bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Standard-Dose Versus High-Dose Dexmedetomidine in Extracorporeal Membrane Oxygenation
Authors: Zarfoss Erika L. , Garavaglia Jeffrey , Hayanga J. W. Awori , Kabulski Galen
Published: June 2022

Background

Dexmedetomidine is commonly used to achieve light sedation in patients on extracorporeal membrane oxygenation (ECMO) despite minimal evidence. In vivo studies have shown dexmedetomidine sequestration in ECMO circuits, and higher doses may be used to overcome sequestration.

Objective

The purpose of this study was to compare safety and efficacy of dexmedetomidine at standard versus high doses in ECMO

Methods

A retrospective analysis of adult ECMO patients was performed. Patients were compared as receiving either standard-dose (≤1.5 µg/kg/h) or high-dose (>1.5 µg/kg/h) dexmedetomidine. Safety outcomes included new onset bradycardia or hypotension. Efficacy was compared by the addition of concomitant sedative and analgesic agents.

Results

One hundred five patients were evaluated, with 20% of patients in the high-dose group. Comparing standard and high dosing, no significant differences were seen in primary safety outcomes including bradycardia (49% vs 38%, P = 0.46), hypotension (79% vs 71%, P = 0.56), or addition of vasopressors (75% vs 71%, P = 0.78). Need for concomitant analgesic agents and propofol was similar between groups.

Conclusion and Relevance

This represents the first evaluation of use of high-dose dexmedetomidine in ECMO. Rates of dexmedetomidine higher than 1.5 µg/kg/h were commonly used in patients on ECMO, with similar rates of adverse effects and need for concomitant propofol and analgesic agents. While high-dose dexmedetomidine may be as safe as standard dose, no additional efficacy was found.
The Impact of a Diabetes Transitions of Care Clinic on Hospital Utilization and Patient Care
Authors: Rinaldi Alyssa , Snider Melissa , James Amy , Harris Cara , Cephas Hill Kelly , Li Junan , Wyne Kathleen
Published: June 2022

Background

There is currently limited guidance from the American Diabetes Association regarding transitions of care for patients with diabetes.

Objective

This study’s aim was to determine the impact of a diabetes-specific transitions of care clinic (TOCC) on hospital utilization and patient outcomes in recently discharged patients with diabetes.

Methods

This retrospective study evaluated patients seen by TOCC as compared with similar patients discharged from the study institution the year prior. The primary outcome was a composite of the number of unique patients with readmissions/emergency department (ED) visits within 30 days of discharge. Secondary outcomes included a subcomponent analysis of readmissions/ED visits, index hospital length of stay (LOS), and to describe clinical interventions made in clinic. This study was approved by the institutional review board of the Office of Responsible Research Practice at the Ohio State University Wexner Medical Center.

Results

There were 165 patients in the TOCC group and 157 in the control group based on the matching criteria. There was a statistically significant decrease in the primary outcome in the TOCC group versus the control group (18% vs 36%, P < 0.001). In evaluation of its subcomponents, there was a statically significant decrease in patients with readmissions (11% vs 26%, P < 0.001) but not ED visits (10% vs 17%, P = 0.096). The LOS for the TOCC group was shorter at 4 days versus 5 days in the control group ( P = 0.055).

Conclusions and Relevance

The implementation of a diabetes-specific TOCC can decrease both readmissions and ED visits and may impact hospital LOS. In addition, a TOCC can be used to identify gaps in preventive care. The results from this study may help support the creation of similar TOCC at other institutions.
The Invisible Primary in an Agent-Based Model: Ideology, Strategy, and Competitive Dynamics
Authors: Nwokora Zim , Brouzet Davy
Published: June 2022

Historical accounts of American presidential nominating contests suggest that candidates jockey over ideology and policy in ways that shape the outcomes of these races. Yet this aspect of competition has been difficult to analyze with the formal and statistical methods that dominate this research agenda. To address this gap, this article presents a computational agent-based model (ABM) of candidates’ ideological maneuvering during the invisible primary. We extend the framework developed by Michael Laver to study dynamic party competition in Europe, but recast it for the different context and to enable model fit to be more rigorously determined. Our analysis of data from the 2012 Republican invisible primary suggests the importance of ideological jockeying in this contest. Moreover, its dynamics can be well-explained by a basic version of the ABM in which candidates select between three strategies (aggregator, hunter or sticker) and then maintain that strategy over time. The fit of this model, particularly in the short run, can be improved by introducing a “momentum effect” that allows the candidates’ standing in the race to rise or fall without any accompanying ideological change.
Solution of optimal control problems governed by volterra integral and fractional integro-differential equations
Authors: Sabermahani Sedigheh , Ordokhani Yadollah , Rabiei Kobra , Razzaghi Mohsen
Published: June 2022

In this manuscript, we investigate two categories of optimal control problems (OCPs), OPCs via fractional Volterra integro-differential equations and Volterra integral equations. Touchard wavelets as an appropriate class of bases are defined to develop a new hybrid scheme for the considered problems. To this approach, Riemann–Liouville fractional integral operator (RLFIO) of Touchard wavelets is achieved exactly using the Hypergeometric functions. Next, by approximating the fractional derivative of the state variables and control variables using the mentioned wavelet functions, applying RLFIO, collocation method, and Gauss–Legendre quadrature formula, the considered problems are inserted into systems of algebraic equations, which can be solved using “FindRoot” package in Mathematica software. Numerical results are presented that validate the theory and show the effectiveness of the established technique.
Designing Equitable Health Care Outreach Programs From Machine Learning Patient Risk Scores
Authors: Hane Christopher A. , Wasserman Melanie
Published: June 2022

There is growing interest in ensuring equity and guarding against bias in the use of risk scores produced by machine learning and artificial intelligence models. Risk scores are used to select patients who will receive outreach and support. Inappropriate use of risk scores, however, can perpetuate disparities. Commonly advocated solutions to improve equity are nontrivial to implement and may not pass legal scrutiny. In this article, we introduce pragmatic tools that support better use of risk scores for more equitable outreach programs. Our model output charts allow modeling and care management teams to see the equity consequences of different threshold choices and to select the optimal risk thresholds to trigger outreach. For best results, as with any health equity tool, we recommend that these charts be used by a diverse team and shared with relevant stakeholders.
Selection Incentives in the Dutch Basic Health Insurance: To What Extent Does End-of-Life Spending Contribute to Predictable Profits and Losses for Selective Groups?
Authors: Withagen-Koster A. A. , van Kleef R. C. , Eijkenaar F.
Published: June 2022

Existing risk-equalization models in individual health insurance markets with premium-rate restrictions do not completely compensate insurers for predictable profits/losses, confronting insurers with risk selection incentives. To guide further improvement of risk-equalization models, it is important to obtain insight into the drivers of remaining predictable profits/losses. This article studies a specific potential driver: end-of-life spending (defined here as spending in the last 1–5 years of life). Using administrative ( N = 16.9 m) and health survey ( N = 384 k) data from the Netherlands, we examine the extent to which end-of-life spending contributes to predictable profits/losses for selective groups. We do so by simulating the predictable profits/losses for these groups with and without end-of-life spending while correcting for the overall spending difference between these two situations. Our main finding is that—even under a sophisticated risk-equalization model—end-of-life spending can contribute to predictable losses for specific chronic conditions.
Contributing Factors of Sugar-Sweetened Beverage Intake in the Latinx Population: A Narrative Review Using the Social-Ecological Model
Authors: Cuy Castellanos Diana , Miller Beth , Zoellner Jamie
Published: June 2022

Sugar-sweetened beverage (SSB) consumption in the Latinx population has been a topic of increasing interest due to higher rates of consumption in this population, as well as higher prevalence of chronic health conditions, such as diabetes and obesity. SSB behaviors are influenced by multiple factors across the socio-ecological model. Understanding these factors can inform future intervention development and improve SSB consumption and overall health. Therefore, this narrative review identifies factors contributing to SSB consumption, as well as interventions conducted to address SSB consumption in the Latinx population residing in the United States. Contributing factors that are not currently addressed in published interventions are highlighted with the intent to inform the development of future comprehensive interventions.
Trust the Facts: The Impact of Reviews’ Written Style and Subject-Focus on Peer-to-Peer Accommodation Consumption
Authors: Shin Hhye Won , Fan Alei , Wu Laurie
Published: June 2022

Applying dual-process theory, the current research examines the impact of written style (i.e., fact-based vs. emotion-based) and subject focus of online reviews (i.e., property-focused vs. host-focused) on customer trust and booking intention in the peer-to-peer (P2P) accommodation context. Following a theory-led conceptualization of customer trust in the P2P accommodation context, a series of three scenario-based experimental studies are conducted to examine the proposed hypotheses. Study results show that fact-based (vs. emotion-based) reviews of the property/host enhance customers’ booking intention, which is mediated by trust in the property/host, respectively. Moreover, among fact-based reviews, host-focused (vs. property-focused) reviews lead to a higher level of booking intention among female customers, but male customers show no significant difference in booking intention when reading either host-focused or property-focused reviews. The present research findings bear important theoretical and managerial implications for researchers and P2P accommodation practitioners alike, which are discussed at the end.
Transforming the Paradigm for LGBTQ+ Evaluation: Advancing a Praxis of LGBTQ+ Inclusion and Liberation in Evaluation
Authors: Phillips Gregory , Felt Dylan , Perez-Bill Esrea , Ruprecht Megan M. , Glenn Erik Elías , Lindeman Peter , Miller Robin Lin
Published: June 2022

Lesbian, gay, bisexual, transgender, queer, intersex, Two-Spirit, and other sexual and gender minority (LGBTQ+) individuals encounter numerous obstacles to equity across health and healthcare, education, housing, employment, and other domains. Such barriers are even greater for LGBTQ+ individuals who are also Black, Indigenous, and People of Color (BIPOC), as well as those who are disabled, and those who are working-class, poor, and otherwise economically disadvantaged, among other intersecting forms of oppression. Given this, an evaluation cannot be equitable for LGBTQ+ people without meaningfully including our experiences and voices. Unfortunately, all evidence indicates that evaluation has systematically failed to recognize the presence and value of LGBTQ+ populations. Thus, we propose critical action steps and the articulation of a new paradigm of LGBTQ+ Evaluation. Our recommendations are grounded in transformative, equitable, culturally responsive, and decolonial frameworks, as well as our own experiences as LGBTQ+ evaluators and accomplices. We conclude by inviting others to participate in the articulation and enactment of this new paradigm.
Effect of COVID-19 lockdown on refractive errors in Italian children aged 5–12 years: A multi-center retrospective study
Authors: Trovato Battagliola Edoardo , Mangiantini Pietro , D’Andrea Mattia , Malvasi Mariaelena , Loffredo Lorenzo , Scalinci Sergio Zaccaria , Comberiati Anna Maria , Migliorini Raffaele , Pacella Elena
Published: June 2022

Purpose

to explore the potential consequences of the COVID-19 lockdown on the prevalence of myopia among Italian children aged 5–12 years.

Materials and Methods

retrospective multicenter study conducted in Italy. Population: children aged 5–12. Selection: random selection of children who received an eye exam between 2016 to 2021. Inclusion criteria: healthy children presenting for a routine eye exam. Exclusion criteria: presence of ocular comorbidities other than refractive error, such as blepharoptosis, media opacities, corneal or retinal dystrophies, strabismus, amblyopia, or concurrent therapy with atropine 0.01%. Outcome measure: age and spherical equivalent (SE) measured in diopters (D) in the right eye (RE) in cycloplegia. Statistical analysis: ANOVA test.

Results

total of 803 children. In the years prior to COVID-19, the mean SE ± SD of healthy age-school children was: 0.54 ± 1.49 D in 2016; 0.43 ± 1.84 D in 2017; 0.34 ± 1.41 D in 2018; 0.35 ± 1.75 D in 2019 (ANOVA, p = .659). In 2021, the mean SE changed to −0.08 ± 1.44 D (ANOVA, p = .005). Mean age was comparable in all groups (ANOVA, p = .307). The prevalence of myopes (SE ≤−0.5D) and hyperopes (SE ≥ 2D) was respectively 24.10% and 9.64% among children aged 60–96 months, and 63.86% and 6.02% among children aged 97–144 months. These values represent a statistically-significant increase in the number of myopes (Chi-square, p = .016) and decrease in the number of hyperopes (Chi-square, p = .001), as compared to previous years (.06 and.48 respectively).

Conclusion

this retrospective study shows a statistically-significant decrease in the mean SE in children aged 5–12 in the year following the COVID-19 lockdown. The percentage of myopes has increased significantly, while the percentage of hyperopes has decreased. The lifestyle changes caused by the lockdown led children to spend more time on near-work activities and digital devices, and less time outdoors. These are known risk factors for the development and progression of myopia. Studies in different countries are encouraged.
Low probability of myasthenia Gravis in patients presenting to neuro-ophthalmology clinic for evaluation of isolated ptosis
Authors: Donaldson Laura , Issa Mariam , Dezard Victoria , Margolin Edward
Published: June 2022

Background

Concerning causes of ptosis, most notably third nerve palsy and Horner's syndrome, can be ruled out with normal ocular motility and pupillary examination. Myasthenia gravis (MG) however, rarely can present with ptosis as an isolated finding. We reviewed all patients presenting to tertiary neuro-ophthalmology practice with ptosis of unknown etiology to determine the frequency of MG.

Methods

Retrospective chart review of patients referred to a tertiary neuro-ophthalmology practice with undifferentiated ptosis.

Results

Sixty patients were included in the study. Twenty eight (47%) patients had ptosis along with various abnormalities of ocular motility and/or alignment and 32 (53%) had isolated unilateral ptosis defined as ptosis with absence of diplopia, or symptoms of generalized MG (GMG). Final diagnosis was aponeurotic ptosis due to levator palpebrae dehiscence in the majority (73%) of patients, while 10 (17%) were diagnosed with MG (6 with OMG, 4 with GMG). Diplopia was present in 9/10 patients with MG and 8/10 had abnormal ocular findings on clinical examination such as orbicularis oculi weakness, Cogan's lid twitch or fatiguability of ptosis on sustained upgaze. Only one patient referred for isolated unilateral ptosis was diagnosed with OMG and this patient had orbicularis oculi weakness.

Conclusions

None of the patients with isolated unilateral ptosis and otherwise normal examination had MG. All patients eventually diagnosed with MG had diplopia or orbicularis weakness on examination. Thus, the yield of investigating patients with isolated ptosis for MG is exceedingly low.
A national co-design workshop of a mobile-based application for vascular access as a patient decision aid
Authors: Kingsmore David , Meiklem Ramsay , Stevenson Karen , Thomson Peter , Bouamrane Matt , Dunlop Mark
Published: June 2022

Background:

Increasing options for vascular access have increased the need for more effective communication to optimize patient engagement and ensure effective consent. An advanced prototype of the mobile application (VA App) was developed over 3 years as a patient decision aid. For the first time, entry to the 2021 UK Kidney Week was opened to all professions and patients and was held online. The VA App was presented in an inter-active session. This report summarizes the findings.

Methods:

A 30-min interactive session was allocated with the session delivered in four sections: (1) demographic data was collected; (2) an overall opinion was obtained about current patient information sources and satisfaction with these; (3) the participants were asked a series of eight questions regarding the main problem areas previously identified; (4) following a 6-min demonstration video, the participants were then re-asked the same questions to determine if the VA App would improve/worsen these areas.

Results:

Completed data from 30 participants showed great variation in all demographics. The most cited source was verbal and rated the best, whilst all other sources were felt to be poor by 90%. All eight aspects of current information sources rated poorly. There was a unanimous agreement that the VA App could make this better. Interestingly, when the eight aspects were ranked by order of the worst to best, this matched the order of the benefits of the VA App.

Discussion:

This is the first report of an on-line, multi-professional co-design workshop. With a unanimous view that current systems are very limited and that better patient information systems are required, the VA App was found to be a potential solution as a patient decision aid. Interestingly, paper leaflets were widely viewed as the least used and the least effective mechanism for communicating information to patients. Funding for a commercially produced mobile application has been secured and will be further tested in the near future.
A comparison of arteriovenous fistula failure between Malaysian and Australian and New Zealand participants enrolled in the FAVOURED trial
Authors: Hudson Rebecca , Pascoe Elaine M , See Yong Pey , Cho Yeoungjee , Polkinghorne Kevan R , Paul-Brent Peta-Anne , Hooi Lai-Seong , Ong Loke-Meng , Mori Trevor A , Badve Sunil V , Cass Alan , Kerr Peter G , Voss David , Hawley Carmel M , Johnson David W , Irish Ashley B , Viecelli Andrea K
Published: June 2022

Aim:

To describe and compare de novo arteriovenous fistula (AVF) failure rates between Australia and New Zealand (ANZ), and Malaysia.

Background:

AVFs are preferred for haemodialysis access but are limited by high rates of early failure.

Methods:

A post hoc analysis of 353 participants from ANZ and Malaysia included in the FAVOURED randomised-controlled trial undergoing de novo AVF surgery was performed. Composite AVF failure (thrombosis, abandonment, cannulation failure) and its individual components were compared between ANZ ( n = 209) and Malaysian ( n = 144) participants using logistic regression adjusted for patient- and potentially modifiable clinical factors.

Results:

Participants’ mean age was 55 ± 14.3 years and 64% were male. Compared with ANZ participants, Malaysian participants were younger with lower body mass index, higher prevalence of diabetes mellitus and lower prevalence of cardiovascular disease. AVF failure was less frequent in the Malaysian cohort (38% vs 54%; adjusted odds ratio (OR) 0.53, 95% confidence interval (CI) 0.31–0.93). This difference was driven by lower odds of cannulation failure (29% vs 47%, OR 0.45, 95% CI 0.25–0.80), while the odds of AVF thrombosis (17% vs 20%, OR 1.24, 95% CI 0.62–2.48) and abandonment (25% vs 23%, OR 1.17, 95% CI 0.62–2.16) were similar.

Conclusions:

The risk of AVF failure was significantly lower in Malaysia compared to ANZ and driven by a lower risk of cannulation failure. Differences in practice patterns, including patient selection, surgical techniques, anaesthesia or cannulation techniques may account for regional outcome differences and warrant further investigation.
Bioinformatics identifies predictors of arteriovenous fistula maturation
Authors: Liu Jia , Zhang Dingyao , Brahmandam Anand , Matsubara Yutaka , Gao Mingjie , Tian Jingru , Liu Bing , Shu Chang , Dardik Alan
Published: June 2022

Background:

Arteriovenous fistulae (AVF) are the preferred access for hemodialysis but still have poor rates of maturation and patency limiting their clinical use. The underlying mechanisms of venous remodeling remain poorly understood, and only limited numbers of unbiased approaches have been reported.

Methods:

Biological Gene Ontology (GO) term enrichment analysis and differentially expressed genes (DEG) analysis were performed for three AVF datasets. A microRNA enrichment analysis and L1000CDS2 query were performed to identify factors predicting AVF patency.

Results:

The inflammatory and immune responses were activated during both early and late phases of AVF maturation, with upregulation of neutrophil and leukocyte regulation, cytokine production, and cytokine-mediated signaling. In men with failed AVF, negative regulation of myeloid-leukocyte differentiation and regulation of macrophage activation were significantly upregulated. Compared to non-diabetic patients, diabetic patients had significantly reduced immune response-related enrichment such as cell activation in immune response, regulation of immune-effector process, and positive regulation of defense response; in addition, diabetic patients showed no enrichment of the immune response-regulating signaling pathway.

Conclusions:

These data show coordinated, and differential regulation of genes associated with AVF maturation, and different patterns of several pathways are associated with sex differences in AVF failure. Inflammatory and immune responses are activated during AVF maturation and diabetes may impair AVF maturation by altering these responses. These findings suggest several novel molecular targets to improve sex specific AVF maturation.
The multinational as a myth-prince of the global south: Writing back an emancipating imaginary to the global north
Authors: Hensmans Manuel
Published: June 2022

Three decades of discourse on rising emerging nations have failed to produce a theory of emerging multinational-led emancipation. This paper draws on the case of Huawei in China and the European Union (1987–2020) to theorize multinationals’ role in writing back an emancipating imaginary from the Global South to the Global North. Combining postcolonial theory of the multinational as a hybrid space, and a post-Gramscian lens on the multinational as a counter-hegemonic agent, I theorize the multinational as a “writing-back myth-prince.” The lens of a multinational as a writing-back agent and space from the global south radically broadens the emancipatory potential of the key postcolonial concept mimicry. It also affords a view on emancipation beyond the opposites and distincts of very different subject positions in the Global South and North. I identify four writing back phases, each of which involves the political and fantasmatic articulation of an emancipating imaginary from the Global South. I develop critical explanations of the four writing back phases, insofar as they reproduce inequality, disenfranchisement and oppression, and weaken the multinational as a space and agent of hybridity rather than essentialism.
The corruption of international society? General and complete disarmament from the perspective of the practitioners
Authors: Schouenborg Laust
Published: June 2022

This article investigates whether practitioners argued that general and complete disarmament (GCD) would corrupt international society during the two major debates of this issue in the 20th century, namely in 1927–1928 and 1959. The purpose and value of this analysis is to learn more about the workings of international society. Following Bull and other English School scholars, GCD probably represents the most radical challenge to the traditional conception of international society and its institutions. The only challenge of similar magnitude would appear to be the creation of a universal state or world government, fundamentally removing anarchy from the ‘anarchical society’. The article thus investigates whether those concerns about corruption, raised by scholars, resonate with the expressed public opinion of practitioners – diplomats and statesmen – in the actual deliberation of GCD in international fora: the Preparatory Commission for the Disarmament Conference, 1927–1928, and the United Nations, 1959. The main finding is that the corruption argument does appear in these public deliberations, and in intriguing and complex ways. The article thus offers a novel analysis of how practitioners publicly deal with a supposedly radical challenge to international society.
Mental health among unaccompanied refugee minors after settling in Norway: A matched cross-sectional study
Authors: Nilsen Sondre Aasen , Kvestad Ingrid , Randal Sølve Bjørn , Hysing Mari , Sayyad Nawar , Bøe Tormod
Published: June 2022

Aims: To describe the mental health of unaccompanied refugee minors (URMs) settled in Norway and compare their responses to an age- and sex-matched sample of Norwegian young people. Methods: The data were from the Pathways to Independence study of URMs aged 15–20 years ( n = 81; 82.7% male; response rate 80%) conducted in 2018–2019 in the Bergen municipality, Norway. The data from the URMs were linked to an age- and sex-matched group of young people from the Norwegian youth@hordaland study conducted in 2012 ( n = 324). Mental health was assessed by the Strengths and Difficulties Questionnaire (SDQ). Results: URMs were more likely to agree with most items pertaining to emotional problems, peer problems and prosocial subscales than Norwegian young people. Few differences were found for items on the conduct problems and hyperactivity-inattention problems scales. Poor psychometric properties, including weak factor loadings and low internal consistency, were detected for the SDQ subscales among URMs, except for the emotional problems subscale, indicating that the originally proposed five-factor model fitted the data poorly. Conclusions: URMs appear to have moderately more emotional problems than Norwegian young people. They are more likely to report being alone, getting along better with adults than with their peers and being bullied, but also report being more helpful and sharing with others. Studies with larger samples of URMs should determine the most appropriate factor structure of the SDQ when administered to URM samples.
Dynamic prediction of the pre-dehumidification of a radiant floor cooling and displacement ventilation system based on computational fluid dynamics and a back-propagation neural network: A case study of an office room
Authors: Su Meng , Liu Jiying , Zhou Shiyu , Miao Jikui , Kim Moon Keun
Published: June 2022

This study was carried out to solve the problem of condensation in radiant floor cooling systems. Computational fluid dynamics simulation and back-propagation neural network prediction were employed to conduct thorough research to predict the effects of the displacement ventilation dehumidification phase in an office building located in Jinan, China. The effects of the air supply temperature ( T as), air supply flow rate ( V as), air supply humidity ratio ( H as), floor temperature ( T floor), initial indoor temperature ( T ini) and relative humidity ( H ini) on the duration and energy consumption of pre-dehumidification were investigated. The big data show the air dew point temperature ( T ad) produced the most significant effect on the pre-dehumidification duration and energy consumption, while T as would cause the least significant effect. With the decrease of T ad, the pre-dehumidification duration and energy consumption were, respectively, decreased by 59.1% and 44.2%. Furthermore, with the variation of V as, the energy consumption exhibited a fluctuating trend. This study provides a novel and effective method to assess the pre-dehumidification control of radiant floor surfaces by considering different initial indoor conditions and air supply parameters.
Return visits to the emergency department: An analysis using group based curve models
Authors: Ben-Assuli Ofir , Vest Joshua R.
Published: June 2022

Stratification modeling in health services is useful to identify differential patient risk groups, or latent classes. Given the frequency and costs, repeated emergency department (ED) may be an appropriate candidate for risk stratification modeling. We applied a method called group-based trajectory modeling (GBTM) to a sample of 37,416 patients who visited an urban, safety-net ED between 2006 and 2016. Patients had up to 10 ED visits during the study period. Data sources included the hospital’s electronic health record (EHR), the state-wide health information exchange system, and area-level social determinants of health factors. Results revealed three distinct trajectory groups. Trajectories with a higher risk of revisit were marked by more patients with behavioral diagnoses, injuries, alcohol & substance abuse, stroke, diabetes, and other factors. The application of advanced computational techniques, like GBTM, provides opportunities for health care organizations to better understand the underlying risks of their large patient populations. Identifying those patients who are likely to be members of high-risk trajectories allows healthcare organizations to stratify patients by level of risk and develop early targeted interventions.
A short remark on He’s frequency formulation
Authors: Ma Hongjin
Published: June 2022

Recently Shen suggested a modification of He’s frequency formulation using Lagrange interpolation with great success for the cubic-quintic Duffing oscillator. This paper proposed an alternative modification of He’s frequency formulation by dividing the oscillators into two extreme conditions when the amplitude is either extremely small or remarkably large, and He’s frequency formulation is used for each case, and a final frequency formulation is obtained by matching the two extreme conditions. Comparison of the approximate frequency with the exact one for various amplitudes shows good agreement.
Dynamic cylinder deactivation: Thermodynamic mapping for the case of stoichiometric SI ICE
Authors: Bolehovsky Ondrej , Vitek Oldrich , Mares Bohumil
Published: June 2022

Conventional cylinder deactivation has been improving internal combustion efficiency for decades. It provides benefits for any internal combustion engine, particularly engines with high number of cylinders. The level of engine displacement reduction depends on the number of cylinders that may be deactivated during operation. This limits the potential benefit. Theoretically, maximum benefit of cylinder deactivation would require assignment of specific displacement reduction to each engine operating point. Dynamic cylinder deactivation is a new approach, which does not continuously deactivate cylinders, but deactivates selected engine cycles. This allows to dynamically reduce engine displacement and to assign optimum displacement reduction to each operating point. The paper deals with the one-dimensional thermodynamic simulation of the dynamic cylinder deactivation applied to a small displacement four-cylinder gasoline engine, points out crucial attributes of this new approach and compares it with baseline engine layouts and with the conventional cylinder deactivation as well. The research concludes that the dynamic cylinder deactivation improves the fuel consumption for engines loads BMEP < 5 bar. Deactivation strategy with the lowest trapped mass value in the deactivated cycle shows the most benefit.
Experimental study of the effects of Vee-shaped steps on the hydrodynamic performance of planing hulls
Authors: Ghadimi Parviz , Sajedi Sayyed Mahdi , Sheikholeslami Mohammad
Published: June 2022

Speed and stability are two essential criteria for assessment of planing hull performance. Accordingly, the effects of step shape on these vessels’ hydrodynamic performance and stability are experimentally investigated. Five different models are studied which are based on a high-speed recreational craft and are primarily the same in form and dimensions. One of these models does not have a step, two of them have transverse steps, and two other models have Vee-shaped steps. These five models all have a length of 2.64 m, a beam of 0.55 m, a deadrise angle of 24°, and weigh 86 kg. As the parent model, that is, the non-stepped model is unstable at high speeds, this study is aimed to figure out how different types of steps could prevent this kind of instability. The trim angle, resistance, and lengths of the wetted keel and wetted chine of all these models are reported at beam Froude numbers ranging from 0.43 to 3.44. First, the non-step model is investigated in towing tank tests. The optimum position for the center of gravity of this model is determined to be at a distance of 30% of the model’s length to the transom, which leads to the lowest resistance while the model still remains stable. The models with the aft-wise Vee type and fore-wise Vee type experience the lowest and highest resistance among all studied models, respectively. The steps’ performance appears to be directly related to the ventilation condition at the bottom of stepped models. It is also observed that aft-wise Vee-shaped step leads to the most severe flow separation, and the model with this type of step has the least wetted surface area compared to other studied models.
Robust sparse Bayesian learning for broad learning with application to high-speed railway track monitoring
Authors: Wang Chenyue , Gao Jingze , Li Hui , Lin Chao , Beck James L , Huang Yong
Published: June 2022

In this study, we focus on non-parametric probabilistic modeling for general regression analysis with large amounts of data and present an algorithm called the robust sparse Bayesian broad learning system. Robust sparse Bayesian learning is employed to infer the posterior distribution of the sparse connecting weight parameters in broad learning system. Regardless of the number of candidate features, our algorithm can always produce a compact subset of hidden-layer neurons of almost the same size learned from the data, which allows the algorithm to automatically adjust the model complexity of the network. This algorithm not only solves the regression problem of large amounts of data robustly but also possesses high computational efficiency and low requirements for computing hardware. Moreover, as a Bayesian probabilistic algorithm, it can provide the posterior uncertainty quantification of the predicted output, giving a measure of prediction confidence. The proposed algorithm is verified using simulated data generated by a benchmark function and also applied in non-parametric probabilistic modeling using high-speed railway track monitoring data. The results show that compared with several existing neural network algorithms, our proposed algorithm has strong model robustness, excellent prediction accuracy, and computational efficiency for regression analysis with large amounts of data, and has the potential to be widely used in general regression problems in science and engineering.
Inequality in Pulmonary Rehabilitation – The challenges magnified by the COVID-19 pandemic
Authors: Gardiner Lucy , Singh Sally
Published: June 2022

The COVID-19 pandemic has served to expose and amplify existing inequalities in chronic respiratory disease and the social determinants of health. In this article, we summarise evidence of existing disparities associated with chronic obstructive pulmonary disease and pulmonary rehabilitation; highlighting limitations of existing data. To reduce health inequalities in pulmonary rehabilitation, there is a need to identify and target factors influencing fair access and personal agency to engage. With consideration of the influence of culture on beliefs, expectations and health behaviours, we propose a renewed approach toward progressively achieving health equity in pulmonary rehabilitation based on principles of cultural safety and adaptation. This is a key priority in improving the quality of life of people living with chronic respiratory disease. Building comprehensive pulmonary rehabilitation service delivery models based on an understanding of the holistic needs of the local population should be a priority for service providers and researchers.
A Mixed Methods Assessment of Home-Based Video Pretransplant Lung Education
Authors: Mansell Holly , Fenton Mark E. , Tam Julian S. , Rosaasen Nicola , Cardinal Louise , Nelson Nicole
Published: June 2022

Introduction: Patients awaiting lung transplantation must learn new information to successfully navigate the transplant process. A supplemental video series was piloted to patients at home during the Covid-19 pandemic to improve pre-transplant education. Methods: A mixed methods study was undertaken to assess patient experiences with this method of education, confirm the ideal timing of the education, and identify gaps that require further attention. Semi-structured interviews were conducted with 17 one-on-one or dyadic (patients and caregivers) who viewed the video series at home. A third-party researcher (not involved in creation of the educational materials) conducted the interviews by phone, which were audio recorded and then transcribed verbatim. NVivo 12 Pro for Windows software was used to code the data and identify emerging themes. Results: Participants indicated that home-based videos were applicable, and informative and helpful (4.7 on 5-point Likert scale) and appreciated the advice and experiences of real patients. They were satisfied with their transplant education (4.2/5). While there were few aspects that the participants disliked about the videos, the interviews elicited outstanding questions about the transplant process (eg, logistical aspects of travel) and transplant concerns (eg, medications, expenses, and precautions in daily life). Conclusion: Patients being assessed or listed for lung transplant valued the novel electronic video education, and we will implement the home-based process into standard of care after the patient's initial visit with the transplant respirologist. Pre-transplant education will be tailored to help address the outstanding gaps identified in this program evaluation.
Endovascular Repair of an Intrathoracic Subclavian Artery Aneurysm in a Patient With Dextrocardia
Authors: Motaganahalli Anush R , Wang S Keisin , Sawchuk Alan P
Published: June 2022

This manuscript describes an endovascular repair of a symptomatic, large proximal left subclavian artery aneurysm in a patient with dextrocardia and right-sided aortic arch and absent bilateral internal carotid arteries. The patient had surgical reconstruction as an infant for congenital heart disease with Ventricular Septal Defect, bifid sternum . Given her previous surgical history, we declined an open operation and performed an endovascular repair with stent grafts to successfully repair the subclavian artery aneurysm. The patient had an uneventful postoperative course and follow-up ultrasonography demonstrated successful repair with preservation of flow through the left subclavian and vertebral arteries with resolution of her symptoms.
Hard Boundary-Based Neurofeedback Training Procedure: A Modified Fixed Thresholding Method for More Accurate Guidance of Subjects Within Target Areas During Neurofeedback Training
Authors: Sho'ouri Nasrin
Published: June 2022

In nearly all studies within the domain of neurofeedback, a threshold has been defined for each training feature in a way that subjects’ status can be evaluated during training according to the given value. In this study, a hard boundary-based neurofeedback training (HBNFT) method based on the determination of decision boundary using support vector machine (SVM) classifier was proposed in which subjects’ status were clarified considering a decision boundary and they could also be encouraged once entering a target area. In this method, a scoring index (SI) was similarly defined whose value was determined in accordance with subject performance during training. The results revealed that employing a classifier and determining a decision boundary instead of using a threshold could prove more successful in accurately guiding them towards a target area and also meet no needs to choose a basis for determining a threshold. Moreover, it was likely that the proposed method could be more efficient in controlling features and preventing extreme changes compared to those using variable thresholds.
(De)Centering Whiteness at Summit High: Reflections of a Racialized Rural United States
Authors: Mette Ian M.
Published: June 2022

This case was specifically written for practicing school leaders, as well as educational leadership preparation programs, to help create a nuanced conversation about how to decenter whiteness in the practices and policies of rural schools in the United States. The work is challenging, particularly given how race is baked into social institutions throughout the United States, including but not limited to financial, health care, and education systems. Educators reading this case should examine the historic factors that contribute to a racialized rural United States, as well as what can be done within rural education systems to help decenter whiteness.
Study on continuous heat treatment of Aramid III
Authors: Liu Kejie , Liang Jinsong , Mao Mao , Peng Tao , Jiang Mengjin
Published: June 2022

Aramid III is a high-performance fiber obtained by bulk structure modification based on the molecular structure of Kevlar fiber. Unlike the intermittent heat treatment method of Armos, Aramid III is prepared by continuous heat treatment technology. In this paper, the effects of heat treatment temperature, tension, and speed on fiber properties are studied by orthogonal experimental design. It is concluded that temperature is the most critical factor affecting fiber tensile strength and elastic modulus. The effects of different heat treatment temperatures on the chemical structure, surface morphology, aggregation structure, and the fiber’s mechanical properties and thermal properties are studied. Results show that: the chemical structure of the fiber keeps unchanged and surface morphology of the fibers are similar under the different heat treatment temperatures; the crystallinity of the fiber increases with the increase of temperature; the orientation degree of the fiber increases slightly after heat treatment; with the temperature increasing, the elastic modulus of the fiber increases, the tensile strength and elongation at break increase to a peak and then gradually decrease; the thermal decomposition temperature of the fiber is 533°C, and the decomposition rate is slightly different at different heat treatment temperature.
A comprehensive review on fish-inspired robots
Authors: Li Yi , Xu Yuteng , Wu Zhenguo , Ma Lei , Guo Mingfei , Li Zhixin , Li Yanbiao
Published: June 2022

Recently, the increasing interest in underwater exploration motivates the development of aquatic unmanned vehicles. To execute hazardous tasks in an unknown or even hostile environment, researchers have directed on developing biomimetic robots inspired by the extraordinary maneuverability, cruising speed, and propulsion efficiency of fish. Nevertheless, the performance of current prototypes still has gaps compared with that of real fishes. In this review, recent approaches in structure designs, actuators, and sensors are presented. In addition, the theoretical methods for modeling the robotic fishes are consolidated, and the control strategies are offered. Finally, the current challenges are summarized, and possible future directions are deeply discussed. It is expected that the emergence of new engineering and biological technologies will enhance the field of robotic fish for further advancement.
The psychological impact of the COVID-19 pandemic and a SARS-CoV-2 testing programme on obstetric patients and healthcare workers
Authors: Ross Abigail M , Ramlawi Serine , Fakhraei Romina , Murphy Malia SQ , Ducharme Robin , Dingwall-Harvey Alysha LJ , White Ruth Rennicks , Ritchie Kerri , Muldoon Katherine , El-Chaâr Darine
Published: June 2022

Objectives:

The aim of this study was to describe the psychological impact of the COVID-19 pandemic and the specific impact of a universal SARS-CoV-2 testing programme on obstetric patients and healthcare workers at The Ottawa Hospital.

Methods:

This was a follow-up survey study of obstetric healthcare workers and then-pregnant patients who participated in a SARS-CoV-2 testing programme conducted in The Ottawa Hospital obstetrical triage units from 19 October to 17 November 2020. Surveys explored the effects of the COVID-19 pandemic and the testing programme on participants’ psychological well-being. Responses were collected from April to September 2021. Descriptive summary statistics were calculated for both groups.

Results:

During hospitalization for delivery, obstetric patients (n = 143) worried about giving COVID-19 to their new baby (88.11%), catching COVID-19 (83.22%), and giving COVID-19 to their partner (76.22%). Patients felt relief at being tested for COVID-19 during the universal testing programme (24.65%) and at getting their results (28.87%). Patients also believed that universal SARS-CoV-2 testing was a good way to slow COVID-19 spread (79.72%), reduce anxiety (75.52%), and increase relief (76.22%). In addition, patients felt good about participating in research that could help others (91.61%). Among obstetric healthcare workers (n = 94), job satisfaction decreased and job stress increased during the COVID-19 pandemic. The universal testing programme led to minor increases in healthcare worker job stress and burden, particularly among nurses, but the majority (85.23%) believed it was a valuable research initiative.

Conclusion:

The COVID-19 pandemic has had a negative psychological impact on obstetric patients and healthcare workers. Universal SARS-CoV-2 testing was generally viewed favourably and may serve as an effective strategy for estimating COVID-19 prevalence without adding undue stress onto patients and healthcare workers during the pandemic.
Epistemic Oppression, Construct Validity, and Scientific Rigor: Commentary on Woo et al. (2022)
Authors: Gómez Jennifer M.
Published: June 2022

In this commentary, I highlight flaws in the article by Woo and colleagues (this issue) that undermine its credibility and utility as rigorous science that contributes to the field. I do so by discussing (a) the concept of epistemic oppression regarding the glaring exclusion of multiple germane bodies of research and (b) the importance of including construct validity within a psychometric article regarding the Graduate Record Examination (GRE). I conclude with a plea to the authors that the matter of anti-Black violence and murder, which they reference, is one to be taken respectfully, seriously, and somberly.