bluuebunny/crossref_metadata_2025 huggingface dataset:
Muscle fatigue analysis in biceps brachii surface electromyography signals using synchrosqueezed Morlet wavelet and singular value decomposition
Authors: Hari Lakshmi M. , Venugopal G. , Ramakrishnan S.
Published: December 2020

Muscle fatigue during isometric contraction of biceps brachii is analysed using synchrosqueezed continuous wavelet transform with Morlet wavelet and singular value decomposition (SVD) features. The recorded surface electromyography signals are decomposed to time frequency matrix using Morlet wavelet and the characteristics are extracted using singular value features such as maximum singular value and zero crossing frequency. The percentage difference in feature values for each segment with the progression of fatigue is calculated. Results show that the recorded signals are complex, non‐stationary, multicomponent, and random in nature. Maximum singular value represents the non‐stationarity of a signal, with an increasing trend towards the fatigue condition. Zero crossing frequency represents the complexity or randomness in the signals and it decreases with the progression of fatigue. It is found that both the features are statistically significant with p < 0.01. It appears that the synchrosqueezed continuous wavelet transform and singular value features are able to analyse fatigue in surface electromyography signals.
Privacy‐preserving evaluation for support vector clustering
Authors: Byun J. , Lee J. , Park S.
Published: December 2020

The authors proposed a privacy‐preserving evaluation algorithm for support vector clustering with a fully homomorphic encryption. The proposed method assigns clustering labels to encrypted test data with an encrypted support function. This method inherits the advantageous properties of support vector clustering, which is naturally inductive to cluster new test data from complex distributions. The authors efficiently implemented the proposed method with elaborate packing of the plaintexts and avoiding non‐polynomial operations that are not friendly to homomorphic encryption. These experimental results showed that the proposed model is effective in terms of clustering performance and has robustness against the error that occurs from homomorphic evaluation and approximate operations.
Fusion of semantic and appearance features for loop‐closure detection in a dynamic environment
Authors: Xu Yan , Huang Jiani
Published: December 2020

Loop‐closure detection is important in large‐scale localisation system. However, it is still difficult in a dynamic environment. An online fast loop‐closure detection algorithm based on Deeplabv3 with MobileNetV2 (DpMn2) as network backbone and local difference binary descriptor is proposed, and the algorithm is named as DpMn2‐LDB. DpMn2 splits out common dynamic objects of images, and then uses visual geometry group network (VGG16) that is trained on place‐centric data to extract global features for nearest neighbour image retrieval. The loop‐closure matches are verified based on LDB descriptors and random sample consensus (RANSAC). Experimental results show that the proposed method can obtain a higher recall rate under 100% precision with less execution time per frame on several public datasets compared with other typical or state‐of‐the‐art algorithms.
Face recognition based on adaptive margin and diversity regularization constraints
Authors: Zhang Zhemin , Gong Xun , Chen Junzhou
Published: December 2020

In recent years, a more robust facial feature can be learned by convolutional neural networks once introducing margins into loss functions. Those methods set a margin for each class manually to squeeze the intra‐class variations within each class equally. However, the internal feature distributions of different persons in the real world are highly unbalanced, and the distance between different identities is not uniform either. As a result, applying the same margin on all classes might not lead to higher inter‐class differences. To address this problem, this paper proposes an adaptive margin based on feature distribution to squeeze the feature interior spaces of different classes. Simultaneously, because the inter‐class margin can adequately represent the distribution of different classes in the feature space, this paper proposes a novel diversity regularization method. The regularization weights of each class are dynamically set depending on their margins. This method proposed in this paper is intuitively interpretable and can be easily applied to other classification scenarios. Experiments on current existing benchmarks have demonstrated the superiority of our method over state‐of‐the‐art competitors.
High‐performance traffic speed forecasting based on spatiotemporal clustering of road segments
Authors: Zhang Zhengchao , He Fang , Lin Xi , Wang Yinhai , Li Meng
Published: December 2020

Traffic speed prediction is an indispensable element of intelligent transportation systems. Numerous studies have devoted to high‐precision prediction models. However, most existing methods implement the link‐wise or network‐wide input. The former is time‐consuming especially for large‐scale applications, while the latter may incur the dilemma of underfitting owing to the heterogeneous traffic states within the entire network. Herein, we propose a novel prediction scheme based on spatiotemporal traffic pattern clustering. Firstly, road segments are partitioned into several groups via the developed clustering approach, which considers both the observed data sequence and spatial topology structure. Subsequently, sequence‐to‐sequence learning architecture is employed for each group to generate predictions for the entire traffic network. Validated by a real‐world dataset in Beijing, our proposed paradigm offers a significant improvement over other well‐known benchmarks for various prediction intervals in terms of prediction accuracy and computational efficiency.
Construction of α-Alkylated Amines by Iridium Complex-Catalyzed One-Step Transfer Hydrogenation of C=C and C=N Bonds
Authors: Luo Renshi , Xia Yanping , Ouyang Lu , Liao Jianhua , Yang Xiao
Published: December 2020

Hydrogenation of C=C bond and reductive amination are important transformations utilized in chemistry. An environmentally friendly, efficient, and facile one-pot transfer hydrogenation of C=C bond of enones and reductive amination of C=N bond of imines are reported using iridium complex as catalysts and formic acid as hydrogen source in aqueous medium. In this catalytic system, a wide range of α-alkylated amines were obtained in excellent yields by one-pot transfer hydrogenation of C=C bond and reductive amination. The practical application of this protocol is characterized by gram-scale transformation.
Single Stage Nasal Reconstruction in a Near Total Nasal Defect
Authors: Brajesh Vimalendu , Aggarwal Aditya , Singh Sukhdeep , Vora Vishal , Rana Kanika
Published: December 2020

Reconstruction of nasal defect is difficult and challenging. A full-thickness defect of nose requires reconstruction of thin inner lining, middle skeletal (bony/cartilaginous) support, and outer skin layer cover. Large full-thickness defects of nose require complex multistage reconstruction to achieve good functional and aesthetic result. We present here a case of 12-year-old boy, a known case of xeroderma pigmentosa, who underwent wide local excision for squamous cell carcinoma of the nose, leaving a near total defect of the external nose. The reconstruction was done with a suprafascial, thin radial artery forearm free-flap for the external cover as well as the inner lining along with the septal cartilage graft for skeletal support in a single stage.
Hylocereus undatus (dragon fruit).
Authors: Rojas-Sandoval Julissa , Praciak Andrew
Published: December 2020

Hylocereus undatus is a vine-like cactus that is often grown as a night-flowering ornamental plant and as a fruit crop. The fruit is highly decorative, with a bright red skin, studded with green scales. The flesh is white, juicy and delicious in flavour, with tiny black seeds. Its exact native range is uncertain but is considered to be in Central America. Since the late twentieth century it has been widely planted on a commercial scale as a fruit crop in many tropical regions, particularly in Vietnam and other South-East Asian countries, and has escaped widely from cultivation, become naturalized and in many instances become an invasive weed, sometimes threatening native plants and habitats. Currently it is listed as invasive in China, Australia, South Africa, Cuba, and on many islands in the Pacific Ocean (Oviedo Prieto et al., 2012; PIER, 2016 ; Queensland Government, 2016 < datasheet/27317 >).
Zeuxine strateumatica (soldier's orchid).
Authors: Vélez-Gavilán Jeanine
Published: December 2020

DYW-type PPR proteins independently evolved in mosses and flowering plants restore RNA editing defects across wide phylogenetic distances.
Linearizing a non-linear formulation for general relativistic dissipative fluids
Authors: Celora T , Andersson N , Comer G L
Published: December 2020

Fully non-linear equations of motion for dissipative general relativistic multi-fluids can be obtained from an action principle involving the explicit use of lower dimensional matter spaces. More traditional strategies for incorporating dissipation—like the famous Müller–Israel–Stewart model—are based on expansions away from equilibrium defined, in part, by the laws of thermodynamics. The goal here is to build a formalism to facilitate comparison of the action-based results with those based on the traditional approach. The first step of the process is to use the action-based approach itself to construct self-consistent notions of equilibrium. Next, first-order deviations are developed directly on the matter spaces, which motivates the latter as the natural arena for the underlying thermodynamics. Finally, we identify the dissipation terms of the action-based model with first-order ‛thermodynamical’ fluxes, on which the traditional models are built. The description is developed in a general setting so that the formalism can be used to describe multi-fluid systems, for which causal and stable models are not yet available. As an illustration of the approach, a simple application of a single viscous fluid is considered and, even though the expansion is halted at first order, we sketch how a causal response can be implemented through Cattaneo-type equations.
Lessons from conformally reduced quantum gravity
Authors: Knorr Benjamin
Published: December 2020

In this work we study a significantly enlarged truncation of conformally reduced quantum gravity in the context of asymptotic safety, including all operators that can be resolved in such a truncation including up to the sixth order in derivatives. A fixed point analysis suggests that there is no asymptotically safe fixed point in this system once one goes beyond an Einstein–Hilbert approximation. We will put these findings into context and discuss some lessons that can be learned from these results for general non-perturbative renormalisation group flows.
Approaching detachment in I-mode—response of core confinement and the edge pedestal in the ASDEX Upgrade tokamak
Authors: Happel T. , Reinke M.L. , Silvagni D. , Bernert M. , Grover O. , Hennequin P. , Hubbard A.E. , Plank U. , Trier E. , Brida D. , David P. , Fischer R. , Gil L. , Höfler K. , Manz P. , McDermott R.M. , Merle A. , Stroth U. , Viezzer E. , Willensdorfer M. , the ASDEX Upgrade Team  , the EUROfusion MST1 Team
Published: December 2020

Experiments on nitrogen assisted divertor detachment in the improved energy confinement mode (I-mode) are reported from the ASDEX Upgrade tokamak. When nitrogen is introduced into the divertor and radiation losses cool the divertor plasma down, a loss of core confinement is observed, concomitant with an increase in low frequency edge fluctuation levels. The loss in confinement can be compensated and the I-mode can be maintained by additional heating power input. Detachment of the inner divertor leg has been observed for the first time in an I-mode discharge. The outer divertor leg remains attached in these experiments. Good energy confinement properties (H
98(y, 2) = 0.9) during the detachment of the inner divertor leg are reported.
Integrated modeling of CFETR hybrid scenario plasmas
Authors: Chen Jiale , Chan Vincent S. , Jian Xiang , Zhang Xinjun , Ren Qilong , Li Guoqiang , Zhou Chengxi , CFETR Physics Team
Published: December 2020

Demonstration of DEMO relevant fusion power (P
fus) level and tritium self-sufficiency are two important goals of the China fusion engineering testing reactor (CFETR). In this work the integrated modeling including self-consistent core–pedestal coupling are used to design the hybrid scenario plasmas at flat-top phase for these goals. Such plasmas have been taken as the reference plasma for studying the compatibility of the hybrid scenario with CFETR engineering design in the past two years. The physics justification for the selection of plasma density, Z
eff, safety factor profile, and in particular the choice of auxiliary heating and current drive is presented. According to a scan of plasma density and Z
eff, the target of P
fus ≈ 1 GW and finite ohmic flux consumption ∆Φohm (4 h) ⩽ 250 Vs can be met with Z
eff = 1.9–2.2 and the density at the pedestal top set at 90% of the Greenwald limit. Turbulent transport analysis using the gyro-Landau-ﬂuid model TGLF shows that the electromagnetic effects can enhance the energy confinement but reduce the particle confinement and thus P
fus. A baseline hybrid scenario case matching the target in the concept design is built using a combination of neutral beams (NB) and electron cyclotron (EC) waves to flatten the safety factor profile in the deep core region (with the normalized plasma radius ρ ⩽ 0.4). Such profile can yield better particle and energy confinement than that with either higher magnetic shear in the deep core region or higher q value in outer core region (e.g., due to the addition of lower hybrid current drive). Switching a part of auxiliary heating from electron to ions, e.g., replacing a part of EC waves by waves in the ion cyclotron range of frequencies, reduces the particle confinement and thus P
fus. Since high harmonic fast waves (HHFW) can drive current at the same location as ECCD with higher current drive efficiency than ECCD and yield more electron heating than NB, the case using HHFW to replace a part of EC waves and NB can yield higher P
fus and lower ∆Φohm than the baseline case. A discussion is given on future simulations to explore the improvement in plasma performance and the broadening of the feasible design space.
The achievement of competency standards for machining graduates
Authors: Munadi S , Choiron Z , Harjanto C T , Ardhantano R
Published: December 2020

This study aims to determine the achievement of competency standards of graduates in the fields of lathe machining, milling machining, grinding machining, CNC machining at Piri 1 Yogyakarta Vocational High School. This study uses a descriptive method with a quantitative approach. The subjects of this study were teachers and students of class XII of the engineering technique of Piri 1 Yogyakarta Vocational High School. The data collection technique used a questionnaire and documentation. The data analysis technique used is descriptive statistical analysis. Based on the results of the research, it is known that the achievement of the competency standards of lathe machining graduates is in the excellent category with an average value of 82.51 and the results of the questionnaire show the excellent category The achievement of competency standards for milling machining graduates was in the excellent category with an average score of 84.74 and the results of the questionnaire showed an excellent category. The achievement of the competency standard of grinding machining graduates is in the excellent category with an average score of 80.42, and the results of the questionnaire show an excellent category. The achievement of competency standards for CNC machining graduates is in the excellent category with an average score of 77.81, and the results of the questionnaire show an excellent category.
Linguistic verbal intelligence in welding practice lectures
Authors: Djatmiko R D , Wibowo Y E , Marwanto A
Published: December 2020

This study aims to determine student linguistic intelligence, the level of student linguistic intelligence, and measure the relationship between linguistic intelligence and learning outcomes of welding practice lectures in the Undergraduate Program of Mechanical Engineering Education, Faculty of Engineering, Yogyakarta State University. The method used is a survey. The research was carried out in the Undergraduate Program of Mechanical Engineering Education, Faculty of Engineering, Yogyakarta State University. The research was conducted from April to July 2020. The research subjects were students of the 2018 batch of Undergraduate Program of Mechanical Engineering Education, Faculty of Engineering, Yogyakarta State University. The research variables are students’ linguistic intelligence (independent) and the learning outcomes of welding practice lectures (dependent). The results showed that the students’ verbal-linguistic intelligence was at an average value of 72.01%. 7.79% or as many as 6 students made verbal-linguistic intelligence the highest score compared to other intelligence. The significance value (Sig.) Is 0.450 and greater than 0.05, so it can be concluded that Ha is rejected, and H0 is accepted, that is, there is no significant influence between the verbal-linguistic intelligence of students (X) on student learning outcomes of welding practice (Y). The value of R Square is 0.009, which means that the effect of verbal-linguistic intelligence on students (X) on the learning outcomes of students in the Undergraduate Program of Mechanical Engineering Education, Faculty of Engineering, Yogyakarta State University (Y) is only 0.9% while 99.1% is influenced by other variables.
Development of bamboo handicraft product from Brajan Sendanggung Minggrir Sleman
Authors: Paryanto  , Nurhayati I , Indartono S
Published: December 2020

The targets of this activity are small and medium enterprises (SME) Prinx Mas and Pring Gedhe. This activity’s main objectives are to improve the quality and quantity of products, increase the comfort level of owned facilities/facilities, and increase the product marketing network. The method used is by implementing technology assistance activities as well as training and mentoring. Technology assistance in the form of production equipment, arrangement of the showroom, updating the website and enhancing partners’ capabilities by providing various training and mentoring. The technology equipment provided to partners is a multi-functional grinding machine and drying oven. Meanwhile, the training held was training on the fabrication process and training in drafting contract drafting. The results that have been achieved are (1) Prinx Mas SME experienced an increase in productivity by 11%, an increase in assets by 4.5%, and an increase in turnover by 8.75%; (2) Pring Gedhe SME experienced an increase in productivity by 8.8%, an increase in assets by 4.8%, and an increase in turnover by 7.3%.
Implementation of the blended learning approach in lathe machining learning
Authors: Purwoko B S H , Sukardi T , Rahdiyanta D , Harjanto C T , Saputra D
Published: December 2020

The purpose of this research is to conduct an empirical study to analyze the influence of the aspects related to the application of the blended learning approach and individual student characteristics, especially origin school, on learning outcomes of Lathe Machining. This research is a Quasi Experiment using the Treatment by Level design. The research data analysis was conducted using 2-way ANOVA with one treatment variable and one attribute variable. This research was conducted at the Machining Workshop, Department of Mechanical Education, Faculty of Engineering, Universitas Negeri Yogyakarta. The results of this study indicate; 1) The learning outcomes of students who take learning using the Blended Learning approach are higher than students who take learning using the conventional approach; 2) There is an interaction effect between the learning approach and the origin of the school on learning outcomes of Lathe Machining; 3) The learning outcomes of students from vocational high schools who take blended learning approach are higher than students from vocational schools who take conventional approaches; 4) The learning outcomes of senior high school students who take learning with the blended learning approach are not different from those from vocational high school students who take the conventional approach.
Braking and acceleration mapping control for autonomous overtaking to avoid fatality crash in undivided road
Authors: Sumarli  , Harly Muchammad , Marji
Published: December 2020

Autonomous vehicle control needs two essential algorithms, the first path planning, it covers either finding vehicle subject position and destination point and environment identification to avoid obstacle within tailgating, lane change and overtaking. The second to be tracking control to realize drive, brake and steering action based on complexity of path planning. This research contribute to a path planning for unidirectional and bidirectional on non-lane undivided roads overtaking.It need to be designed and investigated the desired acceleration of vehicle subject for tailgating and overtaking vehicle object 1 in front and has same direction without crash with vehicle object 2, what come front the opposite direction. The results of the investigation show that the desired acceleration of the subject vehicle can be properly mapped under condition of varied position, velocity and acceleration of overtaken vehicle object 1 and vehicle object 2. The maximum desired acceleration was eliminated by consideration of critical rolling and sliding velocity of vehicle subject. The acceleration mapping can be used for safety overtake planning.
Developing learning media of electronic fuel injections (efi) system android-based
Authors: Rohman J N , Ikhsan M R , Solikin M
Published: December 2020

This research aims to: (1) producing android-based Electronic Fuel Injections (EFI) learning media; (2) knowing the feasibility of android-based EFI learning media; and (3) knowing students’ responses to the learning media of the Android-based Electronic Fuel Injections (EFI) system. The rsearch was conducted using the Borg and Gall model modified by Sugiyono. The technique of data collection is done by questionnaire, while the data analysis technique uses descriptive quantitative methods. The results of the research were obtained: (1) products in the form of Android-based Electronic Fuel Injections (EFI) system learning media; (2) learning media in terms of material included in the very feasible category and in terms of media included in the very feasible category; and (3) students’ responses when testing the product, the aspects of use are included in the category very easily and the aspects of usefulness are included in the category of very useful. The response of students when testing the use, the aspects of use included in the category is very easy and the usefulness aspects including the category is very useful.
Simple Design of Electronics Engine Management for Motorcycle
Authors: Sutiman  , Adiyasa I W , Prayoga A , Irfak A G , Ardiyan R S
Published: December 2020

The use of an electronic system to regulate the injection system is a solution that can improve the performance and fuel efficiency of an engine. However, conventional vehicles require retrofit to be able to use the electronic fuel injection (EFI) system. The design uses a microcontroller system with ARM32 architecture. The inputs used to determine the duration and timing of the injection are a crankshaft position sensor (CKP), throttle position sensor (TPS), manifold absolute pressure (MAP), air temperature sensor (ATS), and lambda sensor. Before the sensor signal enters the microcontroller, the signal is filtered using a low pass filter (LPF) with a cut-off point of 50Hz. The actuator system consists of an injector. While the ignition system can use a capacitor discharge ignition (CDI). The novelty in this design is that the type of sensor can be replaced with a resistant type sensor. So that there will be many variants of the fuel injection system tuning retrofit that can be done with conventional motors.
Tenofovir Alafenamide to Prevent Perinatal Hepatitis B Transmission: A Multicenter, Prospective, Observational Study
Authors: Zeng Qing-Lei , Yu Zu-Jiang , Ji Fanpu , Li Guang-Ming , Zhang Guo-Fan , Xu Jiang-Hai , Chen Zhi-Min , Cui Guang-Lin , Li Wei , Zhang Da-Wei , Li Juan , Lv Jun , Li Zhi-Qin , Liang Hong-Xia , Sun Chang-Yu , Pan Ya-Jie , Liu Yan-Min , Wang Fu-Sheng
Published: December 2020

Background

Few safety and effectiveness results have been published regarding the administration of tenofovir alafenamide fumarate (TAF) during pregnancy for the prevention of mother-to-child transmission (MTCT) of hepatitis B virus (HBV).

Methods

In this multicenter prospective observational study, pregnant women with HBV DNA levels higher than 200 000 IU/mL who received TAF or tenofovir disoproxil fumarate (TDF) from gestational weeks 24–35 to delivery were 1:1 enrolled and followed until postpartum month 6. Infants received immunoprophylaxis. The primary endpoint was the safety of mothers and infants. The secondary endpoint was the hepatitis B surface antigen (HBsAg)-positive rate at 7 months for infants.

Results

In total, 116 and 116 mothers were enrolled, and 117 and 116 infants were born, in the TAF and TDF groups, respectively. TAF was well tolerated during a mean treatment duration of 11.0 weeks. The most common maternal adverse event was nausea (19.0%). One (0.9%), 3 (2.6%), and 9 (7.8%) mothers had abnormal alanine aminotransferase levels at delivery and at postpartum months 3 and 6, respectively. The TDF group had safety profiles that were comparable to those of the TAF group. No infants had birth defects in either group. The infants’ physical and neurological development at birth and at 7 months in the TAF group were comparable with those in the TDF group. The HBsAg positive rate was 0% at 7 months in all 233 infants.

Conclusions

Antiviral prophylaxis with TAF was determined to be generally safe for both mothers and infants and reduced the MTCT rate to 0%.
What’s left in the cupboard? Older antimicrobials for treating gonorrhoea
Authors: Fifer Helen , Livermore David M , Uthayakumaran Thinushaa , Woodford Neil , Cole Michelle J
Published: December 2020

Background

Neisseria gonorrhoeae has developed resistance to all antimicrobials used to treat gonorrhoea, with even ceftriaxone being undermined. It is therefore important to examine any potential to redeploy older antimicrobials routinely used for other infections to treat ceftriaxone-resistant gonococcal infections.

Objectives

We examined the susceptibility of N. gonorrhoeae to aztreonam, chloramphenicol, co-trimoxazole, fosfomycin, piperacillin/tazobactam and rifampicin.

Methods

N. gonorrhoeae isolates (n = 94) were selected to include a range of antimicrobial susceptibilities: 58 were collected in the Gonococcal Resistance to Antimicrobials Surveillance Programme; 17 were clinical isolates referred to the PHE reference laboratory; and 19 were control strains. MICs were determined by agar dilution for the six study antimicrobials and for ceftriaxone and azithromycin as comparators.

Results

There was correlation between piperacillin/tazobactam and ceftriaxone MICs, but all five isolates with high ceftriaxone MICs (>0.5 mg/L) were inhibited by piperacillin/tazobactam at 0.06–0.5 mg/L. Aztreonam MICs for ceftriaxone-resistant isolates exceeded those of ceftriaxone. Among non-β-lactams, fosfomycin and co-trimoxazole had low, tightly clustered MICs, suggesting widespread susceptibility, rifampicin split the collection into highly susceptible and highly resistant groups and chloramphenicol had a wide MIC distribution.

Conclusions

Although unsuitable for empirical use, piperacillin/tazobactam, fosfomycin, co-trimoxazole, rifampicin and, possibly, chloramphenicol could be considered for individual patients with ceftriaxone-resistant gonococcal infection once MICs are known. Wider surveillance of the susceptibility of N. gonorrhoeae to these agents is needed, along with clinical trials and the establishment of clinical breakpoints for N gonorrhoeae.
Data-driven method for an improved linearised AVO inversion
Authors: Niu Liping , Geng Jianhua , Wu Xinming , Zhao Luanxiao , Zhang Hong
Published: December 2020

Linearised approximations of the Zoeppritz equation are widely used for amplitude versus offset (AVO) forward modelling and prestack seismic inversion. However, current linearised approximations typically exhibit large errors for strong-contrast media and large incidence angles (even for those less than the critical angle), leading to poor quality estimation of elastic parameters. We therefore develop a data-driven method to improve the linearised AVO approximation, based on the concept that the inaccuracy of the conventional linearised AVO forward operator is solely responsible for generating residuals of the PP reflection coefficients calculated by the conventional linearised approximation compared with using the Zoeppritz equation. Therefore, if true model parameters from well-logging data are known, the residuals of the PP reflection coefficients can be used to estimate linear modifications of the inaccurate linearised AVO forward operators at well sites. We apply estimated linear modifications to original inaccurately linearised forward operators to obtain an improved linear AVO operator (ILAO). Because ILAOs can only be estimated at the well sites by the data-driven method, we construct spatially variant ILAOs using structure-guided interpolation for those at a distance from the well sites. Numerical example results reveal that the improved linear AVO approximation is more accurate than the Aki–Richards approximation for strong-contrast media and large incident angles. Moreover, the accuracy and resolution of the inverted P- and S-wave velocities and density using ILAOs are higher than those using the conventional Aki–Richards operators. Finally, application to the field data successfully demonstrates the feasibility and effectiveness of the improved linearised AVO inversion method.
Structural insights into the substrate specificity of the endonuclease activity of the influenza virus cap-snatching mechanism
Authors: Kumar Gyanendra , Cuypers Maxime , Webby Richard R , Webb Thomas R , White Stephen W
Published: December 2020

The endonuclease activity within the influenza virus cap-snatching process is a proven therapeutic target. The anti-influenza drug baloxavir is highly effective, but is associated with resistance mutations that threaten its clinical efficacy. The endonuclease resides within the N-terminal domain of the PA subunit (PAN) of the influenza RNA dependent RNA polymerase, and we report here complexes of PAN with RNA and DNA oligonucleotides to understand its specificity and the structural basis of baloxavir resistance mutations. The RNA and DNA oligonucleotides bind within the substrate binding groove of PAN in a similar fashion, explaining the ability of the enzyme to cleave both substrates. The individual nucleotides occupy adjacent conserved pockets that flank the two-metal active site. However, the 2′ OH of the RNA ribose moieties engage in additional interactions that appear to optimize the binding and cleavage efficiency for the natural substrate. The major baloxavir resistance mutation at position 38 is at the core of the substrate binding site, but structural studies and modeling suggest that it maintains the necessary virus fitness via compensating interactions with RNA. These studies will facilitate the development of new influenza therapeutics that spatially match the substrate and are less likely to elicit resistance mutations.
Tributyltin Alters Calcium Levels, Mitochondrial Dynamics, and Activates Calpains Within Dorsal Root Ganglion Neurons
Authors: Fross Shaneann , Mansel Clayton , McCormick Madison , Vohra Bhupinder P S
Published: December 2020

Tributyltin (TBT) remains a global health concern. The primary route of human exposure to TBT is either through ingestion or skin absorption, but TBT’s effects on the peripheral nervous system have still not been investigated. Therefore, we exposed in vitro sensory dorsal root ganglion (DRG) neurons to TBT at a concentration of 50–200 nM, which is similar to the observed concentrations of TBT in human blood samples. We observed that TBT causes extensive axon degeneration and neuronal death in the DRG neurons. Furthermore, we discovered that TBT causes an increase in both cytosolic and mitochondrial calcium levels, disrupts mitochondrial dynamics, decreases neuronal ATP levels, and leads to the activation of calpains. Additional experiments demonstrated that inhibition of calpain activation prevented TBT-induced fragmentation of neuronal cytoskeletal proteins and neuronal cell death. Thus, we conclude that calpain activation is the key executioner of TBT-induced peripheral neurodegeneration.
Lifestyle, psychological, socioeconomic and environmental factors and their impact on hypertension during the coronavirus disease 2019 pandemic
Authors: Kreutz Reinhold , Dobrowolski Piotr , Prejbisz Aleksander , Algharably Engi A.E-H , Bilo Grzegorz , Creutzig Felix , Grassi Guido , Kotsis Vasilios , Lovic Dragan , Lurbe Empar , Modesti Pietro A. , Pappaccogli Marco , Parati Gianfranco , Persu Alexandre , Polonia Jorge , Rajzer Marek , de Timary Philippe , Weber Thomas , Weisser Burkhard , Tsioufis Konstantinos , Mancia Giuseppe , Januszewicz Andrzej
Published: December 2020

The coronavirus disease 2019 (COVID-19) pandemic considerably affects health, wellbeing, social, economic and other aspects of daily life. The impact of COVID-19 on blood pressure (BP) control and hypertension remains insufficiently explored. We therefore provide a comprehensive review of the potential changes in lifestyle factors and behaviours as well as environmental changes likely to influence BP control and cardiovascular risk during the pandemic. This includes the impact on physical activity, dietary patterns, alcohol consumption and the resulting consequences, for example increases in body weight. Other risk factors for increases in BP and cardiovascular risk such as smoking, emotional/psychologic stress, changes in sleep patterns and diurnal rhythms may also exhibit significant changes in addition to novel factors such as air pollution and environmental noise. We also highlight potential preventive measures to improve BP control because hypertension is the leading preventable risk factor for worldwide health during and beyond the COVID-19 pandemic.
Changes in Vestibular/Ocular-Motor Screen Scores in Adolescents Treated With Vestibular Therapy After Concussion
Authors: Alsalaheen Bara , Carender Wendy , Grzesiak Melissa , Munday Cindy , Almeida Andrea , Lorincz Matthew , Marchetti Gregory F.
Published: December 2020

Purpose:

To examine interrelationships among Vestibular/Ocular-Motor Screen (VOMS) items and to characterize the recovery of VOMS performance in a sample of adolescents treated with vestibular physical therapy (VPT) after concussion.

Methods:

Seventy-seven patients with concussion and 77 participants without concussion completed the study. Adolescents with concussion received an individualized VPT intervention consisting of targeted exercises for gaze stability, postural stability, ocular-motor control, habituation, and aerobic activities. The exercises were performed during a weekly clinic visit and via a home exercise program.

Results:

Except for near-point convergence distance, all VOMS items were significantly interrelated. Over the course of VPT, significant improvements in VOMS performance were observed, and discharge scores were similar to scores observed in adolescents without concussion.

Conclusions:

The VOMS measured moderately related functions and captured changes over the course of VPT. Clinicians should consider the contextual risk of “false positive” in their interpretation of VOMS.
A Survey of Pediatric Competencies in Entry-Level Physical Therapy Programs in Australia
Authors: Baque Emmah , Jones Taryn , Bialocerkowski Andrea
Published: December 2020

Purpose:

To describe perspectives of pediatric physical therapy clinical facilitators on contemporary curricula for Australian entry-level physical therapy programs.

Methods:

Physical therapy clinical facilitators completed an online survey based on the Academy of Pediatric Physical Therapy of the APTA essential competencies.

Results:

Conditions including cerebral palsy, cystic fibrosis, and prematurity were highly rated by most participants to include in an entry-level program. Exercise prescription, goal-directed training, and group-based physical therapy were the highest rated interventions. Outcome measures considered important to include were the Alberta Infant Motor Scale and Goal Attainment Scale. Students should demonstrate knowledge and skills using relevant frameworks and have practical opportunities to interact with children.

Conclusion:

Pediatric clinical facilitators perceived that theoretical knowledge on frameworks, human development, movement skills, pediatric conditions, exercise prescription, and outcome measurement as well as face-to-face experiences with children are important to include in Australian entry-level physical therapy programs.
Quality of Life and Functional Mobility After Progressive Resistance Exercise in an Adolescent With a Liver Transplant
Authors: Burkhardt Julie A. , Rapport Mary Jane K.
Published: December 2020

Purpose:

This case report describes physical therapy intervention using progressive resistance exercise (PRE) with the recipient of a liver transplant to improve physical fitness, quality of life, and functional mobility.

Summary of Key Points:

Outpatient physical therapy intervention included 2 phases, 10 weeks each, focused on functional training and PRE-based power training and functional tasks. Secondary conditions included excessive weight gain, adjustment disorder, and intensive scarring.

Statement of Conclusions:

PRE-based power training appears to be effective in an adolescent with decreased strength and endurance following liver transplant. Improvements in 1 repetition maximum, functional mobility, aerobic/anaerobic fitness, patient-directed goals, and quality of life were measurable.

Recommendations for Clinical Practice:

A PRE-based program may be useful in physical therapy with adolescents after liver transplant. Choice of musculature for training should be relevant to functional limitations and dosing of exercises must be sufficient for muscular hypertrophy.
In-Home Mobility Training With a Portable Body Weight Support System of an Infant With Down Syndrome
Authors: Kokkoni Elena , Stoner Tracy , Galloway James C.
Published: December 2020

Purpose:

To report on the feasibility of an open-area, portable body weight support system (PBWSS) for in-home use and overground mobility training in an infant with Down syndrome.

Summary of Key Points:

The family used the PBWSS on average 4 days/week and for a mean duration of 27.9 minutes/day. Within sessions, the infant's mobility in the open area was greater with PBWSS assistance. The infant's mobility increased whereas variable trends were noted in the infant's motor, language, and cognitive development.

Conclusions:

The long-term and frequent use of the PBWSS by this family provided opportunities to practice on emerging motor skills and exploratory actions that may have had a positive effect on her mobility and overall development.

Recommendation for Clinical Practice:

High-dose, body weight–supported training on emerging motor skills is feasible in the infants' natural environments. Future studies using a large sample will quantify the effects.
An Initiative to Reduce Preterm Infants Pre-discharge Growth Failure Through Time-specific Feeding Volume Increase
Authors: Chu Sherman S. , White Heather O. , Rindone Shannon L. , Tripp Susan A. , Rhein Lawrence M.
Published: December 2020

Introduction:

Very low birth weight infants often demonstrate poor postnatal longitudinal growth, which negatively impacts survival rates and long-term health outcomes. Improving extrauterine growth restriction (EUGR) among extremely premature infants has become a significant focus of quality improvement initiatives. Prior efforts in the University of Massachusetts Memorial Medical Center neonatal intensive care unit were unsuccessful in improving the EUGR rate at discharge.

Methods:

The primary aim of this initiative was to improve EUGR at discharge [defined as weight less than 10th percentile for postmenstrual age (PMA)] for infants born ≤32 0/7 weeks from a baseline of 25% to 20% by June 2019. We excluded all small for gestational age infants due to the limitation in the EUGR definition. A multidisciplinary team implemented evidence-based nutritional guideline changes using the Institute of Healthcare Improvement methods. The most notable change was the time-specific feeding volume advancement that increased the goal feeding volume between 31 0/7 and 34 0/7 weeks PMA from 150–160 to 170–180 milliliters per kilogram per day. The team monitored nutritional intake, weight, necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), and length of stay (LOS).

Results:

The EUGR rate improved from 25% to 12% after initiation of increased time-specific, enteral feeding guidelines at 31–34 weeks PMA. NEC rate, BPD rate, and LOS remained unchanged throughout the initiative.

Conclusions:

By implementing a time-specific volume increase guideline from 31 0/7 to 34 0/7 weeks PMA, the EUGR rate improved from baseline of 25% to 12% without increasing NEC rate, BPD rate, and LOS.
Improvement Initiative to Ensure Quality Instrumentation in the OR
Authors: Palo Renda J. , Dulaney Bumpers Qran , Mohsenian Yasamin
Published: December 2020

Introduction:

At Seattle Children’s Hospital, in November 2016, the operating room (OR) physicians reported experiencing a high number of issues occurring during cases and believed a significant amount was related to sterile processing department (SPD) errors. These errors, hereafter called “defects,” were not defined or routinely reported. There was no method of capturing these defects. There was no root cause analysis or trending of defect data. This project aimed to improve the quality of surgical instruments received in the OR.

Methods:

The SPD and OR leaders collaborated to develop an OR Case Sign-Out form to capture defects during the case. The data were triaged and assigned to specific departments for root cause analysis. The SPD related data were depicted with a Pareto chart to highlight the most significant opportunities for improvement. We developed a driver diagram and identified the following interventions: orientation and competency, technician OR rotation, capacity/full-time employee analysis, surgical instruments inventory, instrument pouch work trigger, work environment, preventative maintenance, and instrument wrap reduction.

Results:

A 56% improvement in “Non-Sterile” defects was achieved. While a centerline shift in “Sterile” defects was not observed, the most significant “Sterile” defect, “breach of soft instrument wrap,” dropped from 8 occurrences (at baseline) to 1. The number of OR case sign-out forms collected plateaued at 47%, which could indicate missing defect data.

Conclusions:

SPD improved quality in the OR by reducing instrument defects. The physicians gained a mechanism for reporting barriers and tracking improvements. Ultimately, the utilization of lean tools and a quality improvement approach helped drive process changes, creating a more efficient, collaborative, and safe procedural environment for patients and staff.
Better Outcomes for Hospitalized Children through Safe Transitions: A Quality Improvement Project
Authors: Pritt Audra , Johnson Anthony , Kahle Jordan , Preston Deborah L. , Flesher Susan
Published: December 2020

Introduction:

This project’s goal was to implement an already validated pediatric discharge toolkit to enhance the effectiveness of transition from hospital to home, thus reducing 30-day readmission rates.

Methods:

This quality improvement study involved implementing a pediatric discharge planning toolkit to improve upon predetermined outcome measures. Critical elements in the toolkit included: (1) comprehensive patient risk assessment on admission; (2) teach-back curriculum; (3) fax or phone call to the primary care physician; (4) 72-hour follow-up calls; and (5) follow-up appointments, scheduled before discharge, within 2 weeks from discharge from hospital. We used the toolkit to gather data on pediatric patients as they were admitted and then prepare them for discharge from December 2016 until March 2017. The primary outcome measure was the 30-day readmissions to the hospital, and the secondary outcome measure was patient satisfaction scores. Our balancing metrics included follow-up appointments made and length of stay. These measures were compared with preintervention hospital pediatric administrative data collected from December 2015 through March 2016.

Results:

Data collected during the study period (n = 91) compared to preintervention hospital administrative data collected the year prior (n = 132) showed a 31% reduction in readmissions, 4.8% and 7%, respectively (95% confidence interval 0.68–3.8), P = 0.004. Patient satisfaction scores showed no statistical significance. All patients (100%) in both groups had follow-up appointments made before discharge, and the length of stay showed no statistical difference.

Conclusions:

This pediatric discharge toolkit improved the efficacy of transition from hospital to home by reducing 30-day readmissions. Patient satisfaction scores were not reduced by utilizing the toolkit.
Questionnaires to Measure Process and Structure of Quality Indicators for Pediatric Nursing
Authors: Forsner Maria , Mörelius Evalotte , Hanberger Lena
Published: December 2020

Introduction:

The quality of nursing care has a significant impact on the outcomes of care. The specific needs of children requiring hospital care make it essential to monitor and compare data not only on the medically oriented outcome measure but also on nursing care, structure, and process, requiring perspectives from registered nurses (RNs) and nurse managers (NMs). Thus, this project aimed to evaluate the structure and process of nursing quality indicators in pediatric hospital care with questionnaires distributed to RN and NM.

Methods:

We developed separate questionnaires for NMs and RNs to assess the process and structure of the quality indicators of breastfeeding, management of pain, venous access, medication management, and provision of a child-oriented environment. Nine NMs and 113 RNs from 9 pediatric wards answered the questionnaires.

Result:

Local guidelines were available for 3 out of the 5 quality indicators: pain management, venous access, and medication management. RNs reported varying levels of adherence to pain management (62%), and venous access management (72%). Satisfaction with the conditions for safe medication management was 90%. Approximately, two-thirds (67%) of RN reported sufficient knowledge regarding the impact of the child-oriented environment and less than half (44%) regarding how to support breastfeeding.

Conclusion:

Structure and process is a prerequisite for quality of care outcomes. This study discloses areas for quality improvement and offers instruments to compare structure and process in pediatric nursing care to discuss with consumers, managers, staff, and other stakeholders.