bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Electronic Health Records by Older Adults, 85 Years and Older, and Their Caregivers
Authors: Ramirez‐Zohfeld Vanessa , Seltzer Anne , Xiong Linda , Morse Lucy , Lindquist Lee A. 
Published: March 2020

BACKGROUNDHealthcare providers may not offer patient portal (PP) access to electronic health records (EHRs) to their patients older than 85 years, due to the false impression that they do not utilize technology. It is imperative that older adults be given equal opportunity to use technology in regard to their healthcare.OBJECTIVETo characterize the content and frequency of use of PP messaging tethered to EHRs by older adults, aged 85 years and older, and their caregivers.DESIGN, SETTING, AND PARTICIPANTSUser‐initiated communications from electronic PPs (MyChart) tethered to an EHR (Epic) for patients who were 85 years and older, receiving care at outpatient internal medicine and geriatric clinics at an academic health center from July 1, 2016, to December 31, 2016, were reviewed retrospectively and analyzed with mixed methods.RESULTSA total of 1254 user‐initiated messages, sent by 62 patients aged 85 years and older (mean age = 87.9 years; n = 576 messages; mean = 9.9 messages per person) and 82 caregivers (n = 678 messages; mean = 7.8 messages per person), were analyzed. Qualitative analysis revealed 12 main themes: clinical issues, medication/vaccine questions, medication refills, laboratory orders/results, therapy/durable medical equipment, care coordination, care transitions, scheduling, appreciation/thank you, administrative/billing, telephone requests, and death notification. Caregivers significantly initiated messages more for care transitions (P < .001). Patients significantly initiated messages more for scheduling (P = .04) and medication refills (P = .04). Patients who had heart failure, coronary artery disease, or Alzheimerʼs disease were significantly more likely to have caregivers using the PP as their proxy (30.7% vs 21.6%; P = .01).CONCLUSIONSAdults, aged 85 years and older, and their caregivers utilize PPs tethered to EHRs. Healthcare providers should ensure inclusivity and offer access to EHRs to older adult populations, especially those aged 85 years and older. J Am Geriatr Soc 68:1078–1082, 2020
Effect of biting speed and jaw separation on force used to incise food
Authors: Paphangkorakit Jarin , Chaichit Rajda , Khummool Kakanank , Nopphaisit Saowalak , Saengsai Assanon 
Published: March 2020

AbstractBiting food too quickly might affect the control of jaw‐closing muscles and the estimation of bite force. The objectives of this study were to compare the incisal bite forces used to cut food and the activity of masseter (MA) and anterior temporalis (AT) muscles between slow, habitual and fast biting speeds and also between small and large jaw openings. Twenty subjects were asked to use their incisors to cut through a 5 mm thick of chewing gum. In the first experiment, subjects bit at 10‐mm incisal separation with slow, habitual and fast biting speeds, and in the second experiment, subjects bit with their habitual speed at 10‐ and 30‐mm incisal separations. The activities in the MA and AT muscles were assessed with surface electromyography, and the bite force was recorded by a force sensor placed beneath the chewing gum. Peak bite forces and associated MA amplitudes were increased significantly as biting speed was increased (P's < .05). Anterior temporalis amplitude was significantly increased during fast biting compared to slow and habitual biting (P's < .001). At 30‐mm incisal separation, both peak bite force and AT amplitude were significantly increased, whereas MA amplitude was significantly decreased, compared to those at 10‐mm separation (P's < .05). Biting off food quickly with incisor teeth results in larger activities in both MA and AT muscles. In addition, biting a large piece of food resulted in increased activity of AT muscle. Both conditions could be injury stimulator for jaw muscles.
What God Cannot Do: Divine Power, the Gratuity of Grace, and Henri De Lubac
Authors: Lombardo Nicholas E. 
Published: March 2020

AbstractWhen Pius XII promulgated his encyclical Humani generis in 1950, it was widely read as censuring Henri de Lubac’s views on human nature and the desire for God. In recent years, as controversies about nature and grace have revived, this reading of Humani generis has been widely assumed by supporters and critics of de Lubac alike. Henri de Lubac, however, always insisted that the encyclical did not touch his position. This article will argue that, whatever the objectives of the encyclical’s drafters, he was correct. It will make its case by turning to an issue neglected in contemporary debates about nature and grace: divine power. It will first trace the history of Christian reflection on divine power, a story whose twists and turns have only recently been uncovered by medieval historians, and then argue that, with this history in view, interpreting the crucial line in Humani generis as excluding de Lubac’s position becomes untenable. Finally, this article will discuss the implications of this conclusion for contemporary accounts of human nature, the desire for God, and the gratuity of grace.
Influence of Congruency Design on the Contact Stress of a Novel Hinged Knee Prosthesis Using Finite Element Analysis
Authors: Zhang Jing‐yu , Tian Dong‐mu , Ren Zhi‐peng , Hu Yong‐cheng , Yu Xiu‐chun 
Published: March 2020

ObjectivesTo investigate the contact stress and the contact area o tibial inserts and bushings with respect to different congruency designs in a spherical center axis and rotating bearing hinge knee prosthesis under gait cycle loading conditions using finite element analysis.MethodsNine prostheses with different congruency (different degrees of tibiofemoral conformity and different distances between the spherical center and the bushing) designs were developed with the same femoral and tibial components. The models were transferred to finite element software. The peak contact stresses and contact areas on tibial inserts and bushings under the gait cycle loading conditions were investigated and compared.ResultsFor tibial insert, the peak contact stress was the highest in the low conformity‐long group (61.4486 MPa), and it was 1.88 times higher than that in the group with the lowest stress (moderate conformity‐short group, 32.754 MPa). The contact area was the largest in the low conformity‐long group (420.485 mm2), and it was 1.19 times larger than that in the group with the smallest area (moderate conformity‐middle group, 352.332 mm2). For bushing, the peak contact stress was the highest in the high conformity‐long group (72.8093 MPa), and it was 3.21 times higher than that in the group with the lowest stress (high conformity‐short group, 22.6928 MPa). The contact area was the largest in the low conformity‐short group (2.41 mm2), and it was 2.27 times larger than that in the group with the smallest area (high conformity‐middle group, 1.063 mm2).ConclusionThe results of our study showed that the congruency of the tibiofemoral surface and bushing surface should be considered carefully in the design of the spherical center axis and rotating bearing hinge knee prosthesis. Different levels of contact performance were observed with different congruency designs. In addition, the influence of contact stress and contact area on the polyethylene wear of rotating hinge knee prostheses should be confirmed with additional laboratory tests.
Persistent ventilation inhomogeneity after an acute exacerbation in preschool children with recurrent wheezing
Authors: Kowalik Krzysztof , Dai Ruixue , Safavi Shahideh , Reyna Myrtha E. , Lou Wendy , Lepine Claire , McDonald Erica , Schaap Mirjam J. , Brydges May G. , Dubeau Aimee , Boutis Kathy , Narang Indra , Eiwegger Thomas , Moraes Theo J. , Ratjen Felix , Subbarao Padmaja 
Published: March 2020

AbstractBackgroundPreschool children with recurrent wheezing suffer high morbidity. It is unclear whether objective measures of asthma control, such as pulmonary function tests (PFTs), provide additional information to the clinical assessment.MethodsWe recruited children between 3 and 6 years old, with a history of recurrent wheezing in the preceding year and treated for acute wheezing exacerbation in the emergency department (ED) into an observational cohort study. Children attended two outpatient visits: the first study visit within five days of discharge from the ED and the second study visit 12 weeks after the ED visit. We performed standardized symptom score (test for respiratory and asthma control in kids (TRACK)), multiple breath washout (MBW), spirometry, and clinical assessment at both visits.ResultsSeventy‐four children, mean (standard deviation (SD)) age of 4.32 years (0.84), attended both visits. Paired FEV0.75 and lung clearance index (LCI) measurements at both time points were obtained in 37 and 34 subjects, respectively. Feasibility for all tests improved at visit 2 and was not age‐dependent. At the second study visit, a third had controlled asthma based on the TRACK score, and the mean lung clearance index (LCI) improved from 9.86 to 8.31 (P = .003); however, 46% had an LCI in the abnormal range. FEV0.75 z‐score improved from −1.66 to −1.17 (P = .05) but remained in the abnormal range in 24%. LCI was abnormal in more than half of the children with “well‐controlled” asthma based on the TRACK score. There was no correlation between PFT measures and TRACK scores at either visit.ConclusionsLung clearance index demonstrates a persistent deficit post‐exacerbation in a large proportion of preschoolers with recurrent wheezing, highlighting that symptom scores alone may not suffice for monitoring these children.
Impact of dipyridamole on adenosine dosing in pediatric and young adult patients after heart transplantation
Authors: Satzer Michael B. , Flyer Jonathan N. , Zuckerman Warren A. , Liberman Leonardo , Richmond Marc E. , Anderson Brett R. , Addonizio Linda J. , Silver Eric S. 
Published: March 2020

AbstractBackgroundRelative contraindications to adenosine use have included heart transplant and dipyridamole. We previously demonstrated the safety and efficacy of adenosine‐induced atrioventricular (AV) block in healthy young heart transplant recipients while suspending dipyridamole therapy (dual antiplatelet agent). This prospective follow‐up study evaluated the safety and efficacy of adenosine use in the same cohort of heart transplant recipients while on dipyridamole.MethodsAdenosine was incrementally dosed until AV block occurred (maximum 200 mcg/kg up to 12 mg). The primary outcome was clinically significant asystole (≥12 seconds). Secondary outcomes included maximal adenosine dose, AV block duration, dysrhythmias, and clinical symptoms. Outcomes were compared to the parent study.ResultsThirty of 39 eligible patients (5‐24 years) were tested. No patient (0%, CI 0%‐8%) experienced clinically significant asystole. AV block occurred in 29/30 patients (97%, CI 86%‐100%). The median dose causing AV block was 50mcg/kg (vs 100 mcg/kg off dipyridamole; P = .011). Seventeen patients (57%, CI 39%‐72%) required less adenosine to achieve AV block on dipyridamole; six (20%) required more. AV block occurred at doses ≥25 mcg/kg in all patients. In pairwise comparison to prior testing off dipyridamole, no significant change occurred in AV block duration, frequency of cardiac ectopy, or incidence of reported symptoms. No atrial fibrillation/flutter occurred.ConclusionsAV block often occurs at twofold lower adenosine doses in healthy young heart transplant recipients taking oral dipyridamole, compared with previous testing of this cohort off dipyridamole. Results suggest that initial dosing of 25 mcg/kg (maximum 0.8 mg) with stepwise escalation poses low risk of prolonged asystole on dipyridamole.
The effect of flood intermittency on bifurcations in fluviodeltaic systems: Experiment and theory
Authors: Daniller‐Varghese Max S. , Kim Wonsuck , Mohrig David C. 
Published: March 2020

AbstractThe dimensions and organization of deltaic islands and channels dictate delta morphology. This study presents experimental results modelling deposition at a river mouth and flow bifurcation around delta islands. Mouth bar formation and channel bifurcation is achieved in a laboratory setting by alternating input of suspended load transport and bedload transport. These two modes of transport produce two characteristic deposits with different advection lengths. Suspended load transport creates a steep deposit far from the inlet, while bedload creates a low angle, levéed deposit near the inlet. This study found that flow bifurcations occur where the proximal and distal deposits encroach on one another; and determined that there is a relationship between the frequency of suspended load transport and the length to channel bifurcation. Frequent flooding causes shorter length to bifurcations, whereas infrequent flooding causes greater length to bifurcations. This work overturns the hitherto understood mechanism of bifurcation location as a function of only high‐transport conditions. Instead, the interactions between the sediment transport and deposition from normal flow and large‐scale flooding events dictate delta island morphology.
Oryza sativa Lysine‐Histidine‐type Transporter 1 functions in root uptake and root‐to‐shoot allocation of amino acids in rice
Authors: Guo Nan , Hu Jinqi , Yan Ming , Qu Hongye , Luo Le , Tegeder Mechthild , Xu Guohua 
Published: March 2020

SummaryIn agricultural soils, amino acids can represent vital nitrogen (N) sources for crop growth and yield. However, the molecular mechanisms underlying amino acid uptake and allocation are poorly understood in crop plants. This study shows that rice (Oryza sativa L.) roots can acquire aspartate at soil concentration, and that japonica subspecies take up this acidic amino acid 1.5‐fold more efficiently than indica subspecies. Genetic association analyses with 68 representative japonica or indica germplasms identified rice Lysine‐Histidine‐type Transporter 1 (OsLHT1) as a candidate gene associated with the aspartate uptake trait. When expressed in yeast, OsLHT1 supported cell growth on a broad spectrum of amino acids, and effectively transported aspartate, asparagine and glutamate. OsLHT1 is localized throughout the rice root, including root hairs, epidermis, cortex and stele, and to the leaf vasculature. Knockout of OsLHT1 in japonica resulted in reduced root uptake of amino acids. Furthermore, in 15N‐amino acid‐fed mutants versus wild‐type, a higher percentage of 15N remained in roots instead of being allocated to the shoot. 15N‐ammonium uptake and subsequently the delivery of root‐synthesized amino acids to Oslht1 shoots were also significantly decreased, which was accompanied by reduced shoot growth. These results together provide evidence that OsLHT1 functions in both root uptake and root to shoot allocation of a broad spectrum of amino acids in rice.
Retrospective review of cataract surgery outcomes in Miniature Schnauzers
Authors: Rogen Andrew J. , Moradi Rekabdarkolaee Hossein 
Published: March 2020

AbstractObjectiveMiniature Schnauzers commonly develop both inherited and diabetic cataracts. Miniature Schnauzers also often present with concurrent metabolic disease at the time of cataract surgery. The purpose of this study was to evaluate cataract surgery outcomes in Miniature Schnauzers.Materials and methodsThe Eye Care for Animals electronic medical record database (2012‐2018) was searched for “phacoemulsification” and “Miniature Schnauzer.” A minimum follow‐up time of 1 year was required for inclusion in the study. Clinical history, pre‐ and postoperative bloodwork, postoperative treatments, and visual outcomes were reviewed in all cases.ResultsCataract surgery was performed on 67 patients and 124 eyes. 93.5% (116/124) of operated eyes were visual 1 year following cataract surgery. At the time of surgery, 79.1% were diabetic, 64.2% had hypercholesterolemia, 55.2% had hypertriglyceridemia, 16.4% had hyperadrenocorticism, and 9% had a history of pancreatitis. Dorzolamide was used postoperatively in 61.2% of patients, and its use was significantly associated with postoperative cholesterol levels above reference range. Lipemic aqueous occurred in 13.4% of patients.ConclusionsMiniature Schnauzers presenting for cataract surgery are frequently affected by metabolic diseases and dyslipidemia; however, cataract surgery outcomes were not significantly affected during the study period. Dietary management, omega‐3 fatty acid supplementation, and oral fibrates may reduce the incidence of lipemic aqueous in Miniature Schnauzers.
Thermodynamic Analysis of Solar Low-Temperature Differential Stirling Engine Considering Imperfect Regeneration and Thermal Losses
Authors: Ramachandran Siddharth , Kumar Naveen , Timmaraju Mallina Venkata 
Published: March 2020

Abstract
Low-temperature differential Stirling engines (LTDSE) are the gamma-type Stirling engines that can produce useful work from source temperatures less than 350 K, making them a preferred choice/device for solar energy utilization. An improved mathematical model to evaluate the performance of the solar-operated LTDSE has been developed by incorporating the top heat loss coefficient correlation with the finite-time thermodynamic model of the Stirling engine. In order to realize the internal imperfections of the thermodynamic Stirling cycle, the effect of the imperfect regeneration process is incorporated. Input parameters such as absorber plate temperature, irradiation, and geometrical features of the solar LTDSE are taken from real-time experimental data available in the literature. The effect of convective and radiation heat transfer coefficients of working fluid on maximum power output and thermal efficiency is determined to be significant and marginal, respectively. A comprehensive study of various working fluids and regenerator materials is carried out to investigate their impact on the performance of solar LTDSE. Helium is the best-working fluid, among air, hydrogen, ethane, and nitrogen for the considered model. Copper exhibited maximum regenerator effectiveness compared with Monel 400, aluminum, SS-304L.
Design, Fabrication, and Partial Characterization of a Solar Receiver and Air-Cooled Heat Exchanger for a Concentrated Solar Power Supercritical CO2 Testbed
Authors: Nobles-Lookingbill Danielle , Sahm Aaron , Hurt Rick , Boehm Robert 
Published: March 2020

Abstract
This research details the design, fabrication, and partial testing of a concentrated solar receiver and an air-cooled heat exchanger. The solar receiver and heat exchanger have been fabricated for use in an experimental system that uses the supercritical carbon dioxide Brayton cycle. They are coupled with a Science Applications International Corporation (SAIC) solar dish 250× concentrator located on the University of Nevada, Las Vegas campus. The purpose of this solar-powered supercritical CO2 system is to function as a testbed for testing the cycle, system components, and alternate system configurations. Photographic flux mapping of the dish showed peak solar flux just above 200× and is used to appropriately size the receiver. Sun tests of the tubing, receiver, and air-cooled heat exchanger were performed achieving fluid temperatures in the range of 973 K (700 °C) using nitrogen in an open loop at low mass flowrates, and above 1173-K (900 °C) receiver wall temperatures in a no-flow case.
Investigation of the Effect of Porous Material on the Flow and Temperature Patterns of a Passive Solar Air Heater
Authors: Kumar Digpal , Premachandran B. 
Published: March 2020

Abstract
In this work, the effect of flow resistance due to the presence of porous medium representing agricultural products at the exit of free convection-based solar air heater is studied experimentally and numerically. An air heater, along with the drying chamber, is designed as an inclined channel to conduct the experiments. Constant heat flux condition is provided by electrical heating on the top absorber plate of the channel. Experiments are conducted for heat flux ranging from 250 to 750 W/m2 for the channel inclination angle of 30 deg. Porous material bed height is also varied in the drying chamber, while porosity is set at 0.36. The surface-to-surface radiation model is considered for modeling of heat transfer within the flow. For all the heat flux values considered in the experiments, numerical simulations are performed at three different angles of inclinations of 15 deg, 30 deg, and 45 deg. In this analysis, the temperature distribution in the channel wall, the flow pattern, the difference in the mass flowrate, and temperature of the outlet air are investigated with different heights of the porous medium.
Ice Penetration by a Bluff-Body Melting Probe
Authors: Weinberg Kerstin , Ortiz Michael 
Published: March 2020

Abstract
We analyze the operation of melting probes as a Stefan problem for the liquid/solid interface surrounding the probe. We assume that the liquid layer is thin and, therefore, amenable to analysis by the lubrication theory. The resulting Stefan problem is solvable in the closed form. The solution determines the dependence of the penetration speed on the temperature differential between the probe and the surrounding ice, the size, shape and weight of the probe, the viscosity of liquid water and the thermal properties of solid ice.
System Reliability Analysis With Autocorrelated Kriging Predictions
Authors: Wu Hao , Zhu Zhifu , Du Xiaoping 
Published: March 2020

AbstractWhen limit-state functions are highly nonlinear, traditional reliability methods, such as the first-order and second-order reliability methods, are not accurate. Monte Carlo simulation (MCS), on the other hand, is accurate if a sufficient sample size is used but is computationally intensive. This research proposes a new system reliability method that combines MCS and the Kriging method with improved accuracy and efficiency. Accurate surrogate models are created for limit-state functions with minimal variance in the estimate of the system reliability, thereby producing high accuracy for the system reliability prediction. Instead of employing global optimization, this method uses MCS samples from which training points for the surrogate models are selected. By considering the autocorrelation of a surrogate model, this method captures the more accurate contribution of each MCS sample to the uncertainty in the estimate of the serial system reliability and therefore chooses training points efficiently. Good accuracy and efficiency are demonstrated by four examples.