bluuebunny/crossref_metadata_2025 huggingface dataset:
PP19 Use and impact of the pre-hospital 12-lead electrocardiogram in the primary PCI era (PHECG2): mixed methods study protocol
Authors: Gavalova Lucia , Halter Mary , Snooks Helen , Gale Chris , Weston Clive , Watkins Alan , Munro Scott , Davies Glenn , Hampton Chelsey , Driscoll Timothy , Quinn Tom
Published: September 2019

Background

The pre-hospital 12-lead electrocardiogram (PHECG) is recommended in patients presenting to emergency medical services (EMS) with suspected acute coronary syndrome (ACS). Prior research found PHECG was associated with improved 30-day survival, but a third of ACS patients under EMS care did not have PHECG. Such patients tended to be female, older and/or with comorbidities. This previous study was undertaken when thrombolytic treatment was the main treatment for ST segment elevation myocardial infarction (STEMI); practice has since shifted to a predominant interventional strategy – primary percutaneous coronary intervention (pPCI). Moreover, the previous study relied solely on data collected by the Myocardial Ischaemia National Audit Project (MINAP), which does not include information on symptoms, EMS personnel gender, and other factors that may influence decision-making. The PHECG2 study addresses the following research questions: a) Is there a difference in 30-day mortality and reperfusion between those who do and do not receive PHECG? b) Has the proportion of eligible patients who receive PHECG changed since the introduction of pPCI networks? c) Are patients that receive PHECG different from those that do not in social and demographic factors, and in pre-hospital clinical presentation? d) What factors do EMS clinicians report as influencing their decision to perform PHECG?

Methods

Explanatory sequential Quan-Qual mixed methods study comprising 4 Work Packages (WPs): WP1 a population based, linked data analysis of MINAP from 2010–2017 (n=510,000); WP2 retrospective chart review of EMS records from 3 EMS; WP3 focus groups with personnel from 3 EMS. WP4 will synthesise findings from WP1-3.

Conclusions

Gaining an understanding into the clinical and non-clinical factors influencing EMS clinicians’ decisions to record PHECG will enable us to develop (and later test through a randomised trial) an intervention to improve PHECG uptake and patient outcomes following an ACS event.
PP20 A retrospective service evaluation of the presentation of anaphylaxis to a UK ambulance service
Authors: Groom Nicholas , Taylor Sarah , England Ed , Pocock Helen , Deakin Charles D
Published: September 2019

Background

There is a lack of data relating to frequency and presentation of anaphylaxis to the ambulance service in England. Little research exists relating to the patients’ self-treatment of anaphylaxis and there is an absence of evidence to evaluate the impact of self-administered adrenaline, there is a need to describe this patient group to evaluate any potential to develop their care.

Methods

Retrospective data were collected from the electronic patient records of a single NHS ambulance service serving a population of approximately four million. Records between 1stApril 2017 and 31stMarch 2018 were included where a diagnosis of anaphylaxis was recorded. Gender, age, incident location, allergy history, were summarised to identify any trends in presentation. The frequency of patient self-administration, as well as ambulance administration, of adrenaline was also included for analysis to determine any correlation.

Results

326 records were included in the analysis. The mean, median and modal patient ages were 34, 29 and 20 respectively. Patient ages ranged from six months to 95 years. Patients were 65% female, 35% male and 59% of incidents occurred at home. 76% of patients reported having a known allergy with food being the most common allergen (44%). Peak times for calling 999 were midday and 6pm. 35% of patients had self-administered adrenaline. 52% received ambulance-administered adrenaline. The doses of self-administered adrenaline ranged from 0–3 doses and ambulance administered adrenaline ranged from 0–8 doses. Patients who self-administered adrenaline were less likely to receive further adrenaline from the ambulance service. No correlation was found between the number of self-administered doses and ambulance administered doses.

Conclusion

Patient demographics such as age, gender and allergies were consistent with two previous small-scale studies. This study suggests that early self-administration of adrenaline is beneficial. Opportunities for improvements in data recording as well as patient education were identified.
03 Opioid overdose death in wales from 2012 to 2015: a linked data autopsy study
Authors: Jones Matthew , Watkins Alan , Bulger Jenna , John Ann , Snooks Helen , Bradshaw Ceri , Fuller Gordon
Published: September 2019

Background

Opioids account for more fatalities by overdose than any other drug. Fatal opioid overdose is a growing public health problem, with incidence rising in western countries especially. We sought to describe the deaths, sociodemographic characteristics, and service usage patterns of decedents of opioid overdose in Wales.

Methods

We carried out a retrospective cross-sectional analysis of opioid related deaths in Wales identified from Office for National Statistics data between 01/01/2012 and 31/12/2015, in Wales, UK.

Routine data were captured from Office of National Statistics (ONS), the Welsh Demographic Service and National Health Service datasets for the preceding three years and linked using a deterministic algorithm. Demographic, socioeconomic, clinical and service use characteristics were detailed using descriptive statistics.

Results

The majority of opioid overdose deaths (n=312) occurred at home (n=253, 81.09%) and were accidental (n=262, 83.97%). A third (31.09%) involved heroin as the main object of injury (n=97). Decedents were mostly male (n=228, 73.1%) and lived in socioeconomically deprived (lacking in material and social opportunities and/or resources) areas at the time of their death (n=199, 63.75%). The majority of decedents changed address at least once during the 36 month observation period prior to death (n=169, 53.85%), but rarely moved far geographically (e.g. were resident in more than two postcode areas). The majority of decedents visited the emergency department (n=227, 72.76%), were admitted to hospital (n=199, 63.78%) – usually for mental health problems – and were recorded at least one General Practitioner episode (n=258, 82.69%) during the observation period. A minority of decedents used drug treatment services (n=72, 23.08%).

Conclusions

Opioid overdose deaths occur most commonly secondary to heroin use. Decedents demonstrate a peripatetic lifestyle and are rarely engaged with drug treatment services. Frequent contact with unscheduled care providers might present a target for preventative interventions.
OP6 A qualitative study on conveyance decision-making during emergency call outs to people with dementia: The HOMEWARD project
Authors: Voss Sarah , Kirby Kim , Brandling Janet , Benger Jonathan
Published: September 2019

Objectives

Ambulance staff are increasingly required to make complex decisions as to whether they should convey a patient to hospital or ‘see and treat’ at the scene. Dementia can be a significant barrier to the assessment of pain and injury. However, to our knowledge no research has specifically examined the process of decision-making by ambulance staff in relation to people with dementia. This qualitative study was designed to investigate the factors influencing the decision-making process during ambulance calls to older people with dementia.

Methods

This qualitative study used a combination of observation, interview and document analysis, to investigate the factors influencing the decision-making process during ambulance calls to older people with dementia. A researcher worked alongside ambulance crews in the capacity of observer and recruited eligible patients to participate in case studies. Data were collected from observation notes of decision-making during the incident, patient care records and post incident interviews with participants, and analysed thematically.

Results

Four main themes emerged from the data concerning the way that paramedics make decisions in people with dementia: Physical Condition; the key factor influencing paramedics’ decision-making was the physical condition of the patient. Cognitive Capacity; most of the participants preferred not to remove patients with a diagnosis of dementia from surroundings familiar to them, unless they deemed it absolutely essential. Patient Circumstances; this included the patient’s medical history and the support available to them. Professional Influences; paramedics also drew on other perspectives to inform their decision-making.

Conclusion

The preference for avoiding unnecessary conveyance for patients with dementia, combined with difficulties in obtaining an accurate patient medical history and assessment, mean that decision-making can be especially challenging. Further research is needed to find reliable ways of assessing patients and accessing information to support conveyance decisions for ambulance calls to people with dementia.
PP8 Trauma and the obesity epidemic: a systematic review of the impact of obesity on trauma mortality and morbidity
Authors: Mayer Simon , Lahiri Sumitra , Rowles Joseph
Published: September 2019

Background

Trauma and obesity are both current global epidemics. A simple way to measure the body habitus of patients, to identify the overweight or obese is via the internationally recognized calculation of body mass index (BMI). The primary aim of this systematic review is to assess the mortality rate of those patients with a BMI>30 kg/m2in relation to traumatic injury and secondly to assess the effect of those patients with BMI>30 kg/m2upon the length of stay in hospital with regards to traumatic injury.

Method

A systematic review of the literature was conducted via an internet search of databases and hand searching of references in identified publications from 1stJanuary 1990 to 17thFebruary 2018. Data was extracted from identified publications to include odds ratios of mortality and total length of stay in hospital (days) for patients with a BMI>30 kg/m2from included studies when compared to patients with a BMI <24.9 kg/m2.

Results

A total of 23 studies met the inclusion criteria. 32, 378 patients were admitted to hospital with a BMI>30 kg/m2and recorded injury severity score (ISS). Data collated identified BMI>30 kg/m2OR 1.66 (95% CI 0.75 – 4.2) vs BMI <24.9 kg/m2OR 0.93 (95% CI 0.82–1.5) to suffer mortality. ISS, BMI>30 kg/m2–19.93 vs 22.3 respectively. Furthermore, those categorised as BMI>30 kg/m2have 3.78 additional days in the hospital compared to those defined as normal weight.

Conclusion

This systematic review presents a strong relationship of increased mortality and complications in trauma patients with BMI>30 kg/m2. Complications are suggestive of those who have a BMI>30 kg/m2are more likely to suffer detrimental effects following trauma predominantly due to pre-existing unknown co-morbidities. Although, the direct relationship between obesity, trauma and mortality is not fully understood at present and requires more research.
Presence of pathogenic copy number variants (CNVs) is correlated with socioeconomic status
Authors: Burghel George J , Khan Unzela , Lin Wei-Yu , Whittaker William , Banka Siddharth
Published: September 2019

Socioeconomic status (SES) is a major determinant of health. We studied the Index of Multiple Deprivation Rank of 473 families with individuals with pathogenic autosomal copy number variants (CNVs) and known inheritance status. The IMDR distribution of families with pathogenic CNVs was significantly different from the general population. Families with inherited CNVs were significantly more likely to be living in areas of higher deprivation when compared with families that had individuals with de novo CNVs. These results provide unique insights into biological determinants of SES. As CNVs are relatively frequent in the general population, these results have important medical and policy consequences.
Computational wave solutions of generalized higher-order nonlinear Boussinesq dynamical wave equation
Authors: Seadawy Aly R. , Yaro David , Lu Dianchen
Published: September 2019

A Riccati equation rational expansion (RERE) method is implemented to attain solutions of nonlinear partial differential equations (NLPDEs). Subsequently, the technique is used to attain families or sets of nonlinear solutions for the third extended fifth-order nonlinear equation and the generalized (2 + 1)-dimensional Boussinesq equation. By the use of the RERE method, exciting and new forms of solution such as rational solitary wave solutions, solitary wave solutions and periodic solitary wave solutions are obtained. Some of the solutions are demonstrated graphically with specific values assigned to the parameters. It is worth noting that the application of this method is very effective and reliable.
Fast–Slow Dynamics and Bifurcation Mechanism in a Novel Chaotic System
Authors: Huang Lan , Wu Guoqing , Zhang Zhengdi , Bi Qinsheng
Published: September 2019

This paper proposes a novel three-dimensional chaotic system with multiple coexisting attractors, where different values of a constant control parameter may drive the chaotic behaviors to evolve from single-scroll to double-scroll attractors. When the controlling term is replaced by a periodic harmonic excitation where the exciting frequency is far less than the natural frequency, chaotic movement may disappear, while periodic bursting oscillations will take place. Based on the fact that during a period defined by the natural frequency, the exciting term keeps almost a constant, the whole exciting term can be regarded as a slow-varying parameter resulting in a generalized autonomous system, its equilibrium branches as well as the related bifurcations occurring with the variation of the slow-varying parameter are derived. With the increase of the exciting amplitude, asymmetric and symmetric bursting attractors can be observed, for which the mechanism can be analyzed by the overlap of the equilibrium branches and the transformed phase portraits. With different values of the exciting amplitude corresponding to the change region of the slow-varying parameter, different bifurcations such as fold and Hopf bifurcations may involve the bursting structures, leading to different types of bursting oscillations. Furthermore, the phase space can be divided into two regions by a line boundary because of the symmetry of the vector field. When the trajectory from one region returning to the region arrives at the boundary, two asymmetric bursting attractors located in different regions coexist, which are symmetric to each other. However, when the trajectory passes across the boundary, an enlarged symmetric bursting attractor can be observed, whose trajectory connects the two original asymmetric attractors. Furthermore, it is found that when the trajectory runs along a stable equilibrium branch to the bifurcation point, it may move almost strictly along an unstable equilibrium branch of the fast subsystem because of the delay influence of the bifurcation.
Periodic Orbits and Chaos in Nonsmooth Delay Differential Equations
Authors: Bel Andrea , Cobiaga Romina , Reartes Walter
Published: September 2019

In this paper, we present a method to find periodic solutions for certain types of nonsmooth differential equations or nonsmooth delay differential equations. We apply the method to three examples, the first is a second-order differential equation with a nonsmooth term, in this case the method allows us to find periodic orbits in a nonlinear center. The two remaining examples are first-order nonsmooth delay differential equations. In the first one, there is a stable periodic solution and in the second, the presence of a chaotic attractor was detected. In the latter, the method allows us to obtain unstable periodic orbits within the attractor. For large values of the delay, both examples can be seen as singularly perturbed delay differential equations. For them, an analysis is performed with an associated discrete map which is obtained in the limit of large delays.
Anti-Control of Chaos for First-Order Partial Difference Equations via Sine and Cosine Functions
Authors: Liang Wei , Zhang Zihan
Published: September 2019

In this paper, anti-control of chaos for first-order partial difference equations with nonperiod boundary condition is studied. Three new chaotification schemes for first-order partial difference equations with sine and cosine functions are established, respectively. It is proved that all the systems are chaotic in the sense of both Devaney and Li–Yorke by applying coupled-expanding theory of general discrete dynamical systems. Two illustrative examples are provided with computer simulations
Unlocking data to improve public policy
Authors: Hastings Justine S. , Howison Mark , Lawless Ted , Ucles John , White Preston
Published: September 2019

When properly secured, anonymized, and optimized for research, administrative data can be put to work to help government programs better serve those in need.
Consumer-grade fabrication and its potential to revolutionize accessibility
Authors: Mankoff Jennifer , Hofmann Megan , Chen Xiang 'Anthony' , Hudson Scott E. , Hurst Amy , Kim Jeeeun
Published: September 2019

Digital fabrication technologies open new doors---and challenges---for real-world support.
What is a chief security officer good for?
Authors: Neville-Neil George V.
Published: September 2019

Security requires more than an off-the-shelf solution.
High Hydrostatic Pressure-Assisted Extraction of High-Molecular-Weight Melanoidins from Black Garlic: Composition, Structure, and Bioactive Properties
Authors: Zhao Yimeng , Jiang Yongli , Ding Yanfang , Wang Danfeng , Deng Yun
Published: September 2019

Melanoidin is one of the most important ingredients in black garlic due to the high nutritional values and biological functions. High hydrostatic pressures from 200 to 500 MPa were employed to extract the melanoidins from black garlic for improving the extraction efficiency and enhancing the activities. The results indicated that total phenolics, flavonoids, and sugar yields were all increased when pressure was applied and the antioxidant and overall reducing power was maximized. The bioactive properties of protein tyrosine phosphatase 1B, angiotensin-converting enzyme, and trypsin inhibitory activities were also enhanced compared with the control. Moreover, FT-IR spectroscopy indicated high pressure altered the melanoidin structures to different degrees. It was found that an application of 300 MPa for 5 min was the optimal treatment protocol under all operating conditions.
A Central Symmetrical and Low-Profile Omnidirectional Circularly Polarized Antenna
Authors: Wu Zhe , Yang Lin , Wu Jiaji , Wu Zhensen , Li Xi , Yun Yu
Published: September 2019

In this paper, a compact circularly polarized (CP) antenna with omnidirectional radiation is presented, which has a central symmetric configuration (CSC) and planar structure. It consists of three identical end-fire CP antenna units. Based on the combination of two parallel complementary current sources, each unit cell can be realized by a scalloped cavity and a couple of curved strip lines. Due to a single-layer circular structure with low profile, this configuration can be excited by a coaxial probe in the centre of the whole frame simultaneously. In addition, this prototype was miniaturized with a diameter of 32 mm (0.266λr, the wavelength of the centre frequency in free space is represented by λr) and a height of 1.5 mm (0.012λr). Centre resonance frequency 2.492 GHz is selected, resulting in an omnidirectional radiation and impedance bandwidth (VSWR ≤ 2) of 25 MHz (2481–2506 MHz).
Research on a Unified Framework Based on Linear Frequency Modulation and Orthogonal Frequency-Division Multiplexing
Authors: Zhang Tianhong , Xu Limei , Qin Kaiyu , Yan Xiao
Published: September 2019

This paper proposes a unified system framework based on linear frequency modulation (LFM) and orthogonal frequency-division multiplexing (OFDM) as a solution for resource sharing, especially sharing space and hardware. The proposed OFDM-LFM framework can not only transmit data flow by OFDM but also make it possible to extract features from the signal by LFM. Further, the signal features are used to construct a pseudospectrum related to the target speed and distance, thereby estimating the speed and distance of the target. Unified means using signal features to estimate target speed and distance while ensuring data transmission including communication and remote control data information. Besides the traditional data transmission mode, the ability of estimating target speed and distance is an additional benefit. The proposed unified framework makes control of transmission easier and saves more hardware resources. The simulation results show that the proposed LFM-OFDM framework can not only transmit data information including communication and remote control data information, but also estimate the speed and distance of the target by its signal features.
Inhibitory Substances Produced by NativeLactobacillus plantarumUTNCys5-4 Control Microbial Population Growth in Meat
Authors: Tenea Gabriela N. , Guaña Juan Martin
Published: September 2019

Microbial contamination is the cause of extensive economic loss in the food sector. Previously, the wide-range antimicrobial capacity of inhibitory substances secreted by theLactobacillus plantarumUTNCys5-4 strain was demonstratedin vitro; however, its mechanism of action in the food matrix remains unclear. This study was aimed to evaluate the effect of antimicrobials produced by the Cys5-4 strain in raw meat applied as pure cell cultures, cell-free supernatant (CFS), and partially purified peptides. The bacteriological results indicated the presence of commensal microbes exhibiting resistance to several antibiotics in meat samples purchased from the local market. Dipping solutions containing antimicrobial substances produced by Cys5-4 resulted in a decrease by 1.91,1.69, and 1.55 log10in cell counts upon addition of CFS, peptides and respectively pure cell culture in raw meat at day 9 of storage with refrigeration. The microbial population was maintained in the untreated meat samples during storage. An increase in pH and a concentration of released ammonia was detected in nontreated meat, indicating protein degradation. The Cys5-4 peptides exerted their bacteriolytic mode of action inducing damage in the cell membrane of the target bacteria, allowing the leaching of DNA/RNA content. The results indicate that coating meat with CFS containing Cys5-4 is a promising approach to protect against further contamination by microorganism spoilage, as well as an alternative for increasing the shelf life of raw meat.
Effects of Cognitive Performance and Affective Status on Fatigue in Parkinson’s Disease
Authors: Spirgi Susan , Meyer Antonia , Calabrese Pasquale , Gschwandtner Ute , Fuhr Peter
Published: September 2019

Background: Fatigue is a common non-motor symptom in Parkinson’s disease (PD) and is typically assessed via self-reported questionnaires such as the Parkinson’s Fatigue Scale (PFS). The PFS captures the presence of subjective experience of physical fatigue as well as its impact on daily functioning. Objectives: We aimed to investigate whether different variables (cognition, neuropsychiatric symptoms, disease-related measures) are associated with the experience of physical fatigue in comparison to fatigue affecting daily functioning. Method: Sixty-two non-demented PD patients were evaluated through questionnaires assessing fatigue, daytime sleepiness, apathy, depression, anxiety, and cognition. Items of fatigue were classified and summarized into two index variables measuring either the subjective experience of physical fatigue or the impact of fatigue on daily functioning. Linear regression with a stepwise elimination procedure was conducted to select the significant predictors for each index variable separately. Results: Subjective experience of physical fatigue (Model 1; r2 = 0.46; p <0.01) was significantly associated with higher levels of depression (b =0.07; p <0.01), anxiety (b =0.03; p <0.05), and lower performances in verbal episodic memory (b =–0.16; p <0.05). Fatigue affecting daily functioning (Model 2; r2 = 0.44; p <0.05) was significantly related to higher levels of depression (b = 0.07; p < 0.01), anxiety (b = 0.03; p > 0.05), and lower motor functioning (b = 0.01; p = 0.05). Conclusions: In conclusion, our work supports associations between fatigue and other neuropsychiatric symptoms in PD and extends prior work suggesting that motor disturbances are specifically linked to fatigue-related impairment of daily functioning, but not to the subjective experience of physical fatigue.
A Multicenter, Scan-Rescan, Human and Machine Learning CMR Study to Test Generalizability and Precision in Imaging Biomarker Analysis
Authors: Bhuva Anish N. , Bai Wenjia , Lau Clement , Davies Rhodri H. , Ye Yang , Bulluck Heeraj , McAlindon Elisa , Culotta Veronica , Swoboda Peter P. , Captur Gabriella , Treibel Thomas A. , Augusto Joao B. , Knott Kristopher D. , Seraphim Andreas , Cole Graham D. , Petersen Steffen E. , Edwards Nicola C. , Greenwood John P. , Bucciarelli-Ducci Chiara , Hughes Alun D. , Rueckert Daniel , Moon James C. , Manisty Charlotte H
Published: September 2019

Background:

Automated analysis of cardiac structure and function using machine learning (ML) has great potential, but is currently hindered by poor generalizability. Comparison is traditionally against clinicians as a reference, ignoring inherent human inter- and intraobserver error, and ensuring that ML cannot demonstrate superiority. Measuring precision (scan:rescan reproducibility) addresses this. We compared precision of ML and humans using a multicenter, multi-disease, scan:rescan cardiovascular magnetic resonance data set.

Methods:

One hundred ten patients (5 disease categories, 5 institutions, 2 scanner manufacturers, and 2 field strengths) underwent scan:rescan cardiovascular magnetic resonance (96% within one week). After identification of the most precise human technique, left ventricular chamber volumes, mass, and ejection fraction were measured by an expert, a trained junior clinician, and a fully automated convolutional neural network trained on 599 independent multicenter disease cases. Scan:rescan coefficient of variation and 1000 bootstrapped 95% CIs were calculated and compared using mixed linear effects models.

Results:

Clinicians can be confident in detecting a 9% change in left ventricular ejection fraction, with greater than half of coefficient of variation attributable to intraobserver variation. Expert, trained junior, and automated scan:rescan precision were similar (for left ventricular ejection fraction, coefficient of variation 6.1 [5.2%–7.1%],
P
=0.2581; 8.3 [5.6%–10.3%],
P
=0.3653; 8.8 [6.1%–11.1%],
P
=0.8620). Automated analysis was 186× faster than humans (0.07 versus 13 minutes).

Conclusions:

Automated ML analysis is faster with similar precision to the most precise human techniques, even when challenged with real-world scan:rescan data. Assessment of multicenter, multi-vendor, multi-field strength scan:rescan data (available at
www.thevolumesresource.com
) permits a generalizable assessment of ML precision and may facilitate direct translation of ML to clinical practice.
Observations of Island Wakes at High Rossby Numbers: Evolution of Submesoscale Vortices and Free Shear Layers
Authors: Chang Ming-Huei , Jan Sen , Liu Chih-Lun , Cheng Yu-Hsin , Mensah Vigan
Published: September 2019

Oceanic vortex evolution on the lee side of Taiwan’s Green Island (~7 km in diameter), where the Kuroshio flows at a speed of 1–1.5 m s−1, is observationally examined and compared to theories and the preceding results of laboratory experiments. In the near wake, recirculation occurs with a relative vorticity of ζ ~ 20f (where f is the planetary vorticity) and subsequently sheds at a combination of periods resulting from the tidal oscillations and the intrinsic time scale of eddy evolution. The tidal oscillations are the predominant processes. Our analysis suggests that an island positioned in the Kuroshio with periodic and cross-stream tidal excursions is analogous to a cross-stream oscillating cylinder. Consequently, the shedding period of the vortex is synchronized to a tidal period occurring close to the intrinsic period. The free shear layer, which is characterized by an ~30f relative vorticity band (2 km wide) and a wavy thermal front, develops between the Kuroshio and recirculation. The frontal wave occurring over a time period of 0.5–2 h resembles Kelvin–Helmholtz instability corresponding to high Re values. For the far wake, repeated cross-wake surveys suggest that cyclonic and anticyclonic vortices are alternatively present at a period close to the period of M2 tides in agreement with near-wake measurements. Repeated along-wake surveys reveal a cyclonic eddy shedding downstream at a speed of 0.35 m s−1, 1/3 of the upstream current speed, from the near wake. In comparing our observations with the results of previous water tank experiments, an Re value of O(103) for the submesoscale wake regime is expected.
Wave–Current Interaction between Hurricane Matthew Wave Fields and the Gulf Stream
Authors: Hegermiller Christie A. , Warner John C. , Olabarrieta Maitane , Sherwood Christopher R.
Published: September 2019

Hurricanes interact with the Gulf Stream in the South Atlantic Bight (SAB) through a wide variety of processes, which are crucial to understand for prediction of open-ocean and coastal hazards during storms. However, it remains unclear how waves are modified by large-scale ocean currents under storm conditions, when waves are aligned with the storm-driven circulation and tightly coupled to the overlying wind field. Hurricane Matthew (2016) impacted the U.S. Southeast coast, causing extensive coastal change due to large waves and elevated water levels. The hurricane traveled on the continental shelf parallel to the SAB coastline, with the right side of the hurricane directly over the Gulf Stream. Using the Coupled Ocean–Atmosphere–Wave–Sediment Transport modeling system, we investigate wave–current interaction between Hurricane Matthew and the Gulf Stream. The model simulates ocean currents and waves over a grid encompassing the U.S. East Coast, with varied coupling of the hydrodynamic and wave components to isolate the effect of the currents on the waves, and the effect of the Gulf Stream relative to storm-driven circulation. The Gulf Stream modifies the direction of the storm-driven currents beneath the right side of the hurricane. Waves transitioned from following currents that result in wave lengthening, through negative current gradients that result in wave steepening and dissipation. Wave–current interaction over the Gulf Stream modified maximum coastal total water levels and changed incident wave directions at the coast by up to 20°, with strong implications for the morphodynamic response and stability of the coast to the hurricane.
Sea Surface Temperatures: Seasonal Persistence and Trends
Authors: Gil-Alana Luis A. , Monge Manuel , Romero Rojo María Fátima
Published: September 2019

This paper addresses analysis of the global monthly sea surface temperatures using a reconstructed dataset that goes back to 1884. We use fractional integration methods to examine features such as persistence, seasonality, and time trends in the data. The results show that seasonality is a relevant issue, finding evidence of seasonal unit roots. With the seasonal component removed, persistence is also very significant, and, when looking at the data month by month, evidence of significant linear trends is detected in all cases. According to these results, monthly sea surface temperatures increase by between 0.07° and 0.11°C every 100 years.
How Chicago Economics Distorts “Consumer Welfare” in Antitrust
Authors: Glick Mark
Published: September 2019

Since the publication of Robert Bork’s The Antitrust Paradox, lawyers, judges, and many economists have defended “consumer welfare” (CW) as a standard for decisions about antitrust goals and enforcement priorities. This article argues that the CW is actually an empty concept and is an inappropriate goal for antitrust. Judge Bork adopted CW from economics where welfare unambiguously measured utility or well-being. Welfare economists concede that there is no credible measurable link between price and output and human well-being. This means that the concept of CW does not legitimate limited antitrust enforcement nor does it justify the exclusion of other antitrust goals that require more active enforcement practices. This article contends that antitrust policy is not welfare based at all and, that if it were, antitrust policy and enforcement would differ significantly from the Chicago School vision. Without the fiction that economists can establish that in the short run lower price and higher output measurably increase welfare more than other goals, recent defenses of the CW standard resolve down to arguments based on unsupported assumptions.
National Culture and Women Managers: Evidence From Microfinance Institutions Around the World
Authors: Gyapong Ernest , Afrifa Godfred Adjapong
Published: September 2019

We investigate the effect of national culture on women manager appointments. We argue that culture influences women manager appointments through their effects on managerial decision-making. Using firm-level data on 2,456 microfinance institutions (MFIs) across 61 countries, we document that fewer women managers are appointed in societies high on individualism and uncertainty avoidance. On the contrary, high power distance societies are positively associated with the appointment of women managers. We demonstrate that a greater number of women nonmanagers reduces (increases) the appointment of women managers in high individualistic (uncertainty avoidance) cultures. Our findings challenge the “one-size-fit-all” approach adopted by policy makers around the world to increase women manager appointments. Our results are robust to endogeneity.
Exploring cardiologists’ and oncologists’ exercise recommendation and referral practices
Authors: Leach Heather J , LeBreton Kelli A , Wurz Amanda J , Pergolotti Mackenzi , Braun Barry , Schuster Steven R , Green Patrick
Published: September 2019

Objective:

Exercise is beneficial for individuals who have been diagnosed with cardiovascular disease or cancer. Healthcare providers are well placed to discuss exercise with their patients, but their referral practices and the content of exercise recommendations remain unclear.

Method:

Cardiologists and oncologists completed an online survey comprising four closed-ended questions and one open-ended question to assess exercise recommendation and referral practices. Chi-square tests were used to compare the frequency of closed-ended responses, and open-ended responses were coded and analysed using qualitative content analysis.

Results:

Of the 154 surveys, 58 were returned ( n = 25; 43.1% cardiologists, and n = 33; 56.9% oncologists). Respondents ( Mage = 45.5 ± 11.1) were mostly men (62.1%). The majority of cardiologists (95.8%) and oncologists (78.1%) reported referring patients to hospital-based exercise programmes. In this study, the cardiologists were more likely to refer patients to certified exercise physiologists (χ2(1) = 6.140, p = .021), whereas oncologists were more likely to refer to physical therapists (χ2(1) = 11.764, p = .001).

Conclusion:

Findings reveal that cardiologists and oncologists discussed and recommended exercise to their patients at least some or most of the time; there were differences in the type of exercise professionals they were referred to; and exercise recommendations were variable and infrequently concurred with established guidelines.
Mechanisms by Which Small RNAs Affect Bacterial Activity
Authors: Lei L. , Yang Y. , Yang Y. , Wu S. , Ma X. , Mao M. , Hu T.
Published: September 2019

The oral cavity contains a distinct habitat that supports diverse bacterial flora. Recent observations have provided additional evidence that sRNAs are key regulators of bacterial physiology and pathogenesis. These sRNAs have been divided into 5 functional groups: cis-encoded RNAs, trans-encoded RNAs, RNA regulators of protein activity, bacterial CRISPR (clustered regularly interspaced short palindromic repeat) RNAs, and a novel category of miRNA-size small RNAs (msRNAs). In this review, we discuss a critical group of key commensal and opportunistic oral pathogens. In general, supragingival bacterial sRNAs function synergistically to fine-tune the regulation of cellular processes and stress responses in adaptation to environmental changes. Particularly in the cariogenic bacteria Streptococcus mutans, both the antisense vicR RNA and msRNA1657 can impede the metabolism of bacterial exopolysaccharides, prevent biofilm formation, and suppress its cariogenicity. In Enterococcus faecalis, selected sRNAs control the expression of proteins involved in diverse cellular processes and stress responses. In subgingival plaques, sRNAs from periodontal pathogens can function as novel bacterial signaling molecules that mediate bacterial-human interactions in periodontal homeostasis. In Porphyromonas gingivalis, the expression profiles of putative sRNA101 and sRNA42 were found to respond to hemin availability after hemin starvation. Regarding Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), a major periodontal pathogen associated with aggressive periodontitis, the predicted sRNAs interact with several virulence genes, including those encoding leukotoxin and cytolethal distending toxin. Furthermore, in clinical isolates, these associated RNAs could be explored not only as potential biomarkers for oral disease monitoring but also as alternative types of regulators for drug design. Thus, this emerging subspecialty of bacterial regulatory RNAs could reshape our understanding of bacterial gene regulation from their key roles of endogenous regulatory RNAs to their activities in pathologic processes.
Transcutaneous Sonography for Detection of the Cervical Vagus Nerve
Authors: Chen Hao-Hui , Chen Tseng-Cheng , Yang Tsung-Lin , Wang Cheng-Ping
Published: September 2019

Cervical vagus nerve is not identified by computed tomography or magnetic resonance imaging. Transcutaneous sonography may be the best imaging study to evaluate the cervical vagus nerve. A 7 to 18 MHz linear array transducer was placed transversely on the lateral neck focusing on the carotid sheath from the clavicle level upward to the digastric muscle level bilaterally. The gray-scale technique was used, with the scan setting for the thyroid gland. Between January 2015 and March 2016, 314 patients with 628 cervical vagus nerves were enrolled, including 104 men and 210 women. Their ages ranged from 14 to 84 years. Transcutaneous sonography identified the entire trunk of bilateral cervical vagus nerves in 254 (80.9%) patients and did not identify 1 or both cervical vagus nerves in the other 60 (19.1%) patients. Among 628 cervical vagus nerves, transcutaneous sonography identified 626 (99.6%) lower cervical vagus nerves and 551 (87.7%) upper cervical vagus nerves. Among 551 visible upper cervical vagus nerves, 495 (89.8%) nerves were located laterally, 17 (3%) nerves were located medially, 9 (1.6%) nerves were located anteriorly, and 30 (5.4%) nerves were located posterior to the internal carotid artery. Man and left-side nerve were the factors associated with the anatomical variation in the upper cervical vagus nerve. Transcutaneous sonography can be the best imaging study to show the cervical vagus nerve and may be helpful to evaluate the nerve before neck operation.
Development of a classification system for Mathematical Logic
Authors: Sarasa Cabezuelo Antonio
Published: September 2019

The number of digital resources that exist in repositories and on the Internet in general is enormous. Recovering resources that fit with the user’s specific needs poses a problem. To solve this problem, metainformation is added to the resources. One type of metainformation is the classification of a resource using a classification system that is widely recognised and agreed upon by its users. In this way, each resource is assigned a precise place within the classification system, thus facilitating its location. This article proposes a taxonomy for the classification of the resources (notes, exercises, exams or programmes that could be stored within a digital repository) that are generated within the scope of a Mathematical Logic course for a computer science degree programme. It also describes how to represent the proposed taxonomy using the IMS-VDEX standard and how to integrate it in the LOM and Dublin Core metadata specifications and proposes a set of controlled vocabularies that make it possible to refine the taxonomic metainformation.
The Association between Industry Payments and Brand‐Name Prescriptions in Otolaryngologists
Authors: Morse Elliot , Hanna Jonathan , Mehra Saral
Published: September 2019

Objective

To associate pharmaceutical industry payments to brand‐name prescriptions by otolaryngologists.

Study Design

Retrospective cross‐sectional analysis.

Setting

Open Payments Database and the Medicare Part D Participant User File 2013‐2016.

Subjects and Methods

We identified otolaryngologists receiving nonresearch industry payments and prescribing to Medicare Part D recipients. Records were linked by physician name and state. The value of industry payments and the percentage of brand‐name drugs prescribed per hospital referral region (HRR) were characterized as medians. Industry payments were correlated to the rate of brand‐name prescription by Kendall’s τ correlation. This was repeated at the individual physician level and stratified by payment type.

Results

In total, 8167 otolaryngologists received a median of $434 (interquartile range, $138‐$1278) in industry compensation over 11 (3‐26) payments. Brand‐name drugs made up a median of 12.9% (8.6%‐18‐4%) of each physician’s drug claims. The number (τ = 0.05, P <. 001) and dollar amount (τ = 0.04, P <. 001) of industry payments were correlated with the rate of brand‐name drug prescription at the individual physician level. The number of industry payments was also associated with the rate of brand‐name prescription by HRR (τ = 0.14, P <. 001), but the dollar amount was not. By HRR, food and beverage payments received by physicians were associated with the rate of brand‐name drug prescription (τ = 0.04, P <. 001), but travel and lodging payments were not.

Conclusions

Industry financial transactions are associated with brand‐name drug prescriptions in otolaryngologists, and these associations are stronger at the regional level than at the individual physician level. These correlations are of modest strength and should be interpreted cautiously by readers.
Clinical significance of plasma free DNA in patients with non-small cell lung cancer
Authors: Ma Lanxiang , Du Jie , Sui Yongjie , Wang Shuili
Published: September 2019

Objectives

Plasma free DNA is a promising new tumor biomarker, which may have applications in clinical diagnosis and treatment of non-small cell lung cancer (NSCLC).

Methods

Plasma free DNA was collected from 120 healthy controls and 116 patients with NSCLC before and after treatment.

Results

The mean plasma free DNA levels in 116 NSCLC patients (200.70 ± 88.54 ng/mL) were higher than those of 120 healthy controls (18.65 ± 6.30 ng/mL). Further analysis showed that the mean serum free DNA level in stage I/II NSCLC patients was 172.75 ± 72.87 ng/mL, significantly lower than that of stage III/IV patients (221.88 ± 93.86 ng/mL). Following surgery and effective chemotherapy, the plasma free DNA levels of NSCLC patients decreased significantly.

Conclusions

Through quantitation of plasma free DNA, this study established proof-of-concept for a highly sensitive and specific detection method, which can be used for diagnosis, prognosis and treatment monitoring in NSCLC patients.
Collaborating to train the next generation of pilots: Exploring partnerships between higher education and the airline industry
Authors: Lutte Rebecca K. , Mills Russell W.
Published: September 2019

The airline industry is experiencing a pilot supply problem that has dominated headlines across the world. Boeing estimates over 790,000 pilots are needed worldwide in the next 20 years to accommodate growth and staffing retirements. Regulatory reforms implemented in the aftermath of the crash of Colgan Air 3407 resulted in collegiate aviation programs playing a larger role in supplying pilots for the airlines. As a result of the fierce competition for pilots, airlines and higher education institutions (HEIs) have entered into a variety of partnership programs that develop career pathways for students while allowing carriers to secure talent earlier in the training process. Despite the proliferation of these programs, little is known about their structure, effectiveness, and potential challenges. The purpose of this research is to develop a framework of the types of partnerships that exist between HEIs and airlines for the purpose of addressing workforce development. Potential program benefits and challenges are examined from the perspective of HEIs. The methodology includes a review of existing programs and interviews with program coordinators. The research will provide new knowledge about the role of partnerships in meeting the needs of collegiate aviation programs.
Manipulation strategy of tilt quad rotor based on active disturbance rejection control
Authors: Wang Zhigang , Li Jianbo , Duan Dengyan
Published: September 2019

To solve the problem of manipulation redundancy and coupling in transition mode of tilt quad rotor, this paper studied the manipulation strategy in transition mode, and carried out the design of the attitude controller based on active disturbance rejection control (ADRC) with sliding mode control in nonlinear state error feedback (NLSEF). According to the characteristics of flight in transition mode, the rudders and propellers were assigned different control rights. The differential output of the tracking differentiator was used as the attitude angular rate instruction to simplify the structure of the attitude controller. Extended state observer was used to estimate and compensate internal and external uncertainties. The sliding mode control in NLSEF was used to improve response speed of the controller. Through the flight control simulation and flight test of the tilt quad rotor, the validity of the control system and the rationality of the manipulation strategy were verified.
Substance Use Disorder, Intravenous Injection, and HIV Infection: A Review
Authors: Wang Shao-Cheng , Maher Brion
Published: September 2019

DSM-V-defined substance use disorder comprises four groups of symptoms: impaired control, social impairment, risky use, and pharmacological reactions. Behavioral patterns of impaired control, including impulsivity and risk taking, are associated with HIV risk behaviors. Substance users with stronger craving symptoms are more likely to use drugs via intravenous injection than other routes because of the faster drug effect and the higher bioavailability; thus, they are at high risk of HIV infection. HIV risk behaviors such as unprotected sex and intravenous injection facilitate HIV disease spread. Public health policies such as Needle and Syringe Exchange Programs and medication-assisted treatment are proven to reduce HIV risk behaviors such as the frequency of intravenous injection and even the incidence of HIV infection, but both of them have limitations. While intravenous injection is a frequently discussed issue in public policies and the HIV-related literature, it is a much less frequent topic in the addiction literature. We believed that understanding the mental substrate behind impulsivity/risk taking and the possible biological mechanism of intravenous injection may help in creating more effective strategies to slow down HIV infection.