bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vibrational Control of a 2-Link Mechanism
Authors: Ahmed Zakia , Tahmasian Sevak , Woolsey Craig A. 
Published: January 2021

Abstract
This paper describes vibrational control and stability of a planar, horizontal 2-link mechanism using translational control of the base pivot. The system is a 3-DOF two-link mechanism that is subject to torsional damping, torsional stiffness, and is moving on a horizontal plane. The goal is to drive the averaged dynamics of the system to a desired configuration using a high-frequency, high-amplitude force applied at the base pivot. The desired configuration is achieved by applying an amplitude and angle of the input determined using the averaged dynamics of the system. We find the range of stable configurations that can be achieved by the system by changing the amplitude of the oscillations for a fixed input angle and oscillation frequency. The effects of varying the physical parameters on the achievable stable configurations are studied. Stability analysis of the system is performed using two methods: the averaged dynamics and averaged potential.
An Integrative Behavioral-Based Physics-Inspired Approach to Traffic Congestion Control
Authors: Rastgoftar Hossein , Jeannin Jean-Baptiste , Atkins Ella 
Published: January 2021

Abstract
This paper offers an integrative behavioral-based physics-inspired approach to model and control traffic congestion in an efficient manner While existing physics-based approaches commonly assign density and traffic flow states with the Fundamental Diagram, this paper specifies the flow-density relation using past traffic behavior (intent) recorded over a time sliding window with constant horizon length. With this approach, traffic coordination trends can be consistently learned and incorporated into traffic planning. This is integrated with mass conservation law (continuity) to model traffic coordination as a probabilistic process and obtain traffic feasibility conditions using linear temporal logic. By spatial discretization of a network of inter-connected roads (NOIR), the NOIR is represented by a graph with inlet boundary nodes, outlet boundary nodes, and interior nodes. The paper offers a boundary control approach to manage congestion through the inlet boundary nodes. More specifically, model predictive control (MPC) is applied to control traffic congestion through the boundary of the traffic network. Therefore, the optimal boundary in flow is assigned as the solution of a constrained quadratic programming problem with equality and inequality constrained. The simulation results shows that the proposed MPC boundary controller can successfully control the traffic through the inlet boundary nodes where traffic reaches the steady state condition.
Media Portrayals of Athlete-Perpetrated Intimate Partner Violence: An Examination of the Social Ecological Model, Race, and Communication Perceptions
Authors: Scarduzio Jennifer A. , Walker Christina S. , Lewis Nicky , Limperos Anthony M. 
Published: January 2021

This study examined how participants responded to incidents of athlete-perpetrated intimate partner violence in two separate contexts: one featuring an athlete from a league that is at peak popularity among sports audiences (National Football League; NFL) and one featuring an athlete from an up-and-coming league that currently has a lower standing in professional sports (Ultimate Fighting Championship League; UFC). The authors used the social ecological model to qualitatively analyze participant perceptions about athlete-perpetrated intimate partner violence composite news packages. For the purpose of this study specifically, they centered on 1,124 responses to one of the open-ended qualitative questions asked in a larger quantitative experiment. The authors found that the participants most frequently attributed the perpetrator’s behavior to either individual or relationship-level reasons and that there were differences in the level attributed for participants of different races and ethnicities. They also determined that the participants were more likely to ascribe the violence to the suspect’s job (i.e., athlete) if they were a UFC fighter than an NFL player. Theoretical extensions of the social ecological model and practical implications for journalists, the media, and fans are offered.
Gaze-evoked deformations of the optic nerve head in thyroid eye disease
Authors: Fisher Liam K , Wang Xiaofei , Tun Tin A , Chung Hsi-Wei , Milea Dan , Girard Michael J A 
Published: January 2021

PurposeTo assess gaze evoked deformations of the optic nerve head (ONH) in thyroid eye disease (TED), using computational modelling and optical coherence tomography (OCT).MethodsMultiple finite element models were constructed: one model of a healthy eye, and two models mimicking effects of TED; one with proptosis and another with extraocular tissue stiffening. Two additional hypothetical models had extraocular tissue softening or no extraocular tissue at all. Horizontal eye movements were simulated in these models. OCT images of the ONH of 10 healthy volunteers and 1 patient with TED were taken in primary gaze. Additional images were recorded in the same subjects performing eye movements in adduction and abduction. The resulting ONH deformation in the models and human subjects was measured by recording the ‘tilt angle’ (relative antero-posterior deformation of the Bruch’s membrane opening).ResultsIn our computational models the eyes with proptosis and stiffer extraocular tissue had greater gaze-evoked deformations than the healthy eye model, while the models with softer or no extraocular tissue had lesser deformations, in both adduction and abduction. In healthy subjects, the mean tilt angle was 1.46°±0.25 in adduction and −0.42°±0.12 in abduction. The tilt angle measured in the subject with TED was 5.37° in adduction and −2.21° in abduction.ConclusionComputational modelling and experimental observation suggest that TED can cause increased gaze-evoked deformations of the ONH.
International experiences in the development and implementation of guideline-based quality indicators: a qualitative study
Authors: Nothacker Monika , Bolster Marie , Steudtner Mirco , Arnold Katrin , Deckert Stefanie , Becker Monika , Kopp Ina , Schmitt Jochen 
Published: January 2021

ObjectivesEvidence-based clinical guidelines play an important role in healthcare and can be a valuable source for quality indicators (QIs). However, the link between guidelines and QI is often neglected and methodological standards for the development of guideline-based QI are still lacking. The aim of this qualitative study was to get insights into experiences of international authors with developing and implementing guideline-based QI.SettingWe conducted semistructured interviews via phone or skype (September 2017–February 2018) with guideline authors developing guideline-based QI.Participants15 interview participants from eight organisations in six European and North American countries.MethodsOrganisations were selected using purposive sampling with a maximum variation of healthcare settings. From each organisation a clinician and a methodologist were asked to participate. An interview guide was developed based on the QI development steps according to the ‘Reporting standards for guideline-based performance measures’ by the Guidelines International Network. Interviews were analysed using qualitative content analysis with deductive and inductive categories.ResultsInterviewees deemed a programmatic approach, involvement of representative stakeholders with clinical and methodological knowledge and the connection to existing quality improvement strategies important factors for developing QI parallel to or after guideline development. Methodological training of the developing team and a shared understanding of the QI purpose were further seen conducive. Patient participation and direct patient relevance were inconsistently considered important, whereas a strong evidence base was seen essential. To assess measurement characteristics interviewees favoured piloting, but often missed implementation. Lack of measurability is still experienced a serious limitation, especially for qualitative aspects and individualised care.ConclusionOur results suggest that developing guideline-based QI can succeed either parallel to or following the guideline process with careful planning and instruction. Strategic partnerships seem key for implementation. Patient participation and relevance, measurement of qualitative aspects and piloting are areas for further development.Trial registration numberGerman Clinical Trials Registry (DRKS00013006).
Impact of dementia education and training on health and social care staff knowledge, attitudes and confidence: a cross-sectional study
Authors: Parveen Sahdia , Smith Sarah Jane , Sass Cara , Oyebode Jan R , Capstick Andrea , Dennison Alison , Surr Claire A 
Published: January 2021

ObjectivesThe aim of this study was to establish the impact of dementia education and training on the knowledge, attitudes and confidence of health and social care staff. The study also aimed to identify the most effective features (content and pedagogical) of dementia education and training.DesignCross-sectional survey study. Data collection occurred in 2017.SettingsHealth and social care staff in the UK including acute care, mental health community care trusts, primary care and care homes.ParticipantsAll health and social care staff who had completed dementia education and training meeting the minimal standards as set by Health Education England, within the past 5 years were invited to participate in an online survey. A total of 668 health and social care staff provided informed consent and completed an online survey, and responses from 553 participants were included in this study. The majority of the respondents were of white British ethnicity (94.4%) and identified as women (88.4%).OutcomesKnowledge, attitude and confidence of health and social care staff.ResultsHierarchical multiple regression analysis was conducted. Staff characteristics, education and training content variables and pedagogical factors were found to account for 29% of variance in staff confidence (F=4.13, p<0.001), 22% of variance in attitude (knowledge) (F=3.80, p<001), 18% of the variance in staff knowledge (F=2.77, p<0.01) and 14% of variance in staff comfort (attitude) (F=2.11, p<0.01).ConclusionThe results suggest that dementia education and training has limited impact on health and social care staff learning outcomes. While training content variables were important when attempting to improve staff knowledge, more consideration should be given to pedagogical factors when training is aiming to improve staff attitude and confidence.
Systematic review of global clinical practice guidelines for neonatal hyperbilirubinemia
Authors: Zhang Meng , Tang Jun , He Yang , Li Wenxing , Chen Zhong , Xiong Tao , Qu Yi , Li Youping , Mu Dezhi 
Published: January 2021

ObjectiveHyperbilirubinemia is one of the most common clinical symptoms in newborns. To improve patient outcomes, evidence-based and implementable guidelines are required. However, clinical guidelines may vary in quality, criteria and recommendations among regions and countries. In this study, we aimed to systematically assess the quality of guidelines using the Appraisal of Guidelines for Research & Evaluation (AGREE)-II instrument and summarise the specific recommendations for neonatal hyperbilirubinemia in order to provide suggestions for future guideline development.DesignSystematic review.InterventionsWe searched the PubMed, Embase, Medline and guideline databases for relevant articles on 10 April 2020. The studies were screened by two independent reviewers according to our inclusion criteria. Two reviewers independently extracted the descriptive data. Four appraisers assessed the guidelines using the AGREE-II instrument.ResultsOur systematic review appraised 12 clinical practice guidelines for the diagnosis and management of neonatal hyperbilirubinemia. The 12 guidelines achieved an average score of 36%–89%. The guidelines received the highest scores for clarity of presentation and lowest scores for rigour of development. Most recommendations for diagnosis were relatively consistent, but recommendations regarding risk factors, the initiating threshold of treatment and pharmacotherapy varied.ConclusionsOur study revealed that current guidelines vary in the quality of the developing process and are inconsistent with regards to recommendations. Future guidelines should afford more attention to the quality of methodologies in guideline development, and more qualified evidence is needed to standardise the initiating threshold of treatment for neonatal hyperbilirubinemia.
Sustainability of paediatric asthma care quality in community hospitals after ending a national quality improvement collaborative
Authors: Schechter Sarah , Jaladanki Sravya , Rodean Jonathan , Jennings Brittany , Genies Marquita , Cabana Michael D , Kaiser Sunitha Vemula 
Published: January 2021

BackgroundCommunity hospitals, which care for most hospitalised children in the USA, may be vulnerable to declines in paediatric care quality when quality improvement (QI) initiatives end. We aimed to evaluate changes in care quality in community hospitals after the end of the Pathways for Improving Paediatric Asthma Care (PIPA) national QI collaborative.MethodsWe conducted a longitudinal cohort study during and after PIPA. PIPA included 45 community hospitals, of which 34 completed the 12-month collaborative and were invited for extended sustainability monitoring (total of 21–24 months from collaborative start). PIPA provided paediatric asthma pathways, educational materials/seminars, QI mentorship, monthly data reports, a mobile application and peer-to-peer learning opportunities. Access to pathways, educational materials and the mobile application remained during sustainability monitoring. Charts were reviewed for children aged 2–17 years old hospitalised with a primary diagnosis of asthma (maximum 20 monthly per hospital). Outcomes included measures of guideline adherence (early bronchodilator administration via metered-dose inhaler (MDI), secondhand smoke screening and referral to smoking cessation resources) and length of stay (LOS). We evaluated outcomes using multilevel regression models adjusted for patient mix, using an interrupted time-series approach.ResultsWe analysed 2159 hospitalisations from 23 hospitals (68% of eligible). Participating hospitals were structurally similar to those that dropped out but had more improvement in guideline adherence during the collaborative (29% vs 15%, p=0.02). The end of the collaborative was associated with a significant initial decrease in early MDI administration (81%–68%) (adjusted OR (aOR) 0.26 (95% CI 0.15 to 0.42)) and decreased rate of referral to smoking cessation resources (2.2% per month increase to 0.3% per month decrease) (aOR 0.86 (95% CI 0.75 to 0.98)) but no significant changes in LOS or secondhand smoke screening.ConclusionsThe end of a paediatric asthma QI collaborative was associated with concerning declines in guideline adherence in community hospitals.
Endoscopically delivered Purastat for the treatment of severe haemorrhagic radiation proctopathy: a service evaluation of a new endoscopic treatment for a challenging condition
Authors: White Katherine , Henson Caroline Claire 
Published: January 2021

BackgroundA total of 30 000 people are treated with pelvic radiotherapy annually in the UK. Rectal bleeding is common following pelvic radiotherapy and one of the main causes is radiation proctopathy (RP). Six per cent develop severe bleeding from RP, leading to anaemia requiring iron +/− blood transfusion. There are very few safe, effective, evidence-based treatments. Purastat is a haemostatic agent licensed for gastrointestinal bleeding. It is a self-assembling peptide that forms a molecular mesh in contact with blood, thereby sealing blood vessels. There are numerous studies showing its efficacy and safety in various surgical/endoscopic settings. This service evaluation reports the first experience of the use of Purastat in RP.MethodsConsecutive patients attending pelvic radiation disease clinic with severe refractory RP were offered treatment with Purastat. This was defined as rectal bleeding into the pan±anaemia with no response to rectal sucralfate. Purastat was applied endoscopically at four weekly intervals up to three times, with more as required. Bleeding severity, endoscopic grade and haemoglobin were recorded.ResultsTwenty-one patients were treated (18 men, median age 76 years) with a median of three treatments. Ten were on antithrombotics, 1 had thrombocytopenia and 13 had anaemia at baseline. Median episodes of bleeding reduced from 4.5 (0–27) to 2 (0–16) in the 7 days prior to the first and third treatment, respectively. Endoscopic grade was improved. Mean haemoglobin increased from 116.0 to 122.7. There were no complications.ConclusionEven in this cohort of severe refractory RP, there was an improvement in bleeding and endoscopic grade with Purastat. A randomised controlled trial is planned.
Association between maternal employment status during pregnancy and risk of depressive symptomatology 1 month after childbirth: the Japan Environment and Children’s Study
Authors: Aochi Yuri , Honjo Kaori , Kimura Takashi , Ikehara Satoyo , Iso Hiroyasu 
Published: January 2021

BackgroundPrevious studies, which examined the association between employment status and postpartum depression, were limited by binary or ternary employment status measures (employed/unemployed or full-time/part-time/unemployed). This study examined the association between detailed employment status during pregnancy and risk of depressive symptomatology 1 month after childbirth, and the effect modification by one’s perceived level of social support and household equivalent income.MethodsOur study examined 76 822 participants in the Japan Environment and Children’s Study. The exposure included maternal employment status during pregnancy (regular workers, dispatched workers, part-time workers, self-employed workers, non-employed and others), and the outcome was depressive symptomatology 1 month after childbirth: Edinburgh Postnatal Depression Scale (EPDS scores ≥9 and ≥13). Adjusted ORs and 95% CIs of depressive symptomatology associated with employment status were calculated by multivariable logistic regression. Subgroup analyses by perceived level of social support and household equivalent income were conducted.ResultsCompared with regular workers, the risk of depressive symptomatology (EPDS score ≥9) was higher for non-employed and others, and that (EPDS score ≥13) was so for part-time workers. There was no significant interaction by perceived level of social support and household equivalent income in the associations. However, part-time workers and non-employed had excess risk of depressive symptomatology among women with lower perceived level of social support, but not among those with the higher one.ConclusionCompared with regular workers, part-time workers and non-employed had an increased risk of depressive symptomatology, which was confined to women with lower perceived level of social support.
Early ventilator liberation and decreased sedation needs after tracheostomy in patients with COVID-19 infection
Authors: Carmichael Heather , Wright Franklin L , McIntyre Robert C , Vogler Thomas , Urban Shane , Jolley Sarah E , Burnham Ellen L , Firth Whitney , Velopulos Catherine G , Idrovo Juan Pablo 
Published: January 2021

BackgroundSince the outset of the coronavirus disease 2019 (COVID-19) pandemic, published tracheostomy guidelines have generally recommended deferral of the procedure beyond the initial weeks of intubation given high mortality as well as concerns about transmission of the infection to providers. It is unclear whether tracheostomy in patients with COVID-19 infection facilitates ventilator weaning, and long-term outcomes are not yet reported in the literature.MethodsThis is a retrospective study of tracheostomy outcomes in patients with COVID-19 infection at a single-center academic tertiary referral intensive care unit. Patients underwent percutaneous tracheostomy at the bedside; the procedure was performed with limited staffing to reduce risk of disease transmission.ResultsBetween March 1 and June 30, 2020, a total of 206 patients with COVID-19 infection required mechanical ventilation and 26 underwent tracheostomy at a mean of 25±5 days after initial intubation. Overall, 81% of tracheostomy patients were liberated from the ventilator at a mean of 9±6 days postprocedure, and 54% were decannulated prior to hospital discharge at a mean of 21±10 days postprocedure. Sedation and pain medication requirements decreased significantly in the week after the procedure. In-hospital mortality was 15%. Among tracheostomy survivors, 68% were discharged to a facility.DiscussionThe management of patients with COVID-19 related respiratory failure can be challenging due to prolonged ventilator dependency. In our initial experience, outcomes post-tracheostomy in this population are encouraging, with short time to liberation from the ventilator, a high rate of decannulation prior to hospital discharge, and similar mortality to tracheostomy performed for other indications. Barriers to weaning ventilation in this cohort may be high sedation needs and ventilator dyssynchrony.Level of evidenceLevel V—Therapeutic/care management.
Stability of charged thin-shell gravastars with quintessence
Authors: Sharif M. , Javed Faisal 
Published: January 2021

AbstractThis paper develops a new solution of gravitational vacuum star in the background of charged Kiselev black holes as an exterior manifold. We explore physical features and stability of thin-shell gravastars with radial perturbation. The matter thin layer located at thin-shell greatly affects stable configuration of the developed structure. We assume three different choices of matter distribution such as barotropic, generalized Chaplygin gas and generalized phantomlike equation of state. The last two models depend on the shell radius, also known as variable equation of state. For barotropic model, the structure of thin-shell gravastar is mostly unstable while it shows stable configuration for such type of matter distribution with extraordinary quintessence parameter. The resulting gravastar structure indicates stable behavior for generalized Chaplygin gas but unstable for generalized phantomlike model. It is also found that proper length, entropy and energy within the shell show linear relation with thickness of the shell.