Linkage System Research Articles

Analysis on the Utilization of Home Nursing Care Service

Purpose: This study was analyzed the service utilization of subjects who participated in the home nursing care pilot project to improve the home nursing care service management system. Methods: The participants were 944 patients who received home nursing care services during the first and the second pilot project period. The study design was descriptive study to analyze the general characteristics, sickness characteristics, and records of the types of requests and use of home nursing care services. Results: There were many cases of home care nursing patients in the order of cesarean section, cerebral vascular disease, and cancer. The most common types of home care requests were suture removal and OP site dressing. The performance of home care was in the order of patient and caregiver education/training, dressing, removal of sutures, and breast massage. Conclusion: To activate the home nursing care service of medical institutions, it is necessary to supply more professional, efficient, and appropriate home nursing care services and establish a linkage system with other welfare services.

Modeling of Tractor Fuel Consumption

In this paper, the energy diagnostic of tractor performance consists in evaluating the energy (fuel consumption per hectare—dm3 ha−1) for a given agricultural operation and in combining it with working capacity, also called productivity (area productivity—ha h−1). One of the methods of solving this problem is the identification of the functioning process of the machine unit. A model of the process of the machine unit performance was developed, considering the operation of the rear linkage system of the implement with the force control adjustment system. In order to analyze the system, a mathematical model of the system function was built: tractor-implement-soil, defining the physical connections and interdependencies between the individual subsystems of the system. Based on this model, a simulation model was developed and implemented in the Matlab/Simulink environment. The Simulink package was used to test the performance of the machine set. The efficiency indicators according to the adopted criteria were calculated in the evaluation block. To evaluate the process, the technical and operational parameters of the tractor, the type and parameters of the tool, and soil properties were taken into account. The results of simulation studies obtained on a validated model are consistent with experimental data from appropriate soil conditions.

Childhood asthma and cardiovascular morbidity and mortality in adulthood: The Busselton Health Study.

Long-term childhood asthma studies that investigate adult outcomes other than respiratory morbidity are lacking. This study examines the associations of childhood asthma and the occurrence of cardiovascular disease (CVD) events and mortality in adulthood. A cohort of 4430 school children (aged 17 years) who attended the Busselton Health Study between 1967 and 1983 were analyzed. Self-reported history of doctor-diagnosed asthma was determined based on the questionnaire. Subsequent CVD events (hospital admissions or death) up to 2014 were identified using the Western Australia Data Linkage System. Cox regression models were used to investigate the impact of childhood asthma on CVD events and mortality in adulthood. A subgroup of 2153 participants who re-attended a survey in young adulthood was also analyzed. A total of 462 (10%) of the cohort had childhood asthma. During follow-up, 867 participants experienced a CVD event and 22 participants died from CVD. Childhood asthma was not associated with the risk of CVD events in adulthood (HR, 1.12; 95% CI: 0.91-1.39; p = .2833) and this persisted after adjustment for confounders. Childhood asthma was not associated with coronary heart disease events (HR, 0.72; 95% CI: 0.40-1.30; p = .2761), heart failure events (HR, 0.55; 95% CI: 0.07-4.13; p = .5604) or CVD mortality (HR, 0.91; 95% CI: 0.21-3.89; p = .8987) in adulthood. Childhood asthma is not associated with the risk of CVD events and mortality in adulthood.

Comparative performance analysis of hybrid differential evolution and pattern search technique for frequency control of the electric power system

In the current situation, operation and control of power system is a greater challenge. The most significant situation in power system control is load frequency control. In the present work, a hybrid differential evolution and pattern search (hDE-PS) method has been suggested for frequency regulation of electrical power systems. Fractional-order proportional integral derivative (FOPID) controller is implemented for design and analysis purpose. The suggested control method has been applied for two electrical power systems model, i.e., 2-area diverse source power system with/without HVDC linkage and 2-area thermal system. The performances of the suggested controller have been evaluated with PID and optimal controller. The simulation results indicate that system performances are enhanced with the suggested approach for identical structure. Robustness of the suggested approach has been analyzed by variation in random load and the system parameters. The suggested method (hDE-PS tuned FOPID) is further investigated with a 2-area thermal system. The performance of the recommended approach is analyzed by equating the results with other newly available approaches, like Genetic Algorithm (GA), Bacteria Foraging Optimization Algorithm (BFOA), Particle Swarm Optimization (PSO), hybrid BFOA and PSO (hBFOA-PSO), multi-objective Non-dominated Sorting Genetic Algorithm (NSGA)-II and Firefly Algorithm for the similar structure.

Impact of a physician - critical care practitioner pre-hospital service in Wales on trauma survival: a retrospective analysis of linked registry data.

The Emergency Medical Retrieval and Transfer Service for Wales launched in 2015. This service delivers senior pre-hospital doctors and advanced critical care practitioners to the scene of time-critical life- and limb-threatening incidents to provide advanced decision-making and pre-hospital clinical care. The impact of the service on 30-day mortality was evaluated retrospectively using a data linkage system. The study included patients who sustained moderate-to-severe blunt traumatic injuries (injury severity score≥9) between 27 April 2015 and 30 November 2018. The association between pre-hospital management by the Emergency Medical Retrieval and Transfer Service and 30-day mortality was assessed using multivariable logistic regression. In total, data from 4035 patients were analysed, of which 412 (10%) were treated by the Emergency Medical Retrieval and Transfer Service. A greater proportion of patients treated by the Emergency Medical Retrieval and Transfer Service had an injury severity score≥16 and Glasgow coma scale≤12 (288 (70%) vs. 1435 (40%) and 126 (31%) vs. 325 (9%), respectively). The unadjusted 30-day mortality rate was 11.7% for patients managed by the Emergency Medical Retrieval and Transfer Service compared with 9.6% for patients managed by standard pre-hospital care services. However, after adjustment for differences in case-mix, the 30-day mortality rate for patients treated by the Emergency Medical Retrieval and Transfer Service was 37% lower (adjusted odds ratio 0.63 (95%CI 0.41-0.97); p=0.037). The introduction of an emergency medical retrieval service was associated with a reduction in 30-day mortality for patients with blunt traumatic injury.

Long-term Incidence of Kawasaki Disease in a North American Community: A Population-Based Study.

To assess the longitudinal incidence of Kawasaki disease (KD) within the well-defined predominantly White population of Olmsted County, MN. This retrospective cohort study used a population-based medical record linkage system and manual chart reviews to identify children with KD in Olmsted County, MN between January 1, 1979-December 31, 2016. Age- and gender-adjusted incidence rates were calculated using the 2010 U.S. White population. 124 children with KD were confirmed during the study period (median age 3.5, 61% male, 85% White, 9% Asian). The overall age- and gender-adjusted incidence rates for all ages and < 5 years old were 9.8 and 21.4 per 100,000 person-years, respectively. There was an overall increase in incidence up to 1994 followed by plateau, except among children between the ages of 1–5 years. There was also an overall increase in incidence among females compared to males. 24% of children had cardiac complications. While the overall incidence of KD in Olmsted County appears to be stable since 1994, the incidence of KD in subgroups of children 1–5 years old and females seems to have increased. Given the rising trends and one-quarter of children developing cardiac complications, further studies identifying factors driving these trends are warranted.

Structural Elements, Synergy Mechanism and System Optimization of Atmospheric Environmental Self-cleaning Capability

On the basis of defining the connotation and structural elements of atmospheric environmental self-cleaning capability, this paper systematically analyses the synergy mechanism of atmospheric environment self-cleaning capability, and puts forward the system optimization of atmospheric environmental self-cleaning capability. The self-cleaning ability of the atmospheric environment mainly includes nature’s ability to cleanse itself and rationality of human design. The synergy mechanism of self-cleaning capability of nature mostly refers to the fact that pollutants in the atmosphere can be transformed chemically or scavenged by means of the dry deposition, wet deposition, transportation and dispersion of atmospheric hydrometeors, such as rain, snow, wind, geography, humidity and the like. The synergy mechanism of rationality of human design chiefly refers to the human ability to take a variety of comprehensive prevention and control measures such as reasonable urban planning, wind tunnel design, hydraulic facilities, pollution source layout and others to make the most of nature’s self-cleaning capability and the ability to reduce the impact of the atmospheric pollutants. On this basis, seven measures have been proposed system optimization of atmospheric environmental self-cleaning capability. First, we should quicken the construction of artificial wetlands in areas with lower atmospheric self-cleaning capability; second, we should rapidly improve the vegetation coverage rate in the areas with low atmospheric self-cleaning capability; third, we should systematically plan urban construction in areas with lower atmospheric self-cleaning capability; fourth, we should scientifically construct urban air ducts in the area with low atmospheric environment self-cleaning capability; fifth, we should work out scientific production plans for the pollution intensive industries and gradiently transferring pollution intensive industries; sixth, we should vigorously propel the ecological migration work in areas with lower atmospheric self-cleaning capability; seventh, we should strengthen the construction of a linkage system of atmospheric environment self-cleaning capability.

Ceramide Scores Predict Cardiovascular Risk in the Community

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Long-term fate of aortic branches in patients with aortic dissection

ObjectiveLate morbidity and mortality related to aortic branches in patients with aortic dissection (AD) have not been well described. We investigated the fate of aortic branches in a population cohort of patients with newly diagnosed AD. MethodsWe used the Rochester Epidemiology Project record linkage system to identify all Olmsted County, Minnesota, residents with a diagnosis of AD from 1995 to 2015. Only patients with >30 days of available follow-up imaging studies were included in the present analysis. The primary outcome was freedom from any branch-related event (any intervention, aneurysm, malperfusion, rupture, or death occurring after the acute phase >14 days). The secondary outcome was the diameter change in the aortic branches. Univariate and multivariable Cox proportional hazards models were used to identify the predictors of branch-related events. Univariate and multivariate linear regression models were used to assess the aortic branch growth rate. ResultsOf 77 total incident AD cases, 58 patients who had survived and had imaging follow-up studies available were included, 28 (48%) with type A and 30 (52%) with type B AD. The presentation was acute in 39 patients (67%), 6 (10%) of whom had had branch malperfusion. Of 177 aortic branches involved by the AD, 81 (46%) had arisen from the true lumen, 33 (19%) from the false lumen, and 63 (36%) from both. After the acute phase, freedom from any branch-related event at 15 years was 48% (95% confidence interval [CI], 32%-70%). A total of 31 branch-related events had occurred in 19 patients within 15 years, including 12 interventions (76% freedom; 95% CI, 63%-92%), 10 aneurysms (67% freedom; 95% CI, 50%-90%), 8 cases of malperfusion (76% freedom; 95% CI, 61%-94%), and 1 rupture (94% freedom; 95% CI, 84%-100%). No branch-related deaths had occurred. Type B AD (hazard ratio [HR], 3.5; 95% CI, 1.1-10.8; P = .033), patency of the aortic false lumen (HR, 6.8; 95% CI, 1.1-42.2; P = .038), and malperfusion syndrome at presentation (HR, 6.0; 95% CI, 1.3-28.6; P = .023) were predictors of late aortic branch-related events. The overall growth rate of aortic branches was 1.3 ± 3.0 mm annually. Patency of the aortic false lumen, initial branch diameter, and Marfan syndrome were significantly associated with diameter increase. ConclusionsIn patients with AD, aortic branch involvement was responsible for significant long-term morbidity, without any related mortality. Type B AD, patency of the aortic false lumen, and malperfusion syndrome at presentation resulted in a greater risk of branch events during the long-term follow-up. Dilatation of the aortic branches was observed in one third of cases during follow-up, especially in the case of a patent aortic false lumen or the presence of Marfan syndrome.

Mathematical model for studying the operation of a machine-tractor unit with a tractor «DT-175S» with an elastic element in the linkage system

The increase in engine power and the speed of movement of the machine-tractor unit leads to an increase in the amplitude and frequency of oscillations of the hook force. At the same time, the magnitude of these effects depends on fluctuations in the hook load, the nature of the work process, the dynamics of operating modes and the frequency properties of the transmission. Reducing the nature of transient dynamic loads can be achieved by using elastic connections in the tractor structure. The issues of a rational combination of increased operating power of the engine with a simultaneous decrease in dynamic loads in the transmission exacerbate the problem of choosing rational modes of operation of the machine-tractor unit. Uneven hook load causes fluctuations in the engine crankshaft rotation speed, an increase in the load on the transmission parts and, consequently, a decrease in power and an increase in engine fuel consumption. Therefore, to protect the transmission from vibrations that occur in the engine-transmission system, special damping devices are used. A characteristic feature of the device, which is the possibility of using elastic - damping elements, allowing to reduce the frequency of natural vibrations of the transmission.

일본의 허가특허연계제도 및 우리에게 주는 시사점

일본의 허가특허연계제도 및 우리에게 주는 시사점

Neuromechanical linkage between the head and forearm during running.

The main objective was to test the hypothesis of a neuromechanical link in humans between the head and forearm during running mediated by the biceps brachii and superior trapezius muscles. We hypothesized that this linkage helps stabilize the head and combats rapid forward pitching during running which may interfere with gaze stability. Thirteen human participants walked and ran on a treadmill while motion capture recorded body segment kinematics and electromyographic sensors recorded muscle activation. To test perturbations to the linkage system we compared participants running normally as well as with added mass to the face and the hand. The results confirm the presence of a neuromechanical linkage between the head and forearm mediated by the biceps and superior trapezius during running but not during walking. In running, the biceps and superior trapezius activations were temporally linked during the stride cycle, and adding mass to either the head or hand increased activation in both muscles, consistent with our hypothesis. During walking the forces acting on the body segments and muscle activation levels were much smaller than during running, indicating no need for a linkage to keep the head and gaze stable. The results suggest that the evolution of long distance running in early Homo may have favored selection for reduced rotational inertia of both the head and forearm through synergistic muscle activation, contributing to the transition from australopith head and forelimb morphology to the more human-like form of Homo erectus. Selective pressures from the evolution of bipedal walking were likely much smaller, but may explain in part the intermediate form of the australopith scapula between that of extant apes and humans.

Thrust bearing with fluid pivot

This article describes the conditions arising from the operation of compressor and pumping equipment using traditional thrust bearings with mechanical support and leveling linkage system, which negatively affect the operation of dynamic machines in general and the thrust bearing in particular. The possibility of using the hydrodynamic pressure of an oil wedge for hydrostatic support in a thrust bearing was considered, and what positive effects could arise. The working design of a thrust bearing with fluid pivot and a calculation model are shown, allowing to take into account the hydrostatic oil film when determining the characteristics of the bearing. The results of the first tests of the bearing on the stand allow us to evaluate the performance of the design and determine further improvement and optimization of the design of the bearing with fluid pivot.

A Study on Major law related to National⋅Urban-Environmental planning according to the Land-environment linkage system

A Study on Major law related to National⋅Urban-Environmental planning according to the Land-environment linkage system

Design and Modeling of an Impulse Continuously Variable Transmission with a Rotational Swashplate

A novel mechanical impulse continuously variable transmission (ICVT) is developed to provide continuously variable speed ratios and smooth acceleration for drivetrains based on a rotational swashplate, and its design principle is illustrated. A swashplate-guide linkage mechanism is used in the ICVT; the speed ratio of the ICVT is changed with the swirl angle of the rotational swashplate. A slider–linkage system, whose mo-tion is controlled by a speed-regulating handle, is used to adjust the swirl angle of the swashplate. A planetary gear system converts the regulated rotational speed of the swashplate to the output shaft of the ICVT. The speed range of the ICVT can be scaled up by coupling planetary gear sys-tems with different speed ratios. Overrunning clutches are used to rectify the rotational speed from the swashplate-guide linkage mechanism to ob-tain the output speed of the ICVT. Since the rotational swashplate can in-troduce large impulse rates of the instantaneous speed ratio, a connecting linkage is used to reduce the impulse rate and unbalanced inertial forces of the ICVT. Experimental tests of the output speed of the ICVT with four guide linkages verify the feasibility of the design and operation perfor-mance of the ICVT.

701. Blood Stream Infection And Risk Of Endocarditis Following Cardiac Valve Repair: A Population-Based Study

BackgroundBloodstream infections (BSIs) confer an increased risk of infective endocarditis (IE) in patients with a prosthetic cardiac valve. This relationship is less well established in patients undergoing valve repair. We conducted a retrospective population-based study to determine the incidence of BSIs following valve repair and identify risk factors associated with the development of IE.MethodsThe Rochester Epidemiology Project (REP) data linkage system was used to identify all persons who underwent valve repair in a 7-county region in Southeastern Minnesota between January 1, 2010 and December 31, 2018. Medical records were screened for the development of a BSI from time of procedure until May 15, 2020. Patients were classified as having BSI only, BSI with IE at outset, or BSI with subsequent development of new IE. IE at outset was defined as cases where IE was diagnosed at the time of initial positive blood culture.ResultsA total of 387 patients underwent valve repair surgery. A total of 31 (8%) patients subsequently developed a BSI, 4% within one year of surgery. Seventeen patients underwent mitral repair with annuloplasty, 9 underwent tricuspid annuloplasty, and 5 had concurrent repairs. Median time to the development of BSI was 338 days. Of the 31 patients with BSI, 4 (13%) had BSI with IE at outset. No patients developed IE subsequent to BSI, Enterococcus spp. was responsible for 3 cases of IE, and MSSA for 1. All cases occurred within one year of surgery. Given the low incidence, statistical analysis of associated risk factors for IE was not feasible. All patients with BSI and IE at outset, however, died by the end of the study period, versus 11/27 in the BSI only group.ConclusionIncidence of BSIs was higher in patients undergoing cardiac valve repair than in the general population. The incidence of IE with a BSI was 13%, which is lower than what has been previously published. It is notable that all cases of IE occurred within one year of surgery. Recognizing that endothelialization of device surfaces occurs, it is tempting to speculate that the risk of IE may be time dependent and may decline over time. Subsequent investigation of this theory is underway.DisclosuresLarry M. Baddour, MD, Boston Scientific (Consultant)

호텔경영학 교육과정에서 주말현장실습 운영방안 연구 : D대학 호텔경영학전공 운영 사례 중심 현상학적 접근

This study aims to explain the importance of field training raised in the curriculum of the hotel management major, especially to consider the introduction of an operating system in the form of weekend field training. Experimental cases we tried to derive the implications through in-depth interview of 7 students, and research was conducted according to a phenomenological approach. First, looking at the motives for participation in the weekend field training, most of the cases were aimed at linking to employment or industry experience, and a combination of economic goals was accompanied by a complex choice. The activity content of the weekend field training was not much different from that of the existing hotel field training, so it was mainly in charge of auxiliary work for front-line workers in field work such as concierge and F&B service, and served as a practice process for career advancement. The operational results of the weekend field training include help in making career decisions for students, establishing a personal network with employees in the hotel, linking to long-term field training after the weekend field training as a short-term field training, salary paid by the hotel, and government subsidies. In terms of problems and improvement directions of weekend field training, curriculum formation to relieve physical and mental fatigue in combination with education/practice, difficulty in forming relationships with workers, and various experience opportunities through rotational work, uncertainty in the process linking practice, and due to the lack of preparation in advance, it was required to establish a systematic linkage system and reinforcement of additional educational content during the week.

Depression and the Risk of Fractures in Later Life: the Health In Men Cohort Study

IntroductionFractures are common and disabling health events, particularly later in life. The presence of clinically significant depressive symptoms has been associated with increased risk of fractures, and we designed the present study to clarify if this association is likely to be causal or due to the confounding effect of measures associated with both fractures and depression. MethodCohort study of a community-derived sample of 4224 men aged 70 to 88 years at the start of the follow-up period of up to 17 years. Clinically significant symptoms of depression were defined as a recorded diagnosis of depressive episode in the Western Australian Data Linkage System (WADLS) or by a total score of 7 or greater on the 15-item Geriatric Depression Scale. Health contacts associated with fractures were retrieved from WADLS. Other measures included age, past history of fractures, education, smoking, frailty, poor vision, falls, medications, and the concentration of vitamin D, homocysteine, hsCRP and testosterone. Death was considered a competing risk for fractures. Results911 (21.6%) participants had a bone fracture during follow-up. After adjustment for multiple potential confounders, past and current depression were associated with an increase in the risk of novel fractures; respective odds ratios were 1.41 (95%CI = 1.03, 1.93) and 1.64 (95%CI = 1.20, 2.25). Parsimonious competing risk regression showed that both past and current depression were associated with an increase in the risk of novel fractures: sub-hazard ratio = 1.29 (95%CI = 1.03, 1.63) and 1.27 (95%CI = 1.05, 1.55) respectively. Estimation of confounding due to unmeasured factors showed that a small additional effect could potentially dilute the association between depression and fractures. DiscussionHistory of clinically significant symptoms of depression is associated with an increased risk of future fractures. This association may be due to multiple other associated risk factors, both measured and unmeasured, but nevertheless the presence of depression should alert clinicians to the need to develop a management plan that includes the management not only of depression but also of fracture risk.

Improving Inter-Agency Data Sharing Through Linkage Spine Interoperability

IntroductionLinkage of Federal Government data in Australia is conducted primarily through Accredited Integrating Authorities (AIAs). These agencies hold different dataset from Commonwealth and state/territory government agencies. Historically, linkage projects involving data held by different AIAs has been inefficient, requiring the transfer of identifiable data between agencies, and relinking data that have already been linked by another agency.&#x0D; Objectives and ApproachTwo AIAs (the AIHW and ABS) have developed a system of interoperable linkage spines to address this issue. By using common datasets as a base, the agencies have improved the efficiency and security of linkage projects.&#x0D; This process was developed through an analysis of spine datasets, and two test projects to share data between the agencies.&#x0D; ResultsThe two test projects were successfully able to link cross-portfolio and cross-jurisdictional data without the need to share additional identifying information between the AIAs. Preliminary results suggest a high linkage rate from this process, and work is underway to quantify the linkage quality compared to traditional linkage methodologies. The ABS and AIHW are also investigating the implications for linkage quality as more datasets are included in the agencies’ linkage spines.&#x0D; Conclusion / ImplicationsThe success of this project will increase the efficiency of cross-jurisdictional and cross-portfolio linkage in Australia. It will also allow specialised AIAs to work on datasets where they have specific expertise, and feed these into broader projects. This is expected to have an additional impact on public trust in the linkage system, by minimising the sharing of personally identifiable information while still maintaining high quality linkage.

NGLMS-CR: A Web-Based Clerical Review Tool

Native applications often require special permissions to install and update which may not always be available in secure/controlled sensitive-data environments. Deploying new features can be time-consuming and introduce delays. The Next Generation Linkage System Clerical Review tool (NGLMS-CR) is a configurable web application which side-steps these issues. The NGLMS-CR allows rapid response to changing project requirements.&#x0D; Objectives and ApproachWe wanted a lightweight platform-independent tool to run in any modern web-browser. This avoids a need for special administrative privileges and allows rapid deployment/update. The NGLMS-CR communicates via a simple RESTful protocol to a server managing user-permissions, workflows and review data. Data is stored in a relational or graph database. The NGLMS-CR does not require a graph database.&#x0D; Users see various workpools (collections of records) and work through these at their own pace. Different workpools may be configured for different requirements, e.g. clusters requiring special expertise, clusters requiring higher data security, overly-large clusters &amp;c. Custom workflows are built around workpools. Individual clusters can have customisable status indicators displayed to highlight integrity checks and other information, e.g. a cluster containing multiple birth records or containing records with inconsistent gender information.&#x0D; The tool also promotes ergonomic and health objectives as well as collecting metrics about review activity. The review session tracks reviewer engagement and gives feedback on the situation so far: how long has been spent reviewing; how long activity has been undertaken without a break. The user is given visual warnings when sessions extend beyond a set time. Activity is logged and metrics regarding throughput/accuracy collated for analysis.ResultsIn real-time manual clerical review tasks the customisable nature of the NGLMS-CR has proven important. Changes are immediately visible to users and workflow and status icons changes available with no delay while software is ‘rolled out’.&#x0D; Conclusion / ImplicationsUncoupling review from any particular linkage system enables flexibility in project administration. A web-based review application may run on any system and requires minimal administrative permissions. This facilitates deployment in sensitive environments. Customisable workflow allows quick creation of ad hoc projects/tasks, even mid-project as new situations are discovered. Customisable cluster integrity checks allows cluster- and project-sensitive feedback to be rapidly deployed to aid review. By being flexible and independent the NGLMS-CR can supplement and complement existing linkage and review processes.