bluuebunny/crossref_metadata_2025 huggingface dataset:
Individual Ants Do Not Show Activity-Rest Rhythms in Nest Conditions
Authors: Fujioka Haruna , Abe Masato S. , Okada Yasukazu
Published: April 2021

Circadian rhythms, which respond to the day-night cycle on the earth, arise from the endogenous timekeeping system within organisms, called the “biological clock.” For accurate circadian rhythms, daily fluctuations in light and temperature are considered one of the important time cues. In social insects, both abiotic and biotic factors (i.e., social interactions) play a significant role in activity-rest rhythm regulation. However, it is challenging to monitor individual activity-rest rhythms in a colony because of the large group size and small body size. Therefore, it is unclear whether individuals in a colony exhibit activity-rest rhythms and how social interactions regulate their activity-rest rhythms in the colony. This study developed an image-based tracking system using 2D barcodes for Diacamma cf. indicum from Japan (a monomorphic ant) and measured the locomotor activities of all colony members under laboratory colony conditions. We also investigated the effect of broods on activity-rest rhythms by removing all broods under colony conditions. Activity-rest rhythms appeared only in isolated ants, not under colony conditions. In addition, workers showed arrhythmic activities after brood removal. These results suggested that a mixture of social interactions, and not light and temperature, induces the loss of activity-rest rhythms. These results contribute to the knowledge of a diverse pattern of circadian activity rhythms in social insects.
Bradyarrhythmias and Physiologic Pacing in the ICU
Authors: Lattell Jonathan , Upadhyay Gaurav A.
Published: April 2021

Bradyarrhythmias represent a common pathology in the intensive care unit (ICU) with etiologies of varying severity. Treatment has often been focused on correcting underlying causes and may require pacing for urgent hemodynamic support. In recent years, there has been interest in physiologic pacing modalities which avoid the dyssynchrony from right ventricular (RV) only pacing. Cardiac resynchronization therapy (CRT) through biventricular pacing is a well-established device-based electrical therapy in patients with wide QRS and heart failure. Recently, it has been shown that biventricular pacing may also be pursued for hemodynamic rescue in the ICU setting. Efforts to re-engage the conduction system with His bundle pacing or further downstream have also emerged as alternative means to deliver resynchronization, with early applications in the ICU now being reported. The goal of the review is to examine bradyarrhythmia causes and management in the ICU as well as investigate new approaches in physiologic pacing and their potential roles in critically ill patients.
Police and Fire Pensions in Florida: A Comparison of Conditions After 10 Years
Authors: Vonasek Joseph , Lee Robert
Published: April 2021

This article is an analysis of 31 defined benefit police and fire pension plans of 20 municipalities in Florida. The authors conducted a similar assessment of these same plans ten years earlier to determine the fiscal impact of these plans due to state mandates that accompany state funding for each of these plans. The current study analyzes key measures of fiscal health over the last ten years for these same plans to ascertain whether the fiscal condition of these plans remained constant, that is, whether underfunded plans continued to be questionably managed and whether well-funded plans continued to be fiscally stable considering economic trends and the lessening of state mandates on the use of state funding for these plans. The findings show that the overwhelming majority of the plans neither significantly changed their financial condition nor their general ranking among the plans evaluated.
Impact of a Rapid Blood Culture Diagnostic Panel on Time to Optimal Antimicrobial Therapy at a Veterans Affairs Medical Center
Authors: Chiasson Jordan M. , Smith Winter J. , Jodlowski Tomasz Z. , Kouma Marcus A. , Cutrell James B.
Published: April 2021

Purpose:

Utilization of rapid diagnostic testing alongside intensive antimicrobial stewardship interventions improves patient outcomes. We sought to determine the clinical impact of a rapid blood culture identification (BCID) panel in an established Antimicrobial Stewardship Program (ASP) with limited personnel resources.

Methods:

A single center retrospective pre- and post-intervention cohort study was performed following the implementation of a BCID panel on patients admitted with at least 1 positive blood culture during the study period. The primary outcome was time to optimal therapy from blood culture collection. Secondary outcomes included days of therapy (DOT), length of stay, and 30-day mortality and readmission rates.

Results:

277 patients were screened with 180 patients included, with 82 patients in the pre-BCID and 98 in the post-BCID arms. Median time to optimal therapy was 73.8 hours (IQR; 1.1-79.6) in the pre-BCID arm and 34.7 hours (IQR; 10.9-71.6) in the post-BCID arm (p ≤ 0.001). Median DOT for vancomycin was 4 and 3 days (p ≤ 0.001), and for piperacillin-tazobactam was 3.5 and 2 days (p ≤ 0.007), for the pre-BCID and post-BCID arms, respectively. Median length of hospitalization was decreased from 11 to 9 days (p = 0.031). No significant change in 30-day readmission rate was noted, with a trend toward lower mortality (12% vs 5%; p = 0.086).

Conclusion:

Introduction of BCID into the daily workflow resulted in a significant reduction in time to optimal therapy for bloodstream infections and DOT for select broad-spectrum antibiotics, highlighting the potential benefits of rapid diagnostics even in settings with limited personnel resources.
Transitioning From Consult-Based to Automatic Pharmacy-Driven Vancomycin Management: Results From a Single, Primary Care Center
Authors: Cole Jennifer L. , O’Glee Russell , Clark Michael , White Meredith
Published: April 2021

Objective:

The transition to area under the curve (AUC) vancomycin monitoring requires substantial updates in pharmacy policies and procedures. The study facility was tasked with transitioning from a consult-based collaborative agreement to an automatic pharmacist management policy on all intravenous (IV) vancomycin orders. The purpose of this quality assessment (QA) study was to evaluate the effectiveness of this transition.

Methods:

The primary outcome was the proportion of patients with pharmacist assessment of pharmacokinetics and dosing with documentation in IV vancomycin treated patients from January-June 2020. Secondary outcomes included the proportion of AUC24 levels within therapeutic range, the incidence of acute kidney injury (AKI) and treatment failures in patients treated ≥72 hours compared to a historical, trough-based cohort.

Results:

There were 88 patients in the QA analysis with 100% having a pharmacist assessment with documentation. There were 34 patients treated ≥72 hours in the AUC group, 36 in the trough-based group. AUC24 fell within desired range in 45% of monitored patients. Rates of AKI (9% vs 11%, p = 0.75) and treatment failures were similar (3% vs 0%, p = 0.3).

Conclusion:

The transition from consult-based to an automatic pharmacy management agreement was successful with similar safety and efficacy compared to a historical trough-based cohort.
To What Extent Is Trust a Prerequisite for Charitable Giving? A Systematic Review and Meta-Analysis
Authors: Chapman Cassandra M. , Hornsey Matthew J. , Gillespie Nicole
Published: April 2021

Trust is assumed to be important for charitable giving. However, disparate associations have been found, and recent theoretical approaches emphasize motives for giving that do not rely on trust. To resolve this tension, we conducted a systematic review of evidence generated between 1988 and 2020. A meta-analysis of 69 effect sizes from 42 studies sampling 81,604 people in 31 countries confirmed a positive association between trust and giving across diverse measures, r = .22. Meta-regressions showed that organizational ( r = .35) and sectoral trust ( r = .27) were more strongly associated with giving than were generalized ( r = .11) or institutional trust ( r = .14). The relationship was also stronger in non-western (vs Western) countries and in nonrepresentative (vs nationally representative) samples. All evidence was correlational, and few studies measured actual behavior. We discuss implications for theories of trust and for fundraising practice, and highlight critical gaps in evidence.
A comparative study of static and dynamic properties of honeycomb non-pneumatic wheels and a pneumatic wheel
Authors: Zheng Zhou , Rakheja Subhash , Sedaghati Ramin
Published: April 2021

Three-dimensional finite element (FE) models of the honeycomb NPWs with three different spokes’ configurations, realized by varying the cell angle, were formulated. The validity of the proposed NPW FE models was demonstrated by comparing the predicted wheel responses with the reported data. A FE model of the pneumatic wheel of identical size was also formulated and verified on the basis of the measured vertical force-deflection and cornering properties. The verified NPW models were subsequently employed to study their feasibility through comparisons of in-plane as well as out-of-plane properties with those of the pneumatic wheel. The influences of the cell angle and normal wheel load on the static and dynamic properties of the NPWs were also investigated. The results showed load-dependent longitudinal stiffness of the wheel due to strong coupling between radial and longitudinal deformations of the honeycomb spokes. The lateral stiffness, however, was observed to be load-independent due to negligible coupling between radial and lateral deformations of the spokes. The spokes of the honeycomb NPWs could thus be easily tuned to achieve vertical and longitudinal stiffness comparable to those of the reference pneumatic wheel. The lateral and cornering stiffness of the NPWs with the planar spokes, however, were substantially higher, irrespective of the spokes’ configuration considered. The significantly higher cornering stiffness resulted in rapid saturation of the cornering force of the NPWs at side-slip angles about 1.1°, which is likely to cause lateral sliding of the wheels and potential loss of directional control under higher side slip conditions.
The Europeanization of metropolitan regions from below: Comparing the European engagement of two archetypical metropolises
Authors: Fricke Carola
Published: April 2021

Since the early 2000s, the Europeanization of metropolitan regions from below takes place in a political process with variable geometry and differential intensity. While ‘the metropolitan’ as a political label and research topic has witnessed an impressive upswing in Europe, a concrete understanding of the Europeanization of metropolitan regions is still missing. This article highlights and explains the Europeanization of metropolitan regions in Europe as particular subnational authorities of which only a small group of forerunners recently develop the capacity to act at a European scale. The Europeanization of metropolitan regions is conceptualized as a political process from below, going beyond the initial definition of Europeanization as domestic impact. Thereby, the article lays particular focus on ‘where’ and ‘when’ the European dimension of metropolitan regions is produced. Moreover, the analysis puts the emerging European engagement of metropolitan regions into a larger perspective by discussing it in the context of the increasing international agency of cities. The article questions, first, how a European dimension has developed in metropolitan policies and, second, what modes of engagement contribute to the metropolitan regions’ increasing Europeanization. Empirically, the metropolitan regions of Lyon and Stuttgart present examples of Europeanized metropolises with an exceptional engagement. Comparing modes of engagement in these two metropolitan regions allows understanding the particular characteristics contributing to the formation of an archetype of Europeanized metropolis.
Effect of the compressible spaces on the performance of piezoelectric pump with rhombic micro-displacement amplifying vibrator
Authors: Diao Weidong , Ye Yang , Chen Jian , Pan Qiaosheng , Feng Zhihua
Published: April 2021

This paper proposes a rhombic micro-displacement amplifying vibrator piezoelectric pump which introduces a mechanism called “compressible space” near inlet and outlet valves. The working principle of compressible space is presented and a simulation is conducted to verify the effect. Analysis reveals that the compressible space can reduce the transmission time of the pressure wave thus increasing the efficiency of the valves, and suppress the pressure fluctuation due to the rapid closing of the valves. The simulation shows that the pressure fluctuation in the pipe is relieved and the instantaneous pressure wave can be mostly absorbed with the presence of compressible space. Then the effect of three sizes of compressible space (area approximately 100, 150, 200 mm2), the number of compressible space (two and a single), the distance between the compressible space and the valve (near the valve and in the middle of the pipe) on the pump performance is experimentally investigated. Experimental results demonstrate that the effect of two compressible spaces is better than only one, and medium-sized compressible spaces have the best comprehensive effect. Meanwhile, when the compressible spaces are near the valves, the effect is better.
Cultural Beliefs on the Causes of Cleft Lip and/or Palate in Malaysia: A Multicenter Study
Authors: Hussin Ilyasak , Halim Ahmad Sukari , Ibrahim Mohd Ismail , Markos Zara Octavia , Effendie Eryana Susantri A. Bakar
Published: April 2021

Objective:

To identify the cultural beliefs about the causes of cleft among parents of patients with nonsyndromic cleft lip and/or palate in a multiethnic society in Malaysia and the difficulties encountered in receiving cleft treatment.

Design:

A descriptive cross-sectional multicenter study based on a study questionnaire was conducted of parents of patients with cleft lip and/or palate.

Setting:

Three centers providing cleft care from different regions in Malaysia: the national capital of Kuala Lumpur, east coast of peninsular Malaysia, and East Malaysia on the island of Borneo.

Participants:

Parents/primary caregivers of patients with cleft lip and/or palate.

Results:

There were 295 respondents from different ethnic groups: Malays (58.3%), indigenous Sabah (30.5%), Chinese (7.1%), Indian (2.4%), and indigenous Peninsular Malaysia and Sarawak (1.7%). Malay participants reported that attributing causes of cleft to God’s will, superstitious beliefs that the child’s father went fishing when the mother was pregnant or inheritance. Sabahans parents reported that clefts are caused by maternal antenatal trauma, fruit picking, or carpentry. The Chinese attribute clefts to cleaning house drains, sewing, or using scissors. Cultural background was reported by 98.3% of participants to pose no barrier in cleft treatment. Those from lower socioeconomic and educational backgrounds were more likely to encounter difficulties while receiving treatment, which included financial constraints and transportation barriers.

Conclusion:

There is a wide range of cultural beliefs in the multiethnic society of Malaysia. These beliefs do not prevent treatment for children with cleft. However, they face challenges while receiving cleft treatment, particularly financial constraints and transportation barriers. Such barriers are more likely experienced by parents from lower income and lower education backgrounds.
The Law of Embrace: Satisfaction, Forgiveness, and the Cross in Aquinas, Lonergan, and Volf
Authors: Chu Zane E.
Published: April 2021

A dialogue between Aquinas and Volf mediated by Lonergan illuminates the practical significance of Christ’s redemptive work. Aquinas contemplates the mystery of Christ’s passion as an act of satisfaction proceeding from charity that makes amends for wrongdoing. Lonergan specifies this satisfaction as a fitting expression of sorrow for the granting of forgiveness. He further identifies the essential meaning and practical significance of redemption as the transformation of evil into good, and calls it the law of the cross. Volf delineates the significance of the cross for practices of reconciliation, the movement from exclusion to embrace through repentance, forgiveness, and making space for the other. I suggest that Volf’s framework is undergirded by Lonergan’s law of the cross and assists retrieving the latent practical significance of Aquinas’ contemplation. Satisfaction for another is interpreted as forgiveness in the movement from exclusion to embrace proceeding from charity interpreted as the will to embrace.
AngioJet Thrombectomy Versus Catheter-Directed Thrombolysis for Lower Extremity Deep Vein Thrombosis: A Meta-Analysis of Clinical Trials
Authors: Li Guan Qiang , Wang Lei , Zhang Xi Cheng
Published: April 2021

Early catheter-directed thrombolysis (CDT) for lower extremity deep vein thrombosis (LEDVT) can reduce post-thrombotic morbidity and the AngioJet thrombectomy is a new therapy that can be selected for the treatment of LEDVT. We performed a systematic review and meta-analysis of clinical trials comparing AngioJet versus CDT to assess the efficacy and safety of AngioJet thrombectomy. We systematically searched PubMed and Embase for clinical trials that published before November 1, 2020 and compared AngioJet thrombectomy and CDT in the treatment of LEDVT. We meta-analyzed effective rate of treatment, serious complications, PTS, Villalta score, duration of treatment and drug dose. AngioJet does not result in a significant difference in the effective rate (OR 1.00, CI 0.73-1.36, P = 0.98; I2 = 0%) and complications (OR 1.16 CI 0.84-1.61, P = 0.36; I2 = 39%) compare to CDT. And there was a statistically significant decrease in incidence of PTS (OR 0.58 CI 0.37-0.91, P = 0.02; I2 = 0%) and Villalta score (OR −1.86 CI −3.49 to −0.24, P = 0.02; I2 = 34%) for AngioJet compared to CDT. In addition, there was a statistically significant decrease in duration of the treatment (OR −2.45 CI −2.75 to −2.15, P < 0.0001; I2 = 95%) and drug dose (OR −3.15 CI −3.38 to −2.93, P < 0.0001; I2 = 98%) between AngioJet and CDT. AngioJet results in a low severity of PTS compared to CDT therapy. Moreover, the average duration of treatment and thrombolysis time was shorter in the AngioJet group compared to the CDT group. However, the AngioJet group was not significantly different in effective rate of treatment and serious complications compared to the CDT group.
Combination resonance analysis of imperfect functionally graded conical shell resting on nonlinear viscoelastic foundation in thermal environment under multi-excitation
Authors: Aris Hamid , Ahmadi Habib
Published: April 2021

In this work, nonlinear forced vibrations of truncated conical shells are presented using a semi-analytical method. The material properties are varied along the thickness direction as a power law distribution. The functionally graded truncated conical shells are exposed to external harmonic load and placed in the thermal environment and have an initial imperfection. Furthermore, the functionally graded truncated conical shells rests on generalized nonlinear viscoelastic foundations which consisted of a Winkler and Pasternak foundation parameters augmented by a Kelvin–Voigt viscoelastic model and a nonlinear cubic stiffness. The fundamental equations are extracted using first-order shear deformation theory in conjunction with nonlinear von Kármán relationships. The partial differential equations of truncated conical shells are reduced through Galerkin’s method, and the result is extracted using the multiple scales method. To analyze the resonance analyses, a two-term external excitation is considered. In this regard, various secondary resonances are investigated, and finally, the analyses about combination resonances are represented. To investigate the presented approach, a comparison study is performed with those addressed by other researchers. To analyze the nonlinear combination resonance behavior of truncated conical shells, the effect of geometrical characteristics, material properties, power law index, thermal effects, external load amplitude, and initial imperfection are examined. Finally, the steady-state responses of the nonlinear system are analyzed. As one of the most interesting results, the softening behavior of truncated conical shells with inverse quadratic distribution is the most, and for the quadratic distribution is the least.
Analysis of in-flight cabin vibration of a turboprop airplane by proposing a novel noise-tolerant signal decomposition method
Authors: Bagherzadeh Seyed Amin , Salehi Mehdi
Published: April 2021

Vibration in passenger cabins of turboprop airplanes is a serious challenge. One of the essential steps in studying the cabin vibrations is to determine the contributing sources of vibration. The vibration signals are highly nonstationary and noisy. Therefore, one may require a noise-tolerant signal processing method for decomposition of the signals. In this article, the wavelet-based empirical mode decomposition is introduced for the first time to improve the performance of the traditional empirical mode decomposition in dealing with noise. Unlike the traditional empirical mode decomposition that extracts the signal trend by averaging the upper and lower envelopes intersecting local maxima and minima of the signal, the wavelet-based empirical mode decomposition directly extracts the signal trend by applying the multilevel wavelet decomposition of the consecutive approximations within the sifting process. Numerical studies are undertaken to evaluate the effect of noise on the performance of the empirical mode decomposition and wavelet-based empirical mode decomposition. Also, comparisons are made between the methods at dissimilar noise powers based on the orthogonality, integral, and energy decomposition criteria. The results indicate that both methods generate similar results in the absence of noise. Considering the number of obtained intrinsic mode functions, decomposition quality criteria, and computational cost, however, the wavelet-based empirical mode decomposition outperforms the classic method at higher noise levels. In this article, the wavelet-based empirical mode decomposition is used for analysis of in-flight airplane cabin vibration. A 52-passenger turboprop aircraft is equipped with eight triaxial piezoelectric accelerometers, and several flight tests are performed to acquire in-flight vibration signals within the passenger cabin. The proposed wavelet-based empirical mode decomposition is applied to the experimental data. Then, the amplitudes and frequencies of the intrinsic mode functions are examined. Finally, the probable vibration sources are identified based on the intrinsic mode functions characteristics.
Low-frequency sound absorption of a tunable multilayer composite structure
Authors: Shao Hanbo , He Jincheng , Zhu Jiang , Chen Guoping , He Huan
Published: April 2021

Our work investigates a tunable multilayer composite structure for applications in the area of low-frequency absorption. This acoustic device is comprised of three layers, Helmholtz cavity layer, microperforated panel layer, and the porous material layer. For the simulation and experiment in our research, the absorber can fulfill a twofold requirement: the acoustic absorption coefficient can reach near 0.8 in very low frequency (400 Hz) and the range of frequency is very wide (400–3000 Hz). In all its absorption frequency, the average of the acoustic absorption coefficient is over 0.9. Besides, the absorption coefficient can be tunable by the scalable cavity. The multilayer composite structure in our article solved the disadvantages in single material. For example, small absorption coefficient in low frequency in traditional material such as microperforated panel and porous material and narrow reduction frequency range in acoustic metamaterial such as Helmholtz cavity. The design of the composite structure in our article can have more wide application than single material. It can also give us a novel idea to produce new acoustic devices.
Understanding the Latent Structure of Dynamic Risk: Seeking Empirical Constraints on Theory Development Using the VRS-SO and the Theory of Dynamic Risk
Authors: Olver Mark E. , Thornton David , Christofferson Sarah M. Beggs
Published: April 2021

The present study is part of a larger project aiming to more closely integrate theory with empirical research into dynamic risk. It seeks to generate empirical findings with the dynamic risk factors contained in the Violence Risk Scale—Sexual Offense version (VRS-SO) that might constrain and guide the further development of Thornton’s theoretical model of dynamic risk. Two key issues for theory development are (a) whether the structure of pretreatment dynamic risk factors is the same as the structure of the change in the dynamic risk factors that occurs during treatment, and (b) whether theoretical analysis should focus on individual dynamic items or on the broader factors that run through them. Factor analyses and item-level prediction analyses were conducted on VRS-SO pretreatment, posttreatment, and change ratings obtained from a large combined sample of men ( Ns = 1,289–1,431) convicted and treated for sexual offenses. Results indicated that the latent structure of pretreatment dynamic risk was best described by a three-factor model while the latent structure of change items was two dimensional. Prediction analyses examined the degree to which items were predictive beyond prediction obtained from the broader factor that they loaded on. Results showed that for some items, their prediction appeared to be largely carried by the three broad factors. In contrast, other items seem to operate as funnels through which the broader factors’ predictiveness flowed. Implications for theory development implied by these results are identified.
Comparison of preserved bimatoprost 0.01% with preservative-free tafluprost: A randomised, investigator-masked, 3-month crossover, multicentre trial, SPORT II
Authors: Lemmens Sophie , Rossetti Luca , Oddone Francesco , Sunaric-Mégevand Gordana , Hommer Anton , Vandewalle Evelien , Francesca Cordeiro Maria , McNaught Andrew , Montesano Giovanni , Stalmans Ingeborg
Published: April 2021

Importance:

This study compares the efficacy and tolerability of a preservative-free prostaglandin analogue (tafluprost 15 mg/ml) to a prostaglandin analogue that uses 0.02% of benzalkonium chloride (bimatoprost 0.1 mg/ml).

Background:

Different prostaglandin analogues have been commercially approved, with differences in tolerability.

Design:

Prospective, randomised, investigator-masked, 3-month crossover, multicentre trial.

Participants:

Sixty-four patients with ocular hypertension or open-angle glaucoma were randomised to two groups, after a 4-week washout period from their current topical drop regimen.

Methods:

Participants were randomised to tafluprost (Group 1; n = 33) or bimatoprost (Group 2; n = 31). At month 3, each group switched to the opposite treatment. IOP was evaluated at multiple timepoints.

Main outcome measures:

The primary outcome was difference in mean IOP between the two groups at the final visit. Secondary outcomes included change from baseline IOP at month 3 and month 6, difference in mean IOP at month 3 and difference in IOP at all timepoints. Safety outcomes included best-corrected visual acuity (BCVA), adverse events, ocular tolerability, optic nerve assessment and slit lamp biomicroscopy.

Results:

Both medications significantly lowered IOP at month 6 compared to baseline: 5.4 mmHg (27%) for tafluprost and 6.8 mmHg (33%) for bimatoprost ( p < 0.0001). No significant differences in any of the safety measures (including conjunctival hypearemia) were detected.

Conclusions and relevance:

Bimatoprost produced a statistically significant greater IOP reduction compared to tafluprost with minimal to no difference in side effects. This should be borne in mind when weighing up the pros and cons of preserved versus preservative-free prostaglandin analogue therapy.

ClinicalTrials.gov Identifier

NCT02471105.
Representation and resistance: A qualitative study of narratives of Deaf cultural identity
Authors: Chapman Madeleine
Published: April 2021

This qualitative study examines narratives of identity among deaf adults in Denmark who were raised within the Bilingual–Bicultural programme of education. At a time of threat to sign language and the Deaf community, the study explores the distinctiveness of a minority cultural identity rooted in sign language and elaborated through Deaf norms and values. Applying the social psychological theories of social identity and social representations, the analysis shows that while Deaf identity is developed through and against forces of marginalisation and the medicalising system of representation that cochlear implants reify, it both celebrates Deaf culture and embraces cross-cultural dialogue and exchange. The findings run against existing models of deaf identity that posit discrete Deaf (immersive) and bicultural identities. They also disclose the importance of studies of social identity that retrieve the theory’s original emphasis on cultural systems and context to explain identities and intergroup dynamics. Finally, the study has resonances for disability and other minority studies and movements that seek to pay attention to socially creative processes of critiquing normativity and enlarging understandings of culture and identity.
Relevance of immobility as a risk factor for symptomatic proximal and isolated distal deep vein thrombosis in acutely ill medical inpatients
Authors: Sartori Michelangelo , Favaretto Elisabetta , Cosmi Benilde
Published: April 2021

Immobility is a well-recognized risk factor for deep vein thrombosis (DVT) in surgical patients, whereas the level of DVT risk conferred by immobility is less defined in patients on medical wards. The aim of this study was to establish whether immobility and its duration are associated with the risk of DVT in acutely ill medical inpatients. We conducted a cohort study in acutely ill medical inpatients. Patients underwent whole leg ultrasound for suspected lower extremity DVT and were divided into two groups according to presence or absence of immobility, defined as total bed rest or sedentary without bathroom privileges. The endpoint was the detection of proximal DVT or isolated distal DVT (IDDVT). Among the 252 acutely ill medical inpatients with immobility (age 82.6 ± 10.3 years, female 63.9%), ultrasound showed 36 (14.3%) proximal DVTs and 39 (15.5%) IDDVTs, while there were 11 (4.4%) proximal DVTs and 26 (10.5%) IDDVTs among the 248 inpatients without immobility (age 73.6 ± 14.2 years, female 54.8%). The risk of proximal DVT was higher in immobile than in mobile patients (OR 3.59, 95% CI: 1.78–7.23, p = 0.0001), whereas the risk of IDDVT was similar between the two groups (OR 1.56, 95% CI: 0.92–2.66, p = 0.111). During the first 3 days of hospitalization, the frequency of all DVTs was similar in patients with and without immobility, but it was 0.26 ± 0.03 vs 0.18 ± 0.03, respectively, after 4 days. In conclusion, immobility for more than 3 days is a risk factor for proximal DVT in acutely ill medical inpatients.
Complementing standard western measures of depression with locally co-developed instruments: A cross-cultural study on the experience of depression among the Luo in Kenya
Authors: Osborn Tom L. , Kleinman Arthur , Weisz John R.
Published: April 2021

Our present understanding of depression relies on a Western nosology that might not be generalizable across diverse cultures around the world. As a consequence, current clinical research and practice may not capture culturally salient features of depression. Expanded cross-cultural research that uses ethnographic methods and local instruments may yield information of clinical utility to enhance culturally sensitive research and practice. In this mixed methods study, we used ethno-semantic interview procedures based on the DSM-5’s cultural formulation process to elicit a broad range of depression features reported by the Luo people of western Kenya. We identified how the Luo conceptualize depression, including idioms of depressive distress, moods associated with persistent negative affect, and other features including context, stressors and support systems. This information informed the co-development of a Luo Depression Questionnaire (LDQ-17). We used the LDQ-17 in a cross-sectional community survey ( N = 116) to investigate its association with a standard Western instrument (Patient Health Questionnaire-9; PHQ-9). Factor analysis revealed a one-factor model for the PHQ-9 but not the LDQ-17 for which exploratory factor analysis suggested a three-factor model including cognitive, affective, and physical symptoms. Psychological, environmental/social, and even supernatural causes (i.e., ancestors, God and devil) of these symptoms were identified, as were support systems. Finally, visualizations through multidimensional scaling approaches showed some overlap between the LDQ-17 and the PHQ-9, but the local LDQ-17 identified salient features the Luo associated with depression that the PHQ-9 missed. Our findings illustrate how simple ethnographic procedures may guide the development of local instruments to complement current standardized instruments, potentially enhancing cultural relevance.
Dynamic characteristics analysis of a high-speed-level gear transmission system of a wind turbine considering a time-varying wind load and an electromagnetic torque disturbance
Authors: Liu Weiwei , Zhao Weiqiang , Liu Jie
Published: April 2021

A high-speed-level gear transmission system model of a wind turbine is presented considering a time-varying wind load and an electromagnetic torque disturbance, along with eccentricity, dynamic backlash, and friction force. The auto-regressive model is employed for simulating the time-varying wind load in the realistic wind field as external excitation. A doubly fed induction generator model of the wind turbine is established to calculate the disturbance quantity of electromagnetic torque. The nonlinear differential equations of the system are strictly deduced using Lagrange equation and solved by the fourth-order Runge-Kutta method. The effect of friction on the dynamic response of the high-speed-level gear transmission system is analyzed with the time-varying wind load and the electromagnetic torque disturbance. These results show that the friction force is critical because frequency amplitude and components can be changed by it. The friction force also enlarges vibration displacement. The low-frequency components in the vertical direction are affected gravely by the friction force without electrical disturbance. In addition, sidebands exist in the vicinity of the low-frequency parts as the electromagnetic torque disturbance appears at the output end. The amplitude of the low-frequency component is further increased because of electromagnetic torque disturbance. This shows the frequency characteristics of the slight gear system fault. The study offers some fresh references into the design and diagnosis of the gear system.
Engine test bench feasibility for the study and research of real driving cycles: Pollutant emissions uncertainty characterization
Authors: Luján José Manuel , Bermudez Vicente , Pla Benjamín , Redondo Fernando
Published: April 2021

The future of Internal Combustion Engines in the automotive sector seems uncertain, to some extent due to the recent changes in type approval regulations. Current regulations have considerably reduced the engine pollutant emissions limits, as well as introduced more demanding testing conditions. The introduction of real driving cycles presented a challenging issue for car manufacturers when homologating their vehicles, since the traditional and undemanding NEDC (New European Driving Cycle) certification cycle has been replaced by sever cycles as WLTC (World Light Duty Test Cycle) and RDE (Real Driving Emissions). This document presents a methodology for implementing a RDE cycle in an engine test bench. Even knowing that the essence of RDE regulation is to assess actual driving conditions, reproducing RDE cycles in a test bench is of great interest, since the controlled and reproducible conditions that can be achieved in a laboratory lead to valuable information to understand engine behavior in real driving conditions, and therefore contribute to engine development. This document applies the most recent European Community regulation and sets the essential steps to carry out a RDE cycle in an engine test bench. Once the WLTC and RDE cycles were implemented, this study analyses the uncertainty and repeatability of the values obtained in successive repetitions of the test, carried out under the same conditions. Uncertainty values are obtained on the most representative parameters of engine operation, as well as pollutant emissions. One of the most relevant contributions of this study is to obtain the uncertainties of type approval pollutant emissions. As an example, the uncertainty obtained by applying the methodology described in this article on nitrogen oxide emissions (NOx), considered one of the most relevant pollutant emissions of diesel engines, has been extremely reduced, obtaining values of 3.13% and 3.9%, respectively for the RDE and WLTC cycles.
Broadband nonlinear elastic wave modulation spectroscopy for damage detection in composites
Authors: Segers Joost , Hedayatrasa Saeid , Poelman Gaétan , Van Paepegem Wim , Kersemans Mathias
Published: April 2021

A non-destructive testing procedure is proposed for damage detection in composites using full wavefield measurement obtained using a scanning laser Doppler vibrometer. Vibrations are excited using two low-power piezoelectric actuators leading to nonlinear elastic wave modulation at the defect. One actuator is supplied with a broadband chirp signal and the other actuator is supplied with a single-frequency sine signal. First, a time–frequency filtering method is proposed to extract specific nonlinear components of interest (e.g. second higher harmonic and first modulation sideband) without the need for multiple excitation sequences. Next, damage maps are constructed using broadband bandpower calculation of the filtered nonlinear components. It is demonstrated that the modulation sidebands provide an exclusive imaging of defect nonlinearity, and are not affected by potential source nonlinearity. The proposed damage map construction procedure is applied for various carbon fiber reinforced polymer test specimens with different damage features: (1) coupon with quasi-static indentation damage, (2) coupon with artificial delaminations, (3) bicycle frame with impact damage, and (4) stiffened aircraft panel with partially debonded stiffener. The obtained results indicate the high performance of the developed procedure for detection of various defect types in curved and/or stiffened carbon fiber reinforced polymer components.
Retrograde Catheterization of the Superior Mesenteric Artery and Celiac Axis as a Bailout Technique in a Complex FEVAR
Authors: Pineda Fernando Picazo , Pathmarajah Tishanthan , Sieunarine Kishore
Published: April 2021

Introduction:

A retrograde approach of the celiac trunk (CT) and superior mesenteric artery (SMA) to catheterize the visceral vessels during a fenestrated endovascular aortic reparation (FEVAR) is a feasible option when standard access techniques have failed.

Report:

In this report we describe a patient with a previous endoluminal repair of an infrarenal aortic aneurysm, complicated by a persistent type 1a endoleak despite treatment with endoanchor fixation. A decision was made to proceed with a proximal 4 vessel FEVAR to treat the type 1a endoleak. Due to angulation of the mesenteric vessels, and a rotation of the fenestrated stent graft during deployment, the CT and SMA were unable to be catheterized. A decision was made to perform a median laparotomy for retrograde access of the aforementioned vessels, allowing successful catheterization and stenting. The patient was discharged 30 days following the procedure, without any major post-operative complications. Follow up at 6 weeks with a contrasted enhanced computerized tomography scan showed a stable repair with no residual type 1a endoleak.

Discussion:

Catheterization of the target vessels during a FEVAR can be difficult, especially in patients with challenging anatomy. Prolonged surgical time in an attempt to catheterize the vessels can result in increased morbidity for the patient, and ultimately may result in the procedure being abandoned or conversion to an open repair of the aneurysm. Retrograde access of the target vessels as a bailout measure during fenestrated stent graft repair due to failure of an antegrade approach has rarely been reported in the literature. Only a few cases are described in the available literature, however, none of them describe retrograde approach of both the CT and SMA as described in this case. A median laparotomy for retrograde access is a feasible alternative in these situations, and should be considered if the patient is suitable.
Numerical Biomechanics Models of the Interaction Between a Novel Transcatheter Mitral Valve Device and the Subvalvular Apparatus
Authors: Marom Gil , Plitman Mayo Romina , Again Nadav , Raanani Ehud
Published: April 2021

Objective

Mitral valve regurgitation (MR) is a common valvular heart disease where improper closing causes leakage. Currently, no transcatheter mitral valve device is commercially available. Raanani (co-author) and colleagues have previously proposed a unique rotational implantation, ensuring anchoring by metallic arms that pull the chordae tendineae. This technique is now being implemented in a novel device design. The aim of this study is to quantify the rotational implantation effect on the mitral annulus kinematics and on the stresses in the chordae and papillary muscles.

Methods

Finite element analysis of the rotational step of the implantation in a whole heart model is employed to compare 5 arm designs with varying diameters (25.9 mm to 32.4 mm) and rotation angles (up to 140°). The arm rotation that grabs the chordae was modeled when the valve was in systolic configuration.

Results

An increase in the rotation angle results in reduced mitral annulus perimeters. Larger rotation angles led to higher chordae stresses with the 29.8 mm experiencing the maximum stresses. The calculated chordae stresses suggest that arm diameter should be <27.8 mm and the rotation angle <120°.

Conclusions

The upper limit of this diameter range is preferred in order to reduce the stresses in the papillary muscles while grabbing more chords. The findings of this study can help improving the design and performance of this unique device and procedural technique.
SOFIA catheter for direct aspiration of large vessel occlusion stroke: A single-center cohort and meta-analysis
Authors: Bolognini Federico , Lebedinsky Pablo A , Musacchio Mariano , Delaitre Mariette , Traoré Abdoulaye M , Vuillemet Francis , Sellal François , Cerfon Jean-François , Schluck Eric , Iancu Daniela , Cora Elena A , Richard Sébastien , Anxionnat René , Gory Benjamin , Finitsis Stephanos N
Published: April 2021

Background and Purpose

Direct aspiration (DA) using large-bore distal aspiration catheters is an established strategy for the endovascular thrombectomy (EVT) of large-vessel occlusion stroke (LVOS). However, the performance of individual catheters like SOFIA has yet to be examined.

Methods

We present a cohort of 144 consecutive patients treated with first-line DA and SOFIA 6 F Plus catheter for LVOS. We also conducted a systematic review of the literature searching multiple databases for reports on thrombectomy with DA and SOFIA catheters and performed a meta-analysis of recanalization, safety, and clinical outcomes.

Results

In the study cohort a successful recanalization (mTICI 2b-3) rate of 75.7% was achieved with DA alone, the global rate for functional independence (90-day mRS 0-2) was 40.3%. For the metanalysis we selected nine articles that included a total of 758 patients treated with first-line thrombectomy with the SOFIA catheters. The mTICI 2b-3 rate was 71.6% (95%CI, 66.3-76.5%) while a rescue stent-retriever was used in 24.1% (95%CI, 17.7-31.9%) of cases. The overall mTICI2b-3 rate after DA and rescue therapy was 88.9% (95%CI, 82.6-93.1%). We found a pooled estimate of 45.6% (95%CI, 38.6-52.8%) for functional independence, a mortality within 90 days of 19% (95%CI, 14.1-25.0%) and a rate of 5.8% (95%CI, 4.2-8.0%) of symptomatic intracranial hemorrhage.

Conclusion

The DA approach for LVOS with the SOFIA catheters is highly effective with an efficacy and safety profile comparable to those found in contemporary thrombectomy trials and observational studies that use other devices or approaches.
Transnational Teaching: Evaluating the Application of Heideggerian Phenomenology and IPA in a Study of Lived Experiences
Authors: Bordogna Claudia M.
Published: April 2021

Transnational education has increased over the past decade for multiple reasons. Higher education institutions driven by a need to increase non-governmental funding and the concept of higher education as a commodity, have combined to cause many institutions to extend their activities into the field of transnational education partnerships. To ensure the survival of these strategic alliances, teaching faculty are required to service the commodity being exported from the UK. This unique study uses this context to evaluate the application of Heideggerian phenomenology and IPA as a means of analyzing the lived experiences of academic practitioners and the effects on their being. The study concludes that Heideggerian philosophical thought provides an insightful lens when combined with IPA, by providing access to an individual’s personal perception of events as opposed to other methodologies that simply attempt to produce an objective account of the event itself. Two vignettes from the data exemplify how the approach can help us understand participant lived experiences in a given context, as well as documenting the wider benefits of applying this approach in other studies that concern the lived experiences of individuals.