bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a Pressure Measuring Garment to Understand How to Quantify Compression
Authors: Weber Michael , Clarke-Sather Abigail , Bergeron Tara , Janko Anisa , Jensen Alicia , Malvick Brittany , Cope Steven
Published: August 2020

Encouraging research shows reductions in the number of disruptive behaviors for children diagnosed with Autism Spectrum Disorder (ASD) when wearing compression shirts. However, current studies do not consider the amount of pressure compression shirts apply to the body and how different amounts of pressure applied to the body may lead to different outcomes for children diagnosed with ASD. The purpose of this proof of concept research project was to develop a method for measuring the pressure applied by a compression shirt at a specific location on the body. This study used conductive thread as the principle element to measure the compression applied by a garment onto the body, specifically the arm. It was found that for the specific stitch and thread tested, the relationship between the displacement the sensor exhibits and the change in resistance was 25.95 Ω/m. With this relation, the pressure applied by a compression garment to a mannequin arm and the arms of four participants was found. A general trend that the measured pressure applied by a garment onto the body directly correlated with increasing individual arm circumference was found.
Lung Allocation Pipeline: Machine Learning Approach to Optimized Lung Transplant
Authors: Schinstock Emma , Deakyne Alex , Iles Tinen , Shaffer Andrew , Iaizzo Paul A.
Published: August 2020

Lung donation is the most risky transplant procedures. With low survival rates, and poor acceptance of donated lungs, those in need of a lung transplant are at high risk of dying. One reason for poor outcomes is the lack of optimal match between donor and recipient when it comes to lung size and shape. Lungs that do not properly fit in the recipient’s chest cavity can fail to inflate fully and quickly start to deteriorate. In such patients, lung contusions can form, edema occurs in healthy lung tissue, and overall lung function declines. To improve patient outcomes after lung transplant, we describe here a developed a computational pipeline which enables donor lungs to be properly matched to recipients. This tool uses CT scans from both the donor and potential recipients to calculate how anatomically different the sets of lungs are, and therefore provide improved matches in both size and shape for the donor lungs.
Flexible Circuit Board Package Embedded With Multi-Stack Dies
Authors: Ueta Nobuki , Sato Shunsuke , Sato Masakazu , Nakao Yoshio , Magnuson Joshua , Ishizuka Rocky
Published: August 2020

Miniaturization of electronics modules is always required for various medical applications including wearable technology, such as hearing aids, and implantable devices. Many types of high-density packaging technologies, such as package-on-package, bare-die stack, flex folded package and Through Si Via (TSV) technologies, have been proposed and used to fulfill the request. Among them, embedded die technology is one of the promising technologies to realize miniaturization and high-density packaging. We have developed WABE™ (wafer and board level device embedded) technology for embedding dies into multilayer flexible printed circuit (FPC) boards. The WABE package is comprised of thin dies (85 μm thickness), multi-layer polyimide, adhesive films and conductive paste. The dies are sandwiched by polyimide films with Cu circuits (FPCs). The conductive paste provides electrical connections between the layers as well as the layer and embedded die. First, each FPC layer is fabricated individually, and via holes are filled with conductive paste, and the dies are mounted on certain layers. Then, all layers undergo a one-step co-lamination process, and they are pressed to cure the adhesive material and conductive paste at the same time. This WABE technology has enabled multiple dies to be embedded by the one-step lamination process. Even if multiple dies are embedded, the footprint of a package can be reduced drastically by embedding multiple dies vertically in stacks. This paper describes the details of the results of fabricating a test vehicle with six embedded dies (three-dies in two stacks side-by-side). The fabricated test vehicle had 14 copper layers with less than 0.9 mm thickness. This paper also reports the results of various reliability testing on the package. These results were obtained by electrical measurements of daisy chain patterns formed between some of the layers. The fabricated test vehicle showed high reliability based on the results of a moisture and heat test and heat-shock test. These results show that the WABE technology to embed multiple dies vertically in polyimide film is one of the most promising packaging technologies to significantly miniaturize electronic circuits such as medical electronics.
Novel Method and Device for Delivery and Retention of Intrauterine Devices in the Immediate Postpartum Period: Pilot Baboon Feasibility Study
Authors: Campbell Etse-Oghena , Rylander Christopher G. , Thaxton Lauren , Williams-Brown Marian Yvette
Published: August 2020

The immediate post-partum period offers a convenient time to have an intrauterine device placed because of the co-location of a non-pregnant woman and her clinician; however, this practice is associated with increased expulsion rates of up to 30%, compared with a 3% expulsion rate for interval insertions. This paper presents a device and method to improve intrauterine device delivery and retention in the immediate postpartum period. This initial feasibility study illustrates that it is possible to temporarily tether a commercially available intrauterine device within the uterus of an immediately postpartum baboon. The results indicate this device and method are technically feasible, but further studies will be needed to evaluate safety and efficacy in reducing expulsion rates.
Design and Optimization of Patient-Specific Pediatric Laryngoscopes
Authors: Habib Madelene , Sims Robert , Inziello James , Lobo Fluvio , Stubbs Jack
Published: August 2020

Pediatric laryngoscope blades do not vary in size and shape as patients’ airways do. Difficult airway intubations may require physicians to try different blade sizes and even improvise. In addition to physical trauma and complications, difficult intubations may result in longer operating room times. As advanced three-dimensional (3D) imaging, modeling, and printing technologies become more ubiquitous at the point-of-care, so will the development and fabrication of patient-specific solutions. Here we introduce a method for the design and fabrication of patient-specific, single-use pediatric laryngoscope blades. The process seeks to optimize procedures and mitigate complications by providing physicians with the right tool at the right time.
Design of a Miniaturized, Affordable, and Quantifiable Vascular Doppler
Authors: Kubala Matthew , Hodenfield Brooks , Mavanji Vibha , Wales Jeremy , Doenges Jack
Published: August 2020

Peripheral artery disease (PAD) results from atherosclerotic plaque deposition on arterial walls causing reduced blood flow to affected tissue and can result in pain, tissue loss, poor wound healing, limb loss, and death. Diagnosis of PAD and clinical assessment of these patients requires the use of a vascular Doppler device. By emitting an ultrasound signal when placed over an artery and measuring the Doppler shift of the signal reflected from moving blood cells, this device produces an audio output descriptive of several blood flow parameters. As shown through multiple rounds of clinician interviews, current vascular Dopplers are expensive, bulky, and lack objective signal analysis. An improved vascular Doppler offering solutions to these problems was designed and prototyped. This prototype demonstrated a reduction in cost and comparable signal quality compared to Doppler devices currently available, and offered an opportunity for future development of automated signal analysis capabilities.
Respiratory Arrest Monitoring: A Non-Invasive Approach for Early Detection of Breathing Complexities in Psychiatric Patients
Authors: Enayati Moein , Skubic Marjorie
Published: August 2020

Background: Current protocol for monitoring high-risk patients in psychiatric hospital calls for a staff member to enter each room every 15 minutes to visually ensure that each patient is still breathing. This protocol has been set up for fast intervention in the case of a patient’s self-inflicting harm. However, this procedure is disruptive to the patients and a burden for the care providers.

Objective: Continuous and automated overnight monitoring of psychiatric patients for a complete cessation of breath, that eliminates the need for frequent in-person checks.

Method: An IRB approved study conducted in a simulated lab environment, with a radar device placed in the ceiling above the bed. 14 volunteers simulated episodes of respiratory arrest.

Results: The extracted radar signal not only tracks the episodes of complete breath cessation but also estimates the respiration rate with more than 92% accuracy, during normal breathing.

Conclusion: Our proposed approach provides the means for care providers in psychiatric hospitals to ensure the patients can breathe without disturbing the patients’ sleep.
The Pennsylvania Railroad GG1 Electric Locomotive: A Retrospective
Authors: Burshtin Michael L.
Published: August 2020

This paper is a historical review of the design and operation of the Pennsylvania Railroad’s class GG1 electric locomotive over its heavily-trafficked New York City-Washington, DC main line during the period 1934–1983. The locomotive was designed in-house by the railroad in corroboration with Baldwin Locomotive, General Electric and Westinghouse Electric following competitive tests of several electric locomotive designs. Its outstanding performance and long operating life has resulted in it being generally considered the most highly regarded electric locomotive in North America.

The Pennsylvania Railroad embarked in the late 1920’s on a major AC electrification program for its New York-Washington and Philadelphia-Harrisburg main lines and local branches. It initially planned to use a fleet of class P5 rigid frame 2-C-2 electric locomotives for service. However problems were quickly encountered with damaging lateral track impacts, axle cracks, truck hunting, and inadequate tractive effort. The railroad responded with a series of competitive evaluation tests of several locomotive designs including a recent New York, New Haven & Hartford (NYNH&H) Railroad articulated frame locomotive, using an ingenious method to measure truck lateral forces. As a result, the railroad developed two prototype electric locomotive designs, a rigid frame class R1 2-D-2 and an articulated frame class GG1 2-C+C-2. Follow-up track testing verified that the GG1 had lower track lateral forces, and was selected for production.

The 4,620 hp GG1 combined several significant North American design concepts:

- Exceptional power from six double-armature traction motors for heavy passenger train operation at 100 mph;

- Double-ended body design to eliminate the need to turn locomotives;

- Use of separate truck frames with an articulation joint connection, allowing improved rail tracking and lower lateral forces;

- Housing the main transformer and locomotive cabs in the center body, providing increased crew accident protection in collisions;

- Use of high voltage Alternating Current (11 kV at 25 Hz); and

- One of the first applications of Industrial Design (by Donald R. Dohner and Raymond F. Loewy) producing a streamlined locomotive using a welded carbody.

The GG1 was quickly recognized as a rare combination of stellar performance, robust construction, and low maintenance costs. It was used to inaugurate electrified New York-Washington operations, performed admirably during World War II, successfully made the later transition to freight train operation, and was finally retired in October 1983. The prototype GG1 locomotive 4800 has been designated an ASME national engineering landmark.
Security As a Service for Rail Applications
Authors: Ellis Todd
Published: August 2020

State-of-the-art rail systems require reliant, redundant and critical and secure communications. Data integrity is paramount when considering the criticality that the data payload remains secure for 24/7 year-round applications. With technologies such as Communications Based Train Control (CBTC) and Positive Train Control (PTC) being implemented, considerations for data integrity in these networks must include methods to avoid internal and external vulnerabilities.

Unlike traditional encryption methodologies, newer techniques involve tunneling payloads across open or closed networks; this method could include public unsecured networks. By utilizing a unique security appliance tunneled to a remotely connected network operations center, it is possible for a rail system to subscribe to a service to obtain military-grade data security capabilities and distribute secured communications throughout their operational territories via low cost data networks. This “security as a service” concept is especially useful for landlord/tenant relationships that would have previously resulted in duplicative system elements.

Security-as-a-service encryption methods commercially available for rail applications typically fall into one of three color-coded categories; green, red and gray. Green networks offer a single layer solution using NSA-approved cryptographic algorithms and are completely isolated from other methods. Red networks are highly secure, utilizing diverse layers of different algorithm types. Gray networks provide a secure gateway between red and green networks to effectively manage network and operational risks.

In the case of large freight territories, security as a service can help reduce network costs while improving security. For passenger rail systems, communication-based signaling systems should be strongly protected against data vulnerabilities resulting from either unintentional or malicious access to critical networks.
Forward-Looking Infrared Radiometry (FLIR) Application for Detecting Ballast Fouling
Authors: Hosseini SayedMohammad , Tan Yongwen , Ahmadian Mehdi
Published: August 2020

This paper is intended to assess the practical aspects of the previously proposed approach for detecting railroad ballast fouling using an off-the-shelf Forward-Looking Infrared Radiometry (FLIR) Technology. FLIR is among the technologies that are becoming more prevalent in railroad applications [1,2]. The method discussed in this paper takes advantage of the temperature differences measured by the FLIR camera between the top surface of clean and partially fouled ballast samples as an indicator of fouling. The method is intended to potentially serve as an efficient and time-effective manner for detecting early stages of ballast fouling prior to it requiring a costly intervention. Ballast fouling is a common maintenance-of-way issue for the railroad industry, which occurs as a result of contaminants clogging up the ballast and preventing water drainage. The water retained at the sublayers diminishes the strength of the foundation and could result in other undesirable conditions such as clay pumping and reduced track strength. In this study, experiments are performed to study the thermal behavior and characteristics of clean, and partially- and fully-fouled ballast using a FLIR camera. The FLIR camera is set up in a stationary configuration for ease of testing and also providing a more direct approach to analyzing the data, to keep the test conditions highly repeatable and reduce any environmental variations. The results indicate that the cooling and heating rate at the top surface for clean, partially fouled, and fouled ballast are different during the daily heat-up cycle. It is determined that although the FLIR camera is able to measure some changes in the ballast temperature for the fouling conditions that are evaluated in the study, the differences may be within the range of variations that could occur in field conditions. The paper includes the range of measured temperature by the FLIR camera and discusses the pros and cons of using this approach in practice. Additional field testing is needed to validate or dispute the initial findings of the study.
Investigating the Influence of Angle of Attack (Yaw) on Wheel-Rail Interface (WRI) Dynamics
Authors: Radmehr Ahmad , Hosseinian Ahangarnejad Arash , Tajaddini Ali , Ahmadian Mehdi
Published: August 2020

The study provides an accurate measurement of the longitudinal and lateral traction under precisely controlled angles of attack conditions, using the Virginia Tech-Federal Railroad Administration roller rig (“VT-FRA roller rig”). The tests are performed under field-simulated conditions that allow wheel wear and accumulation of worn material at the running surfaces, with angles of attack (AOA) that represent both left- and right-hand curves. Because the roller rig allows testing under extreme conditions, AOAs as large as two degrees (0.035 radian) are evaluated for a scaled wheel with a nominal AAR-1B profile. It is observed that the longitudinal and lateral traction coefficients increase with increasing time, for all AOAs, but far more significantly for large AOA. The effect is nonlinear, meaning that for shallower (lower-degree) curves the friction effect is far less than for steeper (higher-degree) curves. It is further observed that the influence is asymmetric for right- and left-hand curves. The wheel taper introduces a lateral force that adds or subtracts (depending on the orientation of the curve) from lateral curving forces. The curving forces resulting from a positive AOA (corresponding to a left-hand curve) are less than those for negative AOAs, mainly due to the force offset due to the wheel taper.
Wheel-Rail Contact Patch Geometry Measurement and Shape Analysis Under Various Loading Conditions
Authors: Radmehr Ahmad , Hosseinian Ahangarnejad Arash , Pan Yu , Hosseini SayedMohammad , Tajaddini Ali , Ahmadian Mehdi
Published: August 2020

This study evaluates the wheel-rail contact patch geometry of the VT-FRA roller rig, designed and commissioned at the Virginia Tech’s Railway Technologies Laboratory (RTL). Contact patch measurements are crucial for better analyzing the underlying factors that affect the wheel-rail interface (WRI) contact mechanics and dynamics. One of the challenges is in determining the size and pressure distribution at the contact patch, under various conditions. Although past studies have attempted to reach a method that can be used to make such measurements, more research is needed in reaching a practical and consistent method. This is particularly true for making the measurements under dynamic conditions.

The use of pressure sensitive films was considered as the means for contact patch measurements on the VT-FRA rig, however, the thickness of the film influences the contact patch area and shape. This paper provides the results of the measurements with films with different range of pressure sensitivities.

Three types of pressure-sensitive films are used under static conditions. The films are placed in between the wheel and roller in exact positions to enable comparing the test results for various wheel loads. The contact patch measured by the most sensitive film, which reacts to pressures as low as 0.5 MPa, provides the most accurate outline for the contact patch, although it does not provide the highest resolution for the pressure distribution. The other pressure-sensitive films that are used have a higher pressure range, with minimums of 49.0 MPa and 127.6 MPa.

The relationship between the size of the contact patch and average contact pressure is evaluated as a function of the wheel load. The results indicate that with increasing wheel load, the size of the contact patch changes minimally, with the average pressure increasing in a nearly linear relationship to the wheel load as expected.
2019 Nominations for ASME Historic Mechanical Engineering Landmark Status: Rail Transportation Category
Authors: Iden Michael E.
Published: August 2020

The ASME Rail Transportation Division submitted five nominations in 2019 for ASME Historic Mechanical Engineering Landmark status. The nominations are for examples of significant railway technologies involving mechanical engineering and built between 1920 and 1964:

1. SBB 14253 “Crocodile” locomotive (1920): pioneering electric heavy-duty Swiss mountain locomotive, with pioneering features found in many subsequent electric locomotives.

2. Winton 8-201 prototype diesel engine (1933): only surviving of two experimental engines which preceded all GM-Electro-Motive 2-stroke cycle diesel engines for locomotives and other applications; first locomotive diesel engine with lightweight welded steel crankcase and unitized fuel injectors.

3. B&O 50 locomotive (1935): sole surviving example of the first (5) standalone, modular, non-articulated high-speed diesel locomotives from Electro-Motive, functional prototypes for the later “E” passenger and “FT” freight locomotives.

4. Cooper-Bessemer prototype diesel engine (1953): sole surviving example of (4) predecessor 4-stroke cycle diesel engines built for GE Transportation for field test locomotives prior to GE becoming a domestic locomotive manufacturer.

5. SP 9010 locomotive (1964): sole surviving example of (21) experimental German-built diesel locomotives for heavy-duty US mountain railroad operation using a hydromechanical torque converter transmission instead of electric traction motors; proved concept of higher-power and improved wheel-to-rail adhesion.

All five nominations were submitted to the ASME national History & Heritage Committee for review. This paper provides a description of each nomination and the status of each proposed railroad Historic Mechanical Engineering Landmark.
Detecting Dark Cars Using a Novel Multi-Antenna AEI Tag Reader Design for Increased Read Distance and Reliability
Authors: Ghasemzadeh Pejman , Banerjee Subharthi , Hempel Michael , Harms Andrew , Sharif Hamid
Published: August 2020

Automatic Equipment Identification (AEI) tags are installed on all rail cars in North America to tag rolling stock and facilitate fault detection using wayside detectors. And yet, railcars do get lost when parked on sidings, etc., resulting in so-called Dark Cars. No effective solution has been proposed for finding such lost rail cars due to the distance limitations in the current AEI tag readers. However, recent developments in the area of AEI tags in particular multi-antenna wireless communication systems and backscatter communications, now provide the opportunity to read AEI tags from much farther distances. The adavntage of using multiple antennas is to increase read distance and directionality through beamforming while adhering to FCC power limits. The key obstacle to long-distance AEI tag reading is the limited link budget, which is the combination of the FCC-mandated power limit coupled with the minimum required EM field strength needed to power the AEI tag during a read operation. Since it is not feasible to modify the AEI tags themselves because a large number of them installed on railcars, nor boost the transmit power, our design is focused on increasing directionality of the transmitted power. In this work, the authors thus propose a novel use of a Multi-Antenna Beamforming AEI tag reader mounted on — and powered by — a locomotive. This is to detect AEI tags on dark cars by a train passing the dark cars. The authors conducted an in-depth model-driven performance evaluation of this scheme. The analysis includes different channel models, signal reflection, and impact from velocity on read success rates. The channel models considered in this evaluation include multipath models such as Rayleigh, Rician, and Two-Ray Ground. The results presented by the authors show that our proposed novel approach is not only feasible to read AEI tags in this fashion over distances exceeding multiple track separation distances, but also practical, in most cases requiring 10 or less antennas with only simple beamforming methods employed.
Train Sideswipe Accidents and Passengers’ Injury
Authors: Masory Oren , Berkowitz Carl
Published: August 2020

Train sideswipe accidents happen when two trains are traveling next to each other in the same or opposite directions and their sides come into contact. In most cases the relative velocity between the trains is very low. In these accidents, standing passengers might lose their balance, fall and impact with objects in their surroundings. Also, in extreme cases seated passenger might be ejected from their seat and get injured by impacting hard objects like handles and edges. These falls are caused by the acceleration and jerk exerted on the passengers during the impact. The train Event Data Recorder (EDR) does not record the train’s acceleration during the collision, as common in vehicle’s EDR, but provides only velocity information that is sampled in very low rate. To determine acceleration and jerk, train’s velocity is extracted from the train Event Data Recorder (EDR) and is used to estimate their value in order for the purpose of evaluation of the severity of the accident. The analysis of actual data extracted from an EDR of a train, that was that was involved in sideswipe accident is presented and compared to current standards. The results indicate that a standing person in case might lose his balance and fall. This results was verified since the two conductors who were walking along the isle lost their balance, fell and were injured feel and injure.
CFD Model Validation for a Benchmark Data of Texas A&M 1/16th Scaled VHTR Upper Plenum
Authors: Vegendla Prasad , Hu Rui , Zou Ling
Published: August 2020

In High Temperature Gas-cooled Reactors (HTGR), gas flow patterns are very complex and reduced order models (1D or 2D) may be too simplified to predict accurate reactor performance. 3D Computational Fluid Dynamics (CFD) models can help provide the detailed information needed to optimize the reactor thermal performance. The main objective of this work is to validate the CFD models with data of a 1/16th scaled Very High Temperature Reactor (VHTR) upper plenum measured at Texas A&M University.

In this paper, the flow characteristics of a single isothermal jet discharging into the upper plenum was investigated using Nek5000 Large-Eddy Simulation (LES) CFD tool. Several numerical simulations were performed for various jet Reynolds numbers ranging from 3,413 to 12,819. Grid independent study was performed. The numerical results of mean velocity, root-mean-square fluctuating velocity, and Reynolds stress were validated with the benchmark data. Good agreement was obtained between simulated and measured data for axial mean velocities, except near the upper plenum hemisphere. The maximum predicted errors for axial mean velocities at various normalized coolant channel diameter heights of 1, 5 and 10 are 1.56%, 1.88% and 3.82%, respectively. Also, the predicted root-mean-square fluctuating velocity and Reynolds stress are qualitatively agreed with the experimental data.
Supplemental Material: Seismic anisotropy in southern Costa Rica confirms upper mantle flow from the Pacific to the Caribbean
Authors: Levin Vadim , al. et
Published: August 2020

Data sources, details of data analysis methodology, and additional diagrams and maps of shear wave splitting measurements.
A checklist to improve health system resilience to infectious disease outbreaks and natural hazards
Authors: Meyer Diane , Bishai David , Ravi Sanjana J , Rashid Harunor , Mahmood Shehrin Shaila , Toner Eric , Nuzzo Jennifer B
Published: August 2020

Recent infectious disease outbreaks, including the ongoing global COVID-19 pandemic and Ebola in the Democratic Republic of the Congo, have demonstrated the critical importance of resilient health systems in safeguarding global health security. Importantly, the human, economic and political tolls of these crises are being amplified by health systems’ inabilities to respond quickly and effectively. Improving resilience within health systems can build on pre-existing strengths to enhance the readiness of health system actors to respond to crises, while also maintaining core functions. Using data gathered from a scoping literature review, interviews with key informants and from stakeholders who attended a workshop held in Dhaka, Bangladesh, we developed a Health System Resilience Checklist (‘the checklist’). The aim of the checklist is to measure the specific capacities, capabilities and processes that health systems need in order to ensure resilience in the face of both infectious disease outbreaks and natural hazards. The checklist is intended to be adapted and used in a broad set of countries as a component of ongoing processes to ensure that health actors, institutions and populations can mount an effective response to infectious disease outbreaks and natural hazards while also maintaining core healthcare services. The checklist is an important first step in improving health system resilience to these threats, but additional research and resources will be necessary to further refine and prioritise the checklist items and to pilot the checklist with the frontline health facilities that would be using it. This will help ensure its feasibility and durability for the long-term within the health systems strengthening and health security fields.
Barriers and facilitators to optimal supportive end-of-life palliative care in long-term care facilities: a qualitative descriptive study of community-based and specialist palliative care physicians’ experiences, perceptions and perspectives
Authors: Harasym Patricia , Brisbin Sarah , Afzaal Misha , Sinnarajah Aynharan , Venturato Lorraine , Quail Patrick , Kaasalainen Sharon , Straus Sharon E , Sussman Tamara , Virk Navjot , Holroyd-Leduc Jayna
Published: August 2020

Objective

The COVID-19 pandemic has highlighted ongoing challenges to optimal supportive end-of-life care for adults living in long-term care (LTC) facilities. A supportive end-of-life care approach emphasises family involvement, optimal symptom control, multidisciplinary team collaboration and death and bereavement support services for residents and families. Community-based and palliative care specialist physicians who visit residents in LTC facilities play an important role in supportive end-of-life care. Yet, perspectives, experiences and perceptions of these physicians remain unknown. The objective of this study was to explore barriers and facilitators to optimal supportive end-of-life palliative care in LTC through the experiences and perceptions of community-based and palliative specialist physicians who visit LTC facilities.

Design

Qualitative study using semi-structured interviews, basic qualitative description and directed content analysis using the COM-B (capability, opportunity, motivation - behaviour) theoretical framework.

Setting

Residential long-term care.

Participants

23 physicians who visit LTC facilities from across Alberta, Canada, including both in urban and rural settings of whom 18 were community-based physicians and 5 were specialist palliative care physicians.

Results

Motivation barriers include families’ lack of frailty knowledge, unrealistic expectations and emotional reactions to grief and uncertainty. Capability barriers include lack of symptom assessment tools, as well as palliative care knowledge, training and mentorship. Physical and social design barriers include lack of dedicated spaces for death and bereavement, inadequate staff, and mental health and spiritual services of insufficient scope for the population.

Conclusion

Findings reveal that validating families’ concerns, having appropriate symptom assessment tools, providing mentorship in palliative care and adapting the physical and social environment to support dying and grieving with dignity facilitates supportive, end-of-life care within LTC.
Clopidogrel preventive effect based on cytochrome P450 2C19 genotype in ischaemic stroke: protocol for multicentre observational study
Authors: Song Tae-Jin , Kim Jinkwon , Han Sang Won , Kim Young Dae , Lee Jong Yun , Ahn Seong Hwan , Lee Hye Sun , Jung Yo Han , Lee Kyung-Yul
Published: August 2020

Introduction

Clopidogrel is an antiplatelet agent that is widely used for the secondary prevention of cardiovascular and cerebrovascular events. The genotype of cytochrome P450 2C19 (CYP2C19) differentially affects the liver’s metabolism of clopidogrel, which may influence the drug’s response and efficacy for cardiovascular event prevention. In contrast to prior studies of patients with coronary artery diseases, little is known about whether the CYP2C19 genotype influences the preventive efficacy of clopidogrel in patients who had a stroke. We hypothesise that, among patients who had an acute ischaemic stroke who are prescribed clopidogrel, the patients with a loss-of-function CYP2C19 genotype (poor and intermediate metabolisers) may be at a higher risk of composite cardiovascular events than those who are non-carriers (extensive metabolisers).

Methods and analysis

This prospective observational multicentre study was designed to determine whether composite cardiovascular events would differ among patients who had an ischaemic stroke prescribed clopidogrel according to CYP2C19 genotype (poor or intermediate vs extensive metabolisers). Inclusion criteria were patients who had an acute ischaemic stroke who underwent CYP2C19 genotype evaluation and received clopidogrel within 72 hours of stroke onset. The primary outcome is composite cardiovascular events (stroke, myocardial infarction, or cardiovascular death) within 6 months after acute ischaemic stroke between patients categorised as poor or intermediate metabolisers and those categorised as extensive metabolisers according to their CYP2C19 genotype.

Ethics and dissemination

The Institutional Review Board of Severance Hospital, Yonsei University College of Medicine approved this study (3-2019-0195). We received study approval from the institutional review board of each participating hospital. We plan to disseminate our findings at relevant conferences and meetings and through peer-reviewed journals.

Trial registration number

NCT04072705.
Measuring satisfaction in the small animal consultation and its relationship to consult length
Authors: Corah Louise , Mossop Liz , Dean Rachel , Cobb Kate
Published: August 2020

Background

Measuring satisfaction is a useful metric of success of any interaction, but very few validated instruments exist for measuring the satisfaction of the veterinary surgeon (vet) and the client in veterinary consultations. Additionally, there has been no research examining the impact of consultation length on satisfaction. The aim of this observational study was to investigate the use of a single‐question graphic scale to assess vet and client satisfaction and the impact of consultation length on satisfaction.

Methods

Information on consultation timing was collected for 65 health problem consultations across six practices. These measurements were compared with postconsultation measurements of client and vet satisfaction.

Results

A comparison between the long‐form and single‐question satisfaction instruments demonstrated significant correlation for both vet and client tools (ρ=0.609, P<0.005 and ρ=0.483, P<0.005, respectively). The average client satisfaction with the consultation was high; however, vet satisfaction levels were significantly lower (U=1073, P<0.005). Increased consult length was associated with increased vet satisfaction (ρ=0.332, P=0.007) but not increased client satisfaction.

Conclusion

These results demonstrate that the graphic scale is an appropriate proxy for the pre‐existing long‐form questionnaires available for both vets and clients. Further research is required to examine the disparity identified between vet and client satisfaction.
Cosmological analogies, Lagrangians, and symmetries for convective–radiative heat transfer
Authors: Faraoni Valerio , Atieh Farah , Dussault Steve
Published: August 2020

A formal analogy between the Friedmann equation of relativistic cosmology and models of convective–radiative cooling/heating of a body (including Newton’s, Dulong–Petit’s, Newton–Stefan’s laws, and a generalization) is discussed. The analogy highlights Lagrangians, symmetries, and mathematical properties of the solutions of these cooling laws.
Jahn–Teller coupling to moiré phonons in the continuum model formalism for small-angle twisted bilayer graphene
Authors: Angeli Mattia , Fabrizio Michele
Published: August 2020

We show how to include the Jahn–Teller coupling of moiré phonons to the electrons in the continuum model formalism which describes small-angle twisted bilayer graphene. These phonons, which strongly couple to the valley degree of freedom, are able to open gaps at most integer fillings of the four flat bands around the charge neutrality point. Moreover, we derive the full quantum mechanical expression of the electron–phonon Hamiltonian, which may allow accessing phenomena such as the phonon-mediated superconductivity and the dynamical Jahn–Teller effect.
CodeFlow: Improving the Code Review Process at Microsoft
Authors: Czerwonka Jacek , Greiler Michaela , Bird Christian , Panjer Lucas , Coatta Terry
Published: August 2020

Delivering a new set of capabilities for managing and improving Microsoft’s code-review process was the primary goal right from the start. In the course of accomplishing that, much was also learned about certain general code-review principles. In fact, subsequent research has offered surprising evidence of just how similar the impact can be when many of these principles are followed at companies other than Microsoft.
Self-Presentation and Adolescent Altruistic Behaviors in Social Networks
Authors: Zhu Yaling , Shen Yue , Zhao Qiang
Published: August 2020

Social networks provide a convenient place for people to interact; members in social networks may create new connections or break existing connections, driving the evolution of complex network structure. Dynamics in social networks, such as opinion formation and spreading dynamics, may result in complex collective phenomena. This paper conducts a survey on 495 students from six schools in Shaanxi, Henan, and Zhejiang provinces and discusses the impact of self-presentation on adolescent network altruistic behaviors, the intermediary role of social ability cognition, and the moderating role of privacy awareness. The results show the following: (1) Self-presentation in social networks can positively predict adolescent network altruistic behaviors. The positive prediction effect of network sharing is the largest, and the positive prediction effect of network support is the least. (2) Social ability cognition plays an intermediary role between self-presentation and adolescent network altruistic behaviors. (3) The moderating effect of privacy awareness is not significant.
3-Bromopyridine-Heterogenized Phosphotungstic Acid for Efficient Trimerization of Biomass-Derived 5-Hydroxymethylfurfural with 2-Methylfuran to C21 Fuel Precursor
Authors: Xu Yufei , Yu Zhaozhuo , Li Hu , Yang Song
Published: August 2020

The production of long-chain carbon compounds (C9-C21) from biomass derivatives to alternate traditional fossil diesel is sustainable, eco-friendly, and potentially economic for modern industry. In this work, phosphotungstic acid heterogenized by 3-bromopyridine was achieved using a solvothermal method, which was demonstrated to be efficient for trimerization of biomass-derived 5-hydroxymethylfurfural (HMF) with 2-methylfuran (2-MF) to C21 fuel precursor (57.1% yield) under mild reaction conditions. The heterogeneous acidic catalyst could be reused for four consecutive cycles without obvious loss of activity, and different characterization techniques (e.g., XRD (X-ray diffraction), TG (thermogravimetric analysis), SEM (scanning electron microscope), FT-IR (Fourier transform infrared spectroscopy), and BET (Brunauer-Emmet-Teller)) were utilized to investigate the performance of the catalyst. In addition, a plausible reaction pathway was postulated, on the basis of results obtained by NMR (nuclear magnetic resonance) and GC-MS (gas chromatography-mass spectrometer). This strategy provides a facile and efficient approach to prepare a recyclable acidic catalyst for the production of diesel fuel precursor from biomass via controllable polymerization.
A Review of Skin Disease in Schizophrenia
Authors: McPhie Meghan L. , Bridgman Alanna C. , Kirchhof Mark G.
Published: August 2020

Background: Schizophrenia is a debilitating neuropsychiatric condition that affects 0.5% of the North American population. Skin disease in schizophrenia has not been well described. Identifying skin diseases that are commonly comorbid with schizophrenia may help clinicians address the burden of skin disease in patients with schizophrenia. Summary: We conducted a nonsystematic review of the literature to identify skin diseases that may be associated with schizophrenia. We searched MEDLINE, EMBASE, and PsycINFO for articles published in English from December 2000 through April 2020 using the key words “skin disease” or “dermatological” or “dermatology” and “schizophrenia.” Based on our results, we further refined the search terms to include more specific skin diseases. Schizophrenia appears to be associated with a number of skin diseases, including inflammatory dermatoses, autoimmune diseases, and certain genodermatoses. Limitations include being a nonsystematic review and the relative paucity of more rigorous clinical research using longitudinal study designs.
Statistical Evidence for Learnable Lexical Subclasses in Japanese
Authors: Morita Takashi , O’Donnell Timothy J.
Published: August 2020

It has been proposed that the Japanese lexicon can be divided into etymologically defined sublexica on phonotactic and other grounds. However, the psychological reality of this sublexical analysis has been challenged by some authors, who have appealed to putative problems with the learnability of the system. In this study, we apply a commonly used clustering method to Japanese words and show that there is robust statistical evidence for the sublexica and, thereby, that such sublexica are learnable. The model is able to recover phonotactic properties of sublexica previously discussed in the literature, and also reveals hitherto unnoticed phonotactic properties that are characteristic of sublexical membership and can serve as a basis for future experimental investigations. The proposed approach is general and based purely on phonotactic information and thus can be applied to other languages.
Religion, Politics, History, and Culture
Authors: Fitzgerald Timothy
Published: August 2020

In his critique of my 2007 monograph Discourse on Civility and Barbarity: a Critical History of Religion and Related Categories, Daniel Miller attributes me with the error of transcendental historicism and an illusion of cultural authenticity. Miller’s challenge leads me to the question ‘what is history?’—what does it mean to be ‘in history’, or to be ‘out of history’, or to be a ‘historical agent’? I also defend myself against the charge of cultural essentialism by questioning the essentially empty term ‘culture’. First, though, I challenge Miller for his continual insistence that my work is ‘political’. Miller seems to accept at least some aspects of my critique of ‘religion’. However, he does not mention that DCB is as much concerned with the invention of a noun word discourse on ‘politics’ as it is with the invention of ‘religion’. ‘Politics’ and the ‘nation state’ were invented by men of substantial property ambitions to organise, normalise and protect male private property accumulation. Rather than being the foundation of our democratic rights, a gateway to equality and emancipation, ‘politics’ promotes and globally facilitates the processes of ‘accumulation by dispossession’.
High prevalence of clonal hematopoiesis in the blood and bone marrow of healthy volunteers
Authors: Guermouche Hélène , Ravalet Noémie , Gallay Nathalie , Deswarte Caroline , Foucault Amelie , Beaud Jenny , Rault Emmanuelle , Saindoy Emeline , Lachot Sébastien , Martignoles Jean-Alain , Gissot Valérie , Suner Ludovic , Gyan Emmanuel , Delhommeau François , Herault Olivier , Hirsch Pierre
Published: August 2020

Clonal hematopoiesis (CH) of indeterminate potential has been described in blood samples from large series of patients. Its prevalence and consequences are still not well understood because sequencing methods vary and because most studies were performed in cohorts comprising individuals with nonhematologic diseases. Here, we investigated the frequency of CH in 82 paired bone marrow and blood samples from carefully selected healthy adult volunteers. Forty-one genes known to be mutated in myeloid malignancies were sequenced with a 1% threshold of detection. In bone marrow samples, clones were found in almost 40% of healthy volunteers more than 50 years old. The most frequent mutations were found in DNMT3A and TET2, with 1 individual carrying 3 variants. Variant allele frequencies were highly concordant between blood and bone marrow samples. Blood parameters were normal except for those in 2 individuals: 1 had a mild macrocytosis and 1 had a mild thrombocytosis. Furthermore, no morphologic abnormalities or dysplasia were detected when bone marrow smears were carefully evaluated. Individuals with CH differed from others by age (62.8 vs 38.6 years; P < .0001) and platelet count (294 vs 241 ×109/L; P = .0208), the latter being no more significant when removing the 2 individuals who carried the JAK2 p.V617F mutation. These results confirm that CH is a very common condition in healthy adults over 50 years old. Consequently, the detection of driver myeloid mutations should be interpreted with caution in the absence of cytologic abnormalities in the blood and/or the bone marrow.
Neutrophils lacking ERM proteins polarize and crawl directionally but have decreased adhesion strength
Authors: Panicker Sumith R. , Yago Tadayuki , Shao Bojing , McEver Rodger P.
Published: August 2020

Ezrin/radixin/moesin (ERM) proteins are adaptors that link the actin cytoskeleton to the cytoplasmic domains of membrane proteins. Leukocytes express mostly moesin with lower levels of ezrin but no radixin. When leukocytes are activated, ERMs are postulated to redistribute membrane proteins from microvilli into uropods during polarization and to transduce signals that influence adhesion and other responses. However, these functions have not been tested in leukocytes lacking all ERMs. We used knockout (KO) mice with neutrophils lacking ezrin, moesin, or both proteins (double knockout [DKO]) to probe how ERMs modulate cell shape, adhesion, and signaling in vitro and in vivo. Surprisingly, chemokine-stimulated DKO neutrophils still polarized and redistributed ERM-binding proteins such as PSGL-1 and CD44 to the uropods. Selectin binding to PSGL-1 on moesin KO or DKO neutrophils activated kinases that enable integrin-dependent slow rolling but not those that generate neutrophil extracellular traps. Flowing neutrophils of all genotypes rolled normally on selectins and, upon chemokine stimulation, arrested on integrin ligands. However, moesin KO and DKO neutrophils exhibited defective integrin outside-in signaling and reduced adhesion strength. In vivo, DKO neutrophils displayed normal directional crawling toward a chemotactic gradient, but premature detachment markedly reduced migration from venules into inflamed tissues. Our results demonstrate that stimulated neutrophils do not require ERMs to polarize or to move membrane proteins into uropods. They also reveal an unexpected contribution of moesin to integrin outside-in signaling and adhesion strengthening.