Our multidisciplinary team examined published regulatory data to inform a 50-state database describing the environment for midwifery practice and interprofessional collaboration. Items (110) detailed ...differences across jurisdictions in scope of practice, autonomy, governance, and prescriptive authority; as well as restrictions that can affect patient safety, quality, and access to maternity providers across birth settings. A nationwide survey of state regulatory experts (n = 92) verified the 'on the ground' relevance, importance, and realities of local interpretation of these state laws. Using a modified Delphi process, we selected 50/110 key items to include in a weighted, composite Midwifery Integration Scoring (MISS) system. Higher scores indicate greater integration of midwives across all settings. We ranked states by MISS scores; and, using reliable indicators in the CDC-Vital Statistics Database, we calculated correlation coefficients between MISS scores and maternal-newborn outcomes by state, as well as state density of midwives and place of birth. We conducted hierarchical linear regression analysis to control for confounding effects of race.
MISS scores ranged from lowest at 17 (North Carolina) to highest at 61 (Washington), out of 100 points. Higher MISS scores were associated with significantly higher rates of spontaneous vaginal delivery, vaginal birth after cesarean, and breastfeeding, and significantly lower rates of cesarean, preterm birth, low birth weight infants, and neonatal death. MISS scores also correlated with density of midwives and access to care across birth settings. Significant differences in newborn outcomes accounted for by MISS scores persisted after controlling for proportion of African American births in each state.
The MISS scoring system assesses the level of integration of midwives and evaluates regional access to high quality maternity care. In the United States, higher MISS Scores were associated with significantly higher rates of physiologic birth, less obstetric interventions, and fewer adverse neonatal outcomes.
We show for the first time, with direct, multispacecraft calculations of electric current density, and other methods, matched signatures of field‐aligned currents (FACs) sampled simultaneously near ...the ionosphere at low (~500 km altitude) orbit and in the magnetosphere at medium (~2.5 RE altitude) orbits using a particular Swarm and Cluster conjunction. The Cluster signatures are interpreted and ordered through joint mapping of the ground/magnetospheric footprints and estimation of the auroral zone boundaries (taken as indication of the boundaries of Region 1 and Region 2 currents). We find clear evidence of both small‐scale and large‐scale FACs and clear matching of the behavior and structure of the large‐scale currents at both Cluster and Swarm. The methodology is made possible through the joint operations of Cluster and Swarm, which contain, in the first several months of Swarm operations, a number of close three‐spacecraft configurations.
Key Points
Gives correlated FAC signatures between low (~500 km) and high (~4 RE) altitudes
Resolves large‐ and small‐scale structures at low altitude
Confirms the scaling of current strength at each location
Tire-road friction coefficient is an important parameter for vehicle stability and active safety systems. However, precise measurement of tire-road friction coefficient is hard to achieve without ...expensive equipment. Considering easy availability and good economy, this paper proposes a method which first combines auxiliary particle filter and the iterated extended kalman filter (APF-IEKF), and then processes the results of the first step using iteration algorithm. APF-IEKF is used to estimate the slip angle of the front tires with strong nonlinearity and non-Gaussian noise, in which APF filters non-Gaussian noise and reach a preliminary estimation of sideslip angle, then IEKF is used to optimize the result, making the estimation of the sideslip angle more accurate. The iteration algorithm is used to estimate the tire-road friction coefficient based on self-aligning torque, which is more sensitive to tire slip angle and provides faster estimation. In this way, this method can estimate tire road friction coefficient more accurately and in real time. Both numerical simulation in Carsim/Simulink and actual off-vehicle tests in winter are provided to demonstrate the efficiency of the proposed algorithm.
•A method that combines APF-IEKF and iteration algorithm is proposed for tire-road friction coefficient.•Tire slip angle estimated by APF-IEKF is much more accurate than common UKF because it is fit for non-Gaussian noise.•Tire-road friction coefficient estimate by proposed method is also much more accurate.
Selective laser melting (SLM) is one type of metal additive manufacturing technology. Large thermal gradient during SLM process leads to differences in microstructures and further influences ...mechanical properties, resulting in anisotropy. However, the influence of the anisotropic microstructures on the wear behavior has not been studied. This is crucial for fabricating a wear resistant surface using SLM. In this paper, 316L stainless steel samples were produced using SLM and the microstructures of three different surfaces were characterized. The wear behaviors on different surfaces along six scratching directions including Fx, Fz, Sy, Sz, Tx and Ty were studied by performing single and multiple passes scratch tests. The results indicate that the top surface is mainly composed of cellular structures while the side surface is characterized by columnar structures. Both columnar and cellular structures are found in the front surface. Under the load of 1 N, significant difference in scratch depths was found between Sy and Sz. The main failure mechanism is found to be due to slipping. Both highest and lowest wear appear on the side surface in two sliding directions: Sy exhibits the highest wear resistance while Sz shows the lowest wear resistance. Under 3 N, the difference between different sliding directions is less pronounced with the fracture of cellular structure while Sy still shows the lowest scratch depth. Under 5 N, similar wear behavior in terms of cracking were found in all scratch grooves.
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•Wear anisotropy of SLMed 316L stainless steel was studied by scratch tests.•Crystal structures and the direction of grains are crucial to wear resistance.•Wear damage transforms from slipping to fracture to crack with increased load.•Wear anisotropy is prominent under the low load.
Summary Introduction Matrix metalloproteinases and ‘aggrecanase’ ADAMTSs are well established to play key roles in osteoarthritis (OA) through degradation of extracellular matrix type II collagen and ...aggrecan, and are thus potential targets for development of OA therapies. Objective This paper aims to provide a comprehensive review of the expression and potential roles of other, lesser-known ADAMTSs and related adamalysins (or ADAMs) in cartilage, with a view to identifying potentially protective or homeostatic metalloproteinases in the joint and informing consequent selective inhibitor design. Design A comprehensive literature search was performed using PubMed terms ‘osteoarthritis’ and ‘ADAMTS’ or ‘ADAM’. Results Several ADAMTSs and ADAMs were identified as having reportedly increased expression in OA. These include enzymes likely to play roles in cartilage matrix anabolism (e. g. the procollagen N-proteinases ADAMTS-2, ADAMTS-3 and ADAMTS-14), chondrocyte differentiation and proliferation (e. g. ADAM9, ADAM10, ADAM12), as well as enzymes contributing to cartilage catabolism (e. g. COMP-degrading ADAMTS-7 and ADAMTS-12). Conclusions In addition to the well-characterised MMPs, ADAMTS-4 and ADAMTS-5, many other ADAMTSs and ADAMs are expressed in cartilage and several show significantly altered expression in OA. Studies aimed at elucidating the pathophysiological roles of these enzymes in cartilage will contribute to our understanding of OA pathogenesis and enable design of targeted inhibitors that effectively target metalloproteinase-mediated cartilage degradation while sparing cartilage repair pathways.
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