bluuebunny/crossref_metadata_2025 huggingface dataset:
Subjective Voice Outcomes in Surgeon Versus Technician-Monitored Recurrent Laryngeal Nerves in Thyroidectomy
Authors: Peckham Merry , Rose Tyler , King Deanne , Moreno Mauricio , Stack Brendan C. , Vural Emre
Published: August 2021

Objectives:

To compare subjective voice outcomes and postoperative laryngoscopic examination findings of patients with subjective voice complaints between surgeon-monitored and certified technician–monitored thyroidectomies.

Methods:

Patients who underwent hemithyroidectomy, total thyroidectomy, and completion thyroidectomy using a nerve monitoring system between November 2015 and June 2018 were included in the study. Retrospective chart review was carried out to assess how often patients reported voice changes and to record postoperative flexible laryngoscopic findings of patients when that examination was performed. Data were analyzed using the χ2 test to identify significant differences in outcomes for the 2 groups.

Results:

A total of 293 procedures was performed among 3 surgeons. Surgeons monitored the nerves in 147 cases and a certified technician monitored the nerves in 146 cases. Subjective voice changes were identified in 11 (7.48%) cases in the surgeon-monitored group and in 20 (13.70%) cases in the technician-monitored group ( P = .084). Among the patients who expressed subjective voice changes, 7 patients were identified with vocal cord hypomobility or immobility in the surgeon-monitored group and 13 patients had an abnormal examination in the technician-monitored group ( P = .234).

Conclusions:

Subjective voice changes or proven vocal cord mobility problems were not different between surgeon-monitored patients and technician-monitored patients in thyroidectomies.
No End In Sight: How regimes form barriers to addressing the wicked problem of displacement
Authors: Frey-Heger Corinna , Gatzweiler Marian Konstantin , Hinings C.R. (Bob)
Published: August 2021

Wicked problems are complex and dispersed challenges that go beyond the capacity of individual organizations and require a response by multiple actors, often in the form of transnational regimes. While research on regimes has provided insights into such collective responses, less is known about how such regimes may form barriers that hinder and block appropriate responses to addressing wicked problems. Exploring the problematic role of regime-level responses is timely given that many of today’s wicked problems are far from being alleviated and in many instances appear instead to be intensifying. We draw from complementary insights of regime theory and research on institutional barriers to explore our research question: How do regimes form barriers to addressing wicked problems, and which mechanisms sustain such barriers? We explore this question with a longitudinal case study of the transnational regime for refugee protection and its response to displacement in Rwanda. From our findings, we develop a model of dissociation that explains how actors move further away from addressing a wicked problem. We identify four dissociative mechanisms (discounting, delimiting, separating, and displaying) that each create a distinct regime-level barrier. These barriers are distributed and mutually reinforcing, which makes it increasingly hard for actors to find alternative ways of responding to an escalating problem. Our study provides insights for research on regimes and wicked problems as well as studies on institutional barriers. We conclude with policy implications for overcoming those barriers, in line with the wider concerns and motivations of this special issue.
Who is the Responsible Corporation? A multimodal analysis of power in CSR videos of multinational companies
Authors: Shao Kaiyu , Janssens Maddy
Published: August 2021

Drawing on Judith Butler’s understanding of performativity, this study aims to explore how power embeds in CSR videos of multinational companies. It adopts a critical semiotics multimodal analysis to show how a particular kind of responsible corporation is constituted by the language, both verbal and visual, that those CSR videos speak. Our findings show in-depth the multimodal construction of three subjects of a responsible corporation: hero, missionary and architect. We advance the constitutive turn in CSR communication by conceptualizing CSR communication as a political project which (1) subjectifies the corporation through the articulation of a relationship that subordinates CSR beneficiaries and the audience and (2) iterates the business ideology. We discuss how multimodality contributes to masking power, and conclude with guidelines for alternative multimodal CSR communication.
Long-Term Effects of Subsurface Drainage on Performance of Asphalt Pavements
Authors: Ji Pinyu , Gong Hongren , Cong Lin , Jia Xiaoyang , Huang Baoshan
Published: August 2021

This study investigated the effects of subsurface drainage on the long-term performance of pavements. The Specific Pavement Study 1 (SPS-1) experiment of the Long-Term Pavement Performance Program (LTPP) was selected to extract performance data. Four types of cracking, rut depth, and International Roughness Index (IRI) were used as the performance indicators. Other relevant factors affecting the pavement performance were also considered: surface thickness, base type, base thickness, subgrade soil classification, total thickness, age, and climatic conditions. The significant factors to long-term performance were identified using two methods: exploratory data analyses and mixed-effects models (MEMs). Results from the analyses showed that drainage only substantially affected the transverse cracking (TC) and rutting and had little effect on the other performance indicators. Sections in the dry and non-freeze region had the best riding quality and exhibited the least alligator cracking, non-wheelpath longitudinal cracking (NWPLC), and TC, but this climatic condition worsened the wheelpath longitudinal cracking (WPLC). The use of drainage in sections from the wet-freeze (WF) region significantly retarded the development of distress. For drained sections, the base comprising an asphalt-treated base over a permeable asphalt-treated base (PATB) better sustained the smoothness and resisted rutting. For undrained sections, the asphalt-treated base was a superior alternative. Sections on sites with fine subgrade showed less WPLC, NWPLC, and TC, while those on coarse subgrade sites showed less alligator cracking and better riding quality. Sections on sites with fine subgrade showed less WPLC, NWPLC, and TC, while those on coarse subgrade sites showed less alligator cracking and better riding quality.
Effects of Traffic Control Devices on Rural Curve Lateral Position
Authors: Galante Francesco , Mauriello Filomena , Pernetti Mariano , Rella Riccardi Maria , Montella Alfonso
Published: August 2021

This study investigated, by means of a dynamic driving simulator experiment, road users’ behavior inside the curves of rural two-lane highways related to different advance warning signs, perceptual measures, and delineation treatments. These treatments were intended to warn drivers of the presence of low radius curves and to affect their behavior, improving vehicle control and lane-keeping. Five surrogate measures of safety were used in the evaluation of the design alternatives in relation to lateral position performance: standard deviation of lateral position, maximum encroachment in the shoulder, maximum encroachment in the opposite lane, relative length of shoulder encroachment, and relative length of opposite lane encroachment. Statistical tests were performed to verify whether the surrogate measures of safety were significantly different between alternatives. The analysis was divided into three phases. In the first phase, all the measures were preprocessed, testing normality and homoscedasticity assumptions. In the second phase, the presence of an overall effect considering all the alternatives was evaluated using analysis of variance and the Kruskal–Wallis test. In the third phase, Student’s t- and Mann–Whitney tests were used to assess which alternatives showed statistically significant effects. The results demonstrated that the perceptual measures, namely colored transverse strips, dragon teeth markings, and colored median island, were the most effective treatments. Field tests to establish the perceptual measures’ effectiveness on real roads are strongly advised. Implementation of the measures tested in the driving simulator should be carried out on similar rural highways to validate the results.
Automatic Speech Recognition for Air Traffic Control Communications
Authors: Badrinath Sandeep , Balakrishnan Hamsa
Published: August 2021

A significant fraction of communications between air traffic controllers and pilots is through speech, via radio channels. Automatic transcription of air traffic control (ATC) communications has the potential to improve system safety, operational performance, and conformance monitoring, and to enhance air traffic controller training. We present an automatic speech recognition model tailored to the ATC domain that can transcribe ATC voice to text. The transcribed text is used to extract operational information such as call-sign and runway number. The models are based on recent improvements in machine learning techniques for speech recognition and natural language processing. We evaluate the performance of the model on diverse datasets.
Kinematic Alterations After Anterior Cruciate Ligament Reconstruction via Transtibial Techniques With Medial Meniscal Repair Versus Partial Medial Meniscectomy
Authors: Wang Ming , Lin Zefeng , Wang Wanshun , Chen Lingling , Xia Hong , Zhang Yu , Huang Wenhan
Published: August 2021

Background:

The treatment strategies for meniscal injuries during anterior cruciate ligament (ACL) reconstruction remain a topic of debate.

Hypothesis:

After ACL reconstruction, knee kinematics would be affected by different medial meniscal treatment (partial medial meniscectomy [PMM] and medial meniscal repair [MMR]).

Study Design:

Controlled laboratory study.

Methods:

A total of 161 patients underwent primary single-bundle ACL reconstruction and simultaneous medial meniscal treatment. Of these, 32 patients were eligible to participate in the kinematic assessment at 24.8 ± 1.7 months after surgery. Patients were divided into 2 groups: (1) those who underwent MMR (Group MMR; n = 18) and (2) those who underwent PMM (Group PMM; n = 14). Twenty healthy participants (Group Intact) were recruited who were comparable in age, body mass index, and sex. The kinematic parameters were collected using an optical tracking system during treadmill gait. Range of motion and kinematic parameters at key events during the gait cycle were compared between the 3 groups. The primary outcomes were the differences in adduction/abduction and internal/external rotation.

Results:

Patients in Group PMM walked with increased adduction as compared with those in Group Intact during the early stance phase ( P = .003; η2 = 0.172) and midstance phase ( P = .003; η2 = 0.167). In terms of internal/external rotation, patients in Group PMM walked with significantly larger tibial external rotation when compared with Group MMR by approximately 3.4° to 3.7° (loading response: P = .026, η2 = 0.090; midstance: P = .035, η2 = 0.093) and Group Intact ( P = .028; η2 = 0.095) in the early stance phase. In addition, there was significantly increased anterior tibial translation in Groups MMR and PMM compared with Group Intact.

Conclusion:

ACL reconstruction (via transtibial technique) with concurrent PMM demonstrated larger adduction and external tibial rotation at 24 months of follow-up during level walking.

Clinical Relevance:

Patients undergoing different medial meniscal treatment strategies in the presence of ACL reconstruction showed distinct knee kinematics. These results suggest that MMR is strongly recommended during ACL reconstructive surgery to reduce the abnormal kinematics close to that of the ACL-intact condition.
Evaluating the Potential for Correspondence Between Brief Functional Analysis and Interview-Informed Synthesized Contingency Analysis Procedures
Authors: Sidwell MacKenzie D. , Gadke Daniel L. , Farmer Ryan , Ripple Hailey , Tritley Jonathan
Published: August 2021

School Psychologists regularly conduct Functional Behavior Assessment (FBA), though, most FBA are completed using indirect procedures, which are inadequate for creating function-based interventions relative to experimental measures, such as functional analysis (FA). However, traditional FA may be considered arduous in the school setting. Alternative procedures like brief functional analysis (BFA) and interview informed synthesized contingency analysis (IISCA), may be as effective and more efficient than FA. Limited research exploring the correspondence of these procedures exists. The current study used an alternating treatment design across eight school aged children to compare control and test conditions for each measure. A within subjects approach was also used to compare the results of BFA and IISCA. Correspondence across the two measures was 54.17%. With average correspondence yielding just over half, the results indicate the two FA methods did not reliably identify the same function. Implications for practice are discussed.
Effect of rescanning with reduced interlayer times on microstructure and properties of titanium alloy via selective laser melting
Authors: Ma Yiqing , Wu Meiping , Duan Weipeng , Miao Xiaojin , Li Haohao , Han Jitai
Published: August 2021

In the process of selective laser melting, laser rescanning technology is often used to optimize the residual stress and other properties of the formed parts. In order to improve the performance of parts and reduce the manufacturing time concurrently, this paper proposed a combined rescanning strategy. Based on finite element analysis, molten pool solidification behavior was simulated and studied. Ti6Al4V alloy samples were fabricated and analyzed by changing the rescanning strategies and process parameters. The microstructure, relative density, size of pore defects and residual stress were investigated under different rescanning strategies. It can be seen that the average cooling rate ranked in a descending order of SLM > re-SLM+IL1 > re-SLM, and samples formed by rescanning without layer interval had the best relative density and residual stress optimization effect, while the microstructure of each scanning strategy was all acicular α′ phase. When the number of rescanning interlayers and laser power was “one-layer” and 140 W respectively, the residual stress went down from 353 to 294 MPa. Finally, a simplified model was proposed to calculate the time cost for fabrication of rescanning with reduced interlayer times.
A preliminary design method for axisymmetric turbomachinery disks based on topology optimization
Authors: Wang Bo , Wang Guangming , Tian Kuo , Shi Yunfeng , Zhou Caihua , Liu Heng , Xu Shengli
Published: August 2021

The topology optimization can be used to obtain preliminary turbomachinery disk designs which meet strength requirement. In order to eliminate enclosed holes which challenge manufacturing processes and to ensure distinct solid-void interface in the optimal result obtained by the topology optimization, a density distribution function is introduced for each element column in the design domain. Then, a parameter in each function is used to determine the disk’s thickness at corresponding radial position by controlling element densities. Once thicknesses at all radial positions are optimized, the shape of disk is thus determined. In this way, the optimization problem can be simplified by using these parameters as design variables. Illustrative examples are carried out to demonstrate the effectiveness of the proposed method in designing both compressor disks and turbine disks in comparison to the software T-Axis Disk and shape optimization method.
Macroscopic constitutive model for ergodic and non-ergodic lead-free relaxors
Authors: Streich Friedemann A , Martin Alexander , Webber Kyle G , Kamlah Marc
Published: August 2021

A fully electromechanically coupled, three dimensional phenomenological constitutive model for relaxor ferroelectric materials was developed for the use in a finite-element-method (FEM) solution procedure. This macroscopic model was used to simulate the macroscopic electromechanical response of lead-free ergodic [Formula: see text] and non-ergodic [Formula: see text] relaxor materials. The presented constitutive model is capable of accounting for the observed pinched hysteretic response as well as non-deviatoric polarization induced strain and internal order transitions. Time integration of the history dependent internal variables is done with a predictor-corrector integration scheme. The adaptability of the constitutive model regarding the pinching of the hystereses is shown. Simulations are compared to experimental observations.
Examining the Association of Billed Advance Care Planning With End-of-Life Hospital Admissions Among Advanced Cancer Patients in Hospice
Authors: Prater Laura C. , O’Rourke Brian , Schnell Patrick , Xu Wendy , Li Yiting , Gustin Jillian , Lockwood Bethany , Lustberg Maryam , White Susan , Happ Mary Beth , Retchin Sheldon M. , Wickizer Thomas M. , Bose-Brill Seuli
Published: August 2021

Background:

Advance care planning (ACP), or the consideration and communication of care preferences for the end-of-life (EOL), is a critical process for improving quality of care for patients with advanced cancer. The incorporation of billed service codes for ACP allows for new inquiries on the association between systematic ACP and improved EOL outcomes.

Objective:

Using the IBM MarketScan® Database, we conducted a retrospective medical claims analysis for patients with an advanced cancer diagnosis and referral to hospice between January 2016 and December 2017. We evaluated the association between billed ACP services and EOL hospital admissions in the final 30 days of life.

Design:

This is a cross-sectional retrospective cohort study.

Participants:

A total of 3,705 patients met the study criteria.

Main Measures:

ACP was measured via the presence of a billed ACP encounter (codes 99497 and 99498) prior to the last 30 days of life; hospital admissions included a dichotomous indicator for inpatient admission in the final 30 days of life.

Key Results:

Controlling for key covariates, patients who received billed ACP were less likely to experience inpatient hospital admissions in the final 30 days of life compared to those not receiving billed ACP (OR: 0.34; p < 0.001).

Conclusion:

The receipt of a billed ACP encounter is associated with reduced EOL hospital admissions in a population of patients with advanced cancer on hospice care. Strategies for consistent, anticipatory delivery of billable ACP services prior to hospice referral may prevent potentially undesired late-life hospital admissions.
Influence of the inclination angle on the sound field in an irregular enclosure containing two elastic walls
Authors: Cui Huaifeng , Hu Rufu , Luo Shaoying , Chen Nan
Published: August 2021

The sound field model of an irregular enclosure with two elastic walls and an inclined wall is established by the modal theory. The modal parameters of the irregular enclosure are obtained by the envelope rectangular technique. The influence of the inclination wall angle on the sound field in the irregular enclosure is discussed. When the inclination angle is increased from 0° to 45°, the resonance frequencies of the acoustic enclosure are basically reduced in the frequency range of 0∼250 Hz. When the inclination angle is increased from 0° to 45° every 15° interval, the amplitude of a certain acoustic mode itself decreases, while the amplitudes of the acoustic modes coupled to it basically increase. The acoustic potential energy peaks in the enclosure basically shift to the low frequency with the increase of the inclination angle. Furthermore, the change trend of the acoustic potential energy is regular in the low-order modes, but relatively chaotic in the high-order modes. In addition, in order to verify that the accurate description of the primary sound field is the basis of effective noise control, the two-elastic plate model is deliberately treated as one-elastic plate model, and its influence on the performance of active noise control is discussed. Also, if the multi-elastic plate model is regarded as a simplified automobile cab, the research results can be used for the preliminary acoustic design of the cab; that is, the research results can be used for the acoustic design of similar models.
The Ideological Structure of Municipal Non-Ideology
Authors: Lucas Jack
Published: August 2021

This paper explores the structure of elite disagreement about the ideological or nonideological character of municipal politics. I propose two possible relationships between a representative’s own ideology and their beliefs about the character of municipal politics: an “ends-against-the-middle” pattern, in which ideologues on the left and right embrace an ideological vision of municipal politics, whereas moderates insist that municipal politics is not ideological; and an “asymmetric visions” pattern, in which individuals on the left endorse an ideological view of municipal politics and those on the right oppose it. I use new survey data from more than 800 mayors and councillors in Canada to assess these possible relationships. While both are supported by the data, the asymmetric visions pattern is the stronger of the two: the nonideological view of municipal politics is most firmly embraced by municipal politicians of the moderate right, while the ideological vision is most common among representatives on the left. This pattern, I argue, is in keeping with a century of municipal political history and should be incorporated into our theories of municipal elections, representation, and policy disagreement.
Dynamic cushioning energy absorption of paper composite sandwich structures with corrugation and honeycomb cores under drop impact
Authors: Ji Meijuan , Guo Yanfeng , Han Xuxiang , Fu Yungang , Kang Jianfen , Wei Qing
Published: August 2021

The paper composite sandwich structure with corrugation and honeycomb cores has been widely used in civil and national defense industries, and the cushioning energy absorption characteristic is a key indicator to evaluate the performance of this composite structure. Therefore, this paper is focused on the influences of honeycomb thickness on the shock acceleration response and deformation characteristics to analyze cushioning energy absorption performance of the composite structure by various experimental tests. The experimental result shows that the paper corrugation layer firstly comes into crushed, and then the paper honeycomb layer is crushed. Additionally, the large honeycomb thickness may cause the secondary collapse of paper honeycomb layer. Under the same impact energy or impact mass, the cushioning energy absorption of the single-sided composite sandwich structure is better than that of the double-sided structure with the same honeycomb thickness. However, the impact resistance of the double-sided composite structure is better than that of the single-sided structure. For the paper composite sandwich structures with the honeycomb thicknesses 10, 15, 20, and 25 mm, the increase of honeycomb thickness would decrease the cushioning energy absorption of the whole structure under the drop impact with low energy. However, under the drop impact with high energy, the influence of honeycomb thickness on cushioning energy absorption is contrary. For the paper composite sandwich structure, the specific energy absorption, unit volume energy absorption, and stroke efficiency for the honeycomb thicknesses 10, 15, 20, and 25 mm are higher than those for the honeycomb thickness 70 mm. Therefore, the low honeycomb thickness is more advantageous for the cushioning energy absorption of paper composite sandwich structure.
Sound insulation performance of pyramidal truss core sandwich structure with frame
Authors: Wang Yu-Zhou , Ma Li
Published: August 2021

Recently, sandwich structures have been widely used in different fields because of their good mechanical properties, but these structures are weak in acoustic performance. In this paper, by combining pyramidal truss core sandwich structure with frame, a new structure is proposed with both good mechanical properties and excellent acoustic performance at low frequency. An analytical model of the pyramidal truss core sandwich structure with frame is developed to investigate the sound transmission loss (STL) performance. Finite element method (FEM) is also used to investigate the STL performance at low frequency. The effects of the incident wave angle and the geometrical parameters on the STL of the structure are discussed.
‘Hand-to-hand sports and the struggle for belonging’
Authors: Nardini Dario , Scandurra Giuseppe
Published: August 2021

This special issue on hand-to-hand sports aims to analyse how collective identities and forms of group and community belonging are defined, strengthened, built, imagined or even denied in the sportive and social contexts in which hand-to-hand combat or wrestling disciplines are practised. Considering the wide-ranging cross-cultural distribution of combat and wrestling practices in very different cultures and societies across the contemporary world, this issue intends to provide a (not-exhaustive) comparison of practices originating in highly heterogeneous geographical, social and cultural contexts. Indeed, comparisons focus on specific practices (combat and wrestling activities) and their relationship with belonging. The contributing scholars have studied and reflected on a particular style of wrestling or combat practice and its links to social belonging and identity, whether it be expressed on regional or national, local or global, social or ethnic, institutional or ‘counter-cultural’, symbolic or concrete levels.
Outcomes of Total Endovascular Aortic Arch Repair with Surgeon-Modified Fenestrated Stent-Grafts on Zone 0 Landing for Aortic Arch Pathologies
Authors: Li Xiaoye , Zhang Lei , Song Chao , Zhang Hao , Xia Shibo , Li Haiyan , Jing Zaiping , Lu Qingsheng
Published: August 2021

Objectives

This study evaluated the feasibility and safety of total endovascular aortic arch repair with surgeon-modified fenestrated stent-graft on zone 0 landing for aortic arch pathologies.

Methods

Between June 2016 and October 2019, 37 consecutive patients underwent total endovascular arch repair with surgeon-modified fenestrated stent-grafts on zone 0 landing. Outcomes included technical success, perioperative and follow-up morbidity and mortality, and branch artery patency.

Results

During the study period, 37 patients were treated with total endovascular aortic arch repair with surgeon-modified fenestrated stent-graft. Twenty-one (56.8%) patients were diagnosed with aortic dissections, 15 (40.5%) patients with aneurysms, and 1 (2.7%) patient required reintervention due to endoleak and sac expansion from previous thoracic endovascular aortic repair for thoracoabdominal aneurysm. The proximal landing zone for all patients were in zone 0, and all branch arteries of aortic arch were reconstructed. Technical success was achieved in 34 cases (91.9%). Three (8.1%) patients had fenestrations misaligned with target arteries, and the chimney technique was applied as a complementary measure. Thirty-day mortality rate was 5.4% (n=2). Thirty-day stroke rate was 5.4% (n=2). Thirty-day reintervention rate was 2.7% (n=1). At a median follow-up of 20 months (range, 3–49 months), 5 (13.5%) patients died, including 2 aortic-related deaths, 1 nonaortic-related death, and 2 deaths of unknown reason. One (2.7%) patient had stroke. Four patients (10.8%) had reintervention during the follow-up, including 2 cases of left subclavian artery occlusion and 2 cases of type II endoleak. The estimated survival (±SE) at 2 years was 72.4%±9.7% (95% CI 53.4%–91.4%). The estimated freedom from reintervention (±SE) at 2 years was 87.4%±5.9% (95% CI 75.84%–98.96%).

Conclusions

Total endovascular aortic arch repair with surgeon-modified fenestrated stent-grafts on zone 0 landing is an alternate option for the treatment of aortic arch pathologies in experienced centers.
TRIACCESS Study: Randomized Comparison Between Radial, Femoral, and Pedal Access for Percutaneous Femoro-popliteal Artery Angioplasty
Authors: Ruzsa Zoltán , Csavajda Ádám , Hizoh István , Deák Mónika , Sótonyi Péter , Bertrand Olivier F. , Kwan Tak , Merkely Béla , Nemes Balázs
Published: August 2021

Background

The aim of this randomized study was to compare the success and complication rates of different access sites for the treatment of superficial artery stenosis.

Methods and Results

A total of 180 consecutive patients were randomized in a prospective study to treat symptomatic superficial femoral artery stenosis via radial (RA), femoral (FA), or pedal artery (PA) access. Technical success was achieved in 96.7%, 100%, and 100% of the patients in the RA, FA, and PA groups, respectively (p=0.33). Secondary access sites were used in 30%, 3.3%, and 30% of the patients in the RA, FA, and PA access groups, respectively (p=0.0002). Recanalization for chronic total occlusion was performed in 34/36 (94.4%), 30/30 (100%), and 46/46 (100%) patients in the RA, FA, and PA groups, respectively (p=0.17). The X-ray dose was significantly lower in the PA group than that in the RA and FA access groups (63.1 vs 162 vs 153 Dyn, p=0.0004). The cumulative rates of access site complications in the RA, FA, and PA groups were 3.3% (0% major and 3.3% minor), 16.7% (3.3% major and 13.3% minor), and 3.3% (3.3% major and 0% minor) (p=0.0085), respectively. The cumulative incidence of MACEs at 6 months in the RA, FA, and PA groups was 5%, 6.7%, and 1.7%, respectively. The cumulative incidence of MALEs at 6 months in the RA, FA, and PA groups was 20%, 16.7%, and 9.2%, respectively (p=0.54).

Conclusion

Femoral artery intervention can be safely and effectively performed using radial, femoral, and pedal access, but radial and pedal access is associated with a lower access site complication rate and hospitalization. Pedal access is associated with a lower X-ray dose than that with radial and femoral access.
Review of key management techniques for advanced metering infrastructure
Authors: Kebotogetse Otisitswe , Samikannu Ravi , Yahya Abid
Published: August 2021

The electricity industry has been developed through the introduction of the smart grid. This has brought about two-way communication to the grid and its components. The smart grid has managed to increase the efficiency and reliability of the traditional power grid over the years. A smart grid has a system that is used to measure and collect readings for power consumption reflection, and the system is known as the Advanced Metering Infrastructure. The advanced metering infrastructure has its components too which are the smart metre, metre control system, collector or concentrator and communication networks (wide area network, neighbourhood area network, and home area network). The communication networks in the advanced metering infrastructure have created a vulnerability to cyber-attacks over the years. The reliability of the power grid to consumers relies on the readings from the smart metre, and this brings about the need to secure the smart metre data. This article presents a review of key management methods in advanced metering infrastructure environments. The article begins with an overview of advanced metering infrastructure and then shows the relationship between the advanced metering infrastructure and the smart grid. The review then provides the security issues related to advanced metering infrastructure. Finally, the article provides existing works of key management methods in advanced metering infrastructure and future directions in securing advanced metering infrastructure and the smart grid.
Impact of cerebral aneurysm size on distal intracranial hemodynamics and changes following flow diversion
Authors: Brunozzi Denise , See Alfred , Rizko Mark , Choi Jason , Atwal Gursant , Alaraj Ali
Published: August 2021

Background

The impact of cerebral aneurysm size on distal intracranial hemodynamics such as arterial pressure and Pulsatility Index is not completely understood, either before or after flow diversion.

Objective

The aim of the study is to assess the impact of aneurysm size on distal Pulsatility Index and pressure before and after flow diversion.

Methods

From December 2015, prospective measurement of middle cerebral artery pressure and Pulsatility Index was performed in consecutive patients with unruptured cerebral aneurysms in the cavernous to communicating segments of the internal carotid artery, which were treated with single flow diversion. Pressure and Pulsatility Index were recorded at the M1-segment ipsilateral to the cerebral aneurysm. Ratio of middle cerebral artery to radial arterial pressure (pressure ratio) was calculated to control for variations in systemic blood pressure. Correlations between aneurysm size and pressure ratio and Pulsatility Index were assessed before and after treatment.

Results

A total of 28 aneurysms were treated. The mean aneurysm size was 7.2 mm. Aneurysm size correlated linearly with systolic pressure ratio (1% pressure ratio increase per mm aneurysm size increase, P = 0.002, r2 = 0.33), mean pressure ratio (0.6% per mm, P = 0.03, r2 = 0.17) and Pulsatility Index (5% Pulsatility Index increase per mm, P = 0.003, r2 = 0.43). After flow diversion, aneurysm size preserved a linear correlation with the systolic pressure ratio (1% per mm, P = 0.004, r2  =  0.28), but not with the mean pressure ratio (0.4% per mm, P = 0.15, r2 < 0.1) or Pulsatility Index (0.3% per mm, P = 0.78, r2 < 0.1).

Conclusion

Aneurysm size affects distal hemodynamics: patients with larger aneurysms have increased systolic and mean pressure ratio, and increased Pulsatility Index. After flow diversion, mean pressure ratio and Pulsatility Index no longer associate with the aneurysm size, suggesting an effect of the flow diversion also on distal intracranial hemodynamics.
Assessment of cylindricity and roughness tolerances of holes drilled in marble using multiple regression and artificial intelligence
Authors: Abbassi Amira , Trabelsi Ali , Akrichi Sofien , Ben Yahia Noureddine
Published: August 2021

The Calacatta-Carrara marble is widely used due to its excellent physico-chemical characteristics and attractive aspect. However, the sensitivity of this materiel, when performing delicate manufacturing operations, presents for the engineers a hard challenge to overcome. This issue is mainly encountered with complex shapes of parts, for which it is difficult to preserve surface integrity and avoid geometric defects. The paper aims at finding out optimal drilling parameters of cutting in the Calacatta-Carrara white marble material, in order to minimize the holes cylindricity (HC) and surface roughness (HR) using six controlled operating factors, namely, the rotation speed ( N), the feed speed ( F), the drill bit diameter (BD), the drill bit height (BH), the number of pecking cycles ( P), and the drilling depth (DD). The experimental design uses a [Formula: see text] fractional factorial plan that is replicated once for cost consideration. The optimization process, that is, minimum cylindricity and roughness tolerances, is carried out using the Gray Relational Analysis (GRA) technique. Numerical modeling of machining parameters is performed using Multi-Layer Perceptron Artificial Neural Network (MLP ANN) and Multiple Regression Model (MR) to predict surface quality. For the sake of completeness these two models were compared in terms of fitness and predictability. The models were assessed statistically using the correlation coefficient. Results showed that either solution predicts a roughness tolerance which is in good agreement with the test data (both R-sq.(adj.) and R-sq.(pred.) >94%). However, the holes cylindricity tolerance response was shown to be superior with MLP-ANN model (R-sq.(adj.) 50.64% and R-sq.(pred.) 48.67%). The GRA analysis shows that minimum cylindricity and roughness are met when N and F are set high, BD and BH low, P high and DD low.
The bright homunculus in our head: Individual differences in intuitive sensitivity to logical validity
Authors: Ghasemi Omid , Handley Simon , Howarth Stephanie
Published: August 2021

Classic dual process theories of human reasoning attribute explicit reasoning to effortful, deliberative thinking. According to these models, intuitive processes lack any access to the formal rules of logic and probability and hence rely exclusively on superficial problem features to determine a response. However, in recent years, researchers have demonstrated that reasoners are able to solve simple logical or probabilistic problems relatively automatically, a capability which has been called “logical intuition.” In four experiments, we instructed participants to judge the validity (Experiments 1 and 4), likeability (Experiments 1, 2, and 3), and physical brightness (Experiments 2, 3, and 4) of the conclusion to several reasoning problems. Brightness judgements were made by evaluating the font shade brightness of the argument’s conclusion. Participants were also asked to complete a range of individual differences measures, drawing on cognitive ability and cognitive style, to evaluate the extent to which “logical intuitions” were linked to measures of deliberative reasoning. The results showed that participants judged the conclusion of logically valid statements to be more valid, more likable, and more physically bright than invalid statements. Participants with higher cognitive ability and unlimited processing time showed greater effects of logical validity in their liking judgements (varied across experiments). However, these effects were absent in the brightness tasks, suggesting that logic effects observed under instructions to judge conclusion brightness are a purer measure of “logical intuition.” We discuss the implications of our findings for recent dual process theories of human reasoning.
Recombinant factor VIIa for hemorrhagic stroke treatment at earliest possible time (FASTEST): Protocol for a phase III, double-blind, randomized, placebo-controlled trial
Authors: Naidech Andrew M , Grotta James , Elm Jordan , Janis Scott , Dowlatshahi Dar , Toyoda Kazunori , Steiner Thorsten , Mayer Stephan A , Khanolkar Pooja , Denlinger Julie , Audebert Heinrich J , Molina Carlos , Khatri Pooja , Sprigg Nikola , Vagal Achala , Broderick Joseph P
Published: August 2021

Introduction

Intracerebral hemorrhage is the deadliest form of stroke. Hematoma expansion, growth of the hematoma between the baseline computed tomography scan and a follow-up computed tomography scan at 24 ± 6 h, predicts long-term disability or death. Recombinant factor VIIa (rFVIIa) has reduced hematoma expansion in previous clinical trials with a variable effect on clinical outcomes, with the greatest impact on hematoma expansion and potential benefit when administered within 2 h of symptom onset.

Methods

Factor VIIa for Hemorrhagic Stroke Treatment at Earliest Possible Time (FASTEST, NCT03496883) is a randomized controlled trial that will enroll 860 patients at ∼100 emergency departments and mobile stroke units in five countries. Patients are eligible for enrollment if they have acute intracerebral hemorrhage within 2 h of symptom onset confirmed by computed tomography, a hematoma volume of 2 to 60 mL, no or small volumes of intraventricular hemorrhage, do not take anticoagulant medications or concurrent heparin/heparinoids (antiplatelet medications are permissible), and are not deeply comatose. Enrolled patients will receive rFVIIa 80 µg/kg or placebo intravenously over 2 min. The primary outcome measure is the distribution of the ordinal modified Rankin Scale at 180 days. FASTEST is monitored by a Data Safety Monitoring Board. Safety endpoints include thrombotic events (e.g. myocardial infarction). Human subjects research is monitored by an external Institutional Review Board in participating countries.

Discussion

In the US, FASTEST will be first NIH StrokeNet Trial with an Exception from Informed Consent which allows enrollment of non-communicative patients without an immediately identifiable proxy.
Therapeutic hypothermia for intracerebral hemorrhage: Systematic review and meta-analysis of the experimental and clinical literature
Authors: Baker Turner S , Durbin John , Troiani Zachary , Ascanio-Cortez Luis , Baron Rebecca , Costa Anthony , Rincon Fred , Colbourne Frederick , Lyden Patrick , Mayer Stephan A , Kellner Christopher P
Published: August 2021

Background

Intracerebral hemorrhage remains the deadliest form of stroke worldwide, inducing neuronal death through a wide variety of pathways. Therapeutic hypothermia is a robust and well-studied neuroprotectant widely used across a variety of specialties.

Aims

This review summarizes results from preclinical and clinical studies to highlight the overall effectiveness of therapeutic hypothermia to improve long-term intracerebral hemorrhage outcomes while also elucidating optimal protocol regimens to maximize therapeutic effect.

Summary of review

A systematic review was conducted across three databases to identify trials investigating the use of therapeutic hypothermia to treat intracerebral hemorrhage. A random-effects meta-analysis was conducted on preclinical studies, looking at neurobehavioral outcomes, blood brain barrier breakdown, cerebral edema, hematoma volume, and tissue loss. Several mixed-methods meta-regression models were also performed to adjust for variance and variations in hypothermia induction procedures. Twwenty-one preclinical studies and five human studies were identified. The meta-analysis of preclinical studies demonstrated a significant benefit in behavioral scores (ES = −0.43, p = 0.02), cerebral edema (ES = 1.32, p = 0.0001), and blood brain barrier (ES = 2.73, p ≤ 0.00001). Therapeutic hypothermia was not found to significantly affect hematoma expansion (ES = −0.24, p = 0.12) or tissue loss (ES = 0.06, p = 0.68). Clinical study outcome reporting was heterogeneous; however, there was recurring evidence of therapeutic hypothermia-induced edema reduction.

Conclusions

The combined preclinical evidence demonstrates that therapeutic hypothermia reduced multiple cell death mechanisms initiated by intracerebral hemorrhage; yet, there is no definitive evidence in clinical studies. The cooling strategies employed in both preclinical and clinical studies were highly diverse, and focused refinement of cooling protocols should be developed in future preclinical studies. The current data for therapeutic hypothermia in intracerebral hemorrhage remains questionable despite the highly promising indications in preclinical studies. Definitive randomized controlled studies are still required to answer this therapeutic question.
Implications of renal transplantation on serum testosterone and preoperative factors affecting its levels in the post-transplant period
Authors: Singh Rohit Pratap , Tomar Vinay , Yadav Sher Singh
Published: August 2021

Objective:

Low serum testosterone is highly prevalent in chronic kidney disease patients. The objective of the study was to determine levels of serum testosterone at the time of transplantation, the prevalence of testosterone deficiency/insufficiency in the pre- and post-transplant periods, and its correlation with patients’ age, serum creatinine, duration of preoperative dialysis, human leukocyte antigen (HLA) matching, and graft outcomes.

Methods:

The study was conducted from January 2019 to April 2020. Forty-five male renal transplant patients were evaluated before and at one and six months following transplant for changes in testosterone and creatinine levels. Six-month follow-up was possible for 28 patients.

Result:

Renal transplantation resulted in significant improvement in testosterone levels as early as one month after transplantation. The duration of preoperative dialysis and HLA match had a negative and positive impact on postoperative serum testosterone levels, respectively. We did not find any impact of testosterone levels on graft function.

Conclusion:

Successful transplantation among the study population produced a positive impact on serum testosterone levels. The duration of preoperative dialysis and HLA match had a negative and positive impact on postoperative serum testosterone levels, respectively.

Level of evidence:

XXX.
Epidemiological, Clinical, and Laboratory Predictors of In-Hospital Mortality Among COVID-19 Patients Admitted in a Tertiary COVID Dedicated Hospital, Northern India: A Retrospective Observational Study
Authors: Ahmad Shamshad , Kumar Pragya , Shekhar Saket , Saha Rubina , Ranjan Alok , Pandey Sanjay
Published: August 2021

Introduction

COVID-19 pandemic still poses a serious challenge to health system worldwide. This study was planned to determine exposure characteristics, in-hospital mortality, and predictors of in hospital mortality among COVID-19 patients.

Material and methods

We retrospectively investigated epidemiological, clinical, and laboratory profile of confirmed COVID-19 patients admitted from 25th March to 31st August 2020. COVID-19 patient profiles were collected from Medical Record Section of the hospital.

Results

In hospital mortality occurred in 159 (11%) cases. Increasing respiratory rate, higher temperature, higher total leukocyte count, and high blood urea levels were found to be independent risk factors for in hospital mortality whereas higher hemoglobin and higher oxygen saturation at the time of hospital admission were found to be protective against in hospital mortality.

Conclusion

In hospital mortality among COVID-19 patients is almost 1 in 10 in tertiary care hospital. Patients with advancing age (AOR: 1.048; 95% CI: 1.021-1.076), higher respiratory rate (AOR: 1.248; 95% CI: 1.047-1.489), higher temperature (AOR: 1.758; 95% CI: 1.025-3.016), higher leukocyte count (AOR: 1.147; 95% CI: 1.035-1.270), and higher urea levels (AOR: 1.034; 95% CI: 1.005-1.064) at the time of admission are important predictors of COVID-19 in-hospital mortality.
The Effect of Immigration Enforcement on School Engagement: Evidence From 287(g) Programs in North Carolina
Authors: Bellows Laura
Published: August 2021

During the past 15 years, immigration enforcement increased dramatically in the U.S. interior. There is a growing recognition that immigration enforcement in the U.S. interior has spillover effects onto U.S. citizens. I examine the impacts of a type of partnership between Immigration and Customs Enforcement and local law enforcement, 287(g) programs, on school engagement within North Carolina. In North Carolina, nine counties were approved to establish 287(g) programs, and another 15 applied but were not approved to participate. I use a triple difference strategy in which I compare educational outcomes for different groups of students in these two sets of counties before and after activation of 287(g) programs between 2003/2004 and 2012/2013. I find that 287(g) programs decrease school engagement by decreasing attendance. This effect appears to be driven by increabes in chronic absenteeism (missing 15 or more days per year).
Disparities in Educational Access in the Time of COVID: Evidence From a Nationally Representative Panel of American Families
Authors: Haderlein Shira K. , Saavedra Anna Rosefsky , Polikoff Morgan S. , Silver Daniel , Rapaport Amie , Garland Marshall
Published: August 2021

We use data collected between April 2020 and March 2021 from the Understanding America Survey, a nationally representative internet panel of approximately 1,450 households with school-age children, to document the access of American households to K–12 education during the COVID-19 crisis. We also explore disparities by parent race/ethnicity, income, urbanicity, partisanship, and grade level (i.e., elementary school vs. middle/high school). Results shed light on the vectors of inequality that occurred throughout the pandemic in access to technology, instruction, services (e.g., free and reduced-price meals), and in-person learning opportunities. Our work highlights the equity implications of the pandemic and suggests the importance of encouraging widespread in-person learning opportunities and attendance by the beginning of the 2021–2022 school year for addressing COVID-19’s educational effects.