bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel single-stage PWM microinverter topology using two-power switches
Authors: Razi A. , Hidayat M. Nabil , Seroji M. N. , Noor S. Z. Mohammad
Published: June 2020

This paper presents a novel single-stage Microinverter topology using only two-power switches. The number of components count are directly proportional to the power losses, weight, cost and complexity of the design. Nowadays, conventional Microinverter without transformer having minimum of six power switches, while only three power switches involved in a Microinverter structure with the presence of a transformer. Thus, this paper proposed a novel Microinverter topology with only two-power switches to convert DC-voltage from Photovoltaic (PV) module to an AC-output. Modes of operation and current flow during each cycle are being explained. Variation of modulation index, irradiance and temperature of the PV module, the switching frequency and harmonic content of the proposed Microinverter are being analysed. A simulated model of Microinverter topology, employed only two power switches with a standard Unipolar Sinusoidal Pulse Width Modulation (SPWM) having 0.85% harmonic percentage; able to inject current to the load; have been successfully built and demonstrated through simulation based on MATLAB/Simulink, thus provide theoretical validation for further research.
Comparison between single-diode and two diodes models of a grid connected PV technologies: numerical study and experimental validation
Authors: Bouhaki L. , Saadani R. , Rahmoune M.
Published: June 2020

This article presents a simulation model comparison between a diode and two diodes of a photovoltaic cell. The simulation model created under the Matlab-Simulink environment predicts annual performances of the three photovoltaic field technologies connected to the grid. The simulation models have been validated by the experimental data of the photovoltaic system in the meteorological conditions of the city of Meknes. The interest is to inspect the closest model that allows to obtain more reliable results in order to follow the performances and the operation of the installation in the coming years, Also to compare between the efficiency of the three photovoltaic technologies (monocrystalline, polycrystalline and amorphous) in the same climatic conditions of Meknes city in Morocco which is a  Mediterranean climate with very cold winters and very hot summer.
Modeling, simulation and control of a doubly-fed induction generator for wind energy conversion systems
Authors: El Amine Boumerid Bensahila Med , Ahmed Allali , Houari Merabet Boulouiha , Mouloud Denai
Published: June 2020

In recent years, wind energy has become one of the most promising renewable energy sources. Various wind turbine concepts with different generator topologies have been developed to convert this abundant energy into electric power. The doubly-fed induction generator (DFIG) is currently the most common type of generator used in wind farms. Usually the DFIG generator is a wound rotor induction machine, where the stator circuit is directly connected to grid while the rotor’s winding is connected to the grid via a three-phase converter. This paper describes an approach for the independent control of the active and reactive powers of the variable-speed DFIG. The simulation model including a 1.5 MW-DFIG driven by a wind turbine, a PWM back-to-back inverter and the proposed control strategy are developed and implemented using MATLAB/Simulink/SimPowerSystems environment.
Transient stability enhancement in the presence of optimally placed D-FACTS
Authors: Alazzawi Omar Kamil Dahham , Nayyef Mustafa Ahmed , Ahmed Yasir Abdulhafedh
Published: June 2020

The power flow in power system can be controlled in an effective method by using FACTS devices through transmission lines. Distributed FACTS represent a new way to overcome these drawbacks. They are cost-effective, light weighted, higher performance and minimization of environmental impact. They are placed in a distribution method and in selected lines in the network according to line flow stability indices based on load flow calculations. In this paper, distributed static series compensator (DSSC) is used in order to attain the required power flow control by modifying the line reactance. They are installed directly on the present H.V transmission lines and as a result does not require H.V insulation. The load flow analysis has been carried using mat lab and the simulation for the purpose of stability by using Power World Simulator software. The results show an enhancement in stability performances of the system over the conventional controllers. 
THD performance of single phase five level inverter using proportional resonant and harmonic compensators current controller
Authors: Mohamed Abdullahi , Salimin Suriana
Published: June 2020

This paper observe the total harmonic distortion (THD) performance of single phase five level inverter using proportional resonant (PR) and harmonic compensators current controller. The THD when adding PR current controller was 1.6% at first. After more functions were added to the PR current controller to reduce the THD at the 3rd, 5th and 7th harmonic orders, the THD of the 3rd harmonic order was reduced from 0.45% to 0.1% while the 5th and 7th harmonic orders were reduced from 0.6% and 0.43% to 0.25% and 0.4% respectively. The development and simulation is performed using Matlab/Simulink. The simulation result is performed by using Fast Fourier Transform analysis (FFT) for the harmonics captured.
Performance of three-phase three-wire cascaded H-bridge multilevel inverter-based shunt active power filter
Authors: Yusup Lada Musa , Mohd Radzi Mohd Amran , Jasni Jasronita , Hizam Hashim , Jidin Auzani , Mohamad Syahrul Hisham
Published: June 2020

Multilevel inverter (MLI) becomes more significant in Active Power Filter (APF) application due to capability to its produce low harmonic output current in which at the same time improving performance of APF. Among the topologies of MLI, Cascaded H-Bridge (CHB) is the most popular topology with less power devices requirement and simple design. MLI CHB is also capable to produce possible output voltage at twice of the number of DC source which in this case of APF is the best suited topology to replace with the conventional six -step inverter. This paper presents the performance of three- phase three-wire CHB MLI used in Shunt Active Power Filter (SAPF) based on Direct Current Control (DCC) and Indirect Current Control (ICC) schemes. Both schemes are developed and verified in MATLAB/Simulink. The simulation results show that both current control algorithms are capable to mitigate load current with Total Harmonic Distortion below than the permissible value based on IEEE 519 standard.
Potency of PR controller for multiple harmonic compensation for a single-phase grid connected system
Authors: Sattianadan D , Gorai Soumen , Kumar G. R. Prudhvi , Vidyasagar S. , Shanmugasundaram V.
Published: June 2020

Harmonics and grid synchronization are one of the major problems faced when dealing with a single-phase system. The development of technology in the PV system makes the consumer to use it in a wide range. The power transferred from PV to grid needs DC to AC conversion process which is done by static devices operating with the higher frequencies that causes the harmonics in the grid connected system. The main aim of the paper is to implement grid synchronization and reduce total harmonic distortion in a single-phase grid connected system. The design of LCL filter is addressed in this paper which depends on current ripple, filter size and switching ripple attenuation.  In order to account the harmonic content, the FFT analysis is made both in analysis and Matlab Simulink. The Proportional Resonant (PR) controller is developed and work along with LCL filter for reducing the harmonic content. The stability of the system with PR is analyzed using root locus and bode plots and results are compared with PI controls. The result shows that PR controller performs better compared to the PI controller for reducing the harmonic content present in the single-phase system and for improving the system stability.
Grid connected photovoltaic system efficiency and quality improvement using fuzzy-incond MPPT
Authors: Yasmine Amara , Rafik Bradai , Rachid Boukenoui , Adel Mellit
Published: June 2020

Maximum Power Point Tracking (MPPT) techniques are developed to harvest and supply maximum power to the load. This depends on the power generated and the MPPT accuracy. Under quick-changing weather conditions, Incremental Conductance (InCond) and numerous different algorithms may fail to track the exact Maximum Power Point (MPP) which may result in significant power loss. Fuzzy Logic (FL) based MPPT is quick and accurate in tracking the MPP, but the high complexity and the implementation difficulty are their main disadvantages. A novel FL-InCond MPPT improved technique is developed based on the features of InCond and FL techniques to overcome their drawbacks.The newly developed approach can automatically adjust the variation of the duty cycle for tracking the MPP with accuracy. The obtained results are compared with conventional Perturb and observe (P&O) and InCond MPPTs for grid-connected mode under fast weather conditions. It is demonstrated that the developed method outperforms the aforementioned MPPT techniques in terms of tracking response, efficiency and the delivered current quality.
Comparative performance of a solar assisted heat pump dryer with a heat pump dryer for Curcuma
Authors: Hasibuan R. , Yahya M , Fahmi H. , Edison Edison
Published: June 2020

This study evaluated the performances of solar assisted heat pump dryer (SAHPD) and heat pump dryer (HPD) for drying of Curcuma xanthorrhiza Roxb. The HPD and SAHPD reduced mass of Curcuma from 30.70 kg to 7.85 kg needed 10.5 hours and 8 hours with average temperature and relative humidity 49.2oC and 26.5%, and 57.7oC and 19.8%, for SD and SAHPD respectively. The moisture of Curcuma dried from 3.167 db to 0.065 db with an air mass flow rate of 0.121 kg/s. The SAHPD reduced the drying time about 24% compared to HPD. The drying rate and the specific energy consumption were calculated in an average 1.05 kg/h and 1.36kg/h, and 1.17kWh/kg and 2.07kWh/kg for HPD and SAHPD, respectively. The specific moisture extraction rate and the dryer thermal efficiency were calculated in an average 0.931 kg/kWh and 0.521 kg/kWh, and 61.0% and 34.3% for HPD and SAHPD, respectively. Whereas, the pickup efficiency and the coefficient of performance of the heat pump were calculated in an average 57.5% and 59.2%, and 4.03and 4.35 for HPD and SAHPD, respectively. The SAHPD is capable of drying Curcuma quickly because of the high pickup efficiency and high drying rate.
Grey wolf optimizer algorithm based real time implementation of PIDDTC and FDTC of PMSM
Authors: Arafa Osama M. , Wahsh Said A. , Badr Mohamed , Yassin Amir
Published: June 2020

Meta-heuristic optimization techniques are important tools to define the optimal solutions for many problems. In this paper, a new advanced artificial intelligence (AI) based direct torque control (DTC) speed drives are optimally designed and implemented in real time to achieve a high performance permanent-magnet synchronous-motor (PMSM) drive. Grey wolf (GW) algorithms are used with the standard PID-based DTC (PIDDTC) and with the DTC with fuzzy logic (FDTC) based speed controllers. DSPACE DS1202 is utilized in the real-time implementation. MATLAB SIMULINK is used to simulate the steady-state (S.S.) and dynamic responses. The overall system is tested at different operating conditions for both simulation and practical work and all results are presented. A comparison between experimental and simulation results is performed and also a comparison between different applied intelligent techniques is introduced.
Incidence of New-Onset and Worsening Heart Failure Before and After the COVID-19 Epidemic Lockdown in Denmark
Authors: Andersson Charlotte , Gerds Thomas , Fosbøl Emil , Phelps Matthew , Andersen Julie , Lamberts Morten , Holt Anders , Butt Jawad H. , Madelaire Christian , Gislason Gunnar , Torp-Pedersen Christian , Køber Lars , Schou Morten
Published: June 2020

Background:

The Danish government ordered a public lockdown on March 12, 2020, because of the coronavirus disease 2019 (COVID-19) pandemic. We investigated the immediate consequences of such a lockdown for patients with heart failure (HF).

Methods:

Using the Danish nationwide administrative databases, we investigated the incidence of new-onset HF and hospitalizations for worsening HF before and after the lockdown (January 1 to March 11 versus March 12 to March 31) in 2020 versus 2019. We also investigated the mortality for all patients with HF and in COVID-19–infected patients with HF.

Results:

Rates of new-onset HF between January 1 and March 11 were comparable for 2020 and 2019 (1.83 versus 1.78 per 10 000 person-years;
P
=0.19), while hospitalizations for worsening HF were slightly higher in 2020 versus 2019 (1.04 versus 0.93 per 1000 person-years;
P
=0.02). In the lockdown period, rates of new-onset HF diagnoses (1.26 versus 2.25 per 1000 person-years) and of hospitalizations for worsening HF (0.63 versus 0.99 per 1000 person-years) were significantly lower in 2020 versus 2019 (
P
for both, <0.0001). Mortality was similar before and after the national lockdown for the population with HF. We observed 90 HF patients with diagnosed COVID-19 infection, of whom 37% (95% CI, 23%–50%) died within 15 days.

Conclusions:

The number of patients hospitalized with worsening HF or diagnosed with new-onset HF was markedly reduced after lockdown but has not yet impacted mortality in HF patients at a population-based level. However, these data raise concerns for a potential undertreatment of HF currently that may impact prognosis in the longer term.
Improving Cardiovascular Workforce Competencies in Cardio‐Obstetrics: Current Challenges and Future Directions
Authors: Sharma Garima , Zakaria Sammy , Michos Erin D. , Bhatt Ami B. , Lundberg Gina P. , Florio Karen L. , Vaught Arthur Jason , Ouyang Pamela , Mehta Laxmi
Published: June 2020

Maternal mortality in the United States is the highest among all developed nations, partly because of the increased prevalence of cardiovascular disease in pregnancy and beyond. There is growing recognition that specialists involved in caring for obstetric patients with cardiovascular disease need training in the new discipline of cardio‐obstetrics. Training can include integrated formal cardio‐obstetrics curricula in general cardiovascular disease training programs, and developing and disseminating joint cardiac and obstetric societal guidelines. Other efforts to help strengthen the cardio‐obstetric field include increased collaborations and advocacy efforts between stakeholder organizations, development of
US
‐based registries, and widespread establishment of multidisciplinary pregnancy heart teams. In this review, we present the current challenges in creating a cardio‐obstetrics community, present the growing need for education and training of cardiovascular disease practitioners skilled in the care of obstetric patients, and identify potential solutions and future efforts to improve cardiovascular care of this high‐risk patient population.
Liposomal Mediated Carriers of α Lipoic Acid for the Treatment of Acute Lung Injury: Preclinical Study in Rat Model
Authors: Cao Yu , Chai Yanling , Niu Xiaoqun , Hai Bing , He Xiaojie , Li Yongxia
Published: June 2020

The present investigation deals with formulation of lipoic acid as liposomal formulation and to evaluate its efficacy in Lung injury (Pulmonary Fibrosis). The liposomal formulation of Lipoic acid (LA-liposomes) was successfully prepared by thin film hydration method. Such prepared liposomes
were characterized for particle size, encapsulation efficiency, drug loading etc. characteristic. An Pulmonary fibrosis was induced using Bleomycin experimental animals rats. The effect of LA liposomal formulation on pulmonary fibrosis was observed. The histopathological finding confirms the
efficiency of formulation in attenuation of pulmonary fibrosis.
Effects of Rattin on Cognitive Ability and Expressions of B-Cell Lymphoma 2 (BCL-2)/BCL2 Associated X (Bax) and Brain-Derived Neurotrophic Factor (BDNF) in Hippocampus of Rats with Vascular Dementia
Authors: Xing Lifei , Yang Yu , Wang Min , Yan Hongliang , Zhao Meiping , Tan Sujuan , Huang Yanqing , Wang Yanhong
Published: June 2020

Vascular dementia (VD) is a cerebral dysfunction. Brain neuropeptide analogue Rattin is firstly found in rat brain tissue and plays a treatment effect in Alzheimer’s disease. However, its function and related mechanism in VD rat still needs elucidation. Rats were randomly separated
into sham group, VD model group and Rattin treatment group followed by analysis of learning ability by Morris water maze, Rattin level by real time PCR and Western blot, Bcl-2 and Bax levels by Western blot, BDNF expression by immunofluorescence. Rattin mRNA and protein expression was reduced,
Bcl-2 was downregulated, Bax was upregulated, and BDNF expression was attenuated in the brain tissue of VD model group compared to sham group (P < 0005). Rattin significantly increased Rattin mRNA and protein expression, improved learning ability, upregulated Bcl-2 level, suppressed
Bax expres- sion, and enhanced BDNF level in VD rats (P < 0005). Rattin ameliorates VD through regulating cell apoptosis, promoting BDNF expression, and improving learning ability.
MicroRNA-181a-5p Down-Regulation Presents Neuroprotective Effect in 1-Methyl-4-Phenylpyridinium-Induced Parkinson’s Disease: An In Vitro Study
Authors: Guo YanLi , Hua Xu
Published: June 2020

Background: Parkinson’s disease (PD) is a long-term degenerative disease that mainly affects the central nervous system of the motor system. MicroRNA-181a-5p (miR-181a-5p) is well studied a variety of malignancies. But, till now, there is no report of the role of miR-181a-5p
in PD. Methods: miR-181a-5p level was detected using quantitative reverse transcription polymerase chain reaction (qRT-PCR), and western blotting analysis/qRT-PCR was used to measure the level of Sirtuin 1 (SIRT1). We evaluated cell viability and apoptosis using 3-(4,5-dimethyl thiazol-2-yl)-2,5-diphenyl
tetrazolium bromide (MTT) assay and flow cytometry (FCM), and used enzyme linked immunosorbent assay (ELISA) assay to examine the releases of inflammatory cytokines interleukin (IL)-1β and tumor necrosis factor (TNF)-α. Commercially available kits was applied to assess
the lactate dehydrogenase (LDH) activity. Western blotting analyse was used to detect nuclear factor-κB p65 (NF-κB p65) and phosphorylated (p)-p65 protein expression. TargetScan and Dual luciferase reporter assay were carried out to determine the interaction between
miR-181a-5p and SIRT1. Results: Results showed that miR-181a-5p was up-regulated and SIRT1 was down-regulated in MMP+-treated C6 cells. miR-181a-5p knockdown attenuated the neurotoxicity induced by MMP+-treatment in C6 cells, evidenced by the enhancement of C6
cell viability, and the suppression of C6 cell apoptosis, LDH activity and inflammation. SIRT1 was found as a direct target of miR-181a-5p, and all these effects of miR-181a-5p inhibition on MMP+-treated C6 cells were reversed by SIRT1 knockdown. Conclusion: Our data suggested
that miR-181a-5p down-regulation presents neuroprotective effect in MMP+-induced PD in vitro model by targeting SIRT1.
R-Spondin 2 Promoted Proliferation, Invasion and Migration of Triple Negative Breast Cancer Cells Through Activating Wnt/β-Catenin Signaling Pathway After Axin2 Inhibition
Authors: Sun XiaoHu , Yu Yue , Ge Jie , Wang Xin , Cao XuChen
Published: June 2020

Protein R-spondin 2, which is known as roof plate-specific spondin 2, is an extracellular matrix secreted protein that participates in a wide range of biological processes. However, the expression of R-spondin 2 in triple negative breast cancer (TNBC) and its specific mechanism have
not been reported. In this study, RT-qPCR and western blot were used to detect the expression of R-spondin 2 and Axin2 in cells. Cell transfection techniques were used to overexpress Axin2 and interfere with the expression of R-spondin 2. CCk-8 and clone formation assay were used to detect
cell viability. Wound healing and Traswell techniques were used to test the rate of invasion and migration of TNBC cells. Western blot was used to detect the expression of related proteins. The results showed that the expression of R-spondin 2 in TNBC cell lines was significantly increased
compared with normal breast cancer cells. After interfering with the expression of R-spondin 2 in TNBC cell lines, the rate of cell viability, invasion and migration were decreased. It was also found that the expressions of Axin2 and β-catenin and Cyclin-D1, which are wnt/β-catenin
pathway related proteins, were significantly decreased. Subsequently, the overexpression of Axin2 can inhibit the proliferation, invasion and migration that were ever promoted by R-spondin 2 of TNBC cells. Moreover, the overexpression of Axin2 inhibited the activation of wnt/β-catenin
signaling pathway, which was also activated by R-spondin 2 in TNBC cells. In a word, R-spondin 2 promoted proliferation, invasion and migration of triple negative breast cancer cells through activating wnt/β-catenin signaling pathway after Axin2 inhibition.
On the Investigation of the Typology of Fog Events in an Arid Environment and the Link with Climate Patterns
Authors: Mohan T. S. , Temimi Marouane , Ajayamohan R. S. , Nelli Narendra Reddy , Fonseca Ricardo , Weston Michael , Valappil Vineeth
Published: June 2020

The central aim of this work is to investigate the characteristics of fog events over the United Arab Emirates (UAE) and identify the underlying physical processes responsible for fog initiation and dissipation. To achieve this, hourly meteorological measurements at eight airport stations, along with ERA5 reanalysis data (1995–2018), are utilized. The analysis indicates the dominance of radiation fog (RAD) as, on average, 70% of the observed events fall under this category. Fog in the UAE typically forms between 2000 and 0200 local time (LT) and dissipates between 0600 and 0900 LT. During a typical dense fog event recorded during 22–23 December 2017, cooling and moistening tendencies of up to 1.2 K h−1 and 0.7 g kg−1 h−1 are observed ~5–6 h before fog onset. In the vertical, a dry and warm layer above 750 hPa gradually descends from above 500 hPa to promote the development of fog. Similar conclusions are reached when analyzing composites of fog events. Further, the variability of fog occurrence associated with El Niño–Southern Oscillation (ENSO) patterns is explored. It is concluded that the El Niño (warm) and La Niña (cold) phases exhibit very different spatial characteristics with respect to surface meteorological variables. In particular, during El Niño events, the near-surface atmosphere is cooler and moister compared to La Niña events, favoring RAD fog formation over the UAE. Besides, fog events during El Niño years tend to last longer compared to La Niña years due to an earlier onset.
Overcoming failure in higher education: Social inequalities and compensatory advantage in dropout patterns
Authors: Herbaut Estelle
Published: June 2020

The large proportion of dropout students from higher education has become a major concern in many industrialized countries. Despite consistent evidence of the association between social origin and dropout behaviour, it is unclear through which mechanisms social origin influences trajectories and educational outcomes in higher education, especially in countries with low financial costs for higher education studies. This study builds on the compensatory advantage mechanism to investigate the relationship between social origin, academic failure in higher education and dropout behaviour. Using a French longitudinal survey and event history analysis, results confirm that academic failure in the first year of higher education is a strong predictor of dropout, even after controlling for academic readiness for higher education. Supporting the compensatory advantage hypothesis, students from advantaged backgrounds are much less likely to drop out after academic failure than disadvantaged students and this result also holds for high-performing high-school graduates. These results stress the importance of taking into account the interplay between social origin and academic performance during higher education to reduce dropout behaviour.
Social origin and compensation patterns over the occupational career in Italy
Authors: Ballarino Gabriele , Cantalini Stefano , Panichella Nazareno
Published: June 2020

This paper studies dynamically the direct effect of social origin on occupational destinations among men in Italy over the career. It aims at investigating the existence, the pattern over time and the heterogeneity of differences in occupational achievement related to social origins, net of education (DESO) and occupational allocation at first job. It also analyses if the change of the DESO over the career is related to the effect of specific job change episodes (voluntary job change, involuntary job change, internal career move). Results based on growth curve models show the relevance of first job in shaping the DESO, which also slightly increases over the career. The DESO is stronger among highly educated individuals, confirming a boosting pattern primarily driven by a better allocation at first job. The (smaller) DESO among the low-educated, increasing over the career, depends from the higher probabilities to benefit from voluntary and internal career job changes for the children of the service class. The (stronger) DESO among the highly educated is driven by the higher probabilities of experiencing internal career mobility for the children of the service class as well as by their ability to benefit also from an involuntary job change (e.g. dismissal).
Latent Variable Modeling and Adaptive Testing for Experimental Cognitive Psychopathology Research
Authors: Thomas Michael L. , Brown Gregory G. , Patt Virginie M. , Duffy John R.
Published: June 2020

The adaptation of experimental cognitive tasks into measures that can be used to quantify neurocognitive outcomes in translational studies and clinical trials has become a key component of the strategy to address psychiatric and neurological disorders. Unfortunately, while most experimental cognitive tests have strong theoretical bases, they can have poor psychometric properties, leaving them vulnerable to measurement challenges that undermine their use in applied settings. Item response theory–based computerized adaptive testing has been proposed as a solution but has been limited in experimental and translational research due to its large sample requirements. We present a generalized latent variable model that, when combined with strong parametric assumptions based on mathematical cognitive models, permits the use of adaptive testing without large samples or the need to precalibrate item parameters. The approach is demonstrated using data from a common measure of working memory—the N-back task—collected across a diverse sample of participants. After evaluating dimensionality and model fit, we conducted a simulation study to compare adaptive versus nonadaptive testing. Computerized adaptive testing either made the task 36% more efficient or score estimates 23% more precise, when compared to nonadaptive testing. This proof-of-concept study demonstrates that latent variable modeling and adaptive testing can be used in experimental cognitive testing even with relatively small samples. Adaptive testing has the potential to improve the impact and replicability of findings from translational studies and clinical trials that use experimental cognitive tasks as outcome measures.
Accurate Medication Adherence Measurement Using Administrative Data for Frequently Hospitalized Patients
Authors: Rasu Rafia S. , Hunt Suzanne L. , Dai Junqiang , Cui Huizhong , Phadnis Milind A. , Jain Nishank
Published: June 2020

Background: Pharmacy administrative claims data remain an accessible and efficient source to measure medication adherence for frequently hospitalized patient populations that are systematically excluded from the landmark drug trials. Published pharmacotherapy studies use medication possession ratio (MPR) and proportion of days covered (PDC) to calculate medication adherence and usually fail to incorporate hospitalization and prescription overlap/gap from claims data. To make the cacophony of adherence measures clearer, this study created a refined hospital-adjusted algorithm to capture pharmacotherapy adherence among patients with end-stage renal disease (ESRD). Methods: The United States Renal Data System (USRDS) registry of ESRD was used to determine prescription-filling patterns of those receiving new prescriptions for oral P2Y12 inhibitors (P2Y12-I) between 2011 and 2015. P2Y12-I-naïve patients were followed until death, kidney transplantation, discontinuing medications, or loss to follow-up. After flagging/censoring key variables, the algorithm adjusted for hospital length of stay (LOS) and medication overlap. Hospital-adjusted medication adherence (HA-PDC) was calculated and compared with traditional MPR and PDC methods. Analyses were performed with SAS software. Results: Hospitalization occurred for 78% of the cohort (N = 46 514). The median LOS was 12 (interquartile range [IQR] = 2-34) days. MPR and PDC were 61% (IQR = 29%-94%) and 59% (IQR = 31%-93%), respectively. After applying adjustments for overlapping coverage days and hospital stays independently, HA-PDC adherence values changed in 41% and 52.7% of the cohort, respectively. When adjustments for overlap and hospital stay were made concurrently, HA-PDC adherence values changed in 68% of the cohort by 5.8% (HA-PDC median = 0.68, IQR = 0.31-0.93). HA-PDC declined over time (3M-6M-9M-12M). Nearly 48% of the cohort had a ≥30 days refill gap in the first 3 months, and this increased over time ( P < .0001). Conclusions: Refill gaps should be investigated carefully to capture accurate pharmacotherapy adherence. HA-PDC measures increased adherence substantially when adjustments for hospital stay and medication refill overlaps are made. Furthermore, if hospitalizations were ignored for medications that are included in Medicare quality measures, such as Medicare STAR program, the apparent reduction in adherence might be associated with lower quality and health plan reimbursement.
Long-Term Evaluation of Drivers’ Behavioral Adaptation to an Adaptive Collision Avoidance System
Authors: Muslim Husam , Itoh Makoto
Published: June 2020

Objective

Taking human factors approach in which the human is involved as a part of the system design and evaluation process, this paper aims to improve driving performance and safety impact of driver support systems in the long view of human–automation interaction.

Background

Adaptive automation in which the system implements the level of automation based on the situation, user capacity, and risk has proven effective in dynamic environments with wide variations of human workload over time. However, research has indicated that drivers may not efficiently deal with dynamically changing system configurations. Little effort has been made to support drivers’ understanding of and behavioral adaptation to adaptive automation.

Method

Using a within-subjects design, 42 participants completed a four-stage driving simulation experiment during which they had to gradually interact with an adaptive collision avoidance system while exposed to hazardous lane-change scenarios over 1 month.

Results

Compared to unsupported driving (stage i), although collisions have been significantly reduced when first experienced driving with the system (stage ii), improvements in drivers’ trust in and understanding of the system and driving behavior have been achieved with more driver–system interaction and driver training during stages iii and iv.

Conclusion

While designing systems that take into account human skills and abilities can go some way to improving their effectiveness, this alone is not sufficient. To maximize safety and system usability, it is also essential to ensure appropriate users’ understanding and acceptance of the system.

Application

These findings have important implications for the development of active safety systems and automated driving.
Cross-Sectional Research Into People Passing Away Through Self-Ingesting Self-Collected Lethal Medication After Receiving Demedicalized Assistance in Suicide
Authors: Hagens Martijn , Pasman H. Roeline W. , Onwuteaka-Philipsen Bregje D.
Published: June 2020

This study describes the characteristics of—and the counseling received by—counselees who passed away through self-ingesting self-collected lethal medication after receiving demedicalised assistance in suicide. We analyzed registration forms filled in by counselors working with Foundation De Einder about 273 counselees who passed away from 2011 to 2015. The majority of these counselees had a serious disease and physical or psychiatric suffering. Half of them had requested physician assistance in dying. This shows that patients with a denied request for physician assistance in dying can persist in their wish to end life. This also shows that not all people with an underlying medical disease request for physician assistance in dying. Physicians and psychiatrist are often uninvolved in these self-chosen deaths while they could have a valuable role in the process concerning assessing competency, diagnosing diseases, and offering (or referring for) treatment.
Coordinating of multi-echelon supply chains through the generalized (R, S) policy
Authors: Shaban Ahmed , Costantino Francesco , Di Gravio Giulio , Tronci Massimo
Published: June 2020

Numerous studies have confirmed the negative impact of the lack of coordination on supply chain performance. In particular, the lack of coordination leads to the bullwhip effect, which has severe impacts on supply chain stability. This paper evaluates a proposed coordination mechanism that allows a decentralized information sharing in multi-echelon supply chains. The proposed mechanism “Info-Smooth” utilizes the ordering rule of the generalized (R, S) policy in which a replenishment order can be transferred to upstream echelons including two pieces of information (demand forecast and inventory balance). As the generalized (R, S) can allow order smoothing, Info-Smooth combines the power of both information sharing and order smoothing. A simulation modeling methodology is employed to investigate the effectiveness of Info-Smooth in a multi-echelon supply chain. The factorial design results have shown that Info-Smooth is successful in mitigating the bullwhip effect whilst keeping acceptable inventory stability, compared to the traditional supply chain model.
From Medical Pluralism to Medical Marginality: Changing Dynamics Within Unani System of Medicine
Authors: Sharma Priyam
Published: June 2020

The concept of medical marginality operates as a framework to differentiate between medical practice that is sanctioned and regulated by the state (Allopathic medicine or the Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy—(AYUSH) and that which is not regulated by the state. In Indian context, medical systems under the acronym of AYUSH have been given legitimate position and included in the health service sector. By using Hardiman and Mukharji’s concept of ‘medical marginality’ in a different way, the article attempts to study how one system of medicine is marginalised even within the institutionalised framework. It aims to understand the situation of Unani system of medicine with respect to other alternative medicines as enshrined in the concept of AYUSH along with the Allopathic system. In the process of doing so, the present research, through an ethnographic study, takes Unani hospital as a case in point to analyse the position of Unani system of medicine within the larger realm of healthcare.
Race and racism in Poland: Theorising and contextualising ‘Polish-centrism’
Authors: Balogun Bolaji
Published: June 2020

Whilst scholarship has sought to consider migration in Poland, there has been a lack of engagement with the ways in which race and racism interact with migration. In this article, I map the figures in the Polish imaginary of European, and examine whether Poland has different, if related, histories of racial thinking. I ask how such histories have been conceived, shaped and mediated. To examine this, I focus on the lived experiences of sub-Saharan African immigrants and children of immigrants (Black/mixed-race) who are often portrayed as non-Europeans and seen by some as ‘not quite Polish’. In doing so, this article provides an insight into the racial contours of Polish self-conception. I call this logic ‘Polish-centrism’ – a focus on some aspects of Polish culture to the exclusion of a wider view of the world. It is within this logic that I examine what it means to be Black and Polish in Poland.
Nobody becomes stigmatised ‘all at once’: An interactionist account of stigma on a modernist council estate
Authors: Hicks Stephen , Lewis Camilla
Published: June 2020

This article examines how residents experience and account for stigma at Claremont Court, a modernist social housing scheme built in Edinburgh in the early 1960s. Although listed as having special architectural interest, the building has been subject to disinvestment and has a mix of residents, including council and private renters as well as owner-occupiers. This article explores micro-distinctions between residents, showing how the categories ‘stigmatiser’ and ‘stigmatised’ are not as rigid as we might expect. It then considers stigma associated not with residents but, rather, the building itself, and argues that closer attention to the relationship between the material and social is required in order to understand residents’ complex articulations of belonging. Finally, residents’ views on dirt and rubbish are explored, showing how they use these signifiers of stigma to reveal concerns about shame and respectability. Responding to the call from this journal for more sociological understandings of stigma, this article argues that interactionist approaches offer an important alternative, one that highlights how stigma is negotiated, resisted and apportioned in everyday life. This perspective reveals residents’ practices in interaction with the material environment, as well as the ways in which stigmatisation processes work simultaneously in upward and downward directions, rather than in a unidirectional way.
Metastatic Tracheal Tumor of Thyroid Origin: Endoscopic Diode Laser Treatment Combined With Thyroidectomy, Radioactive Iodine, and Radiotherapy
Authors: Karkos Petros D. , Koskinas Ioannis S. , Tsiropoulos Gavriil , Goupou E. , Hatzibougias Dimitrios
Published: June 2020

Tracheal metastasis from papillary thyroid carcinoma (PTC) is an unprecedented and rare entity. We present the case of a 65 year-old lady who suffered from dyspnea and a thyroid goiter that turned out to be PTC. A magnetic resonance imaging (MRI) scan of the lungs revealed a huge tracheal mass causing obstruction of the tracheal lumen. She underwent a surgical tracheostomy and diode laser debulking of the tumor. Following this, she had a total thyroidectomy and postoperative radioiodine ablation and radiotherapy. She remains well under close and regular follow-up. A secondary tracheal tumor usually comes from a lymphatic spread of the primary tumor, whereas the vascular route is rarely reported. Endoscopic minimally invasive laser tracheal surgery with adjuvant radiotherapy appears to be equally effective to more aggressive tracheal resections.
Consequences of Medical Hierarchy on Medical Students, Residents, and Medical Education in Otolaryngology
Authors: Salehi Parsa P. , Jacobs Daniel , Suhail‐Sindhu Timur , Judson Benjamin L. , Azizzadeh Babak , Lee Yan Ho
Published: June 2020

Objective

To (1) review concepts of medical hierarchy; (2) examine the role of medical hierarchy in medical education and resident training; (3) discuss potential negative impacts of dysfunctional hierarchy in medical and surgical training programs, focusing on otolaryngology; and (4) investigate solutions to these issues.

Data Sources

Ovid Medline, Embase, GoogleScholar, JSTOR, Google, and article reference lists.

Review Methods

A literature search was performed to identify articles relating to the objectives of the study using the aforementioned data sources, with subsequent exclusion of articles believed to be outside the scope of the current work. The search was limited to the past 5 years.

Conclusions

Two types of hierarchies exist: “functional” and “dysfunctional.” While functional medical hierarchies aim to optimize patient care through clinical instruction, dysfunctional hierarchies have been linked to negative impacts by creating learning environments that discourage the voicing of concerns, legitimize trainee mistreatment, and create moral distress through ethical dilemmas. Such an environment endangers patient safety, undermines physician empathy, hampers learning, lowers training satisfaction, and amplifies stress, fatigue, and burnout. On the other hand, functional hierarchies may improve resident education and well‐being, as well as patient safety.

Implications for Practice

Otolaryngology–head and neck surgery programs ought to work toward creating healthy systems of hierarchy that emphasize collaboration and improvement of workplace climate for trainees and faculty. The goal should be to identify aspects of dysfunctional hierarchy in one’s own environment with the ambition of rebuilding a functional hierarchy where learning, personal health, and patient safety are optimized.
Time for a Paradigm Shift in Head and Neck Cancer Management During the COVID‐19 Pandemic
Authors: Han Albert Y. , Miller Jessa E. , Long Jennifer L. , St John Maie A.
Published: June 2020

Objective

The coronavirus disease 2019 (COVID‐19) pandemic has caused physicians and surgeons to consider restructuring traditional cancer management paradigms. We aim to review the current evidence regarding the diagnosis and management of head and neck cancer, with an emphasis on the role of the multidisciplinary team (MDT) during a pandemic.

Data Sources

COVID‐19 resources from PubMed, Google Scholar, the American Academy of Otolaryngology–Head and Neck Surgery, and the American Head and Neck Society were examined.

Review Methods

Studies and guidelines related to the multidisciplinary management of head and neck cancer in the COVID‐19 setting were reviewed. A total of 54 studies were included. Given the continuously evolving body of literature, the sources cited include the latest statements from medical and dental societies.

Results

The unpredictable fluctuation of hospital resources and the risk of the nosocomial spread of SARS‐CoV‐2 have direct effects on head and neck cancer management. Using an MDT approach to help define “essential surgery” for immediately life‐ or function‐threatening disease processes in the context of available hospital resources will help to maximize outcomes. Early enrollment in an MDT is often critical for considering nonsurgical options to protect patients and health care workers. The role of the MDT continues after cancer treatment, if delivered, and the MDT plays an essential role in surveillance and survivorship programs in these challenging times.

Conclusion

Head and neck cancer management during the COVID‐19 pandemic poses a unique challenge for all specialists involved. Early MDT involvement is important to maximize patient outcomes and satisfaction in the context of public and community safety.
Extracranial carotid artery pseudoaneurysm due to Mycobacterium tuberculosis
Authors: Patel Surendra , Sharma Alok Kumar , Meena Danishwar , Garg Pawan Kumar , Tiwari Sarbesh , Ghosh Tushar Surva
Published: June 2020

Mycobacterium tuberculosis is a very rare cause of extracranial carotid artery pseudoaneurysm. A 39-year-old man presented with a rapidly increasing neck mass and hoarseness of voice for 15 days. He was on antitubercular treatment for pulmonary tuberculosis. Computed tomography angiography showed a large pseudoaneurysm of the right common carotid artery. Emergency surgery was performed to excise the pseudoaneurysm sac and repair the artery with a Dacron graft. Postoperative angiography showed normal flow in the carotids and cerebral circulation. Histology of the excised tissue was consistent with a tubercular etiology of the pseudoaneurysm.
Associations between language style matching and relationship commitment and satisfaction: An integrative data analysis
Authors: Bierstetel Sabrina J. , Farrell Allison K. , Briskin Julia L. , Harvey Michael W. , Gable Shelly L. , Ha Thao , Ickes William , Lin Wei-Fang , Orina Minda M. , Saxbe Darby , Simpson Jeffry A. , Ta Vivian P. , Slatcher Richard B.
Published: June 2020

Language style matching (LSM) refers to similarity in function word use between two people during a conversation. Previous research has shown that LSM predicts romantic relationship stability, but it remains unknown why LSM is associated with stability. Across five studies from five different labs, we aimed to identify links between LSM and two relationship perceptions strongly associated with stability: commitment and satisfaction. Based on prior work, we hypothesized that LSM would be associated with commitment but not satisfaction. This hypothesis was supported in Study 1 ( N = 82) but was not supported in Study 2 ( N = 158). Preregistered analyses of three additional data sets ( N = 198, 190, 138) were then conducted to attempt to replicate the effect between commitment and LSM. The predicted associations between LSM and commitment/satisfaction, measured concurrently and longitudinally, were not observed in Studies 3–5. Moreover, a meta-analysis across all 766 individuals ( N = 383 couples) revealed that although the association between LSM and satisfaction was marginal ( M r = .10, Z = 1.92, p = .05, confidence interval (CI) = −.002, .203), there was no link between LSM and commitment ( M r = .05, Z = 0.97, p = .33, CI = −.052, .154). Across conflict discussions (i.e., in Studies 1 and 3–5), there were no associations between conflict LSM and satisfaction ( M r = .09, Z = 1.49, p = .14, CI = −.028, .203) or commitment ( M r = .03, Z = 0.50, p = .62, CI = −.087, .145). These findings suggest that if true associations between LSM and commitment and satisfaction exist, they are very small effects. They also emphasize the importance of replicating one’s own findings and illustrate a fruitful approach to replicating findings from high-investment studies through collaborating with researchers with similar data sets to increase statistical power and, in turn, reproducibility.
The effects of speaker accent on syntactic priming in second-language speakers
Authors: Chun Eunjin , Kaan Edith
Published: June 2020

Syntactic priming studies in second language (L2) have contributed to understanding how L2 speakers’ syntactic knowledge is represented and processed. However, little is known about social influences on L2 speakers’ syntactic processing and learning. The present study investigated whether L2 speakers’ syntactic priming is influenced by social factors, specifically different accents of English speakers and their familiarity with those accents. Korean L2 learners of English with intermediate proficiency were asked to describe pictures depicting ditransitive events after listening to sentences recorded by three English speakers with different accents: a standard-accented speaker (an American English speaker), and two speakers with non-standard accents (a Korean English speaker and an Indian English speaker). The results of the picture description task showed that syntactic priming effects in Korean L2 English speakers were significantly influenced by speaker accents and their familiarity with the accents. In addition, their priming patterns and interactions with these factors changed over time. These results suggest that syntactic priming in L2 speakers is socially mediated. We propose that priming effects in real language use can be better accounted for using a combination of cognitive and sociolinguistic models of syntactic priming and speech production.