alerasool Parissa , Garcia Philip , Gogerly-Moragoda Mahalya , Leiter Amanda , Gallagher Emily J , Oh William K. , Galsky Matthew D. , Tsao Che-Kai 
Published: June 2022

Abstract
Purpose: Stress-induced adrenergic signaling can suppress the immune system. In animal models, pharmacological beta-blockade stimulates CD8+ T-cell activity and improves clinical activity of immune checkpoint blockade (ICB) in inhibiting tumor growth. Herein, we investigated the effect of BB on clinical outcomes of patients receiving ICB in advanced solid tumors.Methods:We retrospectively evaluated patients with solid tumors treated with ICB at our institution from January 1, 2011 to April 28, 2017. The primary clinical outcome was disease control. Secondary clinical outcomes were overall survival (OS), and duration of therapy (DoT). The primary predictor was use of BB. Association between disease control status and BB use was assessed in univariable and multivariable logistic regression. OS was calculated using hazard ratios of BB-recipient patients versus BB non-recipient patients via Cox proportional hazards regression models. All tests were two-sided at a significance level of 0.05. ResultsOf 339 identified patients receiving ICB, 109 (32%) also received BB. In covariate-adjusted analysis, odds of disease control were significantly higher among BB recipients compared to BB-non-recipients (2.79; [1.54-5.03]; p=0.001). While we did not observe significant association of OS with the use of BB overall, significant association with better OS was observed for the urothelial carcinoma cohort (HR: 0.24; [0.09, 0.62]; P=0.0031). Conclusions:Concurrent use of BB may enhance the clinical activity of ICB and influence overall survival, particularly in patients with urothelial carcinoma. Our findings warrant further investigation to understand the interaction of beta adrenergic signaling and antitumor immune activity and explore a combination strategy.
Cough Suppression and HRQoL in adult people with Cystic Fibrosis: An Unexplored Correlation
Authors: Niehammer Ute , Steindor Mathis , Straßburg Svenja , Sutharsan Sivagurunathan , Taube Christian , Welsner Matthias , Hirtz Raphael , Stehling Florian 
Published: June 2022

Abstract
Background: Cough suppression assessed by embarrassment about coughing has been shown in adolescents with cystic fibrosis (CF) and negatively affects health-related quality of life (HRQoL) and clinical indicators of disease severity in adolescent females. However, whether cough suppression exists in adults has been studied as little as its effects on clinical and psychological outcomes beyond adolescence. Methods: 71 subjects completed the self-reported 'Cystic Fibrosis Questionnaire-Revised (CFQ-R +14)' and a self-reported questionnaire about cough suppression, health-related perspectives, and therapy adherence. Status of CF disease was quantified in terms of percentage of predicted forced expiratory volume in one second (ppFEV1), body mass index (BMI), Pseudomonas aeruginosa, and pancreatic status, as well as CF-related diabetes (CFRD). Additional demographic data for sex, age, graduation, employment, and marital status were assessed.Results: CS exists in adult CF and is associated with impaired HRQoL, but not the overall CF disease status regarding BMI, ppFEV1, or health-related perspectives. Despite a higher prevalence of cough suppression in women, no effect of sex regarding either outcome measure was observed. Conclusion: The results of this study may suggest that mental health indicators have an impact on cough suppression.
Multilayer perception and radial basis function models for predicting trends of rainfall in Asian megacity Dhaka, Bangladesh
Authors: I Abu Reza Md. Towfiqul , Pal Subodh Chandra , Chakrabortty Rabin , Mallick Javed , Sarkar Showmitra Kumar , Fattah Md. Abdul , Rahman M. Safiur 
Published: June 2022

Abstract
Rainfall prediction is a fascinating topic, particularly in an urban city experiencing climate change; it is also required for hydrologic system analysis and design. Most real-time rainfall prediction algorithms use conceptual models that simulate the hydrological cycle in a changing climate. However, calibration of “conceptual” or “physically based models” is typically challenging and time-consuming due to the large number of variables and factors. Simpler “artificial neural network (ANN)” predictions may thus seem promising. To this end, this study aimed to evaluate the performance of two of the most commonly used ANN models, namely “Multilayer Perception (MLP)” and “Radial Bias Function (RBF)”, by predicting the rainfall trend patterns in the mega city of Dhaka, Bangladesh. In this perspective, rainfall is considered as a dependent variable and the rest of the parameters are considered as independent variables for predicting the trends of rainfall in this region. In the prediction models, fifteen conditioned atmospheric and meteorological parameters were used, and the multi-collinearity of these parameters was checked by the “Variance Inflation Factor” and “Tolerance” methods. The performance of the ANN models was evaluated by comparing the predicted and residuals and also by using AOC and ROC curves. The importance study from the MLP model revealed that PM10, O3, PM2.5, NOx, and wind speed are the highest causal factors influencing the rainfall changes in Dhaka, Bangladesh. Though both ANN models produced similar robustness in rainfall prediction, results showed that MLP performed well with an AUC value of 0.941, compared to the RBF model with an AUC value of 0.915. Therefore, the application of the MLP model can be suggested as an alternative to predict the pattern of rainfall as well as meteorological and atmospheric variables based on historical recorded datasets.
Right atrial lines as primary access for postoperative pediatric cardiac patients
Authors: ANTON-MARTIN PILAR , ZOOK NINA , KOCHANSKI JUSTIN , RAY MEREDITH , NIGRO JOHN J. , VELLORE SHILPA 
Published: June 2022

Abstract
Objectives: To characterize the use of right atrial lines (RALs) as primary access in the postoperative care of neonatal and pediatric patients after cardiothoracic surgery and to identify risk factors associated with RAL complications. Materials and Methods: Observational retrospective cohort study in pediatric cardiac patients who underwent RAL placement in a tertiary children’s hospital from January 2011 through June 2018.Results: A total of 692 children with congenital heart disease underwent 815 RAL placements during the same or subsequent cardiothoracic surgeries during the study period. Median age and weight were 22 days (IQR 7-134) and 3.6 kg (IQR 3.1-5.3), respectively. Neonates accounted for 53.5% of patients and those with single ventricle physiology were 35.4%. Palliation surgery (shunts and cavo-pulmonary connections) accounted for 38%. Survival to hospital discharge was 95.5%. Median RAL duration was 11 days (IQR 7-19) with a median RAL removal to hospital discharge time of 0 days (IQR 0-3). Thrombosis and migration were the most prevalent complications (1.7% each), followed by malfunction (1.4%) and infection (0.7%). Adverse events associated with complications were seen in 12 (1.4%) of these RAL placements: decrease in hemoglobin (n=1), tamponade requiring pericardiocentesis (n=3), pleural effusion requiring chest tube (n=2) and need for antimicrobials (n=6). Multivariable logistic regression showed that RAL duration (OR 1.01, p=0.006) and palliation surgery (OR 2.38, p=0.015) were significant and independent factors for complications.Conclusion: The use of RALs as primary access in postoperative pediatric cardiac patients seems to be feasible and safe. Our overall incidence of complications from prolonged use of RALs remained similar or lower to that reported with short-term use of these lines. While RAL duration and palliation surgeries seemed to be associated with complications, severity of illness could be a confounding factor. A prospective assessment of RAL complications may improve outcomes in this medically complex population.
Mental state diagnosis using Hybrid CNN with EEG signal from wearable device
Authors: S Sivasaravana babu , V Prabhu , V Parthasarathy , G Saravana Kumar 
Published: June 2022

Abstract
Mental state of a person is not easy to read by humans. This mental state may include anxiety, depression and other medical conditions. There is no correct physical testing that is available. Therefore, diagnosing these mental conditions in yearly stage is very important. In our proposed model, we use EEG signal from non-intrusive wearable devices to detect depression patterns in patients. This can be done with the help of proposed Hybrid CNN (Convolutional Neural Network) algorithm. In this algorithm we are introducing adaptive wavelet kernels in convolutional layers to reduce the number of connected neurons in the network. This Mental state diagnosis using Hybrid CNN with EEG signal algorithm is also designed to be shift invariant and can handle real world online data from wearable devices. Finally, the training time requirement of neural network can be reduced with the help of improved learning rate functions. This kind of improvements will make the algorithm consume less training time and power. The algorithm has an accuracy of about 97% from data that is taken from wearable device with very poor SNR ratios. The main motive of the paper will be to construct fast, reliable, energy efficient algorithm for real world wearable applications.
Metadichol, A natural ligand for expression of Yamanaka reprogramming factors in somatic and primary cancer cell lines
Authors: Raghavan P.R. 
Published: June 2022

Abstract

The conversion of somatic cells back into induced pluripotent stem cells (iPSCs) or embryonic-like stem cells involves the introduction of four genes commonly called Yamanaka factors, i.e., Sox2, Oct4, Klf4, and c-Myc, into the cells. Because these genes and the viral vectors used to introduce them into cells have the potential to cause cancer, iPSC lines are not clinically useful. Most instances of direct reprogramming have achieved have been by the forced expression of defined factors using viral vectors. Here, we show that Metadichol® has the potential to generate iPSCs non-virally and may be helpful in clinical applications. Metadichol is a nanoformulation of long-chain alcohols derived from food. Quantitative real-time PCR (qRT-PCR) and western blotting showed that OCT4, SOX2, and Nanog are expressed when fibroblasts were treated with Metadichol at one picogram to 100 nanograms. Reverse-transcription PCR (RT-PCR) also revealed that OCT4, KLF4, Nanog, and Sox2 levels increased compared to controls by 4.01-, 3.51- and 1.26-, and 2.5-fold, respectively, in A549 cancer cells. In Colo-205 cells, OCT4, KLF4, and Sox2 were increased by 1.79-, 13.17-, and 2.25-folds, respectively. Metadichol treatment with triple-negative primary breast cancer (HCAF-TNPBC) primary cancer cells led to multifold increases of OKSM factors by 19-, 6-, 8.07-, 2.45-, and 6.91-folds in concentration ranges 1picogram to 100 nanograms. Metadichol is a natural product that induces the expression of Yamanaka factors needed for reprogramming and Klotho, an anti-aging gene, and curbs the expression of the TP53 gene, which is critical for reprogramming somatic cells into IPSCs.Metadichol increases endogenous vitamin C levels, leading to the efficient reprogramming of somatic cells into iPSCs. Metadichol is nontoxic and commercially available as a nutritional supplement. Thus, it can be directly tested in vivo in human subjects to confirm that cells can indeed be programmed into a state of induced pluripotency and cause the mitigation of disease conditions.
Clinical Study of Patients With Vitamin B12 Deficiency Followed at a University Hospital in Brazil
Authors: Berto Clara Rottschaefer , Frigotto Katia Gleicielly , Valviesse Vitor Ribeiro Gomes de Almeida , Bergier Lavínia Lustosa 
Published: June 2022

Abstract
Background: Vitamin B12 is a vitamin essential for enzymatic reactions and, as it is not synthesized by the human body, and there may be a deficiency in cases of food restriction or reduced absorption. It is estimated that the prevalence of its deficiency is 20% in the population over 60 years and the clinical manifestations may be due to hematological and neurological or neuropsychiatric disorders. Methods: This is a descriptive study, using data from the medical records of patients with vitamin B12 deficiency followed at a University Hospital in Rio de Janeiro, from 2014 to 2016. The following parameters were evaluated: hemoglobin concentration (Hb), mean corpuscular volume (MCV), erythrocyte anisocytosis index (RDW), hematoscopy, platelet count, lactate dehydrogenase (LDH) enzyme dosage, mini mental status examination (MMSE), vibratory sensitivity and strength in physical examination. Main Results: Data from the medical records of 20 patients with vitamin B12 levels <200 pg/dL were analyzed. The clinical and laboratory alterations found were: abnormal hematoscopy (90%), LDH > 200 IU/L (85%), RDW > 15% (80%), Hb < 12 g/dL (70%), MCV > 100 fL (65%), altered vibratory sensitivity (55%), platelet count < 150,000/uL (25%), altered MMSE (20%), altered strength (10%). Regarding the etiologies found, the most frequent were pernicious anemia (40%) and atrophic gastritis (20%). Conclusion: The most frequent alteration in this study was abnormal hematoscopy, and the most frequent etiology was pernicious anemia. Is important knowledge of the subject among health professionals, to identify and diagnose this deficiency at an early stage.
Dirac Equation Redux by Direct Quantization of the 4-Momentum Vector
Authors: Andoni S. 
Published: June 2022

Abstract
The Dirac equation (DE) is a cornerstone of quantum physics. We prove that direct quantization of the 4-momentum vector p with modulus equal to the rest energy m (c =1) yields a manifestly covariant equation with the frame-free operator p. In coordinate representation, this is equivalent to DE with spacetime frame vectors xu replacing Dirac’s gamma-matrices. Recall that standard DE is not manifestly covariant. Adding an independent Hermitian vector x5 to the spacetime basis {xu} allows to accommodate the momentum operator in a real vector space with a complex structure arising alone from vectors and multivectors. The real vector space generated from the action of the Clifford or geometric product onto the quintet {x0, x1, x2, x3, x5} has dimension 32, the same as the equivalent real dimension for the space of Dirac matrices. x5 proves defining for the C& CPT symmetries, distinction of axial vs. polar vectors, left and right handed rotors & spinors, etc. Therefore, we name it reflector and {x0, x1, x2, x3, x5} a basis for spacetime-reflection (STR). The pentavector I = x05123 commutes with all elements of STR and depicts the pseudoscalar in STR. We develop the formalism by deriving all essential results from the novel STR DE: spin ½ magnetic angular momentum, conserved probability currents, symmetries and nonrelativistic approximation. In simple terms, we demonstrate how Dirac matrices are a redundant representation of spacetime-reflection frame vectors.
A short decision time for transcatheter embolization can better predict mortality in patients with pelvic fracture
Authors: Miyake Takahito , Okada Hideshi , Kanda Norihide , Ishihara Takuma , Mizuno Yosuke , Ichihashi Masahiro , Kamidani Ryo , Fukuta Tetsuya , Nachi Sho , Yoshida Takahiro , Nagata Shoma , Kawada Hiroshi , Matsuo Masayuki , Yoshida Shozo , Ogura Shinji 
Published: June 2022

Abstract
Purpose: Early use of hemostasis strategies, such as transcatheter arterial embolization (TAE), is critical in cases of pelvic injury because of the risk of hemorrhagic shock and other fatal injuries. We investigated the influence of delays in TAE administration on mortality.Methods: This retrospective, observational study enrolled patients with pelvic injury who underwent acute TAE and were admitted to the Advanced Critical Care Center at Gifu University Hospital between January 2008 and December 2019. The time from when the doctor decided to administer TAE to the start of TAE (needling time) was defined as “decision-TAE time.”Results: We included 159 patients. The median decision-TAE time was 60 min. Twenty-four patients died. Kaplan–Meier curves for overall survival were compared between patients above and below the median cutoff value for decision-TAE time; survival was significantly better for patients below the median cutoff value (p=0.02). Multivariable Cox proportional hazards regression analysis revealed that the longer the decision-TAE time, the higher the risk of mortality (p=0.037). A short TAE duration (procedure time) with a short decision-TAE time was associated with the best survival (p for interaction=0.023).Conclusions: Decision-TAE time may play a key role in establishing resuscitation in pelvic fracture patients, and efforts to shorten this time should be pursued.
Experimental study of the effect of brake drum cooling grooves on motorcycle braking performance
Authors: Lapisa Remon , Fernandez Donny , Tarihoran Claudio , Milana Milana , Arif Ahmad , Purwantono Purwantono , Jasman Jasman 
Published: June 2022

Some important indicators in the braking system performance on a motorcycle are the braking temperature and stopping distance. High temperatures due to frictional heat in the drum brake can decrease the braking force and cause a slip. To improve braking performance, an effective strategy is needed to reduce the drum temperature and shorten the stopping distance. This study aims to analyze the effect of cooling grooves on the standard brake drum to decrease the drum brake temperature and the length of stopping distance. The measurements were compared to the standard drum brake as a reference, and two types of the modified ones to increase the braking performance by adding the slant-grooved and a straight grooved on brake drum. Braking is performed by providing a compressive load of two kg on the brake pedal for three cases of motorbike speed: 20, 40, and 60 km/hour. The results show that the brake drum with straight cooling grooves provides better braking performance compared to other drum brakes. For a speed of 60 km/h, the temperature of the straight grooved brake is 3.5 ºC. The stopping distance is 29.1 % shorter compared to the standard one. It shows that adding cooling grooves on drum brake can increase the effectiveness of motorcycle braking performance at various speeds. The results show that the brake drum with straight cooling grooves provides better braking performance compared to other drum brakes
Synthesis and characterization of MgB2 superconductors with carbon nanotubes (CNTs) and tin (Sn) addition
Authors: Hendrik Hendrik , Nur Farhanudin Muhammad , Darsono Nono , Herbirowo Satrio , Darminto Darminto , Pramono Andika Widya , Imaduddin Agung 
Published: June 2022

MgB2/CNT is a promising candidate for superconducting wire application due to its excellent mechanical properties and carbon nanotube’s low density. However, strong interfacial adhesion between the CNT reinforcement and the MgB2 matrix is difficult to manage. Therefore, this study examines the synthesis and characterization of magnesium diboride (MgB2) superconductors with carbon nanotubes (CNTs) and tin (Sn) addition. Determining the proper method and combination of CNT & Sn affects MgB2 superconductors is crucial. Raw materials of magnesium (Mg), boron (B), Sn, and multi-walled carbon nanotubes (MWCNTs) were used for a solid-state reaction process to determine the proper synthesis method and the effect of CNT on superconductors’ critical temperature. Each sample was obtained by weighing the raw material first, followed by hand grinding with agate mortars for 3 hours. The pelletization was then conducted by using a compact pressing machine with a pressure of 350 MPa. The compacted samples were then sintered at 800 °C for 2 hours either through the vacuum or PIST process. Finally, all were characterized, and MgB2 was discovered to be the dominant phase with minor impurity phases such as MgO, Mg, Mg2Sn, C, and Sn. Based on SEM morphological analysis, the grain boundaries of sample A1 were more precise than B2. In both, the grain size also varies, and the distribution of elements is uneven. Subsequently, Cryogenic Magnet Characterization indicated that at 40 K, almost all samples possess superconducting characteristics. For future studies, the potential impact of MgB2 on critical current density (Jc) and magnetic density (Hc) in several commercial applications such as Magnetic Resonance Imaging (MRI), magnetic levitation, and transformers needs to be investigated