bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing learning media of electronic fuel injections (efi) system android-based
Authors: Rohman J N , Ikhsan M R , Solikin M 
Published: December 2020

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

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

AbstractBackgroundFew safety and effectiveness results have been published regarding the administration of tenofovir alafenamide fumarate (TAF) during pregnancy for the prevention of mother-to-child transmission (MTCT) of hepatitis B virus (HBV).MethodsIn this multicenter prospective observational study, pregnant women with HBV DNA levels higher than 200 000 IU/mL who received TAF or tenofovir disoproxil fumarate (TDF) from gestational weeks 24–35 to delivery were 1:1 enrolled and followed until postpartum month 6. Infants received immunoprophylaxis. The primary endpoint was the safety of mothers and infants. The secondary endpoint was the hepatitis B surface antigen (HBsAg)-positive rate at 7 months for infants.ResultsIn total, 116 and 116 mothers were enrolled, and 117 and 116 infants were born, in the TAF and TDF groups, respectively. TAF was well tolerated during a mean treatment duration of 11.0 weeks. The most common maternal adverse event was nausea (19.0%). One (0.9%), 3 (2.6%), and 9 (7.8%) mothers had abnormal alanine aminotransferase levels at delivery and at postpartum months 3 and 6, respectively. The TDF group had safety profiles that were comparable to those of the TAF group. No infants had birth defects in either group. The infants’ physical and neurological development at birth and at 7 months in the TAF group were comparable with those in the TDF group. The HBsAg positive rate was 0% at 7 months in all 233 infants.ConclusionsAntiviral prophylaxis with TAF was determined to be generally safe for both mothers and infants and reduced the MTCT rate to 0%.
What’s left in the cupboard? Older antimicrobials for treating gonorrhoea
Authors: Fifer Helen , Livermore David M , Uthayakumaran Thinushaa , Woodford Neil , Cole Michelle J 
Published: December 2020

Abstract

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Conclusions:
This pediatric discharge toolkit improved the efficacy of transition from hospital to home by reducing 30-day readmissions. Patient satisfaction scores were not reduced by utilizing the toolkit.