bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adaptive dynamic programing based optimal control for a robot manipulator
Authors: Nam Dao Phuong , Hong Quang Nguyen , Phuong Nam Tran , Hai Yen Tran Thi 
Published: June 2020

<p><span>In this paper, the optimal control problem of a nonlinear robot manipulator in absence of holonomic constraint force based on the point of view of adaptive dynamic programming (ADP) is presented. To begin with, the manipulator was intervened by exact linearization. Then the framework of ADP and Robust Integral of the Sign of the Error (RISE) was developed. The ADP algorithm employs Neural Network technique to tune simultaneously the actor-critic network to approximate the control policy and the cost function, respectively. The convergence of weight as well as position tracking control problem was considered by theoretical analysis. Finally, the numerical example is considered to illustrate the effectiveness of proposed control design. </span></p>
Impact of field roughness and power losses, turbulence intensity on electricity production for an onshore wind farm
Authors: Dragusha Bedri , Hoxha Bukurije 
Published: June 2020

<span lang="EN-US">When designing a power generation project from a different source, and in our case study, wind, when calculating the annual energy produced, it is necessary to define and calculate the losses incurred in the system. The main cause of losses in a wind park is due to the oscillations caused by the turbulence of the air around the turbine because of roughness of terrain. The paper describes two methods of estimating turbulence intensity: one based on the mean and standard deviation (SD) of wind speed from the nacelle anemometer, the other from mean power output and its SD. These analyses are very important for understanding the fatigue and mechanical stress on the wind turbines. Then significance of the site ruggedness index (RIX) and the associated performance indicator (ΔRIX) are confirmed for terrain and the consequences of applying WAsP outside its operating envelope are quantified.</span>
Near-Surface Ocean Kinetic Energy Spectra and Small-Scale Intermittency from Ship-Based ADCP Data in the Bay of Bengal
Authors: Sukhatme Jai , Chaudhuri Dipanjan , MacKinnon Jennifer , Shivaprasad S. , Sengupta Debasis 
Published: June 2020

AbstractHorizontal currents in the Bay of Bengal were measured on eight cruises covering a total of 8600 km using a 300-kHz acoustic Doppler current profiler (ADCP). The cruises are distributed over multiple seasons and regions of the Bay. Horizontal wavenumber spectra of these currents over depths of 12–54 m and wavelengths from 2 to 400 km were decomposed into rotational and divergent components assuming isotropy. An average of across- and along-track spectra over all cruises shows that the spectral slope of horizontal kinetic energy for wavelengths of 10–80-km scales with an exponent of −1.7 ± 0.05, which transitions to a steeper slope for wavelengths above 80 km. The rotational component is significantly larger than the divergent component at scales greater than 80 km, while the ratio of the two is nearly constant with a mean of 1.16 ± 0.4 between 10 and 80 km. The measurements show a fair amount of variability and spectral levels vary between cruises by about a factor of 5 over 10–100 km. Velocity differences over 10–80 km show probability density functions and structure functions with stretched exponential behavior and anomalous scaling. Comparisons with the Garrett–Munk internal wave spectrum indicate that inertia–gravity waves account for only a modest fraction of the kinetic energy between 10 and 80 km. These constraints suggest that the near-surface flow in the Bay is primarily balanced and follows a forward enstrophy transfer quasigeostrophic regime for wavelengths greater than approximately 80 km, with a larger role for unbalanced rotating stratified turbulence and internal waves at smaller scales.
Laryngeal Electromyography-Guided Hyaluronic Acid Vocal Fold Injections for Glottic Insufficiency
Authors: Liu Alice Q. , Singer Joel , Lee Terry , Hu Amanda 
Published: June 2020

Objectives: To assess voice outcomes using the novel technique of in-office laryngeal electromyography-guided vocal fold injections (LEVFI) with hyaluronic acid to treat glottal insufficiency. Secondary objectives included determining the complication/completion rates and if any factors were associated with improved voice outcomes. Methods: Retrospective review of patients who received their first LEVFI from August 2017 to December 2018. Three- and six-month voice outcomes were assessed. Outcomes included voice handicap index-10 (VHI-10), maximum phonation time (MPT), perceptual analysis of voice (GRBAS), fundamental frequency, and stroboscopy. Results: Of the 121 eligible patients (55.4% male, age 63.7 years), 94 (77.7%) had complete 3-month data and 59 (48.8%) had complete 6-month data. VHI-10 was significantly improved from 25.7 ± 7.5 to 20.9 ± 10.9 at 3 months ( P < .001) and to 19.1 ± 11.5 at 6 months ( P < .001). MPT improved from 6.2 ± 5.4 seconds to 9.4 ± 7.1 seconds at 3 months ( P < .001) and to 11.3 ± 8.2 seconds at 6 months ( P < .001). GRBAS was improved in 74.8% of patients ([65.2, 82.8] 95% CI) at 3 months and 80.8% ([69.9, 89.1]) 95% CI) at 6 months. Stroboscopy showed a glottic gap improvement in 74.8% of patients ([65.8, 82.4] 95% CI) at 3 months and in 80.3% ([65.9, 88.5] 95% CI) at 6 months. Fundamental frequency was unchanged, as expected. Multivariate analysis reported that no factors were associated with better voice outcomes. Overall, 177/181 (97.8%) injections were completed. There were no complications. Conclusion: In-office LEVFI is an effective, novel technique to treat glottic insufficiency with improved voice outcomes, high completion rate, and no significant complications.
Factors Affecting Post-Anesthesia Care Unit Length of Stay in Pediatric Patients after an Adenotonsillectomy
Authors: Anandan Dhivyaa , Zhao Shilin , Whigham Amy S. 
Published: June 2020

Objectives: (1) To identify clinical factors and perioperative practices that correlate with longer length of stay (LOS) in the post-anesthesia care unit (PACU) after adenotonsillectomy (T&A) in pediatric populations. (2) To understand the relationship between family presence and PACU LOS for pediatric patients after T&A. Methods: Pediatric patients (ages 3-17) who underwent T&A between February 2016 and December 2016 were retrospectively reviewed. Factors assessed for impact on PACU LOS included BMI, preoperative medications, intraoperative medications/narcotics, postoperative medications/narcotics, method of postoperative medication administration, and family presence in the PACU. Kruskal–Wallis and Spearman tests were used to assess correlations. Statistical significance was set a priori at P < .05. Results: Our cohort included 500 patients. Patients were in the PACU for an average of 135.4 minutes (±65.8). Subset analyses of the type of medications administered intra-operatively and in the PACU show that the intraoperative administration of sedatives is associated with increased LOS ( P = .014). Postoperative administration of any medications ( P < .001), and specifically, postoperative administration of narcotics ( P < .001), analgesics ( P = .043), antihistamines ( P < .001), and dopamine antagonists ( P = .011), are associated with increased LOS. Administration of PACU medications by IV was also correlated with shorter LOS compared to oral administration of PACU medications ( P = .016). A comparison of patients who received PACU medications to those who did not demonstrated that intraoperative administration of acetaminophen was associated with a reduced need for PACU medication administration ( P = .012). Shorter waiting times for family arrival in the PACU was also associated with shorter LOS ( P < .001). Conclusion: Our results suggest that postoperative medication administration and time until family arrival in the PACU are associated with significant differences in LOS. We also find that intraoperative administration of acetaminophen is correlated with reduced need for postoperative medication administration. Standardizing postoperative practices to minimize PACU LOS could result in a more efficient recovery for pediatric patients undergoing T&A.
Voice Quality, Function, and Quality of Life for Laryngeal Cancer: A Prospective Longitudinal Study Up to 24 Months Following Radiotherapy
Authors: Tuomi Lisa , Karlsson Therese 
Published: June 2020

Objective: To study the potential changes of health-related quality of life (HRQL), voice quality, and communicative function up to 24 months following radiotherapy for patients with laryngeal cancer. Methods: A total of 28 patients with laryngeal cancer, treated by curatively intended radiotherapy were included in this prospective longitudinal descriptive study. Patients were followed pre-radiotherapy, 12 months, and 24 months post-radiotherapy. At each time point, voice recordings and patient-reported outcome instruments (European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core30, Head and Neck35, Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer) were completed. Perceptual analysis using the Grade-Roughness-Breathiness-Asthenia-Strain was performed using the voice recordings. Results: Voice quality remains inferior to the voices of healthy controls both before and up to 24 months post-radiotherapy, demonstrating no statistically significant changes during the study period. Self-perceived communicative function revealed a trend toward improvement. Health-related quality of life remains mostly at stable levels, however, with statistically significant deterioration regarding dry mouth and sticky saliva. Generally, patients reported inferior scores compared to a normal population. Conclusion: This study demonstrated no statistically significant changes over time in HRQL and perceptual voice quality at pre-radiotherapy compared to 24 months post-radiotherapy. However, the values remain inferior to the voices of healthy controls or a normal population.
Socioeconomic Disparities in Pediatric Single‐Sided Deafness
Authors: Lipschitz Noga , Kohlberg Gavriel D. , Scott Michael , Smith Matthew M. , Greinwald John H. 
Published: June 2020

ObjectiveTo explore socioeconomic disparities in pediatric single‐sided deafness (SSD) treatment.Study DesignRetrospective chart review.SettingTertiary referral academic center.MethodsThe charts of 190 pediatric patients with SSD were reviewed for demographic and clinical characteristics. Socioeconomic variables included race and insurance status. ZIP codes were used to obtain additional socioeconomic data from the American Community Survey, including mean and median income, percentage of families below the poverty level, and employment status. Socioeconomic status (SES) was classified by insurance status and income. Treatment outcomes were analyzed by socioeconomic variables.ResultsThere were 105 males and 85 females with a mean follow‐up of 55.2 months and a mean age at diagnosis of 4.4 years. Sixty‐three percent of children received treatment at last follow‐up. Thirty‐five percent of children had public insurance and 65% had private insurance. Treatment rates were similar in the private and public insurance groups (60.6% vs 66.7%, P =. 42), but device type was different between groups (P =. 02). Consistent device use was associated with private insurance (47.5% vs 38.9%, P =. 003) and high SES (94.4% vs 80%, P =. 04) on univariate but not on multivariate analysis. Aided audiometry results were similar between SES groups. No association was found between sex, race, income level, poverty level, or employment status and treatment outcomes.ConclusionInsurance type and SES were not associated with SSD treatment outcomes in children, although device use may be higher in children with private insurance and higher SES. Further research should focus on strategies to reduce barriers to treatment and improve adherence.
Otolaryngology in the Time of Corona: Assessing Operative Impact and Risk During the COVID‐19 Crisis
Authors: Kuhar Hannah N. , Heilingoetter Ashley , Bergman Maxwell , Worobetz Noah , Chiang Tendy , Matrka Laura 
Published: June 2020

ObjectiveLimited research exists on the coronavirus disease 2019 (COVID‐19) pandemic pertaining to otolaryngology–head and neck surgery (OHNS). The present study seeks to understand the response of OHNS workflows in the context of policy changes and to contribute to developing preparatory guidelines for perioperative management in OHNS.Study DesignRetrospective cohort study.SettingPediatric and general adult academic medical centers and a Comprehensive Cancer Center (CCC).Subjects and MethodsOHNS cases from March 18 to April 8, 2020—the 3 weeks immediately following the Ohio state‐mandated suspension of all elective surgery on March 18, 2020—were compared with a 2019 control data set.ResultsDuring this time, OHNS at the general adult and pediatric medical centers and CCC experienced 87.8%, 77.1%, and 32% decreases in surgical procedures as compared with 2019, respectively. Aerosol‐generating procedures accounted for 86.8% of general adult cases, 92.4% of pediatric cases, and 62.0% of CCC cases. Preoperative COVID‐19 testing occurred in 7.1% of general adult, 9% of pediatric, and 6.9% of CCC cases. The majority of procedures were tiers 3a and 3b per the Centers for Medicare & Medicaid Services. Aerosol‐protective personal protective equipment (PPE) was worn in 28.6% of general adult, 90% of pediatric, and 15.5% of CCC cases.ConclusionFor OHNS, the majority of essential surgical cases remained high‐risk aerosol‐generating procedures. Preoperative COVID‐19 testing and intraoperative PPE usage were initially inconsistent; systemwide guidelines were developed rapidly but lagged behind recommendations of the OHNS department and its academy. OHNS best practice standards are needed for preoperative COVID‐19 status screening and PPE usage as we begin national reopening.
Enhanced recovery after surgery (ERAS) pathway optimizes outcomes and costs for minimally invasive radical prostatectomy
Authors: Xu Ying , Liu Ao , Chen Lu , Huang Hai , Gao Yi , Zhang Chuanjie , Xu Yang , Huang Da , Xu Danfeng , Zhang Min 
Published: June 2020

Objective To evaluate the impact of an enhanced recovery after surgery (ERAS) pathway on patients undergoing minimally invasive radical prostatectomy at a single institute. Methods In this retrospective study, 301 patients who underwent laparoscopic or robot-assisted laparoscopic radical prostatectomy from May 2014 to September 2018 were consecutively recruited. Before April 2017, the patients were treated with conventional care; all patients were treated with the ERAS pathway thereafter. The primary outcome was the postoperative length of hospital stay (LOS). The secondary outcomes were hospitalization costs and postoperative complications. Results In total, 138 patients were treated with the ERAS pathway, and the remaining patients underwent conventional care. The postoperative LOS was significantly shorter in the ERAS group than in the conventional group (median, 6 vs. 8 days). The hospitalization costs were also significantly lower in the ERAS group ($4086 vs. $5530). Ten (6.1%) patients in the ERAS group and 17 (12.3%) patients in the conventional group developed postoperative complications. The multivariable analysis showed that ERAS care was a significant independent predictive factor for a shortened LOS and reduced hospitalization costs. Conclusions The ERAS pathway was associated with a shortened LOS and reduced hospitalization costs for patients undergoing minimally invasive radical prostatectomy.
Comparison of analgesic efficacy of continuous transversus abdominis plane block with continuous epidural analgesia in patients undergoing abdominal surgery: a systematic review and meta-analysis
Authors: Liu Xiangbo , Ou Cehua , Peng Fei , Mu Guo 
Published: June 2020

Background A novel technique of continuous transversus abdominis plane block (TAPB) has been reported to be beneficial to patients undergoing abdominal surgery because it can significantly relieve postoperative pain. The aim of our study is to compare this novel technique with a traditional technique of continuous epidural analgesia (EA). Methods We conducted our meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only randomized controlled trials (RCTs) that compared the efficacy of continuous TAPB and continuous EA to relieve postoperative pain were included. Patients were classified by nationality (Chinese, non-Chinese) for the subgroup analysis. Results Nine RCTs with 598 patients were included in our study. Pain levels measured by visual analog scale (VAS) scores at rest on postoperative day 1 were equivalent for continuous TAPB groups and continuous EA groups in non-Chinese and Chinese patients. The TAPB groups experienced a lower rate of hypotension, sensorimotor disorder, and nausea compared with the continuous EA group within 48 hours after surgery. Conclusion Continuous TAPB and continuous EA are equally effective in relieving postoperative pain at rest 24 hours after surgery, but EA was associated with more side effects such as hypotension, nausea, and sensorimotor disorder.
Liquidity and speed of leverage adjustment
Authors: Ho Ly , Lu Yue , Bai Min 
Published: June 2020

This article investigates the effect of liquidity on the speed of adjustment (SOA) of corporate leverage at the individual company level. Using panel analysis of data from 35 countries between 1996 and 2016, we find that high-liquidity firms have a significantly faster SOA than less liquid firms. This result survives a series of robustness checks and holds after addressing the endogeneity concern using exogenous shocks and additional control variables. We find that the positive effect of liquidity on the SOA exists only for over-levered firms, and this impact is moderated in countries with bankruptcy codes. We further find that the positive liquidity-SOA relationship is less (more) pronounced for firms in strong (weak) institutional environments. The results provide new insights into the role of liquidity in firms’ capital structure decisions and the determinants of capital structure dynamics. JEL Classification: G12, G32
Clinical Value of Ultrasonographic Assessment in Lateral Epicondylitis Versus Asymptomatic Healthy Controls
Authors: Krogh Thøger P. , Fredberg Ulrich , Ammitzbøll Christian , Ellingsen Torkell 
Published: June 2020

Background: Ultrasonography (US) is often used in the assessment of lateral epicondylitis (LE). The strength of evidence supporting its role is, however, not well-documented. Purpose: To describe and compare the US tendinopathic changes observed in patients with LE and the general population, including any correlation between patient characteristics and US outcomes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Tendon thickness, color Doppler activity, and bone spur were assessed by US in 264 participants with healthy elbows and 60 patients with chronic LE. In addition to patient characteristics, Patient-Rated Tennis Elbow Evaluation (PRTEE) score, pain, and disability were recorded. Results: Depending on the measurement technique used, mean LE tendon thickness increased by 0.53 mm (10.2%) or 0.70 mm (14.5%) as compared with the contralateral arm and 0.40 mm (7.9%) or 0.41 mm (8.5%) as compared with the general population. Mean color Doppler activity (scale, 0-4) was 3.47 in the LE arm versus 0.13 in the contralateral asymptomatic arm and 0.26 in the general population. Bone spur was observed in 78% of the LE arms as opposed to 45% in the contralateral arms and 50% in the general population. In the LE group and the general population, the prevalence of bone spur increases with age. No correlations were observed with pain, disability, PRTEE, and disease duration. Conclusion: Increased common extensor tendon thickness is part of the tendinopathic changes observed in LE. However, given the marked variation in natural tendon thickness and small increases in tendon thickness in patients with LE, this technique cannot be used as a stand-alone diagnostic tool but rather as a supplement to the overall assessment. The contralateral elbow (if asymptomatic) is a better tendon thickness comparator than a general population mean value. Color Doppler activity is an indicator of ongoing tendinopathy and supports the LE diagnosis, but it is not pathognomonic for the condition. Absence of Doppler activity in a patient with suspected LE should raise suspicion of other diagnoses. Identification of a bone spur is of very limited clinical value given the high prevalence in the general population. The important outcomes of pain, disability, PRTEE, and disease duration did not correlate with any of the investigated US techniques.
Summer Camp: Enhancing Empathy Through Positive Behavior and Social and Emotional Learning
Authors: Carpio de los Pinos Carmen , Soto Antonio Gobea , Martín Conty José Luis , Serrano Rosa Conty 
Published: June 2020

Background: Summer camp is proposed as a context to enhance prosocial behavior. This context could be used to apply intervention programs, in addition to being a time of fun and conviviality. A camp-based intervention program to increase empathy was administered for adolescents at risk. Purpose: The aim of this study was to apply and evaluate a positive behavior and social and emotional learning (SEL) intervention on empathy. Methodology/Approach: This exploratory study was carried out with pre–post quantitative design, based on a single-group intervention, with 113 adolescents aged 12 to 17 years. Change in empathy was measured by means of a standardized test and participant observation. We used evidence-based interventions, drawing on the principles of positive behavioral interventions and supports (PBIS) and SEL approach. Findings/Conclusions: An intervention in positive behavior and SEL was useful in improving empathy in at-risk adolescents. The enhancement was noticeable in both cognitive and emotional empathy, more specifically in the constructs of perspective taking and empathic concern. Implications: Summer camps might be considered an appropriate setting for interventions with at-risk adolescents.
How State Responses to Economic Crisis Shape Income Inequality and Financial Well-Being
Authors: Franko William W. 
Published: June 2020

AbstractThis study examines how state government responses to economic crisis, in the form of unexpected changes in state fiscal policy, influence income inequality. State governments are vital actors in times of fiscal stress as nearly every state must make difficult policy decisions related to taxes and spending to address budget deficits, both of which are policies that shape the income gap. Focusing on periods of fiscal stress is important for the study of state inequality as those with fewer resources are the most likely to experience the consequences of their state’s fiscal response during these times. Using time-series cross-sectional data, this research demonstrates that income inequality increases when states respond to economic crisis by relying on unexpected spending cuts. These effects tend to persist even after initial economic downturns. In addition, one individual-level implication of the aggregate relationship between state policy responses and inequality—that people will be worse off financially when their states emphasize budget cuts in response to economic decline—is assessed using several post–Great Recession surveys. The findings have implications for the future of inequality in the United States and provide potential paths for state fiscal reform.