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To assess the safety, technical success, and midterm outcomes of endoanchor (Heli-FX, Medtronic, Santa Rosa, California) deployment in thoracic endovascular aortic repair (TEVAR) or abdominal endovascular aortic repair (EVAR). This single-institution, retrospective study of all endoanchor procedures was performed from February 1, 2017 to March 30, 2021. All procedures were performed percutaneously by interventional radiologists. Clinical information and outcome data were retrieved from electronic medical records. Fifty patients (14% females, n = 7; 86% males, n = 43; median age, 79 years [range, 56–93 years]) underwent Endoanchor procedures, with 349 Endoanchors implanted; 33 procedures were primary deployments (at initial stent deployment) and 17 were secondary deployments (previous stent deployment). For the primary group (4 TEVARs and 29 EVARs), indications were prophylactic (n = 30), hostile neck (n = 28), hostile distal landing zone (n = 2), and intraprocedural type 1a endoleaks (n = 3). For the secondary group (4 TEVARs and 13 EVARs), indications were graft migration (n = 8), seal zone expansion without proven endoleak (n = 7) (proximal [n = 4] or distal seal [n = 3]), and proven type 1a endoleak (n = 2). Median number of endoanchors deployed per procedure was 7 (range, 3–10). Median time to deploy endoanchors was 22 minutes (range, 8–46 minutes). The technical success rate of Endoanchor was 99.7% (348/349). The 30-day mortality rate was 0%. The overall adverse event rate was 6% (n = 3). Reinterventions were performed in 12% of patients (n = 6). Median follow-up was 38 months (range, 2–71 months). Overall survival at 1 and 3 years was 95% and 85%, respectively. Overall freedom from type 1a endoleak at 1 and 3 years was 96% and 93%, respectively. Endoanchor procedures are safe with excellent technical success rate and good midterm clinical outcomes. [Display omitted] [ABSTRACT FROM AUTHOR]

Ascending aortic aneurysm (AsAA) is a high-risk cardiovascular disease with an increased incidence over years. In this study, we compared different risk factors based on the pre-failure behavior (from a biomechanical point of view) obtained ex-vivo from an equi-biaxial tensile test. A total of 100 patients (63 ± 12 years, 72 males) with AsAA replacement, were recruited. Equi-biaxial tensile tests of AsAA walls were performed on freshly sampled aortic wall tissue after ascending aortic replacement. The aneurysmal aortic walls were divided into four quadrants (medial, anterior, lateral, and posterior) and two directions (longitudinal and circumferential) were considered. The stiffness was represented by the maximum Young modulus (MYM). Based on patient information, the following subgroups were considered: age, gender, hypertension, obesity, dyslipidemia, diabetes, smoking history, aortic insufficiency, aortic stenosis, coronary artery disease, aortic diameter and aortic valve type. In general, when the aortic diameter increased, the aortic wall became thicker. In terms of the MYM, the longitudinal direction was significantly higher than that in the circumferential direction. In the multivariant analysis, the impact factors of age (p = 0.07), smoking (p = 0.05), diabetes (p = 0.03), aortic stenosis (p = 0.02), coronary artery disease (p < 10−3), and aortic diameters (p = 0.02) were significantly influencing the MYM. There was no significant MYM difference when the patients presented arterial hypertension, dyslipidemia, obesity, or bicuspid aortic valve. To conclude, the pre-failure aortic stiffness is multi-factorial, according to our population of 100 patients with AsAA. Our research on the topic of "Aortic local biomechanical properties in case of ascending aortic aneurysms" is about the biomechanical properties on one hundred aortic samples according to the aortic wall quadrants and the direction. More than ten factors and risks which may impact ascending aortic aneurysms have been studied. According to our knowledge, so far, this article involved the largest population on this topic. It will be our pleasure to share this information with all the readers. [Display omitted] [ABSTRACT FROM AUTHOR]

This study aimed to assess second year student pharmacists' (P2) confidence in communicating with patients with limited English proficiency before and after a required community-based health screening experience. All P2s were required to complete a 0.5 credit hour Ambulatory Care Introductory Pharmacy Practice Experience (IPPE). As part of this experience, P2s conducted blood pressure (BP) and blood glucose (BG) screenings with a medical interpreter at a low-income apartment building that has a large Mandarin-speaking population. Each student was required to attend one health screening event. Between September 2022 and April 2023,we administered paper questionnaires to P2s and community members to obtain feedback about the experience. Quantitative data was analyzed using descriptive statistics, chi-squared tests, and paired t -tests while a content analysis was conducted on qualitative data. P2s (n = 82, 100%) conducted an average of 5.7 (SD 2.6) BP and 5.9 (SD 2.7) BG screenings per two-hour event. P2s reported higher confidence in conducting assessments, communicating via a medical interpreter, and working on a team at the end of the event. P2s agreed that it should be kept as part of the IPPE (99%). Community members (n = 55, 22%) participated in a bilingual paper-based questionnaire. Community members reported positive experiences and a desire to continue to participate. At the end of the health screening event, P2s were more confident in their ability to communicate with older adult community members using translated written documents and verbally with a medical interpreter. P2s and community members supported continuation of the program. [ABSTRACT FROM AUTHOR]

Background: Racial and ethnic disparities in access to hip and knee total joint arthroplasty (TJA) and postoperative outcomes have wide-reaching implications for patients and the health care system. The aim of this study is to evaluate the effect of ethnicity on clinical outcomes and complications following revision hip and knee TJA.Methods: A single-institution, retrospective analysis of a consecutive series of 4424 revision hip and knee TJA patients was evaluated. Student's t-test and chi-squared analysis were used to identify significant differences in patient demographics and clinical outcomes between Caucasians and various ethnic minorities, including African Americans, Hispanics, and Asians.Results: When compared with white patients, African American patients demonstrated a significantly higher BMI (P = .04), ASA score (P = .04), length of hospital stay (P = .06), and postoperative infection rates (P = .04). Hispanics demonstrated a significantly higher BMI (P = .04), when compared with white patients, alongside a significantly higher risk for postoperative infection (P < .01). African American demonstrated a significantly higher ASA score (P = .02; P = .03), when compared with Hispanics and Asians, alongside a significantly increased length of stay (P = .01) and higher risk for postoperative infection (P = .02).Conclusion: The study findings demonstrate an underutilization of revision TJA by ethnic minority groups, suggesting that disparities in access to orthopedic surgery increase from primary to revision surgery despite higher failure rates of minority ethnic groups reported after primary TJA surgery. In addition, inferior postoperative outcomes were associated with African Americans and Hispanics, when compared to white patients, with African Americans demonstrating the highest risk of postoperative complications. [ABSTRACT FROM AUTHOR]

Pharmacy education programs use simulation to provide a realistic and safe environment for student learning. We studied whether incorporation of virtual simulation into a required first year self-care therapeutics course impacted frequency of interactions, self-reported student confidence, and preceptor-reported student performance during second-year community pharmacy introductory pharmacy practice experiences (IPPEs). Virtual simulation cases using MyDispense were incorporated into a self-care therapeutics course in winter 2017. Students and preceptors were surveyed at the end of the fall semester community pharmacy IPPE. Data from IPPE experiences was compared with students who took the self-care therapeutics course in winter 2016 (control). Students completed 30 virtual simulation cases and three cases as part of the final examination (n = 33). Students in the intervention group reported more patient care interactions during their IPPEs than students who did not complete virtual simulation cases, but there was no difference in self-reported confidence. Preceptors did not report any differences in the ability of students to complete over-the-counter medication interactions during IPPEs. Cases were well received by students although they took longer to complete than initially anticipated. Students in the intervention group reported significantly more patient care interactions during IPPEs than those in the control group; however, there were no differences in self-reported confidence. Incorporation of virtual simulation was a sustainable change as the cases were able to be re-used the following year with minimal edits. [ABSTRACT FROM AUTHOR]

Highlights • Develop a dual input clutchless transmission system based on AMT. • An energy management strategy is designed to decide the optimal power distribution. • A shifting stability control is designed to avoid undesired gear shifting. • A multi-objective optimizer is proposed for the stabilizer parameter optimization. Abstract A dual input clutchless transmission system based on automated manual transmission (AMT) structure is developed for pure electric vehicles. An energy management strategy (EMS) is proposed to determine the power distribution between two motors and the optimal gear state. A mathematical model is built to minimize the energy consumption of the motors at each instant based on the motor efficiency maps. However, the proposed EMS in line with other energy-oriented strategies often result in excessive gear shifts and compromised drivability. To avoid the undesired gear shift, a shifting stabilizer is built in the EMS objective function to improve the shift quality. Accordingly, to achieve a balance between the energy consumption and the drivability, a multi-objective optimization method is adopted to reduce the unnecessary shift events while minimizing energy consumption. Two driving cycles representing typical daily driving conditions are used to demonstrate the effectiveness of the proposed system in terms of energy efficiency and shifting stability. [ABSTRACT FROM AUTHOR]

Highlights • A dynamic model of powertrain system integrating the model of Harpoon-shift synchronizer for electric vehicles is built to investigate the gearshift dynamics. • Harpoon-shift can improve gearbox efficiency, simplify gearshift control and improve shifting quality. • Harpoon-Shift overcomes several shortcomings of the traditional synchronizers such as friction loss and wear. • The optimized spring stiffness of Harpoon-Shift can reduce the shifting jerk significantly. • Impacts of inertia and speed difference on the Harpoon-shift engaging performance are analyzed. Abstract In order to improve shifting quality and the overall efficiency of electric vehicles, this paper presents a multi-gear electric vehicle powertrain system with a Harpoon-shift synchronizer as an alternative to the traditional cone clutch synchronizer. An original dynamic model of the powertrain integrating the model of the Harpoon-shift mechanism is established to investigate the transient responses of driveline system during gear shifting process. In addition, a shifting control method based on a special step function is proposed to improve the driving comfort. Upshift and downshift simulation results validate the effectiveness of the proposed mathematic model and control strategy. Then the torque spring stiffness of Harpoon-shift for each gear is optimized to reduce the shifting jerk. Furthermore, the influences of rotating inertia and speed difference on the shifting jerk of vehicle are quantitatively analyzed. Simulation results demonstrate that the jerk reduces considerably during engagement using the optimized torque springs, which shows the significant advantages of the proposed Harpoon-shift synchronizer compared to traditional synchronizers. [ABSTRACT FROM AUTHOR]

Abstract To alleviate the problem of limited driving range per charge in electric vehicles, a dual clutch transmission based regenerative braking power-on shifting control system is proposed and investigated in this paper. Power-on shifting refers to the shift process where the power flow between the wheel and the power source is not cut off and could be maintained around a desirable value. This character is more important for regenerative braking than the normal driving conditions as the regenerative braking force from the motor accounts for a large part of the total braking force. Due to the difference between the normal driving condition and the regenerative braking process, existing normal driving shifting control strategies, which could introduce significant torque interruption, cannot be directly applied for regenerative braking. As a result, the energy recovery capability and efficiency are compromised. To solve this problem, a power-on shifting control strategy for regenerative braking is proposed as well as an energy-safety oriented braking strategy. To demonstrate the effectiveness of the proposed system, mathematical models are built and dynamic responses of the transmission system during braking both in up-shift and down-shift processes are presented. Moreover, the efficiency and recovery capability improvements made by achieving power-on shifting during regenerative braking are verified through a typical deceleration driving cycle and a specially designed daily deceleration scenario. [ABSTRACT FROM AUTHOR]

Abstract Introduction With over a third of the doctor of pharmacy curriculum relying on experiential education (EE), it is critical that students are assessed and graded in accordance with their actual performance. The objective of this paper is to review advanced pharmacy practice experience (APPE) grading across the Big Ten Academic Alliance to describe how APPE grading occurs at these institutions and highlight differences in approach and outcomes. Methods Experiential directors/deans were asked to import de-identified data (e.g., APPE curriculum, midpoint and final evaluation score and grade, number of preceptors, number of students, number of years of pharmacy school, total hours of APPEs offered, number and duration of APPEs per year, grading scale information). A chi-square test including pairwise comparisons with a Bonferroni p -value adjustment for multiple comparisons was performed. Results Seven college/schools submitted data from over 3600 students between 2012–2015. The distribution of letter grades differed significantly across all colleges/schools in 2012–2013, 2013–2014 and 2014–2015 (p < 0.0001). Similarly, the distribution of letter grades by rotation type varied significantly for all colleges/schools (p < 0.0001). Students in acute care, ambulatory care, and other patient care rotation types were less likely to obtain an "A" and more likely to obtain a "B" compared to students in other rotation types. Conclusions When letter grades are used for APPEs, the trend suggests over 95% of students receive an "A" or "B" grade. Final grades varied by rotation type with more "B" grades observed in patient care rotations than "A" grades over the three-year period. [ABSTRACT FROM AUTHOR]

Owing to a lack of power density of conventional batteries, the onboard energy storage systems of an electric vehicle has to be oversized to compensate worst-case load condition, which is sub-optimal as it induces a heavy penalty on overall system weight and cost. One solution to overcome this limitation is to hybridize it with supercapacitors in order to boost its power performance via a power converter. This paper presents a multi-objective optimization problem over the parameters of such hybrid energy storage systems, with the aims to solve two conflicting objectives – cost and total stored energy in the hybrid energy storage system, under a set of pre-defined design constraints. An algorithm is first developed to find all feasible solutions to the problem. Two popular design examples are then tested differentiating Lithium Iron Phosphate based batteries from Lithium Manganese Oxide/Nickel-Cobalt-Manganese based batteries. A Pareto frontier is recreated for each example and an ξ-constraint method is finally adopted to choose the best member for comparison. This is so far, according to the authors' knowledge, the first reported multi-objective optimal sizing method for an active hybrid energy storage system considering the effect of the power converter to gain a clearer understanding of its impact over various design choices. [ABSTRACT FROM AUTHOR]

Thanks to the lower overall emission of Electric Vehicles, the promising transportation has attracted numerous attentions from industry and academy. However, as a consequence of lower energy density in widely adopted electrochemical energy source-battery, the driving range per charge presents a major barrier for electric vehicle's large-scale commercialization. Additionally, the limited battery life and extra costs associated with its replacement are other negative factors that hinder the development of electric vehicle. Currently, the one-speed gearbox is dominant in electric vehicles' market though it is only a trade-off between manufacturing cost and vehicle performance. Therefore, multi-speed electrified powertrains have been proposed and investigated in this paper to pursue the improvement of energy efficiency and dynamic performance without increasing battery size. In addition, supercapacitor, as the supplementary to battery, is combined with multi-speed transmissions to improve driving range and battery life. The combination of two advanced technologies are investigated in both B and E-class electric vehicle. Results demonstrate that considerable benefits attained for both small and large passenger vehicles through the application of multi-speed transmissions. The effectiveness of hybrid energy storage system in protecting battery from damage is verified. The relationship of hybrid energy storage system and multi-speed transmission is reported. [ABSTRACT FROM AUTHOR]

The target torque of engaging clutches during gearshift is a key factor that affects the dynamic response of powertrains equipped with the dual clutch transmissions (DCT). This paper investigates a method to estimate the target torque of engaging clutches under conditions where engine torque and measurement signals contain white noise and some vehicle parameters (the radius of wheel and rolling friction coefficient) are uncertain. To compute the target torque accurately, the state of system should be estimated when the uncertain parameters exist. The vehicle powertrain is modeled as the 3DOF system when one clutch is closed and the 4DOF system when two clutches are open, while the measured signals include speeds of the engine, transmission, and vehicle (rotational speed of wheels). In addition to traditional extended Kalman filter (EKF), both the joint extended Kalman filter (JEKF) and dual extended Kalman filter (DEKF) are used to estimate the target torque. The simulation results show that DEKF and JEKF provide much higher accuracy in the estimation of target torque than EKF when some parameters of the model are uncertain, so as to produce a better ride performance of the transmission during gearshift, i.e. reduction of power interruption and compressed shifting time. Furthermore, the DEKF provides higher accuracy than the JEKF in estimating uncertain parameters. [ABSTRACT FROM AUTHOR]

This paper studies the reliability of numerical models used for estimating multi-chamber oscillating water column (MC-OWC) response in the time-domain. The model for the internal water surface level and instantaneous pressure inside the chamber at regular waves conditions using a hybrid system of hydrodynamic and thermodynamic rigid piston models without power take-off. Reliability is assessed using experimental data obtained from a wave tank used in the model concept validation. The results show the method could be extended to describe the hydrodynamics of the MC-OWC in regular and irregular wave conditions. [ABSTRACT FROM AUTHOR]

Objectives: To incorporate a published clinical tool related to heart failure (HF) assessment into advanced pharmacy practice experiences in the community pharmacy setting to provide a meaningful and innovative learning experience for students.Setting: Sixteen independent and chain community pharmacies that served as advanced pharmacy practice experience locations.Practice Description: Sixteen community pharmacy locations served as rotation sites and participated in data collection (8 chain and 8 independent).Practice Innovation: This was the first study in which pharmacy students used The One-Minute Clinic for Heart Failure (TOM-C HF) tool to assess HF within the community pharmacy setting.Interventions: Trained student pharmacists identified patients who may have heart failure by evaluating medication dispensing records, interviewed the patient using the TOM-C HF tool, and made interventions as clinically appropriate.Evaluation: The number of students using the TOM-C HF tool, the number and types of interventions made, and student perceptions about the educational and professional value of the patient interaction.Results: Thirty-three of 83 (40%) students completed 63 patient assessments. Thirty-five percent of patients (22/63) were candidates for an intervention. Interventions were performed in 9 of 22 patients (41%). More than 65% of students found the patient interaction to have educational and professional value.Conclusion: Students were able to assess HF patients and make interventions in a community pharmacy setting. The majority of students also perceived some value in these assessments. The incorporation of a clinical tool in the community setting driven by fourth-year pharmacy students has been shown to be feasible and to provide both a novel advanced practice experience. In addition, it may be expandable to the services offered at community pharmacies. [ABSTRACT FROM AUTHOR]

For solving a class of complex symmetric singular linear systems, we propose a parameterized generalized MHSS (PGMHSS) iteration method and investigate the semi-convergence conditions by analyzing the spectrum of the iteration matrix. Then we analyze the optimal iteration parameters that minimize the upper bound of the semi-convergence factor. Numerical experiments are used to test the feasibility and the effectiveness of the PGMHSS iteration method. [ABSTRACT FROM AUTHOR]

Purpose: To compare the diagnostic performance of 18F-fluorocholine positron emission tomography/computed tomography (FCH-PET/CT), multiparametric prostate magnetic resonance imaging (mpMRI), and a combination of both techniques for the detection of local recurrence of prostate cancer initially treated by radiation therapy.Methods and Materials: This was a retrospective, single-institution study of 32 patients with suspected prostate cancer recurrence who underwent both FCH-PET/CT and 3T mpMRI within 3 months of one another for the detection of recurrence. All included patients had to be cleared for metastatic recurrence. The reference procedure was systematic 3-dimensional (3D)-transperineal prostate biopsy for the final assessment of local recurrence. Both imaging modalities were analyzed by 2 experienced readers blinded to clinical data. The analysis was made per-patient and per-segment using a 4-segment model.Results: The median prostate-specific antigen value at the time of imaging was 2.92 ng/mL. The mean prostate-specific antigen doubling time was 14 months. Of the 32 patients, 31 had a positive 3D-transperineal mapping biopsy for a local relapse. On a patient-based analysis, the detection rate was 71% (22 of 31) for mpMRI and 74% (23 of 31) for FCH-PET/CT. On a segment-based analysis, the sensitivity and specificity were, respectively, 32% and 87% for mpMRI, 34% and 87% for FCH-PET/CT, and 43% and 83% for the combined analysis of both techniques. Accuracy was 64%, 65%, and 66%, respectively. The interobserver agreement was κ = 0.92 for FCH-PET/CT and κ = 0.74 for mpMRI.Conclusions: Both mpMRI and FCH-PET/CT show limited sensitivity but good specificity for the detection of local cancer recurrence after radiation therapy, when compared with 3D-transperineal mapping biopsy. Prostate biopsy still seems to be mandatory to diagnose local relapse and select patients who could benefit from local salvage therapy. [ABSTRACT FROM AUTHOR]

As motor-supplied braking torque is applied to the wheels in an entirely different way to hydraulic friction braking systems and it is usually only connected to one axle complicated effects such as wheel slip and locking, vehicle body bounce and braking distance variation will inevitability impact on the performance and safety of braking. The potential for braking energy recovery in typical driving cycles is presented to show its benefit in this study. A general predictive model is designed to analysis the economic and dynamic performance of blended braking systems, satisfying the relevant regulations/laws and critical limitations. Braking strategies for different purposes are proposed to achieve a balance between braking performance, driving comfort and energy recovery rate. Special measures are taken to avoid any effects of motor failure. All strategies are analyzed in detail for various braking events. Advanced driver assistance systems (ADAS), such as ABS and EBD, are properly integrated to work with the regenerative braking system (RBS) harmoniously. Different switching plans during braking are discussed. The braking energy recovery rates and brake force distribution details for different driving cycles are simulated. Results for two of the cycles in an ‘Eco’ mode are measured on a drive train test rig and found to agree with the simulated results to within approximately 10%. Reliable conclusions can thus be gained on the economic benefit and dynamic braking performance. The strategies proposed in this paper are shown to not only achieve comfortable and safe braking during all driving conditions, but also to significantly reduce cost in both the short and long term. [ABSTRACT FROM AUTHOR]

Despite the long-term benefit of battery electric vehicles (BEVs) to customers and environment, the initial cost and limited driving range present significant barriers for wide spread commercialization. The integration of multi-speed transmissions to BEVs’ powertrain systems in place of fixed ratio reduction transmissions is considered as a feasible method to improve powertrain efficiency and extend limited driving range for a fixed battery size. The aim of this paper is to enable the researchers or BEV manufacturers, especially for transmission systems, to estimate whether their products are worthwhile for the customer in terms of the price/performance relationship of others’ design solutions. To do so a generic battery electric vehicle is modelled in Matlab/Simulink® to predict motor efficiency and energy consumption for single reduction, two speeds Dual Clutch Transmission (DCT) and simplified Continuous Variable Transmission (CVT) equipped battery electric vehicles. A credible conclusion is gained, through experimental validation of single speed and two speeds DCT scenarios and reasonable assumptions to support the CVT scenario, that both two speeds DCT and simplified CVT improve the overall powertrain efficiency, save battery energy and reduce customer costs. However, each of the configurations has unique cost and energy consumption related trade-offs. [ABSTRACT FROM AUTHOR]

The development of hybrid electric two wheelers in recent years has targeted the reduction of on road emissions produced by these vehicles. However, added cost and complexity have resulted in the failure of these systems to meet consumer expectations. This paper presents a comparative study of the energy economy and essential costs of alternative forms of small two wheelers such as scooters or low capacity motorcycles. This includes conventional, hybrid, plug-in hybrid and electric variants. Through simulations of vehicle driving range using two popular driving cycles it is demonstrated that there is considerable benefit in fuel economy realised by hybridising such vehicles. However, the added costs associated with electrification, i.e. motor/generator, power electronics, and energy storage provide a significant cost obstacle to the purchase of such vehicles. Only the pure electric configuration is demonstrated to be cost effective over its life in comparison to conventional two wheelers. Both the hybrid electric and plug-in equivalents must overcome significant upfront costs to be cost competitive with conventional vehicles. This is demonstrated to be achieved if the annual driving range of the vehicle is increased substantially from the assumed mean. Given the shorter distances travelled by most two wheeler drivers it can therefore be concluded that the development of similar hybrid electric vehicles are unlikely to achieve the desired acceptance that pure electric or conventional equivalents currently achieve. [ABSTRACT FROM AUTHOR]

Regulator of G-protein signaling (RGS) protein 9-2 is enriched in the striatum where it modulates dopamine and opioid receptor-mediated signaling. RGS9 knockout (KO) mice show increased psychostimulant-induced behavioral sensitization, as well as exhibit higher body weights and greater fat accumulation compared to wild-type (WT) littermates. In the present study, we found gender influences on each of these phenotypic characteristics. Female RGS9 KO mice exhibited greater locomotor sensitization to amphetamine (1.0 mg/kg) treatment as compared to male RGS9 KO mice. Male RGS9 KO mice showed increased body weights as compared to male WT littermates, while no such differences were detected in female mice. Quantitative magnetic resonance showed that male RGS9 KO mice accumulated greater fat mass vs. WT littermates at 5 months of age. Such observations could not be explained by increased caloric consumption since male and female RGS9 KO mice demonstrated equivalent daily food intake as compared to their respective WT littermates. Although indirect calorimetry methods found decreased oxygen consumption and carbon dioxide production during the 12-hour dark phase in male RGS9 KO vs. WT mice which are indicative of less energy expenditure, male RGS9 KO mice exhibited lower levels of locomotor activity during this period. Genotype had no effect on metabolic activities when KO and WT groups were compared under fasting vs. feeding treatments. In summary, these results highlight the importance of factoring gender into the experimental design since many studies conducted in RGS9 KO mice utilize locomotor activity as a measured outcome. [ABSTRACT FROM AUTHOR]

Purpose This study evaluated the impact of an admission medication reconciliation process conducted by student pharmacists during an introductory pharmacy practice experience (IPPE). Methods Patients aged 18 years or older admitted to a general medicine service and who received medication reconciliation from a student pharmacist were included. Data were collected retrospectively from electronic medical records. Results Student pharmacists performed medication reconciliation on 21.8% of 6395 patients admitted to the target service, directly involving the majority of patients/caregivers (78.9%) in the process. Potential medication discrepancies were found in 43.8% of patients; the average number of potential discrepancies found per patient was 1.0 ± 1.6. The most common potential discrepancy was “omitted prescription medication.” Prescribers responded to notification about potential discrepancies by correcting or clarifying 74.9% of all potential discrepancies and 77.2% of discrepancies with the potential to causes severe patient discomfort or clinical deterioration. Conclusion IPPE student pharmacists contributed to patient care by performing medication reconciliation on patient admission to hospital. Student pharmacists identified and facilitated correction of unrecognized medication issues that could have adversely impacted patient well-being. [ABSTRACT FROM AUTHOR]

The authors theorize a method for writing assessment that deemphasizes the traditional privileging of validity and reliability generated from multiple-reader, calibrated scoring of samples of student work. While acknowledging the holistic model's benefits to the field of writing studies, the authors assert that its claims of accuracy and objectivity minimize the numerous tangible and intangible variables that writing teacher/experts understand and value as they evaluate writing. The removal of the “object” – writing artifact – from its context in order to assess it quantitatively diminishes the opportunities for achieving meaningful and pedagogically effective results for a writing program. Rather than calibrating teachers to a rubric, the proposed method here generates a rough calibration of teacher “values” via facilitated conversations, accepting the differences of opinions and “messiness” of teachers’ subjective views of writing. Teachers then periodically assess their students’ performance on these values as well as the course objectives. In this way, the process develops teacher contextual expertise while producing focused assessment data that is both useful for outside agencies and meaningful to the program's goals of improving the teaching of writing. [ABSTRACT FROM AUTHOR]

Abstract: The theoretical analysis of drag torques within a two-speed dual clutch transmission is presented in this article. The numerical models are developed to study the different sources of drag torques in dual clutch transmission. Simulations are performed in Matlab/Simulink platform to investigate the variation of drag torques under different operating conditions. Then an experimental investigation is conducted to evaluate the proposed model using an electric vehicle powertrain test rig. Outcomes of experimentation confirm that simulation results agree well with test data. Therefore the proposed model performs well in the prediction of drag torque for the transmission, and can be applied to assess the efficiency of the transmission. Results demonstrate that the entire drag torque is dominated by the viscous shear in the wet clutch pack and gear churning losses. This lays a theoretical foundation to future research on reducing drag torque and applications of drag torque in powertrain system efficiency optimization. [Copyright &y& Elsevier]

Abstract: The purpose of this paper is to investigate the active damping of automotive powertrains for the suppression of gear shift related transient vibrations. Conventionally, powertrain vibration is usually suppressed passively through the application of torsional dampers in dual clutch transmissions (DCT) and torque converters in planetary automatic transmissions (AT). This paper presents an approach for active suppression of transient responses utilising only the current sensors available in the powertrain. An active control strategy for manipulating engine or electric machine output torque post gear change via a proportional-integral-derivative (PID) controller is developed and implemented. Whilst conventional internal combustion engine (ICE) powertrains require manipulation of the engine throttle, for HEV powertrains the electric machine (EM) output torque is controlled to rapidly suppress powertrain transients. Simulations for both conventional internal combustion engine and parallel hybrid vehicles are performed to evaluate the proposed strategy. Results show that while both the conventional and hybrid powertrains are both capable of successfully suppressing undesirable transients, the EM is more successful in achieving vibration suppression. [Copyright &y& Elsevier]

Abstract: Background: It is known that lung cancer incidence and mortality rate are higher in African Americans (AA) than whites. In Eastern North Carolina, there is a higher percentage of AA population than the national average (30.2% vs. 12.4%) and a higher incidence of lung cancer in this region. We investigated demography and survival of lung cancer patients diagnosed and treated in a single institution. Methods: The study includes 2351 patients diagnosed with lung cancer between 2001 and 2010 at East Carolina University. AA and whites were compared by age, sex, race, stage, histology, smoking history and insurance information using chi-square analyses. Patient survival was modeled using Cox proportional hazards regression (SAS version 9.2). Results: The distribution of lung cancer was 70% in whites and 30% in AA. The proportion of AA and whites differed significantly for age, sex, histology, stage, and insurance. Patients aged >70 (p <0.0001) and 51–70 (p =0.0064) died sooner than those ≤50 years old. Compared with squamous cell, SCLC had inferior survival (HR=2.0, 95%CI=1.7–2.3). Privately insured patients survived longer than those with medicare (p <0.0001), medicaid (p =0.0009), or no insurance (p <0.0001). The survival disadvantage for medicaid (p =0.0076) and no insurance (p =0.0033) persisted on multivariable analysis. Race was not a significant predictor of survival on multivariable analysis (p =0.66). Conclusion: This is one of the largest lung cancer patient populations from a single institution showing demographic differences between the two races with similar survival outcome. Age, histology and type of insurance were strong predictors of survival outcome. Older age, small cell histology and medicaid and no insurance had significantly shorter overall survival. [Copyright &y& Elsevier]

Abstract: Popular methods for simulation of shift control in dual clutch transmissions rely on two assumptions, (1) the application of minimal degrees of freedom for the powertrain model, and (2) the use of mean torque engine models to describe engine torque. Such assumptions will impact on both the observed powertrain response and control of lightly damped powertrains. In this paper these two assumptions are tested through a comparative numerical study of shift transient control through the application of alternate powertrain and engine models. To study the influence of engine torque harmonics, model degrees of freedom, and dual mass flywheels on the transient response of a vehicle powertrain equipped with a dual clutch transmission two powertrain models are presented. Four degree of freedom and 15 degree of freedom models are compared using free vibration analysis and shift transient simulations. Models are then extended to include an engine model with torque harmonics resulting from piston-by-piston firing of the engine with and without the addition of a dual mass flywheel to study the impact on powertrain response. Results indicate that degrees of freedom, engine model, and flywheel model all contribute significantly to variance in powertrain response under each configuration. [Copyright &y& Elsevier]

Abstract: This paper proposes a frequency-domain Magnetic Resonance (MR) spectral processing method based on sparse representation for accurate quantification of prostate spectra. Generally, an observed prostate spectrum can be considered as a mixture of resonances of interest, a baseline and noise. As the resonances of interest often overlap and the baseline is unknown, their separation and quantification can be difficult. In the proposed method, based on the commonly used signal model of prostate spectra and some a priori knowledge of nonlinear model parameters, a dictionary is constructed which can sparsely represent the resonances of interest as well as the baseline in an input spectrum. The estimation of the resonances of interest is achieved by finding their sparse representations with respect this dictionary. A linear pursuit algorithm based on regularized FOCUSS (Focal Underdetermined System Solver) algorithm is proposed to estimate these sparse representations. The robustness and accuracy of prostate spectrum quantification of the proposed method are improved compared with two classical spectral processing methods: model-based time domain fitting and frequency-domain analysis based on peak integration when tested on simulation data. Quantification on in vivo prostate spectra is also demonstrated and the results appear encouraging. [ABSTRACT FROM AUTHOR]

Summary: Background: The non-specific bronchial hyper-responsiveness reported in mild to moderate COPD is usually attributed to reduced airway calibre accentuating the effect of airway smooth muscle shortening. We hypothesized that in more severe COPD the fall in forced expiratory volume in 1second (FEV1) seen during methacholine challenge would result from an increase in residual volume and decrease in vital capacity rather than an increase in airways resistance. Methods: Twenty-five subjects with moderate to severe COPD and 10 asthmatic subjects had spirometry and oscillatory mechanics measured before methacholine challenge and at a 20% fall from baseline post challenge (PC20FEV1). Results: In the COPD subjects median PC20 was 0.35mg/mL. Comparing baseline to PC20 there were significant falls in forced vital capacity (FVC) (2.91 vs. 2.2L; p <0.001), slow vital capacity (3.22 vs. 2.58L; p <0.001) and IC (2.21 vs. 1.75L; p <0.001) without change in FEV1/FVC ratio (0.52 vs. 0.52; not significant) or in total lung capacity where this was measured. Total respiratory system resistance (R5) was unchanged (0.66 vs. 0.68; not significant) but total respiratory system reactance decreased significantly (−0.33 vs. −0.44; p <0.001). In contrast, the asthmatics became more obstructed and showed a proportionally smaller fall in lung volume with increase in R5 (0.43 vs. 0.64; p <0.01). Conclusions: In moderate to severe COPD the fall in FEV1 with methacholine is mainly due to increases in residual volume, which may represent airway closure and new-onset expiratory flow limitation. [Copyright &y& Elsevier]

The demands of cancer cell proliferation alongside an inadequate angiogenic response lead to insufficient oxygen availability in the tumor microenvironment. Within the mitochondria, oxygen is the major electron acceptor for NADH, with the result that the reducing potential produced through tricarboxylic acid (TCA) cycle activity and mitochondrial respiration are functionally linked. As the oxidizing activity of the TCA cycle is required for efficient synthesis of anabolic precursors, tumoral hypoxia could lead to a cessation of proliferation without another means of correcting the redox imbalance. We show that in hypoxic conditions, mitochondrial pyrroline 5-carboxylate reductase 1 (PYCR1) activity is increased, oxidizing NADH with the synthesis of proline as a by-product. We further show that PYCR1 activity is required for the successful maintenance of hypoxic regions by permitting continued TCA cycle activity, and that its loss leads to significantly increased hypoxia in vivo and in 3D culture, resulting in widespread cell death. [Display omitted] • Proline synthesis through PYCR1 is increased in low-oxygen conditions • PYCR1 activity in hypoxia supports TCA cycle function through NADH oxidation • PYCR1 is required for maintenance of hypoxic tumor regions Westbrook et al. show that proline synthesis from glutamine through PYCR1 supports NADH oxidation when oxygen is limited. PYCR1 therefore represents an oxygen-independent means of regenerating NAD+ in hypoxia, supporting continued oxidative TCA cycle activity. Loss of PYCR1 in tumors results in increased hypoxia, reduced cell viability, and necrosis. [ABSTRACT FROM AUTHOR]