bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploratory Case Study of Barriers and Facilitators Associated With the Pilot Implementation of a New Electronic Healthcare Record in the Military
Authors: Martin Megan B , Petros Michael , Welter Christina 
Published: February 2021

ABSTRACT

Introduction
The Military Health System (MHS) overhauled its previous Electronic Health Records (EHRs) system. The MHS is in need of modernizing its healthcare system to improve patient safety and coordination of care between the MHS and Veterans Affairs. In 2015, the DoD awarded Cerner, Leidos, and Accenture a $4.3 billion EHR contract for a commercialized off-the-shelf system model to be used by more than 146,000 end users. This exploratory case study looked to access socio-technical barriers and facilitators to EHR implementation specifically in the military.

Materials and Methods
A document review served as the data source: implementation plans, evaluation reports, congressional reports, news articles, and relevant peer-reviewed literature. A series of a priori codes were developed, and emergent codes arose out of the thematic analysis process.

Results
There were several constructs that emerged from the analysis, placing emphasis on the uniqueness of EHR implementation in the MHS. The constructs of people, communication, and hardware and technical factors were strongly tied to EHR implementation. Additionally, medical readiness was identified in the analysis as a unique factor specific to the EHR implementation in the MHS.

Conclusion
This research identified three strategic recommendations for the MHS to consider: hire clinical informaticists, parallel EHR implementation, and enhance EHR training. This research also informed a Socio-Technical Leadership Framework for EHR Implementation to guide MHS leaders during health information technology implementation. Although significant health information technology changes may occur only once every few years, having issues during implementation impacts mission success, overall threatening the vital role that the MHS provides to national defense.
The Successful Use of Left-sided Stellate Ganglion Block in Patients That Fail to Respond to Right-sided Stellate Ganglion Block for the Treatment of Post-traumatic Stress Disorder Symptoms: A Retrospective Analysis of 205 Patients
Authors: Mulvaney Sean W , Lynch James H , Curtis Kamisha E , Ibrahim Tamara S 
Published: February 2021

ABSTRACT

Introduction
Ultrasound-guided stellate ganglion block (SGB) is an injection of local anesthetic (8mL of 0.5% ropivacaine) in the neck to temporarily block the cervical sympathetic trunk which controls the body’s fight-or-flight response. This outpatient procedure takes less than thirty minutes and is immediately effective. Our goal was to determine if a left-sided stellate ganglion block is effective for treating posttraumatic stress disorder (PTSD) symptoms. While right-sided SGB has been extensively studied, left-sided SGB has not been formally evaluated for this indication.

Materials and Methods
Our hypothesis was that patients who fail to improve following a right-sided SGB will report significant improvement following a left-sided SGB. A retrospective chart review was conducted for patients who received SGB for PTSD symptoms between August 2019 and March 2020. All procedures were performed at an established musculoskeletal practice by the same anesthesia/pain fellowship-trained physician. Subjects included those who underwent a left-sided SGB (LSGB) only after non-response to a right-sided SGB (RSGB). Non-response was defined as less than 10 points of improvement on a PTSD Checklist (PCL-5).

Results
Out of 205 patients, 20 did not respond to an RSGB and were included in our analysis. Ten of these patients subsequently received an LSGB, and 90% responded favorably (PCL-5 mean improvement = 28.3 points).

Conclusions
Based on our sample of 205 patients receiving SGB for PTSD, we concluded that at least 4.4% did not respond to a right-sided SGB but did have a significant response to a left-sided SGB.
Formation of the largest galactic cores through binary scouring and gravitational wave recoil
Authors: Nasim Imran Tariq , Gualandris Alessia , Read Justin I , Antonini Fabio , Dehnen Walter , Delorme Maxime 
Published: February 2021

ABSTRACT
Massive elliptical galaxies are typically observed to have central cores in their projected radial light profiles. Such cores have long been thought to form through ‘binary scouring’ as supermassive black holes (SMBHs), brought in through mergers, form a hard binary and eject stars from the galactic centre. However, the most massive cores, like the $\sim 3{\, \mathrm{kpc}}$ core in A2261-BCG, remain challenging to explain in this way. In this paper, we run a suite of dry galaxy merger simulations to explore three different scenarios for central core formation in massive elliptical galaxies: ‘binary scouring’, ‘tidal deposition’, and ‘gravitational wave (GW) induced recoil’. Using the griffin code, we self-consistently model the stars, dark matter, and SMBHs in our merging galaxies, following the SMBH dynamics through to the formation of a hard binary. We find that we can only explain the large surface brightness core of A2261-BCG with a combination of a major merger that produces a small $\sim 1{\, \mathrm{kpc}}$ core through binary scouring, followed by the subsequent GW recoil of its SMBH that acts to grow the core size. Key predictions of this scenario are an offset SMBH surrounded by a compact cluster of bound stars and a non-divergent central density profile. We show that the bright ‘knots’ observed in the core region of A2261-BCG are best explained as stalled perturbers resulting from minor mergers, though the brightest may also represent ejected SMBHs surrounded by a stellar cloak of bound stars.
Hidden in plain sight: a double-lined white dwarf binary 26 pc away and a distant cousin
Authors: Kilic Mukremin , Bédard A , Bergeron P 
Published: February 2021

ABSTRACT
We present high-resolution spectroscopy of two nearby white dwarfs with inconsistent spectroscopic and parallax distances. The first one, PG 1632+177, is a 13th magnitude white dwarf only 25.6 pc away. Previous spectroscopic observations failed to detect any radial velocity changes in this star. Here, we show that PG 1632+177 is a 2.05-d period double-lined spectroscopic binary (SB2) containing a low-mass He-core white dwarf with a more-massive, likely CO-core white dwarf companion. After L 870−2, PG 1632+177 becomes the second closest SB2 white dwarf currently known. Our second target, WD 1534+503, is also an SB2 system with an orbital period of 0.71 d. For each system, we constrain the atmospheric parameters of both components through a composite model-atmosphere analysis. We also present a new set of non-local thermodynamic equilibrium (NLTE) synthetic spectra appropriate for modelling high-resolution observations of cool white dwarfs, and show that NLTE effects in the core of the H α line increase with decreasing effective temperature. We discuss the orbital period and mass distribution of SB2 and eclipsing double white dwarfs with orbital constraints, and demonstrate that the observed population is consistent with the predicted period distribution from the binary population synthesis models. The latter predict more massive CO + CO white dwarf binaries at short (&lt;1 d) periods, as well as binaries with several day orbital periods; such systems are still waiting to be discovered in large numbers.
Angular momentum evolution can be predicted from cosmological initial conditions
Authors: Cadiou Corentin , Pontzen Andrew , Peiris Hiranya V 
Published: February 2021

ABSTRACT
The angular momentum of dark matter haloes controls their spin magnitude and orientation, which in turn influences the galaxies therein. However, the process by which dark matter haloes acquire angular momentum is not fully understood; in particular, it is unclear whether angular momentum growth is stochastic. To address this question, we extend the genetic modification technique to allow control over the angular momentum of any region in the initial conditions. Using this technique to produce a sequence of modified simulations, we can then investigate whether changes to the angular momentum of a specified region in the evolved universe can be accurately predicted from changes in the initial conditions alone. We find that the angular momentum in regions with modified initial conditions can be predicted between 2 and 4 times more accurately than expected from applying tidal torque theory. This result is masked when analysing the angular momentum of haloes, because particles in the outskirts of haloes dominate the angular momentum budget. We conclude that the angular momentum of Lagrangian patches is highly predictable from the initial conditions, with apparent chaotic behaviour being driven by stochastic changes to the arbitrary boundary defining the halo.
Microlensing predictions: impact of Galactic disc dynamical models
Authors: Yang Hongjing , Mao Shude , Zang Weicheng , Zhang Xiangyu 
Published: February 2021

ABSTRACT
Galactic model plays an important role in the microlensing field, not only for analyses of individual events but also for statistics of the ensemble of events. However, the Galactic models used in the field vary, and some are unrealistically simplified. Here, we tested three Galactic disc dynamic models; the first is a simple standard model that was widely used in this field, the second model considers the radial dependence of the velocity dispersion, and the last model employs the asymmetric drift in the disc velocity distribution. We found that for a typical lens mass $M_{\rm L}=0.5\, {\rm M}_\odot$, the two new dynamical models predict $\sim 16{{\ \rm per\ cent}}$ or $\sim 5{{\ \rm per\ cent}}$ less long-time-scale events (e.g. microlensing time-scale tE &gt; 300 d) and $\sim 5{{\ \rm per\ cent}}$ and $\sim 3.5{{\ \rm per\ cent}}$ more short-time-scale events (tE &lt; 3 d) than the standard model. Moreover, the microlensing event rate as a function of Einstein radius θE or microlensing parallax πE also shows some model dependence (a few per cent). The two new models also have an impact on the total microlensing event rate. This result will also to some degree affect the Bayesian analysis of individual events, but overall, the impact is small. However, we still recommend that modellers should be more careful when choosing the Galactic model, especially in statistical works involving Bayesian analyses of a large number of events. Additionally, we find the asymptotic power-law behaviours in both θE and πE distributions, and we provide a simple model to understand them.
Counts-in-cells of subhaloes in the IllustrisTNG simulations: the role of baryonic physics
Authors: Dantas Christine C 
Published: February 2021

ABSTRACT
We present an analysis of the counts-in-cells (CiC) statistics of subhaloes in the publicly available IllustrisTNG cosmological simulations (TNG100-1, TNG100-3, and TNG300-3), considering their full and dark-only versions, in redshifts ranging from z = 0 to z = 5, and different cell sizes. We evaluated two CiC models: the gravitational quasi-equilibrium distribution (GQED) and the negative binomial distribution (NBD), both presenting good fits, with small detectable differences in the presence of baryons. Scaling and time dependencies of the best-fitting parameters showed similar trends compared with the literature. We derived a matter density-in-cells probability distribution function (PDF), associated with the GQED, which was compared to the PDF proposed by Uhlemann et al., for the IllustrisTNG 100-3-Dark run at z = 0. Our results indicate that the simplest gravithermodynamical assumptions of the GQED model hold in the presence of baryonic dissipation. Interestingly, the smoothed (density-in-cells) version of the GQED is also adequate for describing the dark matter one-point statistics of subhaloes and converges, to subpercentage levels (for an interval of parameters), to the Uhlemann et al. PDF in the high density range.
The auto- and cross-angular power spectrum of the Cas A supernova remnant in radio and X-ray
Authors: Saha Preetha , Bharadwaj Somnath , Chakravorty Susmita , Roy Nirupam , Choudhuri Samir , Günther Hans Moritz , Smith Randall K 
Published: February 2021

ABSTRACT
The shell type supernova remnant (SNR) Cas A exhibits structures at nearly all angular scales. Previous studies show the angular power spectrum (Cℓ) of the radio emission to be a broken power law, consistent with MHD turbulence. The break has been identified with the transition from 2D to 3D turbulence at the angular scale corresponding to the shell thickness. Alternatively, this can also be explained as 2D inverse cascade driven by energy injection from knot–shock interactions. Here we present Cℓ measured from archival VLA 5-GHz (C band) data, and Chandra X-ray data in the energy ranges ${\rm A}=0.6{-}1.0$ and ${\rm B} =4.2{-}6.0 \,{\rm keV}$, both of which are continuum dominated. The different emissions all trace fluctuations in the underlying plasma and possibly also the magnetic field, and we expect them to be correlated. We quantify this using the cross-Cℓ between the different emissions. We find that X-ray B is strongly correlated with both radio and X-ray A; however, X-ray A is only very weakly correlated with radio. This supports a picture where X-ray A is predominantly thermal bremsstrahlung, whereas X-ray B is a composite of thermal bremsstrahlung and non-thermal synchrotron emission. The various Cℓ measured here, all show a broken power-law behaviour. However, the slopes are typically shallower than those in radio and the position of the break also corresponds to smaller angular scales. These findings provide observational inputs regarding the nature of turbulence and the emission mechanisms in Cas A.
Dimensional Characterization of the Human Lumbar Interlaminar Space as a Guide for Safe Application of Minimally Invasive Dilators
Authors: Lehrman Jennifer N , Mulholland Celene B , de Andrada Pereira Bernardo , Sawa Anna G U , Kelly Brian P , Tumialán Luis M 
Published: February 2021

Abstract

BACKGROUND
The risk of interlaminar passage of a dilator into the lumbar spinal canal in minimally invasive approaches is currently unknown. Among anthropometric data reported in the medical literature, there is no cadaveric report of the interlaminar dimensions of the lumbar spine.

OBJECTIVE
To report the lumbar interlaminar dimensions in neutral, flexion, and extension postures.

METHODS
A total of 8 spines were sectioned into lumbar segments. Digitized coordinate data defining the locations and movements of chosen anatomic points on the laminar edges at a given spinal level were used to measure changes in the opening dimensions during static neutral posture and flexion-extension movements. Interlaminar dimensions were averaged and categorized for each vertebral level and spinal posture.

RESULTS
The mean interlaminar distance increased from neutral posture to flexion across all vertebral levels. The mean interlaminar distances in the neutral posture ranged from 12.21 mm (L5-S1) to 14.88 mm (L1-L2). In flexion, the range was from 17.15 mm (L5-S1) to 18.50 mm (L4-L5). These measurements are greater than the first several diameters of dilators in all minimally invasive dilator sets.

CONCLUSION
The precise measurements of the lumbar interlaminar space are valuable to minimally invasive spine surgeons for the dilatation phase of the operation. The risk of interlaminar passage of a minimally invasive dilator is greatest in flexion with dilators that have a diameter of 16 mm or less. There is considerably less risk of interlaminar passage in patients positioned on an extended Jackson table.
Bayesian Basics and the Scientific Hypothesis
Authors: Alger Bradley E. 
Published: February 2021

Abstract
This chapter covers the basics of Bayesian statistics, emphasizing the conceptual framework for Bayes’ Theorem. It works through several iterations of the theorem to demonstrate how the same equation is applied in different circumstances, from constructing and updating models to parameter evaluation, to try to establish an intuitive feel for it. The chapter also covers the philosophical underpinnings of Bayesianism and compares them with the frequentist perspective described in Chapter 5. It addresses the question of whether Bayesians are inductivists. Finally, the chapter shows how the Bayesian procedures of model selection and comparison can be pressed into service to allow Bayesian methods to be used in hypothesis testing in essentially the same way that various p-tests are used in the frequentist hypothesis testing framework.
What Scientists Think About Scientific Thinking
Authors: Alger Bradley E. 
Published: February 2021

Abstract
This chapter reports original data from two surveys conducted to find out how scientists view the hypothesis and related concepts. One was an online survey of hundreds of members of biological research societies. The scientists reported on their knowledge of and training in the use of the hypothesis, their views about hypothesis testing as compared with other modes of conducting science, such as Discovery Science, open-ended questioning, and Big Data methods. Respondents estimated how the various scientific modes influenced their work and how much they relied on each one. Most respondents,70% of them, reported having received little or no training in scientific thinking; however, 90% felt confident about their thinking skills. Nevertheless, more than 90% felt that formal training in this area would be helpful. The great majority relied on hypotheses in their research work. The second survey, analyzed all (more than 150) neuroscience research papers that appeared sequentially in top journals during 2015 to determine how the papers were structured, particularly with respect to the hypothesis. Only 33% of the papers had an explicitly stated hypothesis, whereas, in 45%, the hypothesis was “implicit.” A minor, though notable, fraction of the papers misused the term “hypothesis.” The results are germane to several topics covered in the remainder of the book.
Conclusion
Authors: Berry Craig 
Published: February 2021

AbstractThe concluding chapter summarizes the book’s main arguments, distilling its implications for how we understand pensions provision, and specifically its relationship to the wider financialization process, capitalist organization, and generational change. It also reflects more explicitly on some of the book’s implicit themes, such as the implications of pensions individualization for women and low earners, and industrial relations. Crucially, this chapter also offers a programme of reforms to overcome pensions imperilment in the United Kingdom, encompassing: expanded coverage for workplace pensions and employer contributions; new forms of state-managed provision in relation to annuities; increasing the state pension’s generosity over time; abolishing pensions tax relief as it currently exists; nationalizing residual defined benefit provision in order to capitalize a new public pension; and establishing transparent processes for aligning retirement ages with demographic change.
Tuna robotics: hydrodynamics of rapid linear accelerations
Authors: Thandiackal Robin , White Carl H. , Bart-Smith Hilary , Lauder George V. 
Published: February 2021

Fish routinely accelerate during locomotor manoeuvres, yet little is known about the dynamics of acceleration performance. Thunniform fish use their lunate caudal fin to generate lift-based thrust during steady swimming, but the lift is limited during acceleration from rest because required oncoming flows are slow. To investigate what other thrust-generating mechanisms occur during this behaviour, we used the robotic system termed Tunabot Flex, which is a research platform featuring yellowfin tuna-inspired body and tail profiles. We generated linear accelerations from rest of various magnitudes (maximum acceleration of

3.22

m

s

−
2

at

11.6

Hz

tail beat frequency) and recorded instantaneous electrical power consumption. Using particle image velocimetry data, we quantified body kinematics and flow patterns to then compute surface pressures, thrust forces and mechanical power output along the body through time. We found that the head generates net drag and that the posterior body generates significant thrust, which reveals an additional propulsion mechanism to the lift-based caudal fin in this thunniform swimmer during linear accelerations from rest. Studying fish acceleration performance with an experimental platform capable of simultaneously measuring electrical power consumption, kinematics, fluid flow and mechanical power output provides a new opportunity to understand unsteady locomotor behaviours in both fishes and bioinspired aquatic robotic systems.
Associations of DMT therapies with COVID-19 severity in multiple sclerosis
Authors: Simpson-Yap Steve , De Brouwer Edward , Kalincik Tomas , Rijke Nick , Hillert Jan , Walton Clare , Edan Gilles , Moreau Yves , Spelman Tim , Geys Lotte , Parciak Tina , Gautrais Clément , Lazovski Nikola , Pirmani Ashkan , Ardeshirdavani Amin , Forsberg Lars , Glaser Anna , McBurney Robert , Schmidt Hollie , Bergmann Arnfin , Braune Stefan , Stahmann Alexander , Middleton Rodden , Salter Amber , Fox Robert J. , van der Walt Anneke , Butzkueven Helmut , Al-Roughani Raed , Ozakbas Serkan , Rojas Juan I , van der Mei Ingrid , Nag Nupur , Ivanov Rumen , do Olival Guilherme Sciascia , Dias Alice Estavo , Magyari Melinda , Guimarães Brum Doralina , Mendes Maria Fernanda , Alonso Ricardo , Nicholas Richard , Bauer Johana , Chertcoff Anibal , Zabalza Ana , Arrambide Georgina , Fidao Alexander , Comi Giancarlo , Peeters Liesbet M. 
Published: February 2021

AbstractBackgroundPeople with multiple sclerosis (MS) are a vulnerable group for severe COVID-19, particularly those taking immunosuppressive disease-modifying therapies (DMTs). We examined the characteristics of COVID-19 severity in an international sample of people with MS.MethodsData from 12 data-sources in 28 countries were aggregated. Demographic and clinical covariates were queried, alongside COVID-19 clinical severity outcomes, hospitalisation, admission to ICU, requiring artificial ventilation, and death. Characteristics of outcomes were assessed in patients with suspected/confirmed COVID-19 using multilevel mixed-effects logistic regression.Results657 (28.1%) with suspected and 1,683 (61.9%) with confirmed COVID-19 were analysed. Older age, progressive MS-phenotype, and higher disability were associated with worse COVID-19 outcomes. Compared to dimethyl fumarate, ocrelizumab and rituximab were associated with hospitalisation (aOR=1.56,95%CI=1.01-2.41; aOR=2.43,95%CI=1.48-4.02) and ICU admission (aOR=2.30,95%CI=0.98-5.39; aOR=3.93,95%CI=1.56-9.89), though only rituximab was associated with higher risk of artificial ventilation (aOR=4.00,95%CI=1.54-10.39). Compared to pooled other DMTs, ocrelizumab and rituximab were associated with hospitalisation (aOR=1.75,95%CI=1.29-2.38; aOR=2.76,95%CI=1.87-4.07) and ICU admission (aOR=2.55,95%CI=1.49-4.36; aOR=4.32,95%CI=2.27-8.23) but only rituximab with artificial ventilation (aOR=6.15,95%CI=3.09-12.27). Compared to natalizumab, ocrelizumab and rituximab were associated with hospitalisation (aOR=1.86,95%CI=1.13-3.07; aOR=2.88,95%CI=1.68-4.92) and ICU admission (aOR=2.13,95%CI=0.85-5.35; aOR=3.23,95%CI=1.17-8.91), but only rituximab with ventilation (aOR=5.52,95%CI=1.71-17.84). Importantly, associations persisted on restriction to confirmed COVID-19 cases. No associations were observed between DMTs and death.ConclusionsUsing the largest cohort of people with MS and COVID-19 available, we demonstrated consistent associations of rituximab with increased risk of hospitalisation, ICU admission, and requiring artificial ventilation, and ocrelizumab with hospitalisation and ICU admission, suggesting their use may be a risk factor for more severe COVID-19.