bluuebunny/crossref_metadata_2025 huggingface dataset:
Mapping of active major faults in the Mamasa and surrounding areas using satellite gravity data and topographic features
Authors: Rosid M S , Ali Y H , Ramdhan M
Published: July 2020

The mapping of active faults in Indonesia, especially in areas near the city center is very important to determine the building code. Mamasa Regency, West Sulawesi is one of the areas that have active faults, has not been mapped well in the 2017 seismic hazard book, which is a guidebook in creating building codes in Indonesia. A total of 762 earthquakes occurred in this area from November to December 2018. This study aims to map active faults associated with the source of these earthquakes. TOPEX satellite gravity data were processed to obtain the Complete Bouguer Anomaly. The residual and regional gravity values were separated using a Gaussian filter to identify the lineation of the fault and the existing fracture zone. The multiscale second vertical derivative was also implemented to identify and characterize the fault. Topographic contour mapping was carried out to confirm the presence of fault on the surface as well as to observe the direction of fault movement. We used seven focal mechanism data from Global CMT to support the interpretation result of gravity and topographic data. The result, the main fault is a sinistral strike-slip fault with N164E strike orientation. This strike-slip fault has two sides. The movement of the strike-slip fault on these two sides causes a pull-apart which results in normal faults in the pull zone between the two faults.
Employing 3-D inversion of geomagnetic data to identify demagnetized rock associated with reservoir zone of Blawan-Ijen geothermal prospect area
Authors: Daud Y , Arafat Y , Kumara D A , Fortuna D A , Yunus F M , Avicienna H F , Farhan
Published: July 2020

Blawan-Ijen geothermal prospect area is placed at Bondowoso, East Java. Geologically, the presence of geothermal system in this field is controlled by the huge ancient Kendeng caldera complex structure. The heat source of the geothermal system is predicted to be situated at the base of Kendeng caldera. Geomagnetic method was used for detecting the presence of the heat source. The high temperature zone as the main target of geothermal exploration mostly situated around the heat source location. The geomagnetic method was applied because of its ability to identify the magnetic variation of rocks such as the demagnetized zone which is caused by the high temperature condition in geothermal area especially in the center of geothermal reservoir. Geomagnetic survey was conducted in 2017 and 2018 with the total of 151 stations. The 3-D inversion of geomagnetic data was then carried out to image the subsurface magnetic variation which is representing the complex structure of geothermal system in this area. The subsurface magnetic variation structure revealed by 3-D inversion showed the distribution of demagnetization reservoir rock inside the Kendeng caldera which has low magnetic susceptibility. In the upper part of this layer that is a higher magnetic susceptibility layer which may associated with the clay alteration that is overlaying the geothermal reservoir in this area. Moreover, the very low magnetic susceptibility anomaly can be observed start from -1000 m elevation, which is interpreted as the heat source of the geothermal system in this area.
Multiplex PCR for identification of fish substitution in fish fillet products
Authors: Jayaleksana A D , Andayani N , Maryanto A E
Published: July 2020

Fish substitution in fish fillet products is a concern in food safety and sustainability. There are many reports about the mislabeling problem in fish fillet products. DNA-based identification plays an important role in food safety and traceability. The use of advanced techniques of barcode using multiplex PCR for species identification substitution from fish fillet products are demonstrated in this study. The primer was designed from three different species that are usually labeled in fish fillet products. Each pair of primers were designed to amplify different PCR products that are specifically recognized as different species. We found 11, 6 and 0 samples labeled as Tilapia, Pangasius, and Snapper respectively. This method is suggested for rapid identification because it is efficient and accurate.
Methods to maximize environmental DNA (eDNA) for detection the presence of Alligator Gar (Atractosteus spatula)
Authors: Nur M N , Ulayya N , Azis M , Maryanto A E , Andayani N
Published: July 2020

Introduction of alligator gar (Atractosteus spatula) into a new range of its distribution has been reported in several freshwater ecosystems. The presence of alligator gar in Indonesia has been recorded in Jakarta during big flood in 2007. The concern about introducing this species is because of its predatory behavior and can impact the trophic system in freshwater ecosystem in its non-native range. Here, we demonstrated two methods, conventional and kit method, to maximize eDNA concentration in addition to detect the presence of alligator gar in freshwater ecosystem. We used mesocosm study to mimic the real condition of freshwater system in tropic region. We found that both methods can extract eDNA from water samples. The kit showed better yield of eDNA with average concentration 62.28 ± 22.27 ng/μL than conventional method with average concentration 19.35 ± 9.89 ng/μL. Another advantage of the kit method was better purity of eDNA, with average purity 1.92 ± 0.05 compared to conventional method with average purity 2.23 ± 0.42. The better concentration and purity of eDNA could be advantageous for further analyses such as PCR and DNA sequencing.
Application of DNA barcoding to detect mislabeling of fish fillet products from Jabodetabek’s market
Authors: Widowati T A , Andayani N , Maryanto A E
Published: July 2020

Mislabeling of fish fillet product is one of the key issues in food safety and sustainability. Species identification is an important step of fish fillet traceability and DNA barcoding has been proved as a standard method. Fourty seven 47 fish fillet products were collected from modern and traditional markets in the Jabodetabek area. DNA barcoding was used to analyze the compliance of the product label. This research also highlighted that near threatened (NT), Vulnerable (VU), endangered (EN), and critically endangered (CR) species considered to be facing a high risk of extinction have been used as a substitution in fish fillet product. The application of DNA mini-barcoding gives better resolution in species identification for commercial species. From this research, we found that there are some mislabeled fish fillet products, including blue shark meat that is listed as Near Threatened in IUCN Red List in one of the products.
Unintended consequences: Factors influencing oil palm plantation expansion
Authors: Wongsai S , Keson J , Wongsai N
Published: July 2020

We investigated the landscape variables affecting the current dramatic expansion of oil palm plantations in Lam Thap district Krabi Province Thailand. THEOS satellite data was used to map land use classifications using the support vector machine method. Seven land use classes were consolidated into oil palm plantations and other rural uses. A logistic regression model was then applied to search for the relationship between two land use classes and the landscape variables of slope (three classes) and soil drainage (four classes). Overall, slope and drainage were statistically significant in explaining oil palm plantation expansion. Flat areas with poor drainage were the strongest factors. This contradicts the known optimal agronomic requirements for oil palms of well drainage. We suggest that what is observed is an unintended consequence of government oil palm support policies.
Combination study of magnetic method and 3-D inversion of gravity data to determine the Blawan-Ijen geothermal prospect zone
Authors: Arafat Y , Daud Y , Kumara D A , Fortuna D A , Yunus F M , Avicienna H F , Farhan
Published: July 2020

Integrated measurements of magnetic and gravity methods were carried out over Blawan-Ijen Geothermal Prospect area to discover the indication of prospect zone location more convincing. The acquisition was first conducted in 2017, followed by recent measurement in 2018 with a total of 151 stations for each method. In this research, Reduce to Pole for magnetic data was applied to identify the distribution of demagnetized rock which associated with reservoir zone. The prospect zone is usually indicated by low magnetic susceptibility value. Furthermore, to support the interpretation of prospect zone which usually located overlying the heat source, then 3D inversion of gravity data was conducted. Thus, by applying 3D inversion of gravity method, the distribution of density variation beneath the earth surface which represents the location of heat source can be obtained. The result of Reduce to Pole of magnetic data shows demagnetized zone with low magnetic susceptibility value located in the centre to the southeast at the study area. Moreover, 3D gravity data inversion delineates the existence of heat source indicated by high gravity anomaly which corresponds with demagnetized zone shown from magnetic data.
Replication of wave and tidal sedimentation process on coastal Jakarta revealed by a flume tank experimental approach
Authors: Prayoga J J , Prasojo O A
Published: July 2020

The Tidal wave is one of the main factors that producing sedimentary structure and agent of erosion. Study further about it can help for local people living in the coastal area and for academic learning. The tidal wave was replicated using a flume tank. The sand used is fine-grained that taken from Sawarna beach. To obtain the quantitative Digital Elevation Model (DEM) was used. The DEM data were taken using a laser distance meter after the experiment. Reynold’s Rule was used for scaling down the variable that happens in nature to the experiment scale. There are 3 significant changes as a result of this experiment. First, the sediment was sorted according to the grain size of the sediment. Second, the slope of the coast has changed which is measured by DEM. Third, the sediment structure was created which has a similarity with the one created by nature. So, the result was a proof that Reynold’s scaling down methods can be used to scale down a sedimentary process that happens in nature. This research explains what exactly happens in the formation of a sedimentary structure.
Morphotectonic of volcanic area in Rawa Danau, Banten Province
Authors: Kurniawan A , Indra T L , Syahputra R
Published: July 2020

Rawa Danau is a caldera and considered as an inactive volcano. Based on landscape characteristic the morphology was influenced from volcanic processes. However, many geological structures such as fractures were also found. Our research is trying to understand that the landscape in the Rawa Danau area whether it was controlled by tectonic activity or only by volcanic activity. The analysis of this study compared three different data: ridge linearity and river linearity that were obtained from analysis of satellite imagery. All the data then be compared with the fracture azimuth data obtained through field surveys. The three data were compared with each other by statistical analysis (Mann-Whitney U test), to test the relationship between the three. Based on the data analysis that has been carried out, it can be seen the results of the statistical analysis shows the average difference between the two independent samples, it shows that the area’s landscape is controlled by the volcanic process.
Flume tank experiment: An approach in replicating sequence stratigraphy in a laboratory scale
Authors: Hertiansa R P , Prasojo O A , Indra T L
Published: July 2020

Sequence stratigraphy was a study of layered rocks that form in some period of time. It was proven to be a useful tool in industry, especially oil industry. Yet, sequence stratigraphy most people have seen was the result, not the process. Of which, this study wanted to replicate the process that was taken place in sequence stratigraphy in a smaller scale of a laboratory. To replicate sequence stratigraphy, this study used a flume tank device filled with sand and water flowing with controlled rate. This study makes changes in water level in the flume tank to affect accommodation space, on which sedimentation happens, thus, making some morphological change known as progradation and retrogradation. Changes were recorded using time lapse camera and measured using laser distance meter to see how much the morphology had changed after some period of time. Result of this study showed that transgression and regression could be replicated inside the flume tank by changing the height of water level. Though the time scale could not be made close to real condition, but the process and the result could. This would help understanding sequence stratigraphy not only from the outcrop but also from the series of the process that made it.
Reservoir characterization of gas saturated sandstone using Extended Elastic Impedance (EEI), Poisson Impedance (PI) and Curved Pseudo Elastic Impedance (CPEI)
Authors: Riyadi P , Supriyanto  , Purba H
Published: July 2020

The WR field in this study is a gas hydrocarbon proven field with high saturation rate and reservoir character in tight sandstone. There are prestack 3D seismic data and three well data that have P-wave velocity (Vp) and S-wave velocity (Vs). In its development there are three kind of methods using Vp, Vs, and angle function constants that is Extended Elastic Impedance (EEI), Poisson Impedance (PI), and Curved Pseudo Elastic Impedance (CPEI). By using correlation coefficient concept between two kinds of variable, we can look for the angle function constants which used in those three methods. The results obtained from those three methods correlated with lithology log data (Gamma ray (GR)) at the range of angle (-90° to 90°) is EEI = 30°, PI = 59° and CPEI = -69°, whereas with fluid log target (Water Saturation (SW)) obtained angle values correlated with EEI = 20°, PI = 51° and CPEI = -60°. The highest correlation to the target lithology (GR) and fluid (SW) log data of the three methods is CPEI with correlation 0.881 for lithology and 0.604 for fluid. The vertical of the three methods shows a good reservoir character with high saturation rate of gas. The result of the lateral distribution of the three methods shows the character of the depositional environment in the target reservoir located in the estuarine environment in upper shoreface facies for Reservoir A and transition facies for Reservoir B. The direction trend of the source of the sedimentary sediment is the south-east direction, and this result fits with the regional geological concept in the WR field.
Delineating geothermal system through 3D geomagnetic and gravity data inversion on Blawan Ijen geothermal area, East Java
Authors: Sulistyo A , Daud Y
Published: July 2020

Blawan-Ijen is a caldera hosted geothermal system that located in Bondowoso, East Java. To delineate the existence of the geothermal system of Blawan-Ijen, gravity and geomagnetic studies were conducted. Since no impressive manifestation in this area, to delineate the prospect area is very challenging. Both methods are used to detect the presence of basements and potential heat sources. Gravity data processing was processed to obtain CBA and residual gravity anomalies, while geomagnetic data was processed until reduce to pole. The results of data processing are used for 3D inversion of gravity and geomagnetic data to find out anomaly distribution horizontally and vertically. To understanding potential heat source, 3D inversion results are displayed at an elevation of 500 m to 1,000 m. The existence of resources using the geomagnetic method is represented by a low magnetic anomaly value as an indication of demagnetized rocks, but high gravity anomalies are seen in the demagnetization area. The potential heat source from gravity and geomagnetic interpretation located in the center of the Blawan-Ijen geothermal prospect, that is the northern part of the south mountainous area, those areas are located around Mt. Gendingwuluh and the northern part of Mt. Genteng and Mt. Glaman.
Mount Anak Krakatoa geomorphology modelling with kinect-based augmented reality sandbox based on digital elevation model data
Authors: Jhanesta W , Iskandarsyah  , Nagasie T , Supriyanto  , Syahputra R
Published: July 2020

Indonesia has a diversity of landscapes due to it being located at the confluence of several tectonic plates and traversing the Ring of Fire. This diversity of landscapes creates many interesting geological objects that are used for research in studying geomorphology. The research location for this study focuses on the topographic conditions of Mount Anak Krakatoa located in the Sunda Strait. A volcanic peak can be divided according to its landscape, which is the center of the volcanic eruption at the peak, down towards the slope of the mountain foot, and the terrain around it. This landscape-based division is based on topographical and geographical conditions. These parameters will then be made into a 3-dimensional model. Topographic modelling using Kinect based augmented reality sandbox uses a digital elevation model (DEM) from the GIS. Sandbox modelling data can be accepted when it reaches natural state conditions, i.e. augmented reality sandbox data is compatible with DEM satellite image data. Results from this modelling can then be used for follow-up studies on the geomorphology of Mount Anak Krakatoa with a more direct approach.
Facies distribution and limestone depositional history in Gunung Endut geothermal prospect area, Banten Province
Authors: Imtiyaz R Z , Sihombing F M H , Sahdarani D N , Supriyanto
Published: July 2020

Gunung Endut, located in Banten Province, has geothermal pr ospect area in its mountain slope. Some of the area of Gunung Endut has limestone facies which commonly deposited in marine environment. Based on the regional geological map of Leuwidamar, limestone facies are the member of Bojongmanik Formation within the Bogor Physiographic Zone. In Gunung Endut, limestone was developed during the pre-volcanic period, meanwhile most of limestone in Java are found as outcrop in Southern Mountains Zone formed during the post-volcanic period. This study focused on macroscopic and microscopic identification of limestone in order to determine the distribution of facies and the history of limestone sedimentation in the area of Gunung Endut. The macroscopic and microscopic feature of the rock samples are analyzed and classified using modified Dunham classification by Embry-Klovan. The result of the analyses will provide information about the limestone facies distribution and geological history with better detail in the study area than previously known.
Evaluation of Noise Absorption Capacity of Various Materials
Authors: Singh C , Kumar M , Chandravanshi M L
Published: July 2020

Noise absorption and transmission property of materials is of great importance in order to determine the amount of noise transmitted from source to receiver. Unwanted noise can cause various biological and psychological effects to humans and other organisms in nature. This paper deals with the experimental study on noise absorbing and deflecting ability of various available materials. These materials could be utilized in industrial complexes and building construction applications for noise level reduction purposes. The materials such as glass, plywood, thermocol (scientifically known as polystyrene), fiber plastic sheet and coconut fiber sheet have been used in the experiment as a noise barrier. Through experimental analysis, the reduction noise level was obtained in terms of decibel (dB), sound power level and loss of sound energy using hand held noise analyzer. The finding suggests that thermocol has the best sound absorbing capacity at medium to low sound pressure levels, whereas glass has the best sound absorbing capacity at high sound pressure levels.
Optimization of Laminate Topology for Multilayered Composite Structures Subjected To Buckling and Failure Constraints
Authors: Augustyn M , Muc A
Published: July 2020

In the present paper the combinatorial optimization problems dealing with laminate stacking sequence optimization are formulated and studied. Two types of design variables are introduced: 1) classical, discrete and 2) new, continuous ones. In order to obtain the optimal solution a classical genetic algorithm is applied. We are looking for the maximal buckling loads for 2-D multilayered structures subjected to bimodality constraints and FPF constraints. Two special buckling problems are analyzed in details, i.e. buckling of compressed rectangular plates and of cylindrical shells under an external pressure. The results demonstrate the effectiveness and advantages of the use of continuous design variables.
Constrictive pericarditis after heart transplantation: a case report
Authors: Tchana-Sato Vincent , Ancion Arnaud , Ansart François , Defraigne Jean Olivier
Published: July 2020

Background

Constrictive pericarditis (CP) is a disease characterized by inflammation, progressive fibrosis, and thickening of the pericardium. Constrictive pericarditis after heart transplantation (HT) is a rare phenomenon, with a reported incidence of 1.4–3.9%. It is an important clinical problem which shares similar clinical features with entities such as restrictive cardiomyopathy. Therefore, it poses diagnostic challenges and therapeutic dilemmas even for experienced clinicians.

Case summary

A 53-year-old patient developed a zoster infection with pericardial effusion 9 months after HT for idiopathic dilated cardiomyopathy. Two months later, he presented with leg oedema and ascites and was treated by diuretics for volume overload. He was readmitted 8 months later with features of right heart failure. Multimodal imaging investigations were suggestive of CP. He successfully recovered after a radical pericardiectomy.

Discussion

Constrictive pericarditis is a rare complication in HT. Heart transplant recipients (HTR) with a history of post-operative pericardial effusion, or with rejection episodes are at high risk of developing CP. Differentiating CP from other conditions that cause apparent congestive heart failure in HTR is challenging. Management of CP is mainly surgical pericardiectomy.
Conditioning Effect of Inhalational Anesthetics on Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage
Authors: Athiraman Umeshkumar , Dhar Rajat , Jayaraman Keshav , Karanikolas Menelaos , Helsten Daniel , Yuan Jane , Lele Abhijit V , Rath Girija Prasad , Tempelhoff Rene , Roth Steven , Zipfel Gregory J
Published: July 2020

BACKGROUND

Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH) has been identified as an independent predictor of poor outcome in numerous studies.

OBJECTIVE

To investigate the potential protective role of inhalational anesthetics against angiographic vasospasm, DCI, and neurologic outcome in SAH patients.

METHODS

After Institutional Review Board approval, data were collected retrospectively for SAH patients who received general anesthesia for aneurysm repair between January 1st, 2010 and May 31st, 2018. Primary outcomes were angiographic vasospasm, DCI, and neurologic outcome as measured by modified Rankin scale at hospital discharge. Univariate and logistic regression analysis were performed to identify independent predictors of these outcomes.

RESULTS

The cohort included 390 SAH patients with an average age of 56 ± 15 (mean ± SD). Multivariate logistic regression analysis identified inhalational anesthetic only technique, Hunt-Hess grade, age, anterior circulation aneurysm and average intraoperative mean blood pressure as independent predictors of angiographic vasospasm. Inhalational anesthetic only technique and modified Fishers grade were identified as independent predictors of DCI. No impact on neurological outcome at time of discharge was noted.

CONCLUSION

Our data provide additional evidence that inhalational anesthetic conditioning in SAH patients affords protection against angiographic vasospasm and new evidence that it exerts a protective effect against DCI. When coupled with similar results from preclinical studies, our data suggest further investigation into the impact of inhalational anesthetic conditioning on SAH patients, including elucidating the most effective dosing regimen, defining the therapeutic window, determining whether a similar protective effect against early brain injury, and on long-term neurological outcome exists.
Long-acting GLP-1 receptor agonists
Authors: Urquhart Scott , Willis Stephen
Published: July 2020

Cardiovascular disease (CVD) is a common and serious comorbidity of type 2 diabetes mellitus (T2DM), and cardiovascular (CV) risk assessment has become an important aspect of evaluating new therapies for T2DM before approval by the FDA. Since 2008, in order to establish safety, new therapies for T2DM have been required to demonstrate that they will not result in an unacceptable increase in CV risk. Studies performed for this purpose are termed CV outcome trials, or CVOTs. This article reviews CVOTs completed to date for the class of long-acting glucagon-like peptide-1 receptor agonists (GLP-1RAs; liraglutide, exenatide extended-release, albiglutide, dulaglutide, semaglutide injectable, semaglutide oral) and implications for clinical management of T2DM. All CVOTs have confirmed long-acting GLP-1RAs to be noninferior to (not worse than) placebo with regard to first occurrence of a primary outcome of three-point major adverse cardiovascular events (MACE; composite outcome of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke). Further, a number of the studies demonstrated a statistically significant reduction in primary outcomes of three-point MACE with GLP-1RA treatment compared with placebo. As a result, the product labeling for liraglutide, semaglutide injectable, and dulaglutide has been updated with an indication for reducing the risk of MACE in adults with T2DM and established CVD (all) or multiple CV risk factors (dulaglutide only). These findings have brought about an exciting paradigm shift from concern about not inflicting CV harm to the exciting prospect of reducing risks of CV outcomes. Major diabetes care guidelines now encourage early consideration of GLP-1RA use in patients with atherosclerotic CVD.
Beyond Articulation Agreements: Expanding the Pipeline for Baccalaureate Nursing in Ohio
Authors: Bowles Wendy S. , Sharpnack Patricia , Drennen Carol , Sexton Martha , Bowler Connie , Mitchell Kathleen , Mahowald Jane
Published: July 2020

AIM

This article discusses a regionally located approach to seamless nursing education progression in Ohio. The Ohio Action Coalition supported nursing programs in creating educational pathways involving cooperative efforts of academia and clinical practice to provide access for students to achieve a baccalaureate degree.

BACKGROUND

The Ohio Action Coalition was formed in 2011 and received its first State Implementation Program grant in 2013, with a major focus on promoting seamless academic progression models.

METHOD

The seamless academic progression models have been fully implemented, demonstrating positive results for the progression of baccalaureate-prepared nurses in Ohio.

RESULTS

The efforts in Ohio have demonstrated over a 10 percent increase in baccalaureate-prepared nurses.

CONCLUSION

Ohio is moving the needle for higher education of nurses at a faster rate than average across the nation.
Feasibility and Acceptability of Mobile Phone Self-monitoring and Automated Feedback to Enhance Telephone Coaching for People With Risky Substance Use: The QUIT-Mobile Pilot Study
Authors: Swendeman Dallas , Sumstine Stephanie , Aguilar Efren , Gorbach Pamina M. , Comulada W. Scott , Gelberg Lillian
Published: July 2020

Objectives:

This study evaluates the feasibility, acceptability, and perceived benefits of mobile-phone delivered self-monitoring queries and feedback integrated into the evidence-based Quit Using Drugs Intervention Trial (QUIT) screening and brief telephone health coaching intervention to prevent progression from risky drug use to addiction as the QUIT-Mobile intervention.

Methods:

Participants (n = 20) were primarily Black/African American and Latino men in Los Angeles with risky substance use. Self-monitoring surveys were sent by text-message twice-weekly for 6 weeks and once-weekly from 6 to 12-weeks. Surveys consisted of 10 questions regarding drug and alcohol use (ie, # days of use) and cravings, quality of life, and medication adherence. Feedback messages praised or encouraged drug use reductions. Coaches monitored patient responses and discussed them in QUIT's telephone coaching sessions. Participants’ experiences were assessed qualitatively at 3-month follow-up.

Results:

Nineteen out of 20 participants that completed the qualitative evaluation from the 12-week follow-up reported: (1) self-monitoring surveys helped them adhere to drug use reduction goals and reflect on associations between self-monitoring domains; (2) preference for higher frequency (twice-weekly) self-monitoring during the 6-week coaching period, and then weekly surveys thereafter but not monthly; and (3) self-monitoring and coaching were mutually reinforcing for their drug use reduction goals.

Conclusions:

Results are consistent with prior similar research suggesting that mobile phone self-monitoring of drug use and related factors is feasible and acceptable among diverse adults with risky drug use. Findings also suggest the potential benefits of integrating electronic self-monitoring and feedback into substance use reduction interventions such as QUIT to enhance patient self-management and coaching or counseling intervention components.
The Development and Effectiveness of Combining Case-Based Online Lecture and Simulation Programs to Facilitate Interprofessional Function Care Training in Nursing Homes
Authors: Lee Su Jung , Park Min Sun , Kwon Dai Young , Kim YongCheon , Chang Sung Ok
Published: July 2020

The aim of this study was to (1) develop a case-based combination of online lectures and simulations for function-focused care by nursing home interdisciplinary caregivers and (2) evaluate participants' increasing shared team and task knowledge by surrogate measures of team process and team performance. The study comprised the following steps: (1) the design of a learning module using a shared understanding of function-focused care as a shared mental model; (2) the establishment of two computer programs for online lectures and simulations using cases involving older adults with disabilities; and (3) testing the educational programs using a repeated-measures design. Participants were 61 interdisciplinary caregivers from seven nursing homes in four regions. Data from participants' team process and team performance were collected pre test, post online lecture, and post simulation. Repeated-measures analysis of variance showed that the mean scores for scales of “transactive memory system,” “knowledge sharing and utilization,” “team outcomes,” “motivation for learning transfer,” “self-efficacy,” “interpersonal understanding,” “proactivity in problem solving,” and “function-focused care knowledge” differed significantly between the time points. The results indicate that a case-based program of a combination of online lectures and simulations elicits significant improvements in participants' team process and team performance.
New Sutureless, Scleral-Fixated Intraocular Lens (Carlevale, Soleko) Implantation Combined With Descemet Stripping Automated Endothelial Keratoplasty: An Innovative Surgical Approach
Authors: Kymionis Georgios , Petrelli Myrsini , Schmutz Lydia , Petrovic Aleksandra
Published: July 2020

Purpose:

To describe a novel technique of combined Descemet stripping automated endothelial keratoplasty (DSAEK) with implantation of a new scleral fixated, sutureless, posterior chamber intraocular lens (IOL) (Carlevale, Soleko).

Methods:

A new surgical technique description.

Results:

We describe a novel surgical approach, namely combining implantation of a new scleral-fixated sutureless posterior chamber IOL with DSAEK for the management of IOL dislocation and corneal endothelial decompensation. The existing, dislocated IOL was removed, and 2 scleral radial incisions were performed 180 degrees apart. Two partial thickness scleral pockets were created along each scleral radial incision, followed by a 23 G sclerotomy. The IOL was placed in the posterior chamber by using 23 G vitreoretinal forceps, and each plug was secured under the 2 pockets. A standard DSAEK procedure was then performed. Four months postoperatively, the corneal graft was attached and clear. The Carlevale IOL was well positioned, and an improvement in the patient's vision was observed.

Conclusions:

Combining implantation of a new scleral fixated foldable sutureless IOL (Carlevale, Soleko) with DSAEK could represent a viable and effective option for patients with IOL dislocation or aphakia, accompanied by corneal endothelial dysfunction.
Aspergillus Mimicking a Rasmussen Aneurysm in an Immunocompromised Setting Causing Massive Hemoptysis
Authors: Kumar Anil A. , Ramsakal Asha , Greene John N.
Published: July 2020

Aspergillus is a ubiquitous mold found in diverse environments but is mostly limited to infectious complications in immunocompromised patients. Invasive pulmonary aspergillosis (IPA) is a common infection in leukemic patients with prolonged neutropenia. However, mycotic pulmonary artery aneurysm (PAA) is a very rare complication of IPA. We describe the case of a 58-year-old patient with prolonged neutropenia and leukemia who developed invasive aspergillosis, followed by unexpected massive hemoptysis and terminal exsanguination. Surgical resection of IPA in leukemic patients is rarely performed because of early recognition and initiation of preemptive potent antifungals, pancytopenia, bleeding diathesis, and delayed wound healing. Historically, tuberculosis and syphilis were major causes of PAA, but their incidence has decreased significantly since the advent of effective antibiotics. We review nontuberculous causes of PAA and outline the pathology, diagnosis, and treatment options currently available. Currently, Staphylococcus species, Streptococcus species, and Aspergillus species account for 70% cases of PAA.
Validation of the Drip Score at A Community-Teaching Hospital
Authors: Purewal Jaskaran , Kanagala Komali , King Esther A. , Anghel Sharen
Published: July 2020

Rationale

Recent data suggest that health care–associated pneumonia (HCAP) criteria has poor predictive value in determining risk for drug-resistant pathogens (DRPs) and leads to increased use of broad-spectrum antibiotics. The Drug Resistance in Pneumonia (DRIP) Score highlights a selective set of criteria to predict pneumonia risk. Validation studies show conflicting results on the impact of antibiotic selection based on the DRIP score.

Methods

This was a retrospective chart review of hospitalized patients from March 2018 to April 2018 who were started on antibiotics for a respiratory tract infection. The HCAP criteria and DRIP scores were calculated and antibiotic selection was analyzed. The primary focus was to determine if utilization of the DRIP score could modify antipseudomonal beta-lactam (APBL) prescribing patterns.

Results

A total of 82 patients were included in the study. Sixty-four (78%) patients had a DRIP score <4 with 19 (30%) receiving an APBL. There were 18 patients with a DRIP score >4, and 7 (39%) patients received non-APBL antibiotics. The HCAP criteria and subsequent prescribing was also analyzed. Forty-nine patients were identified as not meeting HCAP criteria. Of these patients, 12 (24%) received APBL. Thirty-three patients met HCAP criteria, and 15 (45%) received a non-APBL. If HCAP criteria were used to guide antibiotic prescribing, we would see a net increase of 3% in APBL use; whereas if DRIP scores were implemented, we would see a net decrease of 14% in APBL use.

Conclusions

Our study indicates that implementation of the DRIP score would result in decreased empiric APBL use.
Bordetella trematum Bacteremia Resulting in Sepsis: Case Report and Review of the Literature
Authors: Hummel Connor J. , Buechler Kristin , Webb Kellianne , Amsden Jarrett
Published: July 2020

Bordetella trematum has been isolated from various sources, including wounds, peritoneal fluid, bone, and blood. We report on a new case of B. trematum bacteremia caused by an unknown source in an adult who experienced rapid clinical deterioration despite clearing blood cultures with broad-spectrum antibiotics.
A Component-Based Coordinate System for Static and Dynamic Evaluation of Standard Transtibial Prosthesis Alignment
Authors: Zabala Michael E. , Gupta Raju , Dueitt Madeline , Pasquerello Nicholas , Vazquez Adan
Published: July 2020

Introduction

Lower-limb loss is a disability that is currently estimated to affect more than one million Americans. Provision of a prosthetic lower limb oftentimes restores the ability of the individual to reengage in society by returning to work, sports, military service, or other activities requiring mobility. However, it is critical that these devices are properly aligned to avoid or reduce discomfort, pain, and even serious bone disorders such as osteoarthritis, osteopenia, and osteoporosis. Much work has been done on static prosthesis alignment measurement, and devices and tools currently exist to aid the prosthetist in this task. However, to the authors' knowledge, there is currently no standardized coordinate system for objectively calculating and expressing prosthesis alignment that can be used during both static and dynamic activities.

Methods

The techniques presented here provide a method of creating component-specific coordinate systems for a standard transtibial prosthesis for the purpose of calculating objective measures of alignment while the prosthesis is being worn during both static and dynamic activities. This method is based upon a selection of anatomically relevant points tracked on the residual limb and the prosthesis, along with Euler angle decomposition techniques. A case study analysis was performed on one transtibial test subject to demonstrate the methods presented.

Results

A method for tracking both static and dynamic transtibial prosthesis alignment was established. This method may be used with modern motion-tracking technology that was not widely available when previous static alignment methods were established.

Conclusions

The potential benefit of this standardized method is improved understanding of the relationship between objective measures of prosthesis alignment and various measures of patient outcomes and success such as pain, discomfort, and daily steps walked. A standardized means of calculating and expressing prosthesis alignment will also benefit the design and development of future alignment tool technology.
Adjusting Socket Size Using a Cell Phone App: Observations from Participants with Transtibial Amputation
Authors: Allyn Katheryn J. , Larsen Brian G. , Sanders Joan E.
Published: July 2020

Introduction

An investigation of how prosthesis users chose to adjust their socket size using a cell phone app provides insight relevant to patient care.

Materials and Methods

Participants with transtibial amputation used a motor-driven adjustable socket controlled with a cell phone app to adjust their socket size during an outdoor testing protocol. After donning their socket and adjusting socket size during standing, participants walked for two 20-minute bouts separated by a 5-minute sit, making socket size adjustments as desired.

Results

The 12 participants in this study executed a wide range of socket size adjustment strategies. During donning, some participants fully seated the locking pin before tightening the panels, whereas others chose to tighten the panels first. Some participants executed panel adjustment during weight shifting while standing. Some participants tightened to a too-tight setting, then backed off 1 increment; some slowly tightened or loosened at 1-increment steps until a preferred setting was achieved; and some tightened the socket in anticipation of terrain changes that were visually apparent ahead.

Conclusions

Data from this study provide a starting point for how practitioners may expect their patients to use a phone app that adjusts socket size.
Do Upper-Limb Loss and Prosthesis Use Affect Lower-Limb Gait Dynamics?
Authors: Armstrong Kiley , Brinkmann John T. , Stine Rebecca , Gard Steven A. , Major Matthew J.
Published: July 2020

Introduction

Intentional interruption of upper-limb and lower-limb coordination of able-bodied subjects alters their gait biomechanics. However, the effect of upper-limb loss (ULL) on lower-limb gait biomechanics is not fully understood. The aim of this secondary study was to perform a follow-up analysis of a previous dataset to characterize the spatiotemporal parameters and lower-limb kinematics and kinetics of gait for persons with ULL when wearing and not wearing an upper-limb prosthesis (ULP). We were particularly interested in quantifying the effects of matching the mass and inertia of the prosthetic limb to the sound limb.

Materials and Methods

Ten persons with unilateral ULL walked at a self-selected speed under three randomly presented conditions: 1) not wearing a prosthesis; 2) wearing their customary prosthesis; and 3) wearing a mock prosthesis that can be adjusted to match the length, mass, and inertial properties of each subject's sound limb. Walkway-embedded force plates and a 12-camera digital motion capture system recorded ground reaction forces (GRFs) and retroreflective marker position data, respectively. Average spatiotemporal (walking speed, cadence, stance time, swing time, step length, double support time), lower-limb kinematic (joint angles), and lower-limb kinetic (ground forces, joint moments and powers) data were processed, and their statistical significance values were analyzed.

Result

Walking speed for each condition was nearly equivalent (1.20 ± 0.01 m/s), and differences between condition were nonsignificant (P = 0.769). The interaction effect (side × prosthesis) was significant for peak hip extension (P = 0.01) and second peak (propulsive) vertical GRF (P = 0.028), but separate follow-up analyses of both main effects were not significant (P ≥ 0.099). All other main effect comparisons were not significant (P ≥ 0.102).

Conclusions

Although the sample cohort was small and heterogeneous, the results of this study suggest that persons with unilateral ULL did not display significant limb side asymmetry in lower-limb gait spatiotemporal, kinetic, and kinematic parameters, regardless of ULP use.
Impact of the Affordable Care Act Medicaid Expansion on Utilization of Mental Health Care
Authors: Breslau Joshua , Han Bing , Lai Julie , Yu Hao
Published: July 2020

Background:

The Affordable Care Act’s Medicaid expansions (ME) increased insurance coverage for low-income Americans, among whom unmet need for mental health care is high. Empirical evidence regarding the impact of expanding insurance coverage on use of mental health services among low income and minority populations is lacking.

Methods:

Data on mental health service use collected between 2007 and 2015 by the Medical Expenditures Panel Survey from nationally representative cross-sectional samples of low income (income<138% of the federal poverty line) adults were analyzed. Use trends among people in states that expanded Medicaid (ME states; n=29,827) were compared with concurrent trends among people in states that did not (non-ME states; n=22,873), with statistical adjustment for demographic characteristics and psychological distress.

Results:

Annual outpatient visits for mental health conditions increased by 0.513 (0.053–0.974) visits per person, from a baseline rate in ME states of 0.894 visits per person. However, no significant changes were observed in number of mental health related hospital stays, emergency department visits or prescription fills. The increase outpatient visits was limited to Hispanics and non-Hispanic Whites, with no increase in service use observed among non-Hispanic Blacks. There was no apparent increase in the number of users of outpatient mental health care (AOR=0.992, P=0.942) and a marginally significant (P=0.096) increase of 3.144 visits per user.

Discussion:

ME had a limited but positive impact on use of mental health services by low income Americans, although it may also have increased racial/ethnic disparities.
National Evaluation of Patient Preferences in Selecting Hospitals and Health Care Providers
Authors: Ellis Ryan J. , Yuce Tarik K. , Hewitt Daniel B. , Merkow Ryan P. , Kinnier Christine V. , Johnson Julie K. , Bilimoria Karl Y.
Published: July 2020

Background:

Patient utilization of public reporting has been suboptimal despite attempts to encourage use. Lack of utilization may be due to discordance between reported metrics and what patients want to know when making health care choices.

Objective:

The objective of this study was to identify measures of quality that individuals want to be presented in public reporting and explore factors associated with researching health care.

Research Design:

Patient interviews and focus groups were conducted to develop a survey exploring the relative importance of various health care measures.

Subjects:

Interviews and focus groups conducted at local outpatient clinics. A survey administered nationally on an anonymous digital platform.

Measures:

Likert scale responses were compared using tests of central tendency. Rank-order responses were compared using analysis of variance testing. Associations with binary outcomes were analyzed using multivariable logistic regression.

Results:

Overall, 4672 responses were received (42.0% response rate). Census balancing yielded 2004 surveys for analysis. Measures identified as most important were hospital reputation (considered important by 61.9%), physician experience (51.5%), and primary care recommendations (43.2%). Unimportant factors included guideline adherence (17.6%) and hospital academic affiliation (13.3%, P<0.001 for all compared with most important factors). Morbidity and mortality outcome measures were not among the most important factors. Patients were unlikely to rank outcome measures as the most important factors in choosing health care providers, irrespective of age, sex, educational status, or income.

Conclusions:

Patients valued hospital reputation, physician experience, and primary care recommendations while publicly reported metrics like patient outcomes were less important. Public quality reports contain information that patients perceive to be of relatively low value, which may contribute to low utilization.