bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antiresonance Assignment in Point and Cross Receptances for Undamped Vibrating Systems
Authors: Belotti Roberto , Richiedei Dario , Tamellin Iacopo 
Published: July 2019

Abstract
This paper proposes an inverse structural modification method for the assignment of antiresonances in undamped vibrating systems by modifying the inertial and elastic properties of the existing degrees of freedom of the original system. Hence, no additional degrees of freedom are added to the system. The problem is formulated as an eigenstructure assignment approach since such a novel formulation is suitable for complex systems, such as those modeled through finite elements. Indeed, these systems are difficult to handle with the methods already proposed in the literature. Additionally, the proposed approach is suitable for both point and cross receptances. Assignment is cast as a constrained non-convex non-linear minimization problem and the proposed solving strategy is based on the homotopy optimization approach. The method effectiveness is shown through three meaningful test cases.
Workforce crisis in primary healthcare worldwide: Hungarian example in a longitudinal follow-up study
Authors: Papp Magor , Kőrösi László , Sándor János , Nagy Csilla , Juhász Attila , Ádány Róza 
Published: July 2019

ObjectiveThe study was designed to explore the development of the general practitioner (GP) shortage in primary care and its characteristics in Hungary.DesignLongitudinal follow-up study over the decade 2007–2016.MethodsAnalyses were performed on changes in number, age and sex of GPs by practice type (adult, paediatric and mixed), as well as on their geographical distribution and migration between areas characterised by deprivation index (DI) at municipality level. The association between deprivation and vacancy for GPs was studied by risk analysis. The number of population underserved was defined by DI quintile.Setting and subjectsThe study involved all general practices and GPs in the period examined.Main outcome measureIt is showed that the number of general practices with unfilled GP posts was increasing exponentially, mainly in the most deprived areas of the country.ResultsA decrease in the number of GPs in all types of practices, especially in mixed (by 7.7%; p<0.001) and paediatric (by 6.5%; p<0.001) ones, was shown; the number of adult practices with unfilled GP posts doubled, while the number of paediatric practices with a vacancy for a paediatrician more than tripled. The average age of GPs was increased by 3.7 years (p<0.001) in adult, by 5.4 years (p<0.001) in paediatric and by 4.2 years (p<0.001) in mixed practices. In 2007, 52.27% (95% CI 51.03 to 53.5) of the GPs were women, and this rate increased to 56.19% (95% CI 54.93 to 57.44) by the end of the decade. An exponential association between relative vacancy rate and deprivation was confirmed. As a result of the migration of GPs, in the most deprived areas, the number of GPs decreased by 8.43% (95% CI 5.86 to 10.99).ConclusionsThe workforce crisis in Hungarian primary care is progressively deepening and resulting in more severe inequity in access to healthcare.
Persistence with dual antiplatelet therapy after percutaneous coronary intervention for ST-segment elevation acute coronary syndrome: a population-based cohort study in Catalonia (Spain)
Authors: Ribera Aida , Ferreira-Gonzalez Ignacio , Marsal Josep Ramon , Oristrell Gerard , Faixedas Maria Teresa , Rosas Alba , Tizón-Marcos Helena , Rojas Sergio , Labata Carlos , Cardenas Merida , Homs Silvia , Tomas-Querol Carlos , Garcia-Picart Joan , Gomez-Hospital Joan A , Pijoan Jose Ignacio , Masotti Monica , Mauri Josepa , Garcia Dorado David 
Published: July 2019

ObjectivesGuidelines recommending 12-month dual antiplatelet therapy (DAPT) in patients with ST-elevation acute coronary syndrome (STEACS) undergoing percutaneous coronary intervention (PCI) were published in year 2012. We aimed to describe the influence of guideline implementation on the trend in 12-month persistence with DAPT between 2010 and 2015 and to evaluate its relationship with DAPT duration regimens recommended at discharge from PCI hospitals.DesignObservational study based on region-wide registry data linked to pharmacy billing data for DAPT follow-up.SettingAll PCI hospitals (10) belonging to the acute myocardial infarction (AMI) code network in Catalonia (Spain).Participants10 711 STEACS patients undergoing PCI between 2010 and 2015 were followed up.Primary and secondary outcome measuresPrimary outcome was 12-month persistence with DAPT. Calendar year quarter, publication of guidelines, DAPT duration regimen recommended in the hospital discharge report, baseline patient characteristics and significant interactions were included in mixed-effects logistic regression based interrupted time-series models.ResultsThe proportion of patients on-DAPT at 12 months increased from 58% (56–60) in 2010 to 73% (71–75) in 2015. The rate of 12-month persistence with DAPT significantly increased after the publication of clinical guidelines with a time lag of 1 year (OR=1.20; 95% CI 1.11 to 1.30). A higher risk profile, more extensive and complex coronary disease, use of drug-eluting stents (OR=1.90; 95% CI 1.50 to 2.40) and a 12-month DAPT regimen recommendation at discharge from the PCI hospital (OR=5.76; 95% CI 3.26 to 10.2) were associated with 12-month persistence.ConclusionPersistence with 12-month DAPT has increased since publication of clinical guidelines. Even though most patients were discharged on DAPT, only 73% with potential indication were on-DAPT 12 months after PCI. A guideline-based recommendation at PCI hospital discharge was highly associated with full persistence with DAPT. Establishing evidence-based, common prescribing criteria across hospitals in the AMI-network would favour adherence and reduce variability.
Multicentre cross-sectional observational registry to monitor the safety of early discharge after rule-out of acute myocardial infarction by copeptin and troponin: the Pro-Core registry
Authors: Giannitsis Evangelos , Clifford Piers , Slagman Anna , Ruedelstein Ralph , Liebetrau Christoph , Hamm Christian , Honnart Didier , Huber Kurt , Vollert Jörn Ole , Simonelli Carlo , Schröder Malte , Wiemer Jan C , Mueller-Hennessen Matthias , Schroer Hinrich , Kastner Kim , Möckel Martin 
Published: July 2019

ObjectivesThere is sparse information on the safety of early primary discharge from the emergency department (ED) after rule-out of myocardial infarction in suspected acute coronary syndrome (ACS). This prospective registry aimed to confirm randomised study results in patients at low-to-intermediate risk, with a broader spectrum of symptoms, across different institutional standards and with a range of local troponin assays including high-sensitivity cTn (hs-cTn), cardiac troponin (cTn) and point-of-care troponin (POC Tn).DesignProspective, multicentre European registry.Setting18 emergency departments in nine European countries (Germany, Austria, Switzerland, France, Spain, UK, Turkey, Lithuania and Hungary)ParticipantsThe final study cohort consisted of 2294 patients (57.2% males, median age 57 years) with suspected ACS.InterventionsUsing the new dual markers strategy, 1477 patients were eligible for direct discharge, which was realised in 974 (42.5%) of patients.Main outcome measuresThe primary endpoint was all-cause mortality at 30 days.ResultsCompared with conventional workup after dual marker measurement, the median length of ED stay was 60 min shorter (228 min, 95% CI: 219 to 239 min vs 288 min, 95% CI: 279 to 300 min) in the primary dual marker strategy (DMS) discharge group. All-cause mortality was 0.1% (95% CI: 0% to 0.6%) in the primary DMS discharge group versus 1.1% (95% CI: 0.6% to 1.8%) in the conventional workup group after dual marker measurement. Conventional workup instead of discharge despite negative DMS biomarkers was observed in 503 patients (21.9%) and associated with higher prevalence of ACS (17.1% vs 0.9%, p<0.001), cardiac diagnoses (55.2% vs 23.5%, p<0.001) and risk factors (p<0.01), but with a similar all-cause mortality of 0.2% (95% CI: 0% to 1.1%) versus primary DMS discharge (p=0.64).ConclusionsCopeptin on top of cardiac troponin supports safe discharge in patients with chest pain or other symptoms suggestive of ACS under routine conditions with the use of a broad spectrum of local standard POC, conventional and high-sensitivity troponin assays.Trial registration numberNCT02490969.
Palivizumab and prevention of childhood respiratory syncytial viral infection: protocol for a systematic review and meta-analysis of breakthrough infections
Authors: Jun Shelly , Sebastianski Meghan , Featherstone Robin , Robinson Joan 
Published: July 2019

IntroductionChildhood respiratory syncytial virus (RSV) infection is a global phenomenon that can lead to fatal respiratory illness. Palivizumab is a drug that is routinely used in affluent countries as a prophylaxis against RSV infection; nevertheless, breakthrough infections are often reported. In light of new findings on potential RSV resistance to palivizumab, an up-to-date synthesis of evidence on effectiveness is needed. Furthering existing reviews, a broadened scope to better reflect effectiveness in a ‘real world’ clinical context is also important. This systematic review and meta-analysis will enhance our understanding of the effectiveness of palivizumab in varying populations of children. Findings from this review will inform recommendations for best practices regarding palivizumab use for childhood RSV infection as well as research priorities in RSV vaccine development.Methods and analysisWe will conduct a systematic review of primary population-based studies that examine the incidence of palivizumab breakthrough infections in children, published between 1997 to present. In collaboration with a research librarian, four electronic databases (MEDLINE, Embase, Cochrane Library, Web of Science) and additional sources will be searched. Study screening and quality assessment will be performed in duplicate. Data will be extracted by one reviewer, with partial and random verification by a second reviewer. The primary outcomes to assess breakthrough RSV infection will be hospitalisation, length of stay and the need for intensive care unit admission and mechanical ventilation in children receiving palivizumab. The secondary outcome will be RSV-associated mortality. We will conduct a meta-analysis using pooled effectiveness data, and include subgroup analyses by patient comorbidities and drug compliance. Sensitivity analyses for risk of bias and study design will also be performed.Ethics and disseminationThis systematic review will only include data from previously published literature and is therefore exempt from ethics approval. Final results will be disseminated through peer-reviewed publication and presented at academic conferences and scientific meetings engaging paediatric researchers and healthcare providers. Should findings from this review necessitate updates to current clinical practice guidelines, we intend to establish a working group to engage relevant health administrators and decision makers.PROSPERO registration numberCRD42019122120.
Mental health facility codesign: A new research method for integrating the service user voice in design processes using virtual reality
Authors: Liddicoat Stephanie 
Published: July 2019

BackgroundWithin healthcare environments, the emerging field of evidence-based design (EBD) explores the links between wellbeing and good design practice of the built environment.AimBy optimising both design processes and design outcomes, knowledge produced within this field seeks to improve staff performance, augment patient healing and enhance service outcomes and experiences.MethodsIn a prior study by the author, a mental health service building design was developed which integrated feedback from mental health service users relative to what aspects of the built environments of their care would enhance their service outcomes and experiences, encourage them to avail themselves of services and/or engage in therapy, and those that would reduce their willingness to avail themselves of services.ResultsThe research project protocol detailed here is the final testing stage of this body of work, where service users are invited to evaluate the final building design, experienced through virtual reality. This study addresses a gap in the literature, and aims to advance the field of EBD, and codesign with mental health service users, using virtual reality.ConclusionsThis research method details the aims, study design, methods and limitations of the study, with recommendations for future researchers.
Haemodynamic responses to simulated long working hours in different age groups
Authors: Liu Xinxin , Ikeda Hiroki , Oyama Fuyuki , Takahashi Masaya 
Published: July 2019

ObjectivesThis study aimed to clarify haemodynamic responses of different age groups to simulated long working hours.MethodsMen of three age groups participated in this study (16 in their 30s (mean 33.9±2.7 years old), 15 in their 40s (45.5±2.9) and 16 in their 50s (54.1±2.7)). All participants conducted 12 45-min personal computer-based tasks from 09:00 to 22:00. Nine 10-min to 15-min breaks between task periods, a 1-hour break at noon, and a 50-min break in the evening were provided. Haemodynamic responses were measured during task periods. All participants had normal resting systolic blood pressure (SBP <140 mm Hg) and diastolic blood pressure (DBP<90 mm Hg), which were measured before tasks started in the morning. Two-way repeated-measures analysis of variances and multiple comparisons (Bonferroni) were conducted.ResultsNo haemodynamic indices were significantly different among groups at baseline. Compared with baseline, SBP was almost unchanged for the 30s group but increased for the 40s and 50s groups during task periods. The 50s group showed higher SBP compared with the 30s group especially in the latter half of the working hours (p<0.05). In addition, the 50s group also showed higher total peripheral resistance (TPR) than the 30s group (p<0.1).ConclusionThe 50s group showed higher SBP and TPR responses than the 30s group, especially in the latter half of working hours. These results suggest that older workers might suffer more cardiovascular damage related to long working hours.
Evaluating the recruitment process into UK anaesthesia core training: a national data linkage study of doctors’ performance at selection and subsequent postgraduate training
Authors: Aslet Margaret , Paton Lewis W , Gale Thomas , Tiffin Paul A 
Published: July 2019

AbstractPurpose of the studyTo explore which factors increase the likelihood of being deemed appointable to core anaesthesia training in the UK and whether those factors subsequently predict performance in postgraduate training.Study designObservational study linking UK medical specialty recruitment data with postgraduate educational performance, as measured by Annual Review of Competence Progression (ARCP) outcomes. Data were available for 2782 trainee doctors recruited to anaesthesia core training from 2012 to 2016 with at least one subsequent ARCP outcome.ResultsBoth higher interview and shortlisting scores were independent and statistically significant (p≤0.001) predictors of more satisfactory ARCP outcomes, even after controlling for the influence of postgraduate exam failure. It was noted that a number of background variables (eg, age at application) were independently associated with the odds of being deemed appointable at recruitment. Of these, increasing age and experience were also negative predictors of subsequent ARCP rating. These influences became statistically non-significant once ARCP outcomes associated with exam failure were excluded.ConclusionsThe predictors of ‘appointability’ largely also predict subsequent performance in postgraduate training, as indicated by ARCP ratings. This provides evidence for the validity of the selection process. Our results also suggest that greater weight could be applied to shortlisting scores within the overall process of ranking applicants for posts.
A new metric to quantify influence of nodes in social networks
Authors: Li Xuequn , Zhou Shuming , Liu Jiafei , Chen Gaolin , Gu Zhendong , Wang Yihong 
Published: July 2019

Reasonably ranking the influence of nodes in social networks is increasingly important not only for theoretical research but also for real applications. A great number of strategies to identify the influence of nodes have been proposed so far, such as semi-local centrality (SL), betweenness centrality and coreness centrality, etc. For the sake of ranking more effectively, a new method of identifying influential nodes is proposed in this paper, which takes into account a node’s influence on its neighbors and the node’s position in the network. The influence on neighbors involves two aspects. One is the influence of the target node on its direct neighbors (h-index), the other is the influence on farther neighbors (semi-local centrality). The location of the node in the network is reflected by the improved k-core score, a modified version of k-core index to make it more applicable to practice. Combining both local and global information of node together makes the proposed method a reasonable and effective strategy to identify the influential nodes. The simulation results compared to other well-known methods on six real-world networks demonstrate the effectiveness of the presented method.
Human vestibulo-ocular reflex adaptation is frequency selective
Authors: Rinaudo Carlo N. , Schubert Michael C. , Figtree William V. C. , Todd Christopher J. , Migliaccio Americo A. 
Published: July 2019

The vestibulo-ocular reflex (VOR) is the only system that maintains stable vision during rapid head rotations. The VOR gain (eye/head velocity) can be trained to increase using a vestibular-visual mismatch stimulus. We sought to determine whether low-frequency (sinusoidal) head rotation during training leads to changes in the VOR during high-frequency head rotation testing, where the VOR is more physiologically relevant. We tested eight normal subjects over three sessions. For training protocol 1, subjects performed active sinusoidal head rotations at 1.3 Hz while tracking a laser target, whose velocity incrementally increased relative to head velocity so that the VOR gain required to stabilize the target went from 1.1 to 2 over 15 min. Protocol 2 was the same as protocol 1, except that head rotations were at 0.5 Hz. For protocol 3, head rotation frequency incrementally increased from 0.5 to 2 Hz over 15 min, while the VOR gain required to stabilize the target was kept at 2. We measured the active and passive, sinusoidal (1.3Hz) and head impulse VOR gains before and after each protocol. Sinusoidal and head impulse VOR gains increased in protocols 1 and 3; however, although the sinusoidal VOR gain increase was ~20%, the related head impulse gain increase was only ~10%. Protocol 2 resulted in no-gain adaptation. These data show human VOR adaptation is frequency selective, suggesting that if one seeks to increase the higher-frequency VOR response, i.e., where it is physiologically most relevant, then higher-frequency head movements are required during training, e.g., head impulses.NEW & NOTEWORTHY This study shows that human vestibulo-ocular reflex adaptation is frequency selective at frequencies >0.3 Hz. The VOR in response to mid- (1.3 Hz) and high-frequency (impulse) head rotations were measured before and after mid-frequency sinusoidal VOR adaptation training, revealing that the mid-frequency gain change was higher than high-frequency gain change. Thus, if one seeks to increase the higher-frequency VOR response, where it is physiologically most relevant, then higher-frequency head movements are required during training.
Ipsi- and contralateral corticocortical projection-dependent subcircuits in layer 2 of the rat frontal cortex
Authors: Ueta Yoshifumi , Sohn Jaerin , Agahari Fransiscus Adrian , Im Sanghun , Hirai Yasuharu , Miyata Mariko , Kawaguchi Yasuo 
Published: July 2019

In the neocortex, both layer 2/3 and layer 5 contain corticocortical pyramidal cells projecting to other cortices. We previously found that among L5 pyramidal cells of the secondary motor cortex (M2), not only intratelencephalic projection cells but also pyramidal tract cells innervate ipsilateral cortices and that the two subtypes are different in corticocortical projection diversity and axonal laminar distributions. Layer 2/3 houses intratelencephalically projecting pyramidal cells that also innervate multiple ipsilateral and contralateral cortices. However, it remained unclear whether layer 2/3 pyramidal cells can be divided into projection subtypes each with distinct innervation to specific targets. In the present study we show that layer 2 pyramidal cells are organized into subcircuits on the basis of corticocortical projection targets. Layer 2 corticocortical cells of the same projection subtype were monosynaptically connected. Between the contralaterally and ipsilaterally projecting corticocortical cells, the monosynaptic connection was more common from the former to the latter. We also found that ipsilaterally and contralaterally projecting corticocortical cell subtypes differed in their morphological and physiological characteristics. Our results suggest that layer 2 transfers separate outputs from M2 to individual cortices and that its subcircuits are hierarchically organized to form the discrete corticocortical outputs. NEW & NOTEWORTHY Pyramidal cell subtypes and their dependent subcircuits are well characterized in cortical layer 5, but much less is understood for layer 2/3. We demonstrate that in layer 2 of the rat secondary motor cortex, ipsilaterally and contralaterally projecting corticocortical cells are largely segregated. These layer 2 cell subtypes differ in dendrite morphological and intrinsic electrophysiological properties, and form subtype-dependent connections. Our results suggest that layer 2 pyramidal cells form distinct subcircuits to provide discrete corticocortical outputs.