bluuebunny/crossref_metadata_2025_split huggingface dataset:
Micro‐relational interdependencies are the essence of teaching and learning in the OR
Authors: Sutkin Gary , Littleton Eliza B. , Arnold Louise , Kanter Steven L. 
Published: August 2020

AbstractContextIn the high‐stakes, time‐critical environment of the operating room (OR), attendings and residents strive to complete safe, effective surgeries and ensure that learning occurs. Yet meaningful resident participation often receives less attention, and that impedes residents’ ability to learn and achieve autonomous operative practice. We need a new conceptual framework for understanding progression to autonomous practice that can guide both faculty and residents. Thus, we sought a new conceptualisation of intraoperative teaching and learning (IOT&L) through the lens of Eraut's notion of informal workplace learning and Billett's theory of relational interdependence between social and individual agency.MethodsWe viewed authentic examples of IOT&L in video and transcripts of live OR cases and interviews with participating attendings and residents. By systematically applying Eraut and Billet's theories to the transcripts and interviews, we developed concrete descriptions about how IOT&L occurs, categorised them into theory‐based principles and derived a conceptualisation and related research ideas about IOT&L.ResultsEstablished workplace learning theories frame IOT&L as socially negotiated processes transpiring in distinct interdependent interactions between residents’ individual cognitive experiences and their OR social experiences that direct their learning. As the surgery unfolds, spontaneous events and the rules of surgery create opportunities for unplanned and informal learning. These authentic interrelated cognitive and social experiences are stimulated when residents reveal a learning need or attendings recognise a learning gap, and efforts ensue to bridge that gap. Through these minute distinct exchanges, labelled here as ‘atomic’ IOT&L, residents gain crucial knowledge and skill.ConclusionFraming authentic OR interactions between attendings and residents in terms of micro‐relational interdependencies shows how granular teaching/learning exchanges yield high‐value informal learning. To improve IOT&L, we must examine and change it at this fundamental level by using and testing this new theoretical conceptualisation. These insights produced ideas about IOT&L to test and research.
Theta resonance and synaptic modulation scale activity patterns in the medial entorhinal cortex stellate cells
Authors: Katyare Nupur , Sikdar Sujit Kumar 
Published: August 2020

AbstractStellate cells (SCs) of the medial entorhinal cortex (MEC) are rich in hyperpolarization‐activated cyclic nucleotide–gated (HCN) channels, which are known to effectively shape their activity patterns. The explanatory mechanisms, however, have remained elusive. One important but previously unassessed possibility is that HCN channels control the gain of synaptic inputs to these cells. Here, we test this possibility in rat brain slices, while subjecting SCs to a stochastic synaptic bombardment using the dynamic clamp. We show that in the presence of synaptic noise, HCN channels mainly exert their influence by increasing the relative signal gain in the theta frequency through the theta modulation of stochastic synaptic inputs. This subthreshold synaptic modulation then translates into a spiking resonance, which steepens with excitation in the presence of HCN channels. We present here a systematic assessment of synaptic theta modulation and trace its implications to the suprathreshold control of firing rate motifs. Such analysis was yet lacking in the SC literature. Furthermore, we assess the impact of noise statistics on this gain modulation and indicate possible mechanisms for the emergence of membrane theta oscillations and synaptic ramps, as observed in vivo. We support the data with a computational model that further unveils a competing role of inhibition, suggesting important implications for MEC computations.
Aspects of the assessment and management of pharyngoesophageal dysphagia
Authors: Allen Jacqueline , Dewan Karuna , Herbert Hayley , Randall Derrick R. , Starmer Heather , Stein Ellen 
Published: August 2020

AbstractSwallowing complaints are common and may have significant consequences for nutrition and pulmonary health. Etiology varies and different aspects of the deglutitive system may be affected. A thorough assessment from the oral cavity to the stomach will provide physiologic information that enables specific targeted management plans to be devised. Although the swallow trajectory bridges anatomic areas, there has previously been a tendency to compartmentalize assessment and treatment by arbitrary anatomic boundaries. It is now clear that this approach fails to appreciate the complexity of swallow mechanics and that systems (oral, pharyngeal, esophageal, and pulmonary) are intertwined and codependent. Swallowing specialists from different backgrounds and with complementary skill sets form a multidisciplinary team that can provide insight and address multiple areas of management. With the advent of new tools for instrumental evaluation, such as manometry, targeted rehabilitative strategies can be informed by physiology, increased in precision and breadth, and assessed quantitatively. Surgical approaches have evolved toward endoscopic techniques, and food technology is expanding options in dietary management. The multidisciplinary team is core to managing this varied and often neglected patient population. This review is for clinicians treating swallowing disorders and will explore the selected aspects of the assessment and management of pharyngoesophageal swallowing disorders.
Assessment of angle closure spectrum disease as a continuum of change using gonioscopy and anterior segment optical coherence tomography
Authors: Phu Jack , Wong Brian , Lim Thalia , Kalloniatis Michael 
Published: August 2020

AbstractPurposeStudies examining the anterior chamber angle and angle closure disease often compare quantitative angle information obtained using anterior segment optical coherence tomography (ASOCT) with one of several ordinal scales derived using gonioscopy. We test the assumption that the ordinal gonioscopic angle grades have equal step sizes and can be analysed using metric statistics.MethodsThe medical records of 214 consecutive patients who were referred for assessment of the anterior chamber angle were prospectively examined using gonioscopy and ASOCT (Spectralis Optical Coherence Tomography, OCT, www.heidelbergengineering.com). Anterior chamber angle parameters (angle opening distance, AOD, and trabecular‐iris space area, TISA at 500 and 750 microns) were extracted from ASOCT images using a semi‐automated segmentation algorithm written on MATLAB (www.mathworks.com). We first matched the quantitative values for each gonioscopic grade (0–4, from no structures visible to ciliary body visible) and described the frequency distributions to determine separability. We then applied a grade‐agnostic clustering algorithm to determine the concordance between algorithm‐clustered groups (using solely quantitative data) and those obtained using gonioscopy.ResultsThe frequency distributions of the quantitative ASOCT parameters for each angle grade were mostly non‐parametric and displayed unique distribution characteristics, with a floor effect seen for grade 0 and the lack of a ceiling effect seen for grades 3 and 4. Although we found significant differences in quantitative values across the five angle grades using the frequency distributions, some pairwise comparisons were indistinguishable (such as grades 0 and 1, and grades 3 and 4) due to the overlaps in distributions. On average, differences in quantitative values were consistent between gonioscopic grade steps, but there remained substantial variability that confounds prediction of change between ordinal steps. The clustering algorithm showed approximately 10% of cases with the same group assignment as that of the gonioscopic grade, improving slightly to 30% when the top 5% of quantitative data were excluded from analysis.ConclusionsOur results do not necessarily support the assumption that the ordinal scales used in gonioscopy can be interpreted using an interval scale. We highlight the need for better methods of describing the course and risk of angle closure spectrum disease to identify disease progression and conversion, where gonioscopy remains the gold standard.
Uncovering a unique path: Antidromic AVRT utilizing a left anteroseptal Mahaim‐like accessory pathway
Authors: Sandhu Amneet , Tzou Wendy S. , Borne Ryan T. , Zipse Matthew M. , Nguyen Duy T. , Sauer William H. 
Published: August 2020

AbstractA 40‐year‐old man presented to our emergency department 2 hours after onset of shortness of breath, palpitations, and presyncope secondary to an adenosine‐responsive wide complex tachycardia. Electrophysiology study was diagnostic for antidromic atrioventricular (AV) reentrant tachycardia utilizing a muscular connection from the anterior interventricular vein to the left ventricle with Mahaim‐like properties, successfully treated with ablation in the distal coronary sinus (CS) system. This case highlights accessory pathways (a) with unique features (i.e., Mahaim‐like characteristics) and (b) involving musculature from the distal CS system, thereby limiting the value of endocardial ablation for durable treatment. Importantly, the coronary venous system is an accessible vascular network for evaluation and catheter ablation of such arrhythmias.
Soybean (Glycine max) Haplotype Map (GmHapMap): a universal resource for soybean translational and functional genomics
Authors: Torkamaneh Davoud , Laroche Jérôme , Valliyodan Babu , O’Donoughue Louise , Cober Elroy , Rajcan Istvan , Vilela Abdelnoor Ricardo , Sreedasyam Avinash , Schmutz Jeremy , Nguyen Henry T. , Belzile François 
Published: August 2020

SummaryHere, we describe a worldwide haplotype map for soybean (GmHapMap) constructed using whole‐genome sequence data for 1007 Glycine max accessions and yielding 14.9 million variants as well as 4.3 M tag single‐nucleotide polymorphisms (SNPs). When sampling random subsets of these accessions, the number of variants and tag SNPs plateaued beyond approximately 800 and 600 accessions, respectively. This suggests extensive coverage of diversity within the cultivated soybean. GmHapMap variants were imputed onto 21 618 previously genotyped accessions with up to 96% success for common alleles. A local association analysis was performed with the imputed data using markers located in a 1‐Mb region known to contribute to seed oil content and enabled us to identify a candidate causal SNP residing in the NPC1 gene. We determined gene‐centric haplotypes (407 867 GCHs) for the 55 589 genes and showed that such haplotypes can help to identify alleles that differ in the resulting phenotype. Finally, we predicted 18 031 putative loss‐of‐function (LOF) mutations in 10 662 genes and illustrated how such a resource can be used to explore gene function. The GmHapMap provides a unique worldwide resource for applied soybean genomics and breeding.
Experience of the first 6 years of pediatric kidney transplantation in Indonesia: A multicenter retrospective study
Authors: Ambarsari Cahyani Gita , Hidayati Eka Laksmi , Trihono Partini Pudjiastuti , Saraswati Meilania , Rodjani Arry , Wahyudi Irfan , Situmorang Gerhard Reinaldi , Kim Jon Jin , Mellyana Omega , Kadaristiana Agustina 
Published: August 2020

AbstractBackgroundPediatric kidney transplantation was only introduced in Indonesia in 2013. We therefore aimed to assess the characteristics and outcomes of transplants performed from its inception to January 2019.MethodThe study had a dual‐center retrospective design. We examined the records of kidney transplant recipients and then calculated patient and graft survival rates by Kaplan‐Meier survival analysis with 95% confidence intervals (95% CI).ResultsIn total, 12 kidney transplantations were performed in eleven children during the study period; among these, ten were boys, and nine had renal failure caused by congenital anomaly of the kidney or urinary tract. All donors were living, and all recipients were on dialysis at the time of transplantation, when their median age was 14.5 years (range, 8‐19 years). Three patients died of infection in the first year of follow‐up and two lost their allograft by the time of their last follow‐up (median, 13 months; range, 4‐69 months). The 1‐year patient survival rate was therefore 68.18% (95% CI, 29.72%‐88.61%), which remained unchanged at 3 and 5 years. However, the non‐death‐censored graft survival rates at 1, 3, and 5 years were 68.18% (95% CI, 29.72%‐88.61%), 51.14% (95% CI, 14.5%‐79.46%), and 25.57% (95% CI, 1.38%‐64.78%), respectively.ConclusionPatient and graft survival rates after pediatric kidney transplantation in Indonesia are lower than those reported in other countries. Closer patient follow‐up and stricter adherence to guidelines could improve transplant outcomes, but we must seek to improve the balance between infection and rejection.
Inflation‐Output Trade‐Off in South Africa: Is the Phillips Curve Symmetric?
Authors: Ngalawa Harold , Komba Coretha 
Published: August 2020

AbstractThis study sets out to investigate whether the inflation‐output trade‐off in South Africa is symmetric or asymmetric; and if asymmetric, whether it is convex or concave. A New Keynesian dynamic stochastic general equilibrium model calibrated on South African data reveals that a negative demand shock reduces inflation and output while a positive demand shock of the same magnitude leads to a smaller increase in inflation and a larger increase in output, indicating that the inflation–output relationship in the country is concave asymmetric. These findings corroborate estimation results of the inflation‐expectations augmented Phillips curve conducted using difference GMM on quarterly data.
Proteinase 3 Autoreactivity in Anti‐Neutrophil Cytoplasmic Antibody–associated vasculitis—Immunological versus clinical features
Authors: Sharma Ravi K. , Lövström Björn , Gunnarsson Iva , Malmström Vivianne 
Published: August 2020

AbstractANCA‐associated vasculitis (AAV) is a group of chronic inflammatory diseases of small‐ and medium‐sized vessels, which are broadly subdivided based on organ manifestations and disease‐specific autoantibodies. The so called anti‐neutrophil cytoplasmic antibodies (ANCA) mostly target one of the enzymes, proteinase 3 (PR3) or myeloperoxidase (MPO). Accumulating genetic data demonstrates that these two autoantibodies discriminate two distinct disease entities, more so than the clinical subdivision which is mainly criteria‐based. Treatment of AAV includes heavy immunosuppression and is guided by organs that are involved. Generally, patients with PR3‐ANCA display higher risk for disease relapse than patients with MPO‐ANCA. In this review, we will focus on the autoimmune features of PR3+ AAV and our current understanding of its triggers and the potential translation into clinical practice.
Antibody‐enhanced hepatitis E virus nanofiltration during the manufacture of human immunoglobulin
Authors: Kapsch Anna‐Maria , Farcet Maria R. , Wieser Andreas , Ahmad Monazza Q. , Miyabayashi Tomoyuki , Baylis Sally A. , Blümel Johannes , Kreil Thomas R. 
Published: August 2020

AbstractBackgroundCirculation of hepatitis E virus (HEV) in areas where plasma is sourced for the manufacture of plasma‐derived medicinal products (PDMPs) has prompted verification of HEV clearance. HEV exists as quasi lipid‐enveloped (LE) and non–lipid‐enveloped (NLE) forms, which might be of relevance for HEV clearance from manufacturing processes of antibody‐containing PDMPs with solvent/detergent (S/D) treatment upstream of further clearance steps.Study Design and MethodsPresence of different HEV particles in stocks used in clearance studies was investigated, with nanofilters graded around the assumed HEV particle sizes and by gradient centrifugation. HEV removal by 35‐nm nanofiltration was investigated in the presence or absence of HEV antibodies, in buffer as well as in immunoglobulin (IG) manufacturing process intermediates.ResultsHEV particles consistent with LE, NLE, and an “intermediate” (IM) phenotype, obtained after S/D treatment, were seen in different HEV stocks. In the absence of HEV antibodies, log reduction factors (LRFs) of 4.0 and 2.5 were obtained by 35‐nm nanofiltration of LE and IM HEV, consistent with the larger and smaller sizes of these phenotypes. Addition of HEV antibodies enhanced IM HEV removal around 1000‐fold (LRF, 5.6). Effective (LRF, >4.8 and >4.0) HEV removal was obtained for the nanofiltration processing step for IG intermediates with varying HEV antibody content.ConclusionHEV spikes used in clearance studies should be carefully selected, as differences in physicochemical properties might affect HEV clearance. Antibody‐mediated enhancement of HEV nanofiltration was demonstrated in IG process intermediates even at low HEV antibody concentration, illustrating the robustness of this manufacturing step.
Internal Versus External Cracking—Their Impact on the Fatigue Life of Modern Smoothbore Autofrettaged Tank Gun Barrels
Authors: Perl M. , Saley T. 
Published: August 2020

Abstract
An extensive analysis of the fatigue life of a typical modern autofrettaged smoothbore tank barrel, cracked either internally or externally, in terms of the initial crack depth and shape, type and level of autofrettage, was conducted. Five overstraining cases were considered: no-autofrettage, 70% and 100% hydraulic autofrettage, and 70% and 100% swage autofrettage. KINmax, the maximum combined stress intensity factor (SIF) KINmax = (KIP + KIA) max, due to both internal pressure and autofrettage, as a function of crack depth for a large number of internal and external crack configurations was determined by the finite element method (FEM). A novel realistic experimentally based autofrettage model, incorporating the Bauschinger effect, was integrated into the finite element model, replicating both the hydraulic and swage autofrettage residual stress fields (RSFs) accurately. Fatigue lives were evaluated by integrating Paris' Law using the above values of KINmax. The following conclusions can be drawn from the results: hydraulic and swage autofrettage have a dramatic beneficial effect in extending the fatigue life of an overstrained barrel 4–11 times as compared to an identical nonautofrettaged tube. The fatigue life of overstrained barrels is controlled by internal cracking, for barrels overstrained by up to ε = 100% hydraulic autofrettage, by up to ε = 70% in the case of swage autofrettage, and by external cracking for ε = 100% swage autofrettaged. Eliminating or carefully designing stress concentrators on the tube's external face and keeping away from corrosive agents thus, extending the fatigue-crack initiation life of an external crack, enables the increase of the level of swage autofrettage to up to ε = 100%. Swage autofrettage is much more superior to hydraulic autofrettage. The fatigue life of a 70% swaged autofrettaged barrel is 1.5 times higher than that of a 100% hydraulically autofrettaged tube. If full swage autofrettage is permissible, the fatigue life of such a barrel is twofold that of a fully hydraulically autofrettaged tube. Unlike the commonly accepted concept, the level of hydraulic autofrettage should not be limited to 70%, and full hydraulic autofrettage should be used. Similarly, in the case of swage autofrettage, if the detrimental effect of external cracking is removed by proper design and maintenance of the tube's outer surface, the level of autofrettage can be increased to up to ε = 100%, thus, gaining an increase of 33% in the fatigue life as compared to overstraining the barrel to only ε = 70%. Initial crack depth and shape are major factors affecting the fatigue life of the barrel. The deeper the initial crack depth, a0, and the slenderer its shape, a/c→ 0, the shorter the fatigue life of the barrel.
The Effects of Energy Dissipation of the Closure Bolted Joints Under Vibration Behavior
Authors: Cheng Qiang , Xu Wenxiang , Liu Zhifeng , Yang Congbin , Li Ying 
Published: August 2020

Abstract
Bolted joints are widely used in mechanical construction due to their ease of disassembly. When the bolting member is subjected to the alternating load, the pretightening force is gradually reduced, which may cause the interface contact performance to decrease, and the surface may be microslipped. Preload relaxation of threaded fasteners is the main factor that influences the joint failure under normal cyclic loading, but it is difficult to monitor the energy dissipation between the interface of the bolted joint. This paper presents an energy dissipation model for the bolted joint based on two-degree-of-freedom vibration differential mathematical model. The parameters of the model is calculated by using the fractal theory and differential operator method. The efficiency of the proposed model is verified by experiments. The results show that the experimental modal shape agrees well with the theoretical modal shape. According to the change of cyclic load and vibration frequency, the vibration response and the law of energy dissipation under different factors can be obtained. The results show that the vibration frequency and cyclic load are the main factors affecting the energy dissipation between interfaces. The energy dissipation of the contact surface of the bolted joints account for the main part of the energy dissipation of the bolted structure. The results provide a theoretical basis for reducing the looseness of the bolt connection and ensuring the reliability of the equipment.
Feasibility of Wearable Haptic Biofeedback Training for Reducing the Knee Abduction Moment During Overground Walking
Authors: Lindsey Bryndan W. , Xu Junkai , Chiasson David , Shull Peter , Cortes Nelson 
Published: August 2020

Abstract
Gait modifications are effective in reducing the first peak knee abduction moment (PKAM), a surrogate for knee loading. Reliance on 3D motion capture currently restricts these modifications to the laboratory. Therefore, our purpose was to test the feasibility of a novel wearable biofeedback system to train (1) toe-in and trunk lean modifications and (2) combined toe-in and trunk lean modifications to reduce PKAM during overground walking outside of the laboratory. Twelve healthy participants practiced modifications in a university hallway directly after performing five normal walking trials. The wearable feedback system provided real-time haptic biofeedback during training trials to inform participants if they were within the prescribed modification range (7–12 deg greater than baseline). Participants were instructed to move to the next modification only once they felt comfortable and could perform it with minimal errors. Following training, five trials of each modification were immediately performed in the gait laboratory without feedback. All participants successfully modified their foot progression and trunk angle using the wearable system. At post-test, PKAM decreased from baseline by 62%, 55%, and 28% during combined, trunk leanand toe-in gait, respectively. The wearable feedback system was effective to modify participants' foot and trunk angle by the prescribed amount, resulting in reduced PKAM during all modifications at post-test. Participants were also able to perform a combined modification, although it took longer to report feeling comfortable doing so. This study demonstrates that a wearable feedback system is feasible to modify kinematic parameters and train gait modifications outside the laboratory.