bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is acid suppression associated with the increased length of stay in diabetic ketoacidosis patients? A nationwide analysis
Authors: Farooq Umer , Tarar Zahid Ijaz , Kamal Faisal , Malik Adnan , Bresnahan Joseph , Abegunde Ayokunle T. 
Published: February 2022

AbstractBackgroundDiabetic ketoacidosis (DKA) patients present with low serum bicarbonate (), and an increase in its level to ≥15 mEq/L is considered one of the criteria for DKA resolution. Both proton pump inhibitors and histamine‐2 receptor antagonists inhibit downstream functioning of H+/K+ ATPase in the gastric parietal cells, which results in the decreased secretion of into the bloodstream.ObjectivesWe aimed to introduce the hypothesis that DKA patients on acid‐suppressive medications may have a delayed rise in serum to >15 mEq/L that may cause increased hospital length of stay (LOS) and sought to compare the outcomes of such patients. For the sake of simplicity, conditions requiring acid suppression are grouped under the term peptic ulcer disease (PUD) in this study.MethodsThis is a retrospective study using Nationwide Inpatient Sample employing International Classification of Diseases (ICD‐10) codes for adult patients with a primary diagnosis of DKA. Analyses were performed using STATA, proportions were compared using Fisher exact test, and continuous variables using Student's t‐test. Confounding variables were adjusted using propensity matching, multivariate logistic, and linear regression analyses.ResultsDKA patients with PUD had higher adjusted LOS, intensive care unit admission, and total hospital costs. Mortality and morbidity indicators were similar in both groups. The variables found to be independent predictors of increased LOS were malnutrition, Clostridium difficile infection, pneumonia, Glasgow Coma Scale score of 3–8, and higher Charlson comorbidity score.ConclusionWe found that Clostridium difficile and pneumonia predicted longer LOS in DKA patients with concomitant PUD, hinting at the possible role of acid suppression in prolonging the LOS in such patients. However, further studies are needed to examine the effect of lesser generation on LOS.
Creation as Promise: A Dogmatic Approach to Eco-Theology in the Anthropocene
Authors: Scherle Peter 
Published: February 2022

AbstractThe article constructs the emergence of environmental ethics and eco-theology, referring to ecumenical discussions and influences. It then focuses on the difference between two types of eco-theology: one that may be called eco-centric, the other theo-centric. Following the second model and rooted in Karl Barth's approach to creation theology, the argument is put forward that a dogmatic approach today has to be based on the concept of ‘creatio ex nihilo’. Creation is not a commodity but utterly dependent on God's ongoing creative speech-act. A revision of the doctrine of election focuses on creation in a Trinitarian perspective. Creation is an eschatological and soteriological category that is grounded biblically in the post-exilic hope for a new creation. As a promise, it is a critique of all utopic and dystopic claims in human history. This has two consequences. First, the need to regain a realistic concept of the political that allows for conflicting aims and that challenges the concept of dominion. And second, to regain a realistic approach to ‘nature’ that defines the ethical concern as ‘habitability’. The fundamental challenge is to live in a disenchanted world while waiting for the world to come. This tension is enacted in the Eucharist.
Comorbidity is not associated with dialysis modality choice in patients with end‐stage kidney disease
Authors: Bonenkamp Anna A. , Vonk Sanne , Abrahams Alferso C. , Vermeeren Yolande M. , van Eck van der Sluijs Anita , Hoekstra Tiny , van Ittersum Frans J. , van Jaarsveld Brigit C. ,   DOMESTICO study group
Published: February 2022

AbstractAimOver the past years the proportion of home dialysis patients has decreased in the Netherlands. In addition, the home dialysis use varies significantly among centres. It is unclear whether this is the result of differences in comorbidity, or other factors. Our aim was to investigate the association between comorbidity and dialysis modality choice.MethodsThe multi‐centre DOMESTICO cohort study collected comorbidity data of patients who started dialysis in 35 Dutch centres from 2012 to 2016. Comorbidity was assessed by the Charlson comorbidity index. Home dialysis was defined as any peritoneal dialysis or home haemodialysis treatment during follow‐up. Multivariable logistic regression analysis was used to assess the association between comorbidity and dialysis modality, with a mixed model approach to adjust for clustering of patients within dialysis centres.ResultsA total of 1358 patients were included, of whom 628 were treated with home dialysis. In crude mixed model analyses, the probability of receiving home dialysis was lower when comorbidity score was higher: having a high comorbidity score resulted in an odds ratio of 0.74 (95% CI 0.54–1.00) when compared with patients without comorbidities. After adjustments for age, sex, ethnic background, body mass index and dialysis vintage, there was no association between comorbidity and home dialysis.ConclusionComorbidity was not significantly associated with home dialysis choice, after adjustment for several confounding factors including age and body mass index. Future studies should aim at unravelling the centre‐specific characteristics that probably play a role in dialysis modality choice.
Practising the ethics of person‐centred care balancing ethical conviction and moral obligations
Authors: Ekman Inger 
Published: February 2022

AbstractPerson‐centred care is founded on ethics as a basis for organizing care. In spite of healthcare systems claiming that they have implemented person‐centred care, patients report less satisfaction with care. These contrasting results require clarification of how to practice person‐centred ethics using Paul Ricoeur's ‘Little ethics’, summarized as: ‘aiming for the good life, with and for others in just institutions’. In this ethic Kantian morality is at once subordinate and complementary to Aristotelian ethics because the ethical goal needs to be critically assessed and passed through the examination of the norm in each care situation. This paper presents examples that describes a person‐centred care practice that balance a critical review of care activities based on a conviction of aiming for patients' wellbeing. In contrast to patients' experiences of person‐centred care in real life, research projects have shown that if the clinical performers comprehend and apply the practice of person‐centred ethics, patients report positive outcomes. The implementation of person‐centred care therefore demands that stakeholders and managers enables and requires that healthcare staff study ethics in the same way as studying for example pharmacology is required when handling patients' medicines.
Distal type of nodo‐ventricular pathway: Unique electrophysiological characteristics mimicking fasciculo‐ventricular pathway
Authors: Uetake Shunsuke , Maruyama Mitsunori , Miyauchi Yasushi , Shimizu Wataru 
Published: February 2022

AbstractFasciculo‐ventricular and nodo‐ventricular pathways (FVP and NVP) are rare preexcitation variants. Normally, NVP is electrophysiologically different from FVP. We describe a unique type of NVP emerging from the distal part of the slow pathway, designated as “distal type” NVP. The distal type NVP resembled FVP but was proven by unexpected elimination of the NVP during the slow pathway ablation. Also, NVP was distinguishable from FVP by a careful comparison of the HV intervals during conduction over the fast and slow pathways. Demonstration of this novel type NVP provides insights into how the insertion site of NVP affects its electrophysiologic behaviors.
Fecal impaction detected by imaging predicts recurrent urinary tract infection
Authors: Watanabe Yoshitaka , Ikeda Hirokazu , Onuki Yuta , Oyake Chisato , Fuyama Masaki , Honda Kimiko , Watanabe Tsuneki 
Published: February 2022

AbstractBackgroundFew studies have evaluated the efficacy of ultrasonography (US) and abdominal radiography in assessing bladder and bowel dysfunction in children aged <24 months. We aimed to investigate the association between the risk of urinary tract infection (UTI) recurrence and fecal impaction using imaging findings.MethodsThe medical records of 121 children (aged <24 months) with initial febrile UTI (fUTI) who were admitted to the authors’ institution from January 2004 to September 2019 were reviewed retrospectively. We evaluated the rectal diameters of children with suspected fecal impaction that were measured using transabdominal US, or the rectal diameters divided by the distance between the ischial spines that were measured using abdominal radiography. Based on previous reports, we defined fecal impaction as a transabdominal US score of >30 mm or an abdominal radiography score of >0.5. The definition of functional constipation was based on the child/adolescent Rome IV criteria – i.e., a maximum stool frequency of twice per week.ResultsThe median age at initial fUTI diagnosis was 4 months. The occurrence of fecal impaction identified via imaging was significantly greater in patients with UTI recurrence than in those without recurrence: yes/no: 17/9 (65.4%) versus 35/60 (36.8%); P = 0.013. On the other hand, the occurrence rates of constipation based on stool frequency did not differ between the two groups. In multiple logistic analyses, fecal impaction detected via imaging was identified as an independent risk factor for fUTI recurrence.ConclusionsFecal impaction observed via US and abdominal radiography may be useful in predicting the recurrence of fUTI in children.
Respiratory outcome of spinal muscular atrophy type 1 patients treated with nusinersen
Authors: Ergenekon Almala Pinar , Yilmaz Yegit Cansu , Cenk Muruvvet , Gokdemir Yasemin , Erdem Eralp Ela , Ozturk Gulten , Unver Olcay , Kenis Coskun Ozge , Karadag Saygi Evrim , Turkdogan Dilsad , Karadag Bulent 
Published: February 2022

AbstractBackgroundRespiratory failure is the leading cause of mortality in spinal muscular atrophy type 1 (SMA1) children. The current study aims to evaluate the effect of nusinersen treatment on respiratory outcome of the patients with SMA1.MethodsIn this retrospective, single‐center study, 52 SMA1 patients treated with nusinersen were included in the analysis. Patients were divided into two groups based on their age at the time of their first nusinersen treatment (Group 1: ≤6 months, Group 2: >6 months). Respiratory outcome on the 180th day of treatment is defined as the type of ventilation support (spontaneous breathing, noninvasive ventilation (NIV), and tracheostomized or intubated on invasive mechanical ventilation). Demographic data, respiratory outcome, and Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders scores were obtained from medical records.ResultsOn the 180th day of treatment, 46 of the 52 (88.4%) children were alive. Prevalence of the mortality was similar in both groups (P = 0.65). The comparison of respiratory outcome in patients between group 1 and group 2 was as follows: spontaneous breathing, 7 (43.7%) versus 4 (13.3%) (P = 0.03); NIV <16 h/day, 3 (18.7%) versus 4 (13.3%) (P = 0.68); invasive mechanical ventilation, 6 (37.5%) versus 22 (73.3%) (P = 0.01). There were no patients using NIV ≥16 h/day. There were significant improvements in Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders scores of the patients at day 180 in comparison with the baseline (P < 0.001).ConclusionsEarly initiation of nusinersen treatment in SMA1 patients may alter the disease's natural course.
Protest and state policy agendas: Marches and gun policy after Parkland
Authors: Sato Yuko , Haselswerdt Jake 
Published: February 2022

AbstractDoes protest spur the government to act at the regional or local level? Gun control in the United States offers a promising case for studying this question, due to considerable variation in both protest and policy‐making activity following the mass shooting in Parkland, FL in early 2018. We use an original weekly panel dataset of progress on gun control and pro‐gun legislation in all states between 2017 and 2019, paired with weekly protest march data from the Crowd Counting Consortium, to determine whether or not protest spurred state governments to act on gun policy. We find that marches advocating gun control are associated with an increased likelihood of legislative movement on gun control, though they do not appear to discourage action that loosens gun laws. On the other side, pro‐gun marches do not seem to have the desired effect.
Efficacy and safety of virtual bronchoscopic navigation with fused fluoroscopy and vessel mapping for access of pulmonary lesions
Authors: Sun Jiayuan , Criner Gerard J. , Dibardino David , Li Shiyue , Nader Daniel , Lam Bing , Kopas Lisa , Wahidi Momen M. , Majid Adnan , Marron Robert , Verga Steven , Herth Felix J. F. 
Published: February 2022

AbstractBackground and objectiveVirtual bronchoscopic navigation (VBN) with fused fluoroscopy and vessel mapping provides a point of entry (POE) for puncturing airway wall to biopsy lesions. The study was designed to evaluate the safety and efficacy of this technology to diagnose peripheral pulmonary lesions.MethodsIt was a prospective, single‐arm, multicentre study. Patients underwent lesions biopsy with the Archimedes® VBN System via a POE using one of the two techniques: (1) bronchoscopic transparenchymal nodule access (BTPNA) and (2) guided transbronchial needle aspiration (TBNA). Biopsy yield, sampling yield and diagnostic yield were mainly determined in lesions biopsy attempted.ResultsOne hundred and thirty patients underwent anaesthesia and constituted the intention‐to‐treat population. One hundred and four patients with 114 lesions had biopsy attempted. Mean lesion size was 2.4 ± 1.13 cm. Sufficient tissue samples were obtained from 86 lesions with a biopsy yield of 75.4%. Nevertheless, sufficient samples for diagnosis based on histology ± cytology were obtained from 107 lesions with a sampling yield of 93.9%. Follow‐up was conducted for more than 1 year, with a diagnostic yield of 75.4% and 72.8%, respectively, on high and low estimate with consideration of three lesions without follow‐up. Two (1.9%) pneumothoraxes and one (1.0%) mild bleeding occurred.ConclusionBTPNA and guided TBNA contribute to safe and effective sampling of peripheral pulmonary lesions. A relatively high biopsy yield was obtained independent of the presence or absence of a bronchus sign (BS), and high sampling yield and diagnostic yield were obtained independent of location, lesion size and presence or absence of a BS.
Monitoring iron stores in Icelandic blood donors from 1997 through 2019
Authors: Gestsdottir Erla , Magnusson Magnus Karl , Lund Sigrun Helga , Johannsdottir Vigdis , Jonsson Thorbjörn , Gudmundsson Sveinn , Halldorsdottir Anna Margret 
Published: February 2022

AbstractObjectivesTo estimate the frequency of iron deficiency (ID) and anaemia in blood donors in Iceland and the impact of serum ferritin (SF) testing policy change.BackgroundBlood donations contribute to ID and/or anaemia in whole blood donors (WBD). SF may be used to monitor blood donor iron stores.Materials and MethodsThe study included WBD and new donors (ND) in the Icelandic Blood Bank in 1997–2019. SF was measured for ND and intermittently for WBD until October 2017, but thereafter for all WBD and ND at every visit. In January 2018, the SF threshold increased from 14 to 16 μg/L for ND and from 8 to 10 μg/L for WBD.ResultsThe study included 85 370 SF results from 243 369 visits of 32 910 donors. Median SF was higher for males than females, both for ND (88.0 vs. 31.2 μg/L,p < 0.001) and WBD (before 2018: 43.0 vs. 22.0 μg/L,p < 0.001). After the policy change in 2018, median SF increased for both male WBD (to 45.2 μg/L,p < 0.001) and female WBD (to 25.7 μg/L,p < 0.001). ID (SF <15 μg/L) was present in 10.6% of female ND and 0.5% of male ND. After policy change, the proportion of WB donations associated with ID decreased for males (from 6.4% to 4.0%) and females (from 18.9% to 14.1%). ID anaemia was present at some time in 3.7% of female WBD and 1.2% of male WBD.ConclusionThis nationwide study showed that ID in WB donors is common, especially among females, but monitoring SF may improve donor management.
Development and validation of the safe transfusion assessment tool
Authors: Suleiman Leena , Bakhtary Sara , Boscardin Christy K. , Manuel Solmaz P. 
Published: February 2022

AbstractBackgroundGiven the prevalence and risks of blood transfusion, it is essential that trainees and practicing clinicians have a thorough understanding of relevant transfusion medicine competencies. The aim of this research was to develop and gather validity evidence for an instrument to assess knowledge of core transfusion‐related competencies.MethodsWe developed the safe transfusion assessment tool (STAT) using a multistep process. Initially, 20 core competencies in transfusion medicine were identified through a consensus‐driven Delphi process. Learning objectives and assessment items pertinent to each competency were created. Next, a 13‐item assessment tool was piloted with multidisciplinary experts and trainees. Multiple iterative revisions were made based on feedback. Finally, the 12‐item STAT was administered to 100 participants of varying training level and specialty to establish validity, difficulty and item discrimination indices, and perceived utility.ResultsAnalysis of instrument item difficulty and item discrimination indices demonstrated the ability of the STAT to assess essential knowledge in transfusion medicine relevant to trainees and clinicians in multiple programs and practice settings. Eight of twelve items discriminated between learners with varying degrees of expertise. Hundred percent of students and trainees rated the STAT as Extremely Helpful or Somewhat Helpful and the majority planned to utilize the answer guide as a study aid.ConclusionThe STAT is a concise, valid, and reliable knowledge assessment tool that may be used by researchers and educators to augment transfusion medicine curricula (www.safetransfusion.ucsf.edu). Scores can help inform departments on areas in which trainees require additional support and areas of potential educational interventions.
A Numerical Approach for Natural Convection With Curved Obstacles in an Enclosure Using Lattice Boltzmann Method
Authors: Sen Srijit , Hegde Tarun , Perumal D. Arumuga , Yadav Ajay Kumar 
Published: February 2022

Abstract
The impact of placing curved obstacles on natural convection in enclosures with differentially heated side walls is analyzed in the current study using the lattice Boltzmann method (LBM). A method to choose characteristic velocity based on Knudsen number is implemented which eradicates the need of arbitrarily guessing characteristic velocities to proceed with simulations. In addition, a less computationally intensive probability distribution function for equilibrium temperature is used. For validation, a standard natural convection problem with left wall at high temperature, right wall at low temperature, and top and bottom adiabatic walls is considered. A grid independence test is conducted and the code is validated with existing results for various Rayleigh numbers, which shows a good agreement. The problem is then modified by including circular and elliptical obstacles of adiabatic, hot, and cold nature. A boundary interpolation technique is used to implement the velocity and temperature boundary conditions at the inner boundaries. The streamline patterns and temperature contours show interesting observations such as dependence of location of vortices on the type of obstacle boundary used, and formation of low or high temperature zones around obstacle at high Rayleigh numbers. Results show that the change in the shape of the obstacle contributes to the Nusselt number variations at the high temperature boundary and low Rayleigh numbers.
Nonlinear Lumped Parameter Model and Snap-Through Stability Analysis of Hydraulically Amplified Dielectric Elastomer Actuators
Authors: Zamanian Amir Hosein , Son David Y. , Krueger Paul S. , Richer Edmond 
Published: February 2022

Abstract
Hydraulically amplified dielectric elastomer actuators (HADEAs) are soft actuators comprising a pair of elastic electrodes connected to an inflatable membrane where the membrane and space between the electrodes are filled with an incompressible dielectric fluid. A lumped parameter model (LPM) was developed based on a nonlinear hyper-elastic Mooney–Rivlin material model. We compared the nonlinear LPM with a previous linear model and with a multiphysics finite element model with Mooney–Rivlin materials. The proposed nonlinear LPM showed good agreement in the estimation of strain and internal hydrostatic pressure as a function of actuation voltage compared to the finite element analysis results. Moreover, it better predicts the quasi-static equilibrium state and snap-through instability than the linear LPM.
Mean-Value Exergy Modeling of Internal Combustion Engines: Characterization of Feasible Operating Regions
Authors: Pozzato Gabriele , Rizzo Denise M. , Onori Simona 
Published: February 2022

Abstract
In this paper, a novel mean-value exergy-based modeling framework for internal combustion engines is developed. The characterization of combustion irreversibilities, nonstoichiometric combustion, and thermal exchange between the in-cylinder mixture and the cylinder wall allows for a comprehensive description of the availability transfer and destruction phenomena in the engine. The model is applicable to internal combustion engines operating both at steady-state and over a sequence of operating points and is used to create maps describing the exergetic static behavior of the engine as a function of speed and load. The application of the proposed modeling strategy is shown for a turbocharged diesel engine. Ultimately, the static maps, while providing insightful information about inefficiencies over the operating range of the engine, are the enabling step for the development of exergy-based control strategies aiming at minimizing the overall operational losses of hybrid electric vehicles.