bluuebunny/crossref_metadata_2025_split huggingface dataset:
Timings for HbA1c testing in people with diabetes are associated with incentive payments: an analysis of UK primary care data
Authors: Hirst J. A. , Farmer A. J. , Smith M. C. , Stevens R. J. 
Published: September 2018

AbstractAimsGuidelines recommend testing HbA1c every 3–6 months in people with diabetes. In the United Kingdom (UK), primary care clinics are financially incentivized to monitor HbA1c at least annually and report proportions of patients meeting targets on 31 March. We explored the hypothesis that this reporting deadline may be associated with over‐frequent or delayed HbA1c testing.MethodsThis analysis used HbA1c results from 100 000 people with diabetes during 2005–2014 in the Clinical Practice Research Datalink UK primary care database. Logistic regression was used to explore whether the four months prior to the deadline for quality reporting (December to March) or individual's previous HbA1c were aligned with retesting HbA1c within 60 days or > 1 year from the previous test, and identify other factors associated with the timing of HbA1c testing.ResultsRetesting HbA1c within 60 days or > 1 year was more common in December to March compared with other months of the year (odds ratio 1.06, 95% confidence interval 1.04–1.08 for retesting within 60 days). Those with higher HbA1c were more likely to have a repeat test within 60 days and less likely to have a repeat test > 1 year from the previous test.ConclusionsWe have found that retesting HbA1c within 60 days and > 1 year from the previous test was more common in December to March compared with the other months of the year. This work suggests that both practice‐centred administrative factors and patient‐centred considerations may be influencing diabetes care in the UK.
Treatment gap for convulsive status epilepticus in resource‐poor countries
Authors: Lee Byungin ,   the Asian Status Epilepticus Survey Group
Published: September 2018

SummaryThe magnitude of the treatment gap (TG) for convulsive status epilepticus (CSE) in resource‐poor countries is unknown. Hospital‐based cohort studies from developing countries revealed that the management of CSE was usually suboptimal due to lack of advanced diagnostic and treatment facilities, significant delay in patient's presentation at hospital, and shortages of essential antiepileptic drugs (AEDs). However, there were no significant differences in the proportion of refractory status epilepticus, short‐term mortalities, and morbidities of CSE between the developed and the developing countries. Therefore, the presence of significant TG for CSE in developing countries is still an assumption without evidence. We conducted an expert survey in Asia for potential sources of TG. Experts from 16 Asian countries responded to the questionnaire. An injectable form of diazepam was available in all 16 countries even at the primary care level, but intravenous lorazepam was available only in four countries. Second‐line AEDs were widely available at tertiary care hospitals, but not at primary care hospitals. Lack of second‐line AEDs at primary care hospitals, significant delay in patient transportation to the hospital, shortages of intensive care unit facilities, and absence of trained physicians were important contributing factors to TG in Asia.
Prison Governors as Policymakers,PhroneticPractices as Enacted Knowledge
Authors: DUBOIS CHRISTOPHE 
Published: September 2018

AbstractIn the last 15 years, Belgian prisons have been characterised by an increase of managerial and legal regulations. Building on an empirical account of prison governors’ work practices and bureaucratic working context, this article shows how the rise of policy inscriptions paradoxically leads to a sharper need of prison governors for practical knowledge. Drawing on four years of qualitative research with 40 Belgian prison governors, the article illustrates how they define ‘ethical dilemmas’ – that is, uncertain and ambiguous events – and reach a particular decision. Two analytical concepts are used in that respect. First, the concept of ‘phronetic practices’ (Nonaka and Takeuchi 2011) relates to the practical knowledge used to make decisions in uncertain and ambiguous situations. Second, the concept of ‘enacted knowledge’ (Freeman and Sturdy 2015) enlightens how such decisions contribute to shaping prison policy, organisations, and administration. In that perspective, this article proposes to recognise the ethics of prison governors conceived as policymakers.
Optimal lesion size index to prevent conduction gap during pulmonary vein isolation
Authors: Kanamori Naomi , Kato Takeshi , Sakagami Satoru , Saeki Takahiro , Kato Chieko , Kawai Keiichi , Chikata Akio , Takashima Shin‐ichiro , Murai Hisayoshi , Usui Soichiro , Furusho Hiroshi , Kaneko Shuichi , Takamura Masayuki 
Published: September 2018

AbstractIntroductionA novel real‐time lesion size index (LSI) that incorporates contact force (CF), time, and power has been developed for safe and effective catheter ablation. The optimal LSI was evaluated to eliminate gap formation during pulmonary vein isolation (PVI).Methods and ResultsConsecutive patients were enrolled, who underwent their first PVI using a fiber‐optic CF‐sensing catheter for atrial fibrillation between December 2016 and October 2017. The CF parameters, force‐time integral (FTI), and LSI for 3095 ablation points in 34 patients were evaluated. The FTI and LSI in the lesions with gaps or dormant conduction (gaps/DC) were significantly lower than those in the lesion without gaps/DC (FTI: 140.5 ± 54.5 and 232.4 ± 121.4 g s, P < 0.0001; LSI: 4.0 ± 0.6 and 4.7 ± 0.9, P < 0.0001, respectively). On receiver operating characteristic curve analysis, the optimal LSI threshold was 4.05 (sensitivity, 63.4%; specificity, 76.3%). The LSI of <5.25 predicted a gap or DC with a high sensitivity (sensitivity, 97.6%; specificity, 25.7%). In the posterior wall, which was 37% thinner than the nonposterior wall, a lower LSI of <3.95 showed a relatively high sensitivity (92.3%) and specificity (65.6%).ConclusionsThe LSI can be used to predict gaps/DC during the PVI procedure. An LSI of 5.2 may be a suitable target for effective lesion formation. An LSI of 4.0 may be acceptable in the posterior wall, especially in areas adjacent to the esophagus.
QRS morphology shift following catheter ablation of idiopathic outflow tract ventricular arrhythmias: Prevalence, mapping features, and ablation outcomes
Authors: Shirai Yasuhiro , Liang Jackson J. , Garcia Fermin C. , Supple Gregory E. , Callans David J. , Zado Erica S. , Marchlinski Francis E. , Santangeli Pasquale 
Published: September 2018

AbstractIntroductionIn patients with monomorphic idiopathic outflow tract ventricular arrhythmias (OT‐VAs), catheter ablation (CA) at the earliest activation site can result in a shift in QRS morphology indicating a change in the activation patterns. This study aimed to investigate the prevalence, mapping features, and ablation outcomes of OT‐VAs displaying a QRS morphology shift following CA.Methods and ResultsWe retrospectively analyzed 446 patients with monomorphic OT‐VAs. A QRS morphology shift following CA was observed in 17 (4%) patients. Initially, the earliest activation site was within the right ventricular outflow tract (RVOT) in one (6%) patient, the left ventricular outflow tract (LVOT) in 10 (59%) patients (left coronary cusp/right coronary cusp junction in seven patients and LVOT endocardium in three patients), and within the distal coronary venous system in six (35%) patients. The VA was suppressed in all 17 patients, but VA recurrence with a different QRS morphology was observed after a waiting period. The recurrent VA was remapped in all patients and was eliminated targeting the new earliest site in 15 (88%) cases. In 11 of 15 successful cases, the ablation site for the recurrent VA shifted to an anatomical structure distinct from but adjacent to the initial site. In the remaining four patients, the recurrent VA was eliminated within the same anatomical structure.ConclusionsIn patients with idiopathic OT‐VAs, a QRS morphology shift following CA can be observed in 4% of the cases. In these cases, detailed remapping is necessary since the successful ablation site for the VAs with altered QRS morphology shifts to different anatomical structures in most patients.
Relative Placement: The Best Answer for Our Foster Care System
Authors: Edwards Leonard 
Published: September 2018

AbstractThis article briefly traces the history of the placement of children out of their homes because of parental abuse or neglect. The preference for relative placement is a recent occurrence. The advantages of relative placement instead of foster or group care are summarized as well as the disadvantages. Relative placement rates across the country are about 32%. Several jurisdictions have much higher placement rates including Allegheny County, Pennsylvania. Los Angeles, California, is experimenting with social work practices that have produced over 80% relative placement rates during the past year. How both of these jurisdictions accomplish high relative placement rates is described in detail. Judges should persuade their own social service agencies to adopt these practices.
Treatment for in‐stent restenosis requiring rotational atherectomy
Authors: Hachinohe Daisuke , Kashima Yoshifumi , Hirata Kazuya , Kanno Daitaro , Kobayashi Ken , Kaneko Umihiko , Sugie Takuro , Tadano Yutaka , Watanabe Tomohiko , Shitan Hidemasa , Haraguchi Takuya , Enomoto Morio , Sato Katsuhiko , Fujita Tsutomu 
Published: September 2018

ObjectivesThis study aimed to evaluate the outcomes of patients with in‐stent restenosis (ISR) who underwent rotablation (RA) followed by balloon angioplasty (BA), drug‐eluting stent (DES) implantation, or drug‐coated balloon (DCB) angioplasty.BackgroundInterventional treatment of ISR is occasionally challenging. Despite the availability of various percutaneous treatments, the optimal solution remains unclear.Methods and ResultsA total of 200 patients with ISR who underwent RA were retrospectively identified from our institutional database. Clinical outcomes at 12 months and independent predictors of target lesion revascularization (TLR) were assessed. Of patients, 90, 55, and 55 underwent BA, DES implantation, and DCB angioplasty, respectively. The incidence of all‐cause death, cardiac death, and hospitalization due to heart failure was low in all groups. Moreover, no definite stent thrombosis was observed in the three groups. The TLR rate of BA, DES implantation, and DCB angioplasty following RA for ISR were 40.7%, 35.0%, and 27.3%, respectively. The adjusted outcomes for TLR using the inverse probability of treatment weighting method based on propensity scores indicated that DCB angioplasty following RA was superior to BA after RA. Intraprocedural complications, which could be successfully managed with interventional treatment, were identified in only three cases.ConclusionsTLR at 12 months is dismal. RA is not effective for ISR requiring RA. In unfavorable settings, DCB angioplasty following RA is the most effective treatment option in patients with ISR requiring debulking strategy.
Do Administrative Traditions Matter for Climate Change Adaptation Policy? A Comparative Analysis of 32 High‐Income Countries
Authors: Biesbroek Robbert , Lesnikowski Alexandra , Ford James D. , Berrang‐Ford Lea , Vink Martinus 
Published: September 2018

AbstractAlthough governments are developing and implementing policies to adapt to the impacts of climate change, it remains unclear which factors shape how states are developing these policies. This paper aims to assess whether or not administrative traditions matter for the formation of national climate change adaptation policy in 32 high‐income countries. We operationalize administrative traditions based on five structural criteria: vertical dispersion of authority, horizontal coordination, interest mediation between state‐society, role of public administrator, and how ideas enter bureaucracy. We construct a unique adaptation policy dataset that includes 32 high‐income countries to test seven hypotheses. Our results indicate that countries’ adaptation policies align to some extent with their administrative structure, particularly dispersion of authority and horizontal coordination. However, we find limited evidence that other public bureaucracy factors are related to national adaptation policy. We conclude that administrative traditions matter, but that their influence should not be overestimated.
Are the Sanctified Becoming the Pornified? Religious Conservatism, Commitment, and Pornography Use, 1984–2016*
Authors: Perry Samuel L. , Schleifer Cyrus 
Published: September 2018

ObjectivesAmericans are generally increasing in their pornography viewership. While devout, theologically conservative Christians have been among the most ardent opponents to pornography's dissemination and use historically, there is a growing—but thus far untested—assumption that they too are following this same trend. This study examines (1) whether committed or conservative Christians are increasing in rates of porn viewership similar to other Americans and (2) when potential religious divergences in porn viewership started.MethodsWe fit a series of binary logistic regression models using data from the 1984–2016 General Social Surveys.ResultsHolding other variables constant, American evangelicals are indeed increasing in their reported porn viewership at rates identical to other Americans. Frequent church attendees and biblical literalists, however, show a divergent trend, with both remaining constant in their reported porn viewership across time. Analyses also show clear cutoff points for the divergence starting in the mid‐1990s, roughly when Internet pornography became available.ConclusionsFindings suggest that, all else being equal, Americans who merely identify with conservative Christianity are indeed increasing in their porn viewership, but among the most faithful and theologically conservative Americans, they are no more likely to report viewing pornography than they were over 30 years ago.
Domain swap between two type‐II metacaspases defines key elements for their biochemical properties
Authors: Fortin Jianqiao , Lam Eric 
Published: September 2018

SummaryType‐II metacaspases are conserved cysteine proteases found in eukaryotes with oxygenic photosynthesis, including green plants and some algae, such as Chlamydomonas and Volvox. Genetic and biochemical studies showed that some members in this protease family could be involved in oxidative stress‐induced cell death in higher plants, but their regulatory mechanisms remain unclear. Biochemically, two distinct classes of type‐II metacaspases are exemplified by AtMC4 and AtMC9 from Arabidopsis, with AtMC4 activation dependent on calcium under neutral pH, whereas AtMC9 is active only under mildly acidic pH, regardless of the availability of calcium. Here, we constructed all six possible combinations between the p20, linker, and p10 domains from AtMC4 and AtMC9. Our results show that calcium stimulation of AtMC4 activity is associated with essential amino acids located in its p20 domain. In contrast, the acidic pH optimum trait is lost from AtMC9 if one or two of its domains are replaced by that from AtMC4, suggesting that multiple interactions between domains in AtMC9 may be responsible for this property. Consistent with this, we found conserved ‘signature’ residues in each of the three domains that distinguish AtMC4‐ and AtMC9‐like classes of metacaspases. Tracing the origin of the AtMC9 class, we found evidence for its appearance between lycophytes and gymnosperms, coincident with the evolution of more complex root archetypes in terrestrial plants. Our work suggests that the distinctive properties of the AtMC9‐like protease could be associated with special cellular physiology in the roots of gymnosperms and angiosperms that are distinct from lycophytes.
Nonlinear Adaptive Magneto-Thermal Analysis at Bushing Regions of a Transformers Cover Using Finite Difference Method
Authors: Zia Zahedi Mohammad , Iskender I. 
Published: September 2018

Abstract
In this study, losses analysis at bushing regions of a transformer covers is done using finite difference method (FDM), considering that FDM being more flexible to deal with the nonlinear constitutive law and easier to be implemented than finite element (FE) and analytical methods. The analysis is performed based on a 2-level adaptive mesh solution of Maxwell equations and Ohm law at the cross section area in the axial symmetry page of a steel disk, taking account the nonlinear magnetic permeability of the steel. The losses density obtained, as a heat source, is imported into an alternating direction implicit (ADI) approach of heat conduction equation. Therefore, a finite difference (FD) solution algorithm for magneto-thermal analysis on cover plate is obtained by combination of adaptive mesh refinement and ADI-FDM, which improves the accuracy and decreases the computational time without losing accuracy. The reliability of the proposed technique is confirmed by experimental and FE method (FEM) results, considering the temperature distribution of the cover. The comparison of the results with those obtained from FEM and experiments shows the efficiency and capability of the method.
Experimental Performance Evaluation of Tubular Manifold Heat Exchanger
Authors: Ansab Ali Muhammad , Khan Tariq S. , Al Hajri Ebrahim , Khasawneh Fadi 
Published: September 2018

Abstract
The present work demonstrates the use of manifold microchannel technology in conjunction with conventional macrogeometries to achieve superior performance compared to traditional heat exchangers. A novel tubular manifold heat exchanger is designed using three-dimensional (3D) printed manifold and conventional double enhanced tube. The experiments are performed using water as the working fluid and the manifold side heat transfer coefficient up to 9538 Wm−2K−1 with a low flowrate of 4.25 lpm is achieved with as low pressure drop as 323 Pa. A comparison with respect to thermal hydraulic performance of the results with a plate heat exchanger shows clear advantage of the proposed exchanger. Overall, microscale heat transfer characteristics are obtained by using relatively simple and economical fabrication techniques.
A Numerical Study of Diffusion of Nanoparticles in a Viscous Medium During Solidification
Authors: Rahman Kazi M. , Ruhul Amin M. , Mian Ahsan 
Published: September 2018

Abstract
In the field of additive manufacturing process, laser cladding is widely considered due to its cost effectiveness, small localized heat generation, and full fusion to metals. Introducing nanoparticles with cladding metals produces metal matrix nanocomposites, which in turn improves the material characteristics of the clad layer. The governing equations that control the fluid flow are standard incompressible Navier–Stokes and heat diffusion equation, whereas the Euler–Lagrange approach has been considered for particle tracking. The mathematical formulation for solidification is adopted based on enthalpy porosity method. Liquid titanium has been considered as the initial condition where particle distribution has been assumed uniform throughout the geometry. A numerical model implemented in a commercial software based on control volume method has been developed, which allows to simulate the fluid flow during solidification as well as tracking nanoparticles during this process. A detailed parametric study has been conducted by changing the Marangoni number, convection heat transfer coefficient, constant temperature below the melting point of titanium, and insulated boundary conditions to analyze the behavior of the nanoparticle movement. The influence of increase in Marangoni number results in a higher concentration of nanoparticles in some portions of the geometry and lack of nanoparticles in rest of the geometry. The high concentration of nanoparticles decreases with a decrease in Marangoni number. Furthermore, an increase in the rate of solidification time limits the nanoparticle movement from its original position which results in different distribution patterns with respect to the solidification time.
Design and CFD Analysis of a 150kW 8-Stage ORC-ROT (Organic Rankine Cycle-Radial Outflow Turbine) and Performance Degradation due to Blade Tip Clearance of Labyrinth Seal
Authors: Doğu Yahya , Günaydın İbrahim , Kılıçaslan Zeynal , İleri Tacettin , Soğancı Sinan 
Published: September 2018

In this study, blade tip leakages were calculated for a Radial Outflow Turbine (ROT) designed for an Organic Rankine Cycle (ORC) at a 150kW power output. Since the turbine blade sizes are relatively very small for low-capacity systems, the leakages through the blade tip clearances considerably affect the turbine isentropic efficiency. Therefore, labyrinth seals were applied at the blade tips and the ROT’s performance degradation due to blade tip leakages was investigated.
In order to determine the preliminary ROT sizes, an in-house developed 1-D code was utilized. The blade profiles were optimized with CFD analyses to reach high power output and isentropic efficiency. The designed ROT has 8 stages. Toluene is used as the cycle fluid at inlet conditions of 24bar of total pressure, 310°C and outlet conditions of 0.25bar of static pressure. These conditions are chosen for exhaust conditions of a common biogas engine. Thus, the ORC is supposed to operate at a heat source temperature of 460°C and a heat sink temperature of 35°C. The turbine speed of 14000 rpm is determined.
The CFD model for the entire 3-D turbine geometry is built in the FlowVision software. The real gas equation is employed for the compressible flow. The SST turbulent flow model is employed. The CFD model uses transient state and rotating frame approaches.
Four blade tip configurations were analyzed. The CFD results reveal the followings. The turbine isentropic efficiency is calculated to be 87.62% for the unshrouded geometry with no clearance, which is an ideal case. For a manufacturable and manageable blade tip clearance of 0.2 mm, the turbine isentropic efficiency is calculated to be 71.03% for the unshrouded geometry. The shrouded geometry with the same clearance increases the efficiency to 74.03%. When a labyrinth seal is applied to the shrouded geometry, the efficiency reaches to 77.03%. The best practice in terms of turbine power output and efficiency is the shrouded geometry with labyrinth seal applications.