bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 348: Using the NCDR Cath/pci Registry to Identify Opportunities and to Maintain and Improve Cardiovascular Care
Authors: Lawson William E , Wilbert Lisa A , Boltrek Ashley , Thompson Jay , Hastings Deneen , Dorney Anna M , Monteleone Diane , Olmedo Calderon Wilman , Pyo Robert
Published: May 2020

Background:
The NCDR Cath/PCI Registry provides standardized capture of cardiovascular and anatomic risk factors and national benchmarking of outcomes to identify quality concerns and opportunities for improvement in the quality of care by practitioner and hospital. A rolling 4 quarter analysis is provided to participants that include measures of performance, quality, appropriate use.

Procedure:
Two performance measures [in-hospital PCI mortality and D2B] and two quality measures [in-hospital bleeding/ transfusion post PCI and contrast nephropathy] and were selected for intensive review and process improvement. The rolling 4 quarters ending in 2018 Q3 are compared to the 209Q3 results. Drill down analysis of event contributory factors was performed in a joint practice setting to identify opportunities for improvement.

Results:
In hospital risk adjusted PCI mortality improved over the assessed period from 3.4 Q3208 to 1.4 Q32019 [1.27 for the 3
rd
quarter of 2019]. above the 75
th
percentile. Stony Brook D2B times were maintained in the desired range of < 60 minutes [58 min in 2018Q3 and 59 min in 2019Q3]. Efforts to improve field First Medical Contacts [EMS] to facilitate D2B times by field transmission and ED review of field ECG with activation of the D2B Cath team demonstrate FMC-2B times of 92.2 minutes in 2018 and 83.1 minutes in 2019; achieving and maintaining the desired range of < 90 minutes. Transport times from external hospitals were extremely variable, dependent on intake process, transport availability and distance. Rate of bleeding and transfusion post PCI were <10% outliers at 7.82% and 3.42% for 2018Q3. Both have improved but remain challenges at < 10
th
percentile at 4.25% bleeding and 2.25% transfusion rate for 2019Q3. Interestingly radial operators also remain outliers, with preprocedure severe anemia, active bleeding, inappropriate transfusion thresholds have been identified as contributory concerns. Acute kidney injury [presumptive contrast nephropathy] improved from 9.57% in 2018Q3 to 6.16% [50
th
percentile] 2019Q3. More aggressive hydration with the “Poseidon trial” protocol improved post procedure CIN, which is often aggravated by hypotension, aggressive diuresis, ACEI/ARB/AA medications in patients with volume overload and heart failure.

Conclusions:
The NCDR Cath/PCI is a valuable resource for benchmarking performance, outcomes and appropriateness on an ongoing basis. Continuing feedback has allowed us to document and sustain improvement and to evaluate the effect of interventions implemented to improve the quality of care. Analysis also demonstrated that individual operators were not identified as significant outliers for the analyzed variables suggesting that systemic process improvement should be pursued.
Abstract 395: Building A Regional Multi-stakeholder Consortium To Implement Innovation In Healthcare: Lessons From The Quality & Value Innovation Consortium (QVIC)
Authors: Farr Stacy , Decker Carole J , Spertus John
Published: May 2020

Research Objective:
A challenge to improving the quality and value of healthcare has been the need for multiple stakeholders to collaborate in a coordinated effort. To address this, a novel program has been developed to create a regional commitment to deliver high quality care that is more patient-centered and efficient.

Study Design:
The Kansas City Quality & Value Innovation Consortium (QVIC) has created a network of hospitals and other stakeholder to collaborate and innovate on healthcare delivery. This initiative began by first identifying healthcare systems’ priorities through individual meetings with leadership from regional hospitals, including CEOs, CNOs, COOs, CQOs, and CMOs. Concurrently, meetings were held with payers, hospital associations, providers, health departments, researchers, patients, and community-based organizations (CBOs). These interviews identified 32 key quality improvement topics. Focus groups and surveys reduced this to 11 topics that were then selected for community forums where stakeholders provided brief presentations on the biggest challenges and strategies for improving healthcare value within the specified topic. A multi-stakeholder advisory board was created to oversee the program. Through this mixed methods approach, valuable feedback from the strategic advisory board, community forums, and surveys were aggregated and resulted in the selection of two topics.

Population Studied:
Study participants included leadership from 14 regional hospitals, 4 payer organizations, 2 state hospital associations, 4 public health departments, and 9 community based organizations, as well as 50+ regional researchers. In total, over 75 meetings and interviews with more than 200 individuals and groups were held. The twenty community forums have been attended by over 1,700 attendees.

Principal Findings:
Evaluations of the community forums have shown broad interest and satisfaction. The QVIC efforts have been recognized as a community asset for helping build collaboration and partnerships across stakeholder groups and competitors. Ultimately, these two regional initiatives (opioid management and transitions in heart failure care to reduce readmissions by impacting social determinants of health) were selected for novel implementation, measurement, and dissemination strategies. A suite of interventions is being offered and adopted by providers, within each of the two regional initiatives. Metrics for quantifying improvements in healthcare value are being developed and data collection is beginning. Implementation strategies are identified and being customized for pragmatic integration into each healthcare system.

Conclusions:
While the entire country is grappling with the challenge of improving the quality of care, while lowering its costs, Kansas City has modeled a unique culture and strategy for achieving this goal.
Abstract 398: Use Of Guideline-Directed Medical Therapy For Patients Hospitalized With Heart Failure In The Veterans Health Care System, 2013-2017
Authors: Hess Paul L , Langner Paula , Grunwald Gary K , Heidenreich Paul A , Ho P. M
Published: May 2020

Background:
Guidelines issued by the American Heart Association and American College of Cardiology recommend the use of key heart failure (HF) medications. Contemporary use of HF medications in Veterans Affairs (VA) hospitals is unknown.

Methods:
Using national administrative data maintained by the Corporate Data Warehouse, we identified all patients admitted with a primary diagnosis of HF who were discharged from a VA hospital between January 1, 2013, and December 29, 2017, and had a left ventricular ejection fraction ≤ 40% by echocardiography. Left ventricular ejection fraction was extracted from the medical record using natural language processing with high precision and sensitivity. Rates of guideline-directed medical therapy use at hospital discharge were assessed overall and over time. Defect-free care was defined as use of any beta-blocker and an angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), or angiotensin receptor neprilysin inhibitor (ARNI). Use of an evidence-based beta-blocker (bisoprolol, carvedilol, or metoprolol succinate) and an aldosterone antagonist were also evaluated.

Results:
A total of 13,767 patients from 126 sites with HF with reduced ejection fraction underwent 18,769 hospitalizations (1.4 hospitalizations/patient). Their mean age was 70.7 (standard deviation 11.4) years, the predominant sex was male (98.3%), and the principle race/ethnicity was white (67.2%). Defect-free HF care was achieved during 13,941 (74.2%) hospitalizations. A beta-blocker was prescribed during 17,196 (91.6%), and an ACEI, ARB, or ARNI was prescribed during 14,626 (77.9%). An evidence-based blocker was prescribed during 17,057 (90.9%) hospitalizations, and an aldosterone antagonist during 6,934 (36.9%). Defect-free care decreased over time from 76.4% in 2013 to 71.9% in 2017 owing to a reduction in ACEI/ARB/ARNI use from 80.2% in 2013 to 76.0% in 2017. Rates of use of other HF medications were stable over time (
Figure 1
).

Conclusions:
The majority of patients hospitalized with heart failure in VA hospitals receive defect-free HF care. However, rates of defect-free HF care have decreased over time. Opportunities to improve the use of HF medical therapy use exist.
Automatic Triage of 12‐Lead ECGs Using Deep Convolutional Neural Networks
Authors: van de Leur Rutger R. , Blom Lennart J. , Gavves Efstratios , Hof Irene E. , van der Heijden Jeroen F. , Clappers Nick C. , Doevendans Pieter A. , Hassink Rutger J. , van Es René
Published: May 2020

BACKGROUND

The correct interpretation of the
ECG
is pivotal for the accurate diagnosis of many cardiac abnormalities, and conventional computerized interpretation has not been able to reach physician‐level accuracy in detecting (acute) cardiac abnormalities. This study aims to develop and validate a deep neural network for comprehensive automated
ECG
triage in daily practice.

METHODS AND RESULTS

We developed a 37‐layer convolutional residual deep neural network on a data set of free‐text physician‐annotated 12‐lead
ECG
s. The deep neural network was trained on a data set with 336.835 recordings from 142.040 patients and validated on an independent validation data set (n=984), annotated by a panel of 5 cardiologists electrophysiologists. The 12‐lead
ECG
s were acquired in all noncardiology departments of the University Medical Center Utrecht. The algorithm learned to classify these
ECG
s into the following 4 triage categories: normal, abnormal not acute, subacute, and acute. Discriminative performance is presented with overall and category‐specific concordance statistics, polytomous discrimination indexes, sensitivities, specificities, and positive and negative predictive values. The patients in the validation data set had a mean age of 60.4 years and 54.3% were men. The deep neural network showed excellent overall discrimination with an overall concordance statistic of 0.93 (95%
CI
, 0.92–0.95) and a polytomous discriminatory index of 0.83 (95%
CI
, 0.79–0.87).

CONCLUSIONS

This study demonstrates that an end‐to‐end deep neural network can be accurately trained on unstructured free‐text physician annotations and used to consistently triage 12‐lead
ECG
s. When further fine‐tuned with other clinical outcomes and externally validated in clinical practice, the demonstrated deep learning–based
ECG
interpretation can potentially improve time to treatment and decrease healthcare burden.
The effect of school closings on teacher labor market outcomes and teacher effectiveness
Authors: Hill Andrew J. , Jones Daniel B.
Published: May 2020

School closings displace thousands of teachers in the U.S. every year. This paper explores how elementary school teachers in North Carolina respond to this labor market shock. After documenting that declining enrollment is a key driver of school closings in our study, we find that while most displaced teachers move to new schools in the same district, a considerable share leave public education altogether. We find that the increase in the propensity to leave teaching is largest for experienced teachers. It is also marginally larger for the highest and lowest value-added teachers compared to teachers in the middle of the value-added distribution, and, strikingly, twice as large for black teachers than white teachers even from the same closing school. Moving schools after a school closing has no impact on teacher effectiveness as measured by value-added. Although the primary goal of school closings is typically to move students out of declining or failing schools, school closings also affect the overall distributions of important teacher characteristics such as experience, race, and effectiveness in raising test scores.
Expanding or Accepting
Authors: Li Jiangyu
Published: May 2020

The Confucius Institute (CI), one vehicle for promoting a new narrative of Chinese national identity, has been controversial since its establishment. In contrast with political scientists who discuss the CI from a macro-perspective and argue that it is a state apparatus, this article focuses on micro- and meso-aspects of CI teachers’ everyday lives and social engagement in their locality, Thailand. When Chinese nationness meets Thainess, CI teachers made their own calculations as to how much Chineseness and Thainess they should dip in and out of to accomplish their nation-work. Nation-work is a synthesised concept that includes the way CI teachers are “saying,” “doing,” and “otherising” the nations. By employing “Chinese and Thais are like one family,” CI teachers reproduced the Sino-Thai “brotherhood.” For staying in Thailand “peacefully,” they invented their own “tradition.” Cultural activities become a nuanced way to “overcommunicate” Chineseness on the stage, with uneven quality.
Taxonomic assessment and distribution of common toads (Bufo bufo and B. verrucosissimus) in Turkey based on morphological and molecular data
Authors: Özdemir Nurhayat , Dursun Cantekin , Üzüm Nazan , Kutrup Bilal , Gül Serkan
Published: May 2020

The Bufo bufo species group includes four species distributed in the western Palearctic: B. bufo, B. eichwaldii, B. spinosus and B. verrucosissimus. Both B. bufo and B. verrucosissimus are known to occur in Turkey, but their range boundaries and the taxonomic status of B. verrucosissimus are still uncertain. In this study, we analyzed the variation in a set of morphological characters and in two mitochondrial and two nuclear DNA markers to address these questions. Phylogenetic analyses of sequence data support two main clades of common toads in Turkey, corresponding to B. bufo and B. verrucosissimus. The latter is subdivided into two allopatric subclades including populations along the Mediterranean and Black Sea coast, respectively. Discriminant analysis of morphological data showed separation among groups as defined by molecular analyses. We discuss these results and their implications for the evolutionary history of common toads in Turkey.
Cardiac response to stimulation and stress in the American alligator (Alligator mississippiensis)
Authors: Young Bruce A. , Potter James , Blanchard Joshua , Knoche Lucas , Kondrashova Tatyana
Published: May 2020

Previous descriptions of the direction (tachycardia versus bradycardia), magnitude, and duration of the cardiac stimulation/stress response of the American alligator (Alligator mississippiensis) have been contradictory. Superficial EKG leads were used to quantify heart rate while presenting a graded series of stimuli to a cohort of 5 sub-adult alligators. Only tachycardic responses were recorded. Stress (manual restraint and transport) induced a nearly 3-fold increase over the resting heart rate (∼17 bpm), which decreased only 7 bpm over 40 minutes in a stimulus-free environment. Lower-level stimulation (i.e., exposure to room light) produced a significantly smaller response than did higher-level stimulation (i.e., physical contact), both responses were transitory, lasting approximately 120 s.
The Priority of the Good and the Contrapuntal Character of Aristotle’s Politics I
Authors: Smith Thomas W.
Published: May 2020

Politics I has been the subject of a number of textual questions about the relation of the Ethics to the Politics. These textual questions involve us in theoretical questions about the differences between contemporary and ancient conceptions of political rule. Resolving the exegetical challenges can help us clarify the theoretical differences. A fresh approach to the textual challenges reveals that Politics I has a contrapuntal character with two reinforcing movements. One explores why and how despotic conceptions of politics fail using case studies of despotic power: slavery and money-making. Aristotle shows dialectically how this despotic approach to rule undermines the requirements for political life. The other movement explores the character of natural human associations, culminating in the polis. The two movements converge in Aristotle’s claim about the centrality of the human good for political rule. This claim challenges modern social contract theory’s understanding of the differences between despotic and political rule.
Sciences, Technology, and Social Inequality in the Arab World
Authors: Djeflat Abdelkader
Published: May 2020

The past few decades have been characterized by enormous wealth accumulation in many Arab countries—in particular, through the production of minerals such as oil and gas. Paradoxically, however, it is during this same period that pervasive inequalities and large portions of the population fell into poverty. The rising economic inequality in the region has been examined through different angles—income distribution, political regimes, social fragmentation, etc.—but rarely through the lens of inequality of access to science and technology in a world economy largely driven by scientific knowledge and innovation. This contribution intends to fill this gap through an in-depth examination of science and social inequality in the Arab World. This paper examines three main dimensions: the foundations of unequal and elitist access to science and technology in the Arab World; the limited access and further sidelining of already marginalized groups in Arab societies; and the potential implications of science and technology benefiting larger segments of the population. This analysis is illustrated with reference to examples from Egypt, but with particular focus on the Maghreb countries, Algeria, Morocco, and Tunisia.
Synesthesia and the Perception of Unseen Realities
Authors: Simmonds-Moore Christine
Published: May 2020

Exceptional experiences (ExE) incorporate a range of phenomena including subjective paranormal and transpersonal experiences. Synesthesia and synesthetic experiences are discussed as important variables in understanding the etiologies of ExE. The neural and psychological correlates of synesthetic experiences (associated with hyperconnectivity) are discussed in relation to ExE. It is argued that synesthetic processes enable both the detection and conscious perception of information from a range of sources that are usually unseen or inaccessible, including abstract, unlanguaged, preconscious, and potentially other nonlocal sources.
Effects of Mindfulness-based Interventions on Dementia Patients: A Meta-analysis
Authors: Wang Feng Ling , Tang Qian Yun , Zhang Lu Lu , Yang Jing Jing , Li Yu , Peng Hua , Wang Shu Hong
Published: May 2020

This study aims to systematically evaluate the efficacy of mindfulness-based intervention (MBI) in improving mental health and quality of life for people with dementia. Comprehensive literature search was performed using the PubMed, EMBASE, Web of Science, Cochrane Library, and CINAHL databases from their inception till June 26, 2019. In total, nine articles met the eligibility criteria and were included. The results of the meta-analysis showed a statistically significant decrease in depressive symptoms (SMD = −0.39, 95% CI: − 0.62 to − 0.15), in people with dementia who were treated with MBI. However, there were no significant improvements in anxiety, stress, or quality of life. These findings suggest that MBI is a promising alternative to conventional interventions in the treatment of depression among dementia patients and warrant further study.
Leukoreduction in ex vivo perfusion circuits: comparison of leukocyte depletion efficiency with leukocyte filters
Authors: Fahradyan Vahe , Annunziata Michael J , Said Sayf , Rao Maya , Shah Hirsh , Ordenana Carlos , Papay Frank A , Rampazzo Antonio , Bassiri Gharb Bahar
Published: May 2020

Background:

Leukodepletion of whole blood-based perfusates remains a challenge in experimental models of ex vivo perfusion. This study investigated the leukoreduction efficacy of the commonly used LeukoGuard LG Arterial and BC2 Cardioplegia filters.

Methods:

Eleven liters of washed porcine blood was used to evaluate the filtration efficiency of LG (n = 6) and BC2 (n = 5) filters. Filter efficacy was tested by passing 1 L of washed blood through each filter. Complete blood count was performed to detect a reduction of white blood cells, red blood cells, and hemoglobin concentration.

Results:

The BC2 Cardioplegia filter showed a significant reduction in white blood cell count (13.16 ± 4.2 × 103 cells/μL pre-filtration, 0.62 ± 0.61 cells/μL post-filtration, p = 0.005), red blood cell count (9.18 ± 0.16 × 106 cells/μL pre-filtration, 9.02 ± 0.16 × 106 cells/μL post-filtration, p = 0.012) and hemoglobin concentration (15.89 ± 0.66 g/dL pre-filtration, 15.67 ± 0.83 g/dL post-filtration, p = 0.017). Platelet reduction in the LG filter group was statistically significant (13.23 ± 13.98 × 103 cells/μL pre-filtration, 7.15 ± 3.31 × 103 cells/μL post-filtration, p = 0.029), but no difference was seen in the BC2 group. There was no significant difference in white blood cell count in the LG filter group (10.12 ± 3.0 × 103 cells/μL pre-filtration, 10.32 ± 2.44 × 103 cells/μL post-filtration, p = 0.861).

Conclusion:

Our results suggest that the LG filter should not be used in ex vivo perfusion circuits for the purpose of leukodepletion. The BC2 filter can be used in EVP circuits with flow rates of less than 350 mL/min. Alternatively, perfusate may be leukodepleted before perfusion.
Hips With Acetabular Retroversion Can Be Safely Treated With Advanced Arthroscopic Techniques Without Anteverting Periacetabular Osteotomy: Midterm Outcomes With Propensity-Matched Control Group
Authors: Maldonado David R. , Chen Jeffery W. , Kyin Cynthia , Rosinsky Philip J. , Shapira Jacob , Karom Jarod M. , Lall Ajay C. , Domb Benjamin G.
Published: May 2020

Background:

Different options, from reverse (anteverting) periacetabular osteotomy to hip arthroscopy, have been proposed for surgical treatment of femoroacetabular impingement syndrome (FAIS) in the setting of acetabular retroversion.

Purpose:

(1) To report and analyze midterm patient-reported outcome scores (PROs) in patients with FAIS and labral tears in the setting of acetabular retroversion after isolated hip arthroscopy and (2) to compare these PROs with those of a propensity-matched control group without acetabular retroversion.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Prospectively collected data were retrospectively reviewed for patients who underwent hip arthroscopy for FAIS and labral tear treatment between June 2008 and March 2014. Inclusion criteria were as follows: acetabular retroversion, pre- and postoperative PROs for modified Harris Hip Score (mHHS), Non-arthritic Hip Score, Hip Outcome Score–Sports Specific Scale (HOS-SSS), and visual analog scale (VAS). Propensity score matching was utilized to identify a control group without acetabular retroversion matched 1:1 with similar age, sex, body mass index, acetabular and femoral head Outerbridge grade, preoperative lateral center-edge angle, and labral treatment. Patient acceptable symptomatic state (PASS) and/or minimal clinically important difference (MCID) for the mHHS, HOS-SSS, International Hip Outcome Tool–12, and VAS was calculated.

Results:

A total of 205 hips with acetabular retroversion were matched to a control group. The groups showed no difference in demographic variables. The retroversion group was composed of 139 female and 66 male hips, with a mean ± SD age of 23.81 ± 7.28 years and follow-up time of 65.24 ± 20.31 months. Intraoperative diagnostic data and procedures performed were similar between groups, except more femoroplasties were performed in the retroversion group. Significant improvements for the mHHS, Non-arthritic Hip Score, HOS-SSS, and VAS were seen for both groups at a mean 5-year follow-up. The proportion of patients who reached the PASS and MCID were similar.

Conclusion:

In the setting of FAIS and labral tears, patients with acetabular retroversion can be safely treated with advanced hip arthroscopic techniques without reverse (anteverting) periacetabular osteotomy in a high-volume surgeon’s hands. Patients with acetabular retroversion demonstrated favorable PROs at midterm follow-up. Furthermore, the proportion of patients reaching the MCID and PASS for several PROs were comparable with those of a propensity-matched control group without acetabular retroversion.
Examining What Works for Youth With Moderate Risk Involved With the Juvenile Justice System: Comparing the Effect of the Community Connections Program and a Vocational Support Program Over a 9-Year Time Period
Authors: Espinosa Erin M. , Sass Dan , Creswell Báez Johanna , Harper Cassandra
Published: May 2020

Using administrative data from an urban juvenile probation department between January 2007 and August 2016, the study included youth who were placed on court-ordered postadjudication community supervision and who were deemed to have a moderate risk of reoffending by the department’s risk and needs assessment. The two programs evaluated include a vocational support program (VSP) and the Community Connections program (CC). Youth across both groups were matched using propensity score matching, creating a final sample of 301 individual youth per program. When examining the program effect of CC versus VSP across six time-to-event variables (i.e., time to second program, detention, out-of-home placement, another offense, violation of court order, and days in program), the findings were mixed. However, across both programs, analyses revealed youth with a successful discharge and longer time spent in their program had better outcomes.
Research Use and Politics in the Federal Higher Education Rulemaking Process
Authors: Natow Rebecca S.
Published: May 2020

This case study examined how research has been used in the federal higher education rulemaking process, through which the U.S. Department of Education implements programs under the Higher Education Act. Findings indicate that in this high-conflict policymaking process, politics infuses various forms of research use to create several overlapping categories of use (political-instrumental, political-conceptual, and political-imposed) that existing typologies of research use omit. This study demonstrates how previous conceptualizations of forms of research use should be expanded to account for these politically infused forms of research use. This study also uncovered consequences of widespread political research use in rulemaking, including a general distrust of research presented in the process and political actors using the same or similar data to reach different conclusions.
Small sample test approach for obtaining P-S-N curves based on a unified mathematical model
Authors: Gao Jianxiong , Yuan Yiping
Published: May 2020

[Formula: see text] curves provide the essential reference data for fatigue life prediction and reliability evaluation of mechanical component. In practical applications, [Formula: see text] curves can be transformed as a group of straight lines in the dual-logarithm coordinates system. Based on such a characteristic and according to the basic principle that two points that do not coincide can uniquely determine a straight line, a small sample test approach for determining [Formula: see text] curves from the viewpoint of geometry is proposed. The proposed approach can derive the [Formula: see text] curves of mechanical component from a unified mathematical model, which can significantly reduce the fatigue test time and the number of specimens. The fatigue test data of engine connecting rod under four stress levels are applied to verify the proposed approach. Compared with traditional group test approach, both the number of specimens and fatigue test time are decreased by 42.11%, but the average relative error of the proposed approach is less than 7%. Furthermore, the proposed approach has the advantages of mathematically being simple and easy to be used in engineering.
Effects of the injection timing on knock and combustion characteristics in dual-fuel dual-injection engines
Authors: Li Jie , Liu Changwen , Kang Rui , Zhou Lei , Wei Haiqiao
Published: May 2020

To utilize ethanol fuel in spark ignition engines more efficiently and flexibly, a new ethanol/gasoline dual-direct injection concept in gasoline engine is proposed. Therefore, based on the dual-fuel dual-direct injection system, the effects of different injection timings and two injector positions on the characteristics of combustion were studied comprehensively, and the effects of different octane numbers and temperature stratifications on knock and combustion were explored. The results show that as for Position A (ethanol injecting toward spark plug), with the delay of injection timing, knock tendency and its intensity increase initially and then decrease due to the comprehensive effect of ethanol evaporation and fuel stratification; on the contrary, for Position B (ethanol injecting toward end-gas region), retarding the injection timing of ethanol can effectively reduce the knock propensity. As for the engine performance, a dual-direct injection performs best, especially the retarded injection timing of ethanol for Position A. It can be found that with the delay of the fuel injection timing, the torque first increases and then decreases. The brake-specific fuel consumption decreases initially and then increases at maximum brake torque spark timing.
Psittacid herpesvirus 3 infection in rose-ringed parakeets in southern Brazil
Authors: Murer Laurete , Ribeiro Marília B. , Kommers Glaucia D. , Soares Mauro P. , Cargnelutti Juliana F. , Flores Eduardo F. , Lovato Maristela
Published: May 2020

We diagnosed disease caused by psittacid herpesvirus 3 (PsHV-3), a novel psittacid pathogen, in rose-ringed parakeets ( Psittacula krameri) housed in an exotic psittacine breeding colony in southern Brazil. The disease affected several adult birds. Clinical signs included apathy, tachypnea, and wheezing. Four birds were autopsied, and sections of lungs and liver were examined histologically and by electron microscopy (EM), revealing pulmonary congestion, bronchopneumonia, or multifocal necrosis of tertiary bronchi, with syncytial cells and eosinophilic intranuclear inclusion bodies. Viral particles morphologically compatible with herpesviruses were observed by EM in lung sections. PCR with pan-herpesvirus primers performed on total DNA extracted from paraffinized tissue resulted in a 278-bp product. Sequencing of the amplicon revealed 93% nucleotide identity with a PsHV-3 sequence available in GenBank. Phylogenetic analysis grouped the obtained sequence with the only PsHV-3 DNA polymerase gene sequence available (GenBank accession JX028240) and separated the sequence from psittacid herpesviruses 1 and 2. The clinical, pathologic, and molecular findings support the association of PsHV-3 with pneumonia found in these rose-ringed parakeets in southern Brazil.
The Diné (Navajo) Hózhó Lifeway: A Focused Ethnography on Intergenerational Understanding of American Indian Cultural Wisdom
Authors: Kahn-John Michelle , Badger Terry , McEwen Marylyn Morris , Koithan Mary , Arnault Denise Saint , Chico-Jarillo Tara M.
Published: May 2020

Purpose: Hózhó is the cultural wisdom that guides the Diné lifeway. This study examines understanding of cultural wisdom (CW) across three generations: elders, adults, and adolescents. Method: A focused ethnography was conducted on the Navajo Nation. Twenty-two Diné (Navajo) were recruited through convenience sampling. Data were collected via two semistructured interviews and photovoice methods. Data were analyzed using content analysis, thematic analysis, and participatory visual analysis of photos. Results: The Diné elders embodied the greatest in-depth understanding of CW followed by the adolescents. An unexpected finding was the scarcity of understanding of CW among the adults. Conclusion: The Diné understanding of CW is transferred through discussion with elders, listening to and speaking traditional language, cultural preservation activities, and participation in cultural practices. The Diné believe cultural wisdom is a health sustaining protective factor, therefore strategies to restore, promote, and support the intergenerational transfer of cultural wisdom remains a tribal priority.
Fault diagnosis of adaptive beam using the Mahalanobis–Taguchi system
Authors: Okubo Hiroshi , Ushiku Toui , Satoh Marika
Published: May 2020

The application of adaptive structures (smart structures) in ultrahigh precision space structures such as X-ray astronomical satellites is being studied extensively. To ensure the reliability of such ultrahigh precision space structures, it is necessary to introduce an automated fault diagnosis system. In this study, the Taguchi method (Mahalanobis–Taguchi system) is applied to the self-diagnosis problem, wherein a damage in the smart structure is detected using the vibration response data of a smart beam. This article reports on the preliminary results of hardware experiments using a smart beam model in the laboratory.
The hysteresis modeling of pneumatic artificial muscles using least squares support vector machine approach
Authors: Xie Shenglong , Ren Guoying
Published: May 2020

Reducing the modeling errors of hysteresis model is of great significance for improving the control accuracy of pneumatic artificial muscles. However, the asymmetry and complexity of its hysteresis loops limit the effect of existing modeling approach, especially for the irregular loops. This article extends the least squares support vector machine approach to the domain of asymmetric and irregular hysteresis characterization for pneumatic artificial muscles. Compared with the established hysteresis models, the significance of this approach is that it does not depend on the shapes of hysteresis loops and possess the advantages of both few identification parameters and high accuracy. The effectiveness and advantage of the presented model is compared with modified symmetric generalized Prandtl–Ishlinskii model. In addition, the length–pressure hysteresis experiment and modeling comparison on both of Festo commercial and self-made pneumatic artificial muscles are presented. The modeling errors of least squares support vector machine model for both loops are suppressed to a negligible level, and are not affected by the shape and complexity of hysteresis loops, which validates the effectiveness of this approach.
Optical coherence tomography angiography reveals vascular alterations in pediatric commotio retinae
Authors: Papageorgiou Eleni , Voutsas Nikolaos , Kotoula Maria , Dastiridou Anna , Tsironi Evangelia E , Androudi Sofia
Published: May 2020

Introduction

Aim of this study is to present the acute and long-term swept-source optical coherence tomography angiography findings in pediatric commotio retinae.

Materials and methods

Two children presented with reduced visual acuity and Berlin edema after blunt trauma.

Results

Swept-source optical coherence tomography revealed hyperreflectivity of the retinal nerve fiber layer and disruption of the ellipsoid zone and the retinal pigment epithelium. Swept-source optical coherence tomography angiography showed enlarged superficial foveal avascular zone in both cases. In the more severe case, there was enlargement of both superficial and deep foveal avascular zone, and reduction of the superficial vascular plexus density.

Conclusion

The present findings suggest that pediatric commotio retinae may be associated with retinal vascular changes, that is, foveal avascular zone enlargement and decreased vessel density. The extent of the microvascular alterations is possibly related to trauma severity.
Lamellar sclerectomy augmented XEN gel stent glaucoma surgery
Authors: Kuo Chih-Hung
Published: May 2020

Purpose

To describe a surgical technique to optimize XEN gel stent position and its outflow.

Methods

A small 1- to 1.5-mm square lamellar sclerectomy was created at the external tip of the XEN gel stent implant. The lamellar scleral tissue, served as a patch graft, was secured at the gel stent insertion site.

Results

Four sequential, unselected, patients with failed primary XEN gel stent surgeries underwent bleb revisions with the technique described. These four patients achieved unmedicated intraocular pressures between 10 and 12 mmHg and a favourable bleb morphology despite repeated mitomycin C applications at 6 months.

Conclusion

Lamellar sclerectomy with auto-scleral graft augmented XEN gel stent surgery deliver successful short-term outcomes without major complications observed.
Ford’s metaphysics: On the Transcendental origins of Henry Ford’s Fordism
Authors: Watt Peter
Published: May 2020

Since it was first articulated by Antonio Gramsci in his Prison Notebooks (1929–1935), Fordism has been understood at two interconnected levels. At one level, it is understood in secular materialist terms as an archetypal system of mass production. At another, as a techno-economic paradigm of capitalist expansion. However, little attention has been given to the philosophical influences and ideas that underpinned Henry Ford’s (1863–1947) worldview and how this came to influence the formation of the factory systems at his Highland Park and River Rouge complexes. In most textbooks, it is assumed that Ford based his industrial design on a technological intensification of F.W. Taylor’s Principles of Scientific Management. This article seeks to examine the origins and rationale behind Ford’s factory system by exploring the relationship between his personal worldview and the ‘ism’ which came to bear his name. Through a cultural-historical analysis, this article critically explores Henry Ford’s personal Fordism, and argues that what has come to be understood as one of the most ‘secular’ and ‘materialist’ processes of organising ‘men and machine’ began with an attempt by Henry Ford to realise a ‘metaphysical’ ideal that was informed by the popular philosophical and theological thought of the previous century. By returning to the ideas and the context of this period, Ford’s engagement with the work of the American Transcendentalist, Ralph Waldo Emerson (1803–1882) is considered to both contextualise Henry Ford’s Fordism and explore the philosophical tensions at the heart of his organisational theory and practice.
Safety and feasibility of the distal transradial approach: A novel technique for diagnostic cerebral angiography
Authors: Saito Shoji , Hasegawa Hitoshi , Ota Tomoyoshi , Takino Toru , Yoshida Yuichi , Ando Kazuhiro , Shibuya Kohei , Takahashi Haruhiko , Suzuki Tomoaki , Oishi Makoto , Fujii Yukihiko
Published: May 2020

Purpose

We aimed to evaluate the safety and feasibility of the distal transradial approach (DTRA) as a novel technique for cerebral angiography based on our institutional initial experience.

Methods

We retrospectively analyzed our institutional database of consecutive diagnostic cerebral angiographies performed with DTRA from December 2018 to August 2019. Patient demographics and clinical and procedural data were recorded.

Results

In total, 51 diagnostic cerebral angiographies in 51 patients (age, 15–83 years; mean age, 59.4 years, SD 13.5; 35 (69%) females) were performed or attempted with DTRA. Ultrasound evaluation showed that the mean inner distal radial artery diameter was significantly smaller than the mean inner forearm radial artery diameter (2.19 mm vs. 2.56 mm, P < 0.001). Cannulation via the distal radial artery was successful in 47 (92%) procedures. In the four procedures that failed, operators converted to the ipsilateral transradial approach without repositioning or redraping. Selective catheterization of the intended vessel was achieved in 64 (91%) of 70 vessels. In the remaining six, operators achieved the objective of the examination with angiography injecting from proximal and conversion to another approach was not required. One patient experienced temporary numbness around the puncture site after the procedure. No radial artery occlusion was identified in the patients who underwent ultrasound evaluation.

Conclusion

Our results demonstrate that DTRA could become a standard approach for diagnostic cerebral angiography owing to the low complication rate and the high cannulation success rate.
High-flow nasal cannula oxygen therapy as an emerging option for respiratory failure: the present and the future
Authors: Spicuzza Lucia , Schisano Matteo
Published: May 2020

Conventional oxygen therapy (COT) and noninvasive ventilation (NIV) have been considered for decades as frontline treatment for acute or chronic respiratory failure. However, COT can be insufficient in severe hypoxaemia whereas NIV, although highly effective, is poorly tolerated by patients and its use requires a specific expertise. High-flow nasal cannula (HFNC) is an emerging technique, designed to provide oxygen at high flows with an optimal degree of heat and humidification, which is well tolerated and easy to use in all clinical settings. Physiologically, HFNC reduces the anatomical dead space and improves carbon dioxide wash-out, reduces the work of breathing, and generates a positive end-expiratory pressure and a constant fraction of inspired oxygen. Clinically, HFNC effectively reduces dyspnoea and improves oxygenation in respiratory failure from a variety of aetiologies, thus avoiding escalation to more invasive supports. In recent years it has been adopted to treat de novo hypoxaemic respiratory failure, exacerbation of chronic obstructive pulmonary disease (COPD), postintubation hypoxaemia and used for palliative respiratory care. While the use of HFNC in acute respiratory failure is now routine as an alternative to COT and sometimes NIV, new potential applications in patients with chronic respiratory diseases (e.g. domiciliary treatment of patients with stable COPD), are currently under evaluation and will become a topic of great interest in the coming years.
(Can’t Get No) Neighborhood Satisfaction? How Multilevel Immigration Factors Shape Latinos’ Neighborhood Attitudes
Authors: Schachter Ariela , Sharp Gregory , Kimbro Rachel T.
Published: May 2020

How does immigrant generation shape Latinos’ neighborhood attitudes? We extend theoretical frameworks focused on neighborhood attainment to explore how immigrant generation structures Latinos’ neighborhood satisfaction, particularly with respect to neighborhood immigrant composition. Using longitudinal data from the Los Angeles Family and Neighborhood Survey, we estimate fixed-effects regression models to examine the associations between self-reported neighborhood satisfaction and changes in neighborhood immigrant composition. We find that first-generation Latino immigrants tend to react more positively to growing immigrant populations in their neighborhoods compared to 1.5-generation and native-born Latinos; these differences are most pronounced in more socioeconomically advantaged neighborhoods. We consider the implications of these attitudinal differences for understanding the mechanisms of Latino residential segregation and neighborhood attainment.
Sleep disordered breathing and metabolic comorbidities across sex and menopausal status in East Asians: the Nagahama Study
Authors: Matsumoto Takeshi , Murase Kimihiko , Tabara Yasuharu , Minami Takuma , Kanai Osamu , Takeyama Hirofumi , Takahashi Naomi , Hamada Satoshi , Tanizawa Kiminobu , Wakamura Tomoko , Komenami Naoko , Setoh Kazuya , Kawaguchi Takahisa , Tsutsumi Takanobu , Morita Satoshi , Takahashi Yoshimitsu , Nakayama Takeo , Hirai Toyohiro , Matsuda Fumihiko , Chin Kazuo
Published: May 2020

It is well known that the prevalence of sleep disordered breathing (SDB) is increased in patients with obesity or metabolic comorbidities. However, the way in which the prevalence of SDB increases in relation to comorbidities according to the severity of obesity remains unclear.

This cross-sectional study evaluated 7713 community participants using nocturnal oximetry ≥2 nights. SDB was assessed by the 3% oxygen desaturation index corrected for sleep duration obtained by wrist actigraphy (acti-ODI3%). SDB severity was defined by acti-ODI3%. Obesity was defined as body mass index ≥25 kg·m−2.

The prevalence of SDB was 41.0% (95% CI 39.9–42.1%), 46.9% (45.8–48.0%), 10.1% (9.5–10.8%) and 2.0% (1.7–2.3%) in normal, mild, moderate and severe SDB, respectively, with notable sex differences evident (males>post-menopausal females>premenopausal females). Comorbidities such as hypertension, diabetes and metabolic syndrome were independently associated with the prevalence of moderate-to-severe SDB, and coincidence of any one of these with obesity was associated with a higher probability of moderate-to-severe SDB (hypertension OR 8.2, 95% CI 6.6–10.2; diabetes OR 7.8, 95% CI 5.6–10.9; metabolic syndrome OR 6.7, 95% CI 5.2–8.6). Dyslipidaemia in addition to obesity was not additively associated with the prevalence of moderate-to-severe SDB. The number of antihypertensive drugs was associated with SDB (p for trend <0.001). Proportion of a high cumulative percentage of sleep time with oxygen saturation measured by pulse oximetry <90% increased, even among moderate-to-severe SDB with increases in obesity.

Metabolic comorbidities contribute to SDB regardless of the degree of obesity. We should recognise the extremely high prevalence of moderate-to-severe SDB in patients with obesity and metabolic comorbidities.
Improved Cycling Stability of LiCoO2 at 4.5 V via Surface Modification of Electrodes with Conductive Amorphous LLTO Thin Film
Authors: Song Shipai , Peng Xiang , Huang Kai , Zhang Hao , Wu Fang , Xiang Yong , Zhang Xiaokun
Published: May 2020

The stability issue of LiCoO2 cycled at high voltages is one of the burning questions for the development of lithium ion batteries with high energy density and long cycling life. Although it is effective to improve the cycling performance of LiCoO2 via coating individual LiCoO2 particles with another metal oxides or fluorides, the rate capacity is generally compromised because the typical coating materials are poor conductors. Herein, amorphous Li0.33La0.56TiO3, one of the most successful solid electrolytes, was directly deposited on the surface of made-up LiCoO2 electrodes through magnetron sputtering. Not only the inherent conductive network in the made-up LiCoO2 electrodes was retained, but also the Li+ transport in bulk and across the cathode-electrolyte interface was enhanced. In addition, the surface chemical analysis of the cycled LiCoO2 electrodes suggests that most of the stability issues can be addressed via the deposition of amorphous Li0.33La0.56TiO3. With an optimized deposition time, the LiCoO2 electrodes modified by Li0.33La0.56TiO3 performed a steady reversible capacity of 150 mAh/g at 0.2 C with the cutoff voltage from 2.75 to 4.5 V vs. Li+/Li and an 84.6% capacity gain at 5 C comparing with the pristine one.