bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the effect of multidisciplinary simulation-based team training on patients, staff and organisations: protocol for a stepped-wedge cluster-mixed methods study of a national, insurer-funded initiative for surgical teams in New Zealand public hospitals
Authors: Weller Jennifer , Long Jennifer Anne , Beaver Peter , Cumin David , Frampton Chris , Garden Alexander L , Moore Matthew , Webster Craig S , Merry Alan 
Published: February 2020

IntroductionNetworkZ is a national, insurer-funded multidisciplinary simulation-based team-training programme for all New Zealand surgical teams. NetworkZ is delivered in situ, using full-body commercial simulators integrated with bespoke surgical models. Rolled out nationally over 4 years, the programme builds local capacity through instructor training and provision of simulation resources. We aim to improve surgical patient outcomes by improving teamwork through regular simulation-based multidisciplinary training in all New Zealand hospitals.Methods and analysisOur primary hypothesis is that surgical patient outcomes will improve following NetworkZ. Our secondary hypotheses are that teamwork processes will improve, and treatment injury claims will decline. In addition, we will explore factors that influence implementation and sustainability of NetworkZ and identify organisational changes following its introduction. The study uses a stepped-wedge cluster design. The intervention will roll out at yearly intervals to four cohorts of five District Health Boards. Allocation to cohort was purposive for year 1, and subsequently randomised. The primary outcome measure is Days Alive and Out of Hospital at 90 days using patient data from an existing national administrative database. Secondary outcomes measures will include analysis of postoperative complications and treatment injury claims, surveys of teamwork and safety culture, in-theatre observations and stakeholder interviews.Ethics and disseminationWe believe this is the first surgical team training intervention to be implemented on a national scale, and a unique opportunity to evaluate a nation-wide team-training intervention for healthcare teams. By using a pre-existing large administrative data set, we have the potential to demonstrate a difference to surgical patient outcomes. This will be of interest to those working in the field of healthcare teamwork, quality improvement and patient safety. New Zealand Health and Disability Ethic Committee approval (#16/NTB/143).Trial registration numberAustralian and New Zealand Clinical Trials Registry ID ACTRN12617000017325 and the Universal Trial Number is U1111-1189-3992.
Feasibility and acceptability of introducing advance care planning on a thoracic medicine inpatient ward: an exploratory mixed method study
Authors: Hjorth Nina Elisabeth , Schaufel Margrethe Aase , Sigurdardottir Katrin Ruth , Haugen Dagny R Faksvåg 
Published: February 2020

Background and aimsAdvance care planning (ACP) is communication about wishes and preferences for end-of-life care. ACP is not routinely used in any Norwegian hospitals. We performed a pilot study (2014–2017) introducing ACP on a thoracic medicine ward in Norway. The aims of this study were to explore which topics patients discussed during ACP conversations and to assess how patients, relatives and clinicians experienced the acceptability and feasibility of performing ACP.MethodsConversations were led by a study nurse or physician using a semistructured guide, encouraging patients to talk freely. Each conversation was summarised in a report in the patient’s medical record. At the end of the pilot period, clinicians discussed their experiences in focus group interviews. Reports and transcribed interviews were analysed using systematic text condensation.ResultsFifty-one patients participated in ACP conversations (41–86 years; 9 COPD, 41 lung cancer, 1 lung fibrosis; 11 women); 18 were accompanied by a relative. Four themes emerged: (1) disturbing symptoms, (2) existential topics, (3) care planning and (4) important relationships. All participants appreciated the conversations. Clinicians (1 physician and 7 nurses) participated in two focus group interviews. Reports from ACP conversations revealed patient values previously unknown to clinicians; important information was passed on to primary care. Fearing they would deprive patients of hope, clinicians acted as gatekeepers for recruitment. Although they reported barriers during recruitment, many clinicians saw ACP as pertinent and called for time and skills to integrate it into their daily clinical practice.ConclusionsPatients, relatives and clinicians showed a positive attitude towards ACP. Focusing on present and future symptom control may be an acceptable way to introduce ACP. Important aspects for implementing ACP in this patient group are management support, education, training, feasible routines and allocated time to perform the conversations.
Predictors of independent outcome of thrombectomy in stroke patients with large baseline infarcts in clinical practice: a multicenter analysis
Authors: Deb-Chatterji Milani , Pinnschmidt Hans , Flottmann Fabian , Leischner Hannes , Broocks Gabriel , Alegiani Anna , Brekenfeld C , Fiehler Jens , Gerloff Christian , Thomalla Goetz 
Published: February 2020

ObjectiveTo analyze outcome and its predictors after endovascular treatment (ET) in stroke patients suffering from large vessel occlusion with large pre-treatment infarct cores defined by an Alberta Stroke Program Early CT Score (ASPECTS) <6.MethodsWe analyzed data from an industry-independent, multicenter, prospective registry (German Stroke Registry – Endovascular Treatment) which enrolled consecutive patients treated by ET (June 2015–April 2018) with different devices. Multivariate logistic regression analyses identified predictors of independent outcome (IO) defined as a modified Rankin Scale (mRS) 0–2, and mortality at 90 days in patients with ASPECTS <6.ResultsOf 1700 patients included in the analysis, 152 (8.9%) had a baseline ASPECTS <6. Of these, 33 patients (21.6%) achieved IO, and 68 (44.7%) were dead at 90 days. A lower age, lower baseline National Institutes of Health Stroke Scale (NIHSS) score, and successful recanalization (defined as modified Thrombolysis in Cerebral Infarction Score, mTICI 2b/3) were predictors of IO. Successful recanalization had the strongest association with IO (OR 7.0, 95% CI 1.8 to 26.8). Pre-treatment parameters predicting IO were age <70 years (sensitivity 0.79, specificity 0.69) and NIHSS <12 (0.57 and 0.94). A higher age, a pre-stroke mRS score >1, and failed recanalization were predictors of death.ConclusionsA substantial proportion of stroke patients with an ASPECTS <6 can achieve independence after thrombectomy, in particular, if they are younger, have only moderate baseline stroke symptoms, and no relevant pre-stroke disability. These results may encourage considering thrombectomy in low ASPECTS patients in clinical practice until randomized trials are available.
Body composition in heart failure and the impact of cardiac resynchronisation therapy: a proof-of-concept study
Authors: McAloon Christopher J , Hyndman Samantha , Ansell Valerie , O'Hare Paul , Randeva Harpal , Osman Faizel 
Published: February 2020

AimsBody composition (BC) is known to alter in heart failure. Cardiac resynchronisation therapy (CRT) improves left ventricular geometry but the impact on BC is unknown. Our aim was to evaluate BC in these patients before and after CRT implantation.MethodsProspective proof-of-concept pilot study of heart failure patients undergoing CRT between September 2014 and December 2015. Assessments performed pre-CRT and post-CRT (6 weeks and 6 months) were: BC parameters (using air-displacement plethysmography), New York Heart Failure classification for assessing symptom severity, echocardiography to assess left ventricular geometry, electrocardiography, Minnesota Heart Failure Questionnaire and N-terminal probrain natriuretic peptide (NT-pro-BNP). Repeated measures analysis of variance was performed to assess relative change over time and potential correlations.ResultsTwenty-five patients were recruited; mean-age (±SD) was 73.4±10.0 years, 23 males, 18 CRT defibrillators (remainder CRT pacemakers), 16 had ischaemic aetiology, 6 diabetics, 17 with left bundle-branch morphology on ECG and 10 had atrial fibrillation. Significant inverse correlations were observed in the first 6 weeks following CRT between fat mass and left ventricular end-diastolic volume (r=−0.69, p<0.01) and NT-pro-BNP and fat mass (r=0.41, p=0.05). No significant differences were noted over 6 months. There was an observed trend towards reduced fat mass in the first 6 weeks post-CRT implant driven by non-responders. There was no significant difference between responders and non-responders in BC over 6 months.ConclusionThis is the first study to observe interplay between BC and cardiac geometry/function following CRT; a trend in overall fat mass reduction was noted following CRT and merits further study.
E-cigarette advertising expenditures in the United States, 2014–2018
Authors: Ali Fatma Romeh M , Marynak Kristy L , Kim Yoonsang , Binns Steven , Emery Sherry L , Gomez Yessica , King Brian A 
Published: February 2020

BackgroundTobacco product advertising has been shown to reach youth and promote initiation. This study assessed trends in e-cigarette advertising expenditures in the USA during 2014–2018, overall and by manufacturer and media type.MethodsData came from Kantar Media, which provides information on US advertising expenditures, including for e-cigarettes. Advertising expenditures were estimated as the dollar amount spent by e-cigarette companies to purchase advertising space in print, television, Internet, radio and outdoors. Dollar amounts were adjusted to 2017 dollars. Trends in e-cigarette advertising expenditures during 2014–2018 were analysed using Joinpoint regression overall, by media type, and by manufacturers based on 2017–2018 national sales.ResultsTotal e-cigarette advertising expenditures in print, radio, television, Internet and outdoors decreased substantially from US$133 million in 2014 to US$48 million in 2017, followed by an increase to US$110 million in 2018. By media type, expenditures were highest for print advertising, irrespective of year. By manufacturer, Altria had the highest e-cigarette advertising expenditures, totalling over US$134 million during 2014–2018. Imperial Tobacco had the second highest, totalling over US$85 million during 2014–2018, while JUUL Labs had the highest single-year expenditures, spending over US$73 million in 2018 alone.ConclusionsE-cigarette advertising expenditures have been volatile in the USA, with declines in traditional advertising venues during 2014–2017 that may reflect a shift towards social media. However, an increase occurred in 2018 that is likely reflective of advertising by newer manufacturers. Continued monitoring of e-cigarette advertising is important to inform tobacco control strategies.
Probing GHz gravitational waves with graviton–magnon resonance
Authors: Ito Asuka , Ikeda Tomonori , Miuchi Kentaro , Soda Jiro 
Published: February 2020

AbstractA novel method for extending the frequency frontier in gravitational wave observations is proposed. It is shown that gravitational waves can excite a magnon. Thus, gravitational waves can be probed by a graviton–magnon detector which measures resonance fluorescence of magnons. Searching for gravitational waves with a wave length$$\lambda $$λby using a ferromagnetic sample with a dimensionl, the sensitivity of the graviton–magnon detector reaches spectral densities, around$$5.4 \times 10^{-22} \times (\frac{l}{\lambda /2\pi })^{-2} \ [\mathrm{Hz}^{-1/2}]$$5.4×10-22×(lλ/2π)-2[Hz-1/2]at 14 GHz and$$8.6 \times 10^{-21} \times (\frac{l}{\lambda /2\pi })^{-2} \ [\mathrm{Hz}^{-1/2}]$$8.6×10-21×(lλ/2π)-2[Hz-1/2]at 8.2 GHz, respectively.
Automatic corneal nerve fiber segmentation and geometric biomarker quantification
Authors: Zhang Dan , Huang Fan , Khansari Maziyar , Berendschot Tos T. J. M. , Xu Xiayu , Dashtbozorg Behdad , Sun Yue , Zhang Jiong , Tan Tao 
Published: February 2020

AbstractGeometric and topological features of corneal nerve fibers in confocal microscopy images are important indicators for the diagnosis of common diseases such as diabetic neuropathy. Quantitative analysis of these important biomarkers requires an accurate segmentation of the nerve fiber network. Currently, most of the analysis are performed based on manual annotations of the nerve fiber segments, while a fully automatic corneal nerve fiber extraction and analysis framework is still needed. In this paper, we establish a fully convolutional network method to precisely enhance and segment corneal nerve fibers in microscopy images. Based on the segmentation results, automatic tortuosity measurement and branching detection modules are established to extract valuable geometric and topological biomarkers. The proposed segmentation method is validated on a dataset with 142 images. The experimental results show that our deep learning-based framework outperforms state-of-the-art segmentation approaches. The biomarker extraction methods are validated on two different datasets, demonstrating high effectiveness and reliability of the proposed methods.
Submarine canyons, slope failures and mass transport processes in southern Cascadia
Authors: Hill Jenna C. , Watt Janet T. , Brothers Daniel S. , Kluesner Jared W. 
Published: February 2020

Abstract

Marine turbidite records have been used to infer palaeoseismicity and estimate recurrence intervals for large (>M
w
7) earthquakes along the Cascadia Subduction Zone. Conventional models propose that upper slope failures are funneled into submarine canyons and develop into turbidity flows that are routed down-canyon to deep-water channel and fan systems. However, the sources and pathways of these turbidity flows are poorly constrained, leading to uncertainties in the connections between ground shaking, slope failure and deep-water turbidites. We examine the spatial distribution of submarine landslides along the southern Cascadia margin to identify source regions for slope failures that may have developed into turbidity flows. Using multibeam bathymetry, sparker multichannel seismic and chirp sub-bottom data, we observe relatively few canyon head slope failures and limited evidence of large landslides on the upper and middle slope. Most of the submarine canyons are draped with sediment infill in the upper reaches and do not appear to be active sediment conduits during the recent sea-level highstand. In contrast, there is evidence of extensive mass wasting of the lower slope and non-channelized downslope flows. Contrary to previous studies, we propose that failures along the lower slope are the primary sources for deep-sea seismoturbidites in southern Cascadia.
A Semi-IPN Polymeric Binder for High Performance Silicone Negative Electrodes in Lithium Ion Batteries
Authors: Kim Nam Seon , Chung Byung Joo , Kim Soo Jung , Choi Kwang Shik 
Published: February 2020

As applications of rechargeable lithium ion batteries are gradually increasing from small electronic devices to automobiles or power storages, there is increasing demand for electrode materials for use in rechargeable batteries having various advantageous characteristics including high safety, extended cycle life, high energy density and high output characteristic.
To develop rechargeable lithium ion batteries with high energy density, intensive studies have focused on silicone anode materials due to their high theoretical capacity (4200mAh/g). However, the commercial use of Si-based material is still hindered because of severe volume expansion by up to 300% during the repeated charge and discharge cycles, which results in pulverization and capacity fading.
In order to alleviate the volume changes, various nanostructured Si electrodes have drawn attention. Although the pulverization issue can be resolved by using the nanometer-scale materials, an effective low-cost solution to the volume-change problem remains elusive.
In the past, polymeric binder has played only passive roles in the performance of lithium ion batteries. But recent works show that the choice of binder is very important to stabilize the cycling performance of Si-based negative electrodes for LIB, and the functions of binders have become critical.
So we synthesized the new semi-interpenetrating network (semi-IPN) binder that can endure expansion of the Si-based active material. The term semi-IPN refers to a network structure of a linear polymer and a cross-linking polymer. Such a semi-IPN polymeric binder includes two kinds of polymers in a chain shape to form a network structure, and has high mechanical strength and excellent stability in the liquid electrolyte compared with general polymer. Accordingly, a rechargeable lithium ion battery including this binder can effectively control the expansion of a Si-based active material and exhibit improved cycling performance.
Materials Exploration in Na-Fe-S-O System: Crystal Structure
Authors: Nishimura Shinichi , Oyama Gosuke , Yamada Atsuo 
Published: February 2020

The sodium-ion battery system has attracted growing interest as a potential candidate for larger energy storage systems. The ubiquitous element Na allows us to realize the stable production of larger scale systems for broader applications. For such strategies, material design of the electrode should be done by utilizing the abundant elements for not only the guest species but also the host framework. Recently new iron sulphate compounds were discovered by explorations in Li-Fe-S-O(-F) system for example Li2Fe(SO4)2 (3.83 V vs. Li/Li+) and various polymorphs LiFeSO4F (3.6 – 3.9 V vs. Li/Li+), which show higher redox-potential than the other Fe oxysalt compounds as expected from the high electronegativity of the sulphate anion [SO4]2–.[1-3] Inspired by this strategy, we explored Na-Fe-S-O system for the sodium ion battery and identified some new compounds, a few of which demonstrate good rate-capabilities and high redox-potentials. [4]
One of the Na containing Fe(II) compounds showed a high redox potential of 3.6 V vs. Na/Na+, higher than the NASICON-type FeIII
2(SO4)3 of ca. 3.4 V vs. Na/Na+. To elucidate the origin of the superior performances, we performed crystal structure determinations and structural analysis of the new phase. It has a unique Fe local environment with Fe2O10 dimer. The dimer is interconnected by sulphate anion and forms a 3-dimensional framework, which consists 2 kind of large tunnel-like structure. Na atoms in the tunnels show a significant positional disordering, suggesting a good Na ionic conductivity. For further analysis, we applied a modified bond-valence-sum (mBVS) calculation [5], where deviations of the calculated mBVS from the ideal valence |ΔV| can provide information on preferable positions in the static structural model. Figure 1 shows an example of contour plot of the |ΔV| map. Based on this, we will discuss about the more detailed structural features and expected sodium diffusion mechanisms.

References

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S. Adams, Acta Crysta B57: 278 2001.

Acknowledgments

This work was supported by the ‘Element Strategy Initiative for Catalysts & Batteries’ (ESICB) project.
In Situ Solid State 7li NMR Observation of Lithium Metal Deposition during Overcharge of Lithium Ion Battery
Authors: Arai Juichi , Okada Yumika , Gotoh Kazuma 
Published: February 2020

Understanding the reaction inside sealed lithium ion battery (LIB) is a key to handle it safe and life well, and to improve its performance. In situ measurement is necessary to achieve it, because LIB has a quasi equilibrium state in its system which is no more existing if it is disassembled. In situ NMR is one of the most suitable technique which can detect the change in lithium. So far, excellent studies have been done using modified electrodes and electrolyte to obtain a good NMR signal. [1,2] But, the LIB performance and reaction may change depending on the electrode density, electrolyte, packaging, and etc. This paper reports in situ solid NMR measurement using small size cell composed of high density coated electrodes and ordinal liquid electrolyte with heat sealed pouch cell having Al coat layer.[3]
Lithium deposition and Lithium ion behaviors of Lithium battery composed of cathode selected from LCO, NMC, NCA, LMO and graphite anode during charge-discharge and overcharge were analyzed by in-situ 7Li solid state NMR. The cell used in this study was made using typical energy density coated electrode, ordinal 25 mm polypropylene separator, 1M LiPF6 EC/EMC (3/7 vol%) liquid organic electrolyte and laminate film containing Al layer. The average cell capacity is 4.3 mAh with 1×1.5 cm electrode size. In situ NMR measurements were carried out with an originally prepared flattened coil detector and home build NMR equipment with 7.0T magnet (resonance frequency 116.4 MHz for 7Li). A single pulse sequence was applied with 6 ms pulse length. 7Li chemical shifts were referenced to a signal of saturated LiCl solution (0 ppm).
The peak corresponding to metallic Lithium was observed after 1 mAh overcharge from SOC 100% for LCO, NMC and NCA cell. The intensity of Li metallic peak increased with overcharge capacity in these cells, while the metallic peak was not appeared in LMO cell due to Li content in its. The peak after overcharge in LCO cell was the strongest in these cells and did not disappeared after one night, but the peak in NCA gone after one night. This suggests that the stability of Lithium dendrite depends on the cell chemistry.
The peak belonging to Li ion in electrolyte split into two peaks which may due to the surface interaction with cathode electrode. The peak ratio among these two in LCO cell decreased with discharge, indicating the peak is influenced by the state of cathode structure, voltage or relaxation of ion flow.
[1] Michel Letellier, Frederic Chevallier, Christian Clinard, Elzbieta frackowiak, Jean-Noel Rouzaud, and Francois Beguin, J. Chem. Phys., 118, p.6038 (2003).
[2] Nicole M. Trease, Lina Zhou, Hee Jung Chang, Ben Yunxu Chang, Clare P. Grey, Sol. Sta. Nuc. Mag. Res., 42, p.62 (2012).
[3] Arai Juichi, Okada Yumika, Takeda Kazuyuki, Gotoh Kazuma, Izuka Masato and Ishida Hiroyuki, The 7th Asian Conference on Electrochemical Power Sources, Abstract 1P-19, p.88 (Osaka)2013.11.24-27