bluuebunny/crossref_metadata_2025 huggingface dataset:
Ex vivo mechanical properties of a 2.5‐mm bone anchor for treatment of cranial cruciate ligament rupture in toy breed dogs
Authors: Roca Rodrigo Y. , Peura Aliisa , Kowaleski Michael P. , Watson Mallory T. , Lendhey Matin , Rocheleau P. J. , Hulse Donald A.
Published: February 2020

Objective

To determine the mechanical pull‐out properties of a 2.5‐mm bone anchor implanted in ex vivo femurs of toy breed dogs and to determine whether there is a difference between knotted and knotless configurations.

Study design

Experimental study.

Sample population

Eight paired harvested femurs.

Methods

Femurs were assigned to knotted or knotless configuration. Equal numbers of right and left femurs were tested. The caudolateral femoral condyle at the distal pole of the lateral fabella (F2 site) was drilled. The assigned configuration with braided suture combined with the bone anchor was implanted into the F2 site. Each configuration was positioned into a mechanical testing machine to measure yield load, load at 3‐mm displacement, ultimate load, stiffness, and mode of failure at the beginning of the canine standing phase angle (150°).

Results

Mean ultimate load was 100.14 and 88.69 N (P= .798), mean yield load was 59.72 and 55.85 N (P= .708), load at 3‐mm displacement was 46.72 and 43.33 N (P= .656), and stiffness was calculated to be 43.06 and 47.09 N/mm (P= .548) for knotted and knotless configurations, respectively. Mode of failure occurred primarily by anchor pull‐out.

Conclusion

The bone anchor withstood deformation at the estimated forces applied on the native cranial cruciate ligament (CCL) of toy breed dogs in both configurations.

Clinical significance

This bone anchor may constitute a useful alternative for stabilization of the CCL deficient stifle in toy breed dogs. However, before it can be recommended for widespread use in dogs, closely monitored clinical trials must be conducted to assess outcome and complications associated with this implant.
Hierarchical Nonlinear Moving Horizon Estimation of Vehicle Lateral Speed and Road Friction Coefficient
Authors: Jin Chi , Maitland Anson , McPhee John
Published: February 2020

In this paper, we address nonlinear moving horizon estimation (NMHE) of vehicle lateral speed, as well as the road friction coefficient, using measured signals from sensors common to modern series-production automobiles. Due to nonlinear vehicle dynamics, a standard nonlinear moving horizon formulation leads to non-convex optimization problems, and numerical optimization algorithms can be trapped in undesirable local minima, leading to incorrect solutions. To address the challenge of non-convex cost functions, we propose an estimator with a two-level hierarchy. At the high level, a grid search combined with numerical optimization aims to find reference estimates that are sufficiently close to the global optimum. The reference estimates are refined at the low level leading to high-precision solutions. Our algorithm ensures that the estimates converge to the true values for the nominal model without the need for accurate initialization. Our design is tested in simulation with both the nominal model as well as a high-fidelity model of Autonomoose, the self-driving car of the University of Waterloo.
A Fluid–Structure Interaction Study on a Bionic Fish Fin With Non-Uniform Stiffness Distribution
Authors: Luo Yang , Xiao Qing , Shi Guangyu
Published: February 2020

In this paper, the propulsive performance of a caudal peduncle-fin swimmer mimicking a bio-inspired robotic fish model is numerically studied using a fully coupled FSI solver. The model consists of a rigid peduncle and a flexible fin which pitches in a uniform flow. The flexible fin is modeled as a thin plate assigned with non-uniformly distributed stiffness. A finite volume method based in-house Navier–Stokes solver is used to solve the fluid equations, while the fin deformation is resolved using a finite element code. The effect of the fin flexibility on the propulsive performance is investigated. The numerical results indicate that compliance has a significant influence on performance. Under the parameters studied in this paper, the medium flexible fin exhibits remarkable efficiency improvement, as well as thrust augment, while the least flexible fin shows no obvious difference from the rigid one. However, for the most flexible fin, although the thrust production decreases sharply, the efficiency reaches the maximum value. It should be noted that by non-uniformly distributing the rigidity across the caudal fin, our model is able to replicate some fin deformation patterns observed in both the live fish and the experimental robotic fish.
Design of Novel Gas Foil Thrust Bearings and Test Validation in a High-Speed Test Rig
Authors: LaTray Nguyen , Kim Daejong
Published: February 2020

Small gas foil bearings (FBs) with shaft diameter below 25 mm can find many applications in air compressors for fuel cells, electrical turbo chargers, small unmanned air vehicles, turbo alternators, etc. These small machines are characterized by very light load to the radial FBs, and thus rotordynamics stability is more challenging than load capacity. However, a main challenge of gas foil thrust bearings (GFTBs) is how to increase the load capacity, and the challenge remains the same regardless of the size. In previous publications on experimental studies on GFTBs, the measured load capacity is well below the prediction due to challenges in testing as well as manufacturing of GFTBs. Difficulty in achieving the design load capacity often leads to increasing the bearing size in actual applications with penalty of higher power loss. This paper presents design feature of a novel GFTB with outer diameter of 38 mm and static performance up to 155 krpm under external load of 75 N using a high-speed test rig. The 38 mm GFTB presented in this paper is a three-layered structure for easy design and manufacturing, and the unique design feature allows easy scale down and scale up to different sizes. Reynolds equations for compressible gas and the two-dimensional thin plate model were adopted for fluid–structure interaction simulation to predict load capacity and power loss of the GFTB. The predicted power loss and load capacity agree well with the measurements.
Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation
Authors: Wrapp Daniel , Wang Nianshuang , Corbett Kizzmekia S. , Goldsmith Jory A. , Hsieh Ching-Lin , Abiona Olubukola , Graham Barney S. , McLellan Jason S.
Published: February 2020

The outbreak of a novel coronavirus (2019-nCoV) represents a pandemic threat that has been declared a public health emergency of international concern. The CoV spike (S) glycoprotein is a key target for vaccines, therapeutic antibodies, and diagnostics. To facilitate medical countermeasure development, we determined a 3.5-angstrom-resolution cryo–electron microscopy structure of the 2019-nCoV S trimer in the prefusion conformation. The predominant state of the trimer has one of the three receptor-binding domains (RBDs) rotated up in a receptor-accessible conformation. We also provide biophysical and structural evidence that the 2019-nCoV S protein binds angiotensin-converting enzyme 2 (ACE2) with higher affinity than does severe acute respiratory syndrome (SARS)-CoV S. Additionally, we tested several published SARS-CoV RBD-specific monoclonal antibodies and found that they do not have appreciable binding to 2019-nCoV S, suggesting that antibody cross-reactivity may be limited between the two RBDs. The structure of 2019-nCoV S should enable the rapid development and evaluation of medical countermeasures to address the ongoing public health crisis.
The Pyrimidine Analog FNC Potently Inhibits the Replication of Multiple Enteroviruses
Authors: Xu Na , Yang Jing , Zheng Baisong , Zhang Yan , Cao Yiming , Huan Chen , Wang Shengqi , Chang Junbiao , Zhang Wenyan
Published: February 2020

Human enterovirus (EV) pathogens cause various contagious diseases such as hand, foot, and mouth disease, encephalitis, myocarditis, acute flaccid myelitis, pneumonia, and bronchiolitis, which have become serious health threats. However, except for the EV71 vaccine on the market, there are no effective strategies to prevent and treat other EV pathogen infections. Therefore, broad-spectrum anti-EV drugs are urgently needed. In this study, we demonstrated that FNC, a small nucleoside analog inhibitor that has been demonstrated to be a potent inhibitor of HIV and entered into a clinical phase II trial in China, potently inhibits the viral replication of a multitude of EVs at the nanomolar level. Further investigation revealed that FNC inhibits positive- and negative-strand RNA synthesis of EVs by interacting and interfering with the activity of EV71 viral RNA-dependent RNA polymerase (3D
pol
). Our findings demonstrate for the first time that FNC is an effective broad-spectrum inhibitor for human EV pathogens.
Whole-Genome Sequence of the Cyanobacterium
Synechococcus
sp. Strain WH 8101
Authors: Marston Marcia F. , Polson Shawn W.
Published: February 2020

Synechococcus
spp. are unicellular cyanobacteria that are globally distributed and are important primary producers in marine coastal environments. Here, we report the complete genome sequence of
Synechococcus
sp. strain WH 8101 and identify genomic islands that may play a role in virus-host interactions.
Impact of isolation on hospitalised patients who are infectious: systematic review with meta-analysis
Authors: Purssell Edward , Gould Dinah , Chudleigh Jane
Published: February 2020

Objective

To systematically review the literature exploring the impact of isolation on hospitalised patients who are infectious: psychological and non-psychological outcomes.

Design

Systematic review with meta-analysis.

Data sources

Embase, Medline and PsycINFO were searched from inception until December 2018. Reference lists and Google Scholar were also handsearched.

Results

Twenty-six papers published from database inception to December 2018 were reviewed. A wide range of psychological and non-psychological outcomes were reported. There was a marked trend for isolated patients to exhibit higher levels of depression, the pooled standardised mean difference being 1.28 (95% CI 0.47 to 2.09) and anxiety 1.45 (95% CI 0.56 to 2.34), although both had high levels of heterogeneity, and worse outcomes for a range of care-related factors but with significant variation.

Conclusion

The review indicates that isolation to contain the risk of infection has negative consequences for segregated patients. Although strength of the evidence is weak, comprising primarily single-centre convenience samples, consistency of the effects may strengthen this conclusion. More research needs to be undertaken to examine this relationship and develop and test interventions to reduce the negative effects of isolation.
Problem and non-problem gamblers: a cross-sectional clustering study by gambling characteristics
Authors: Guillou Landreat Morgane , Chereau Boudet Isabelle , Perrot Bastien , Romo Lucia , Codina Irene , Magalon David , Fatseas Melina , Luquiens Amandine , Brousse Georges , Challet-Bouju Gaëlle , Grall-Bronnec Marie
Published: February 2020

Objectives

Gambling characteristics are factors that could influence problem gambling development. The aim of this study was to identify a typology of gamblers to frame risky behaviour based on gambling characteristics (age of initiation/of problem gambling, type of gambling: pure chance/chance with pseudoskills/chance with elements of skill, gambling online/offline, amount wagered monthly) and to investigate clinical factors associated with these different profiles in a large representative sample of gamblers.

Design and setting

The study is a cross-sectional analysis to the baseline data of the french JEU cohort study (study protocol : Challet-Boujuet al, 2014). Recruitment (April 2009 to September 2011) involved clinicians and researchers from seven institutions that offer care for or conduct research on problem gamblers (PG). Participants were recruited in gambling places, and in care centres. Only participants who reported gambling in the previous year between 18 and 65 years old were included.

Participants gave their written informed consent, it was approved by the French Research Ethics Committee.

Participants

The participants were 628 gamblers : 256 non-problem gamblers (NPG), 169 problem gamblers without treatment (PGWT) and 203 problem gamblers seeking treatment (PGST).

Results

Six clustering models were tested, the one with three clusters displayed a lower classification error rate (7.92%) and was better suited to clinical interpretation : ‘Early Onset and Short Course’ (47.5%), ‘Early Onset and Long Course’ (35%) and ‘Late Onset and Short Course’ (17.5%). Gambling characteristics differed significantly between the three clusters.

Conclusions

We defined clusters through the analysis of gambling variables, easy to identify, by psychiatrists or by physicians in primary care. Simple screening concerning these gambling characteristics could be constructed to prevent and to help PG identification. It is important to consider gambling characteristics : policy measures targeting gambling characteristics may reduce the risk of PG or minimise harm from gambling.

Trial registration number

NCT01207674(ClinicalTrials.gov); Results.
Community-based doula support for migrant women during labour and birth: study protocol for a randomised controlled trial in Stockholm, Sweden (NCT03461640)
Authors: Schytt Erica , Wahlberg Anna , Eltayb Amani , Small Rhonda , Tsekhmestruk Nataliia , Lindgren Helena
Published: February 2020

Introduction

Migrant women consistently rate their care during labour and birth more negatively than non-migrant women, due to communication difficulties, lack of familiarity with how care is provided, and discrimination and prejudicial staff attitudes. They also report being left alone, feeling fearful, unsafe and unsupported, and have poorer birth outcomes than non-migrant women. Community-based doulas (CBDs) are bilingual women from migrant communities who are trained in childbirth and labour support, and who facilitate communication between woman-partner-staff during childbirth. This study protocol describes the design, rationale and methods of a randomised controlled trial that aims to evaluate the effectiveness of CBD support for improving the intrapartum care experiences and postnatal well-being of migrant women giving birth in Sweden.

Methods and analysis

A randomised controlled trial. From six antenatal care clinics in Stockholm, Sweden, we aim to recruit 200 pregnant Somali, Arabic, Polish, Russian and Tigrinya-speaking women who cannot communicate fluently in Swedish, are 18 years or older and with no contraindications for vaginal birth. In addition to standard labour support, women are randomised to CBD support (n=100) or no such support during labour (n=100). Trained CBDs meet with women once or twice before the birth, provide emotional, physical and communication support to women throughout labour and birth in hospital, and then meet with women once or twice after the birth. Women’s ratings of the intrapartum care experiences and postnatal well-being are assessed at 6–8 weeks after the birth using selected questions from the Migrant Friendly Maternity Care Questionnaire and by the Edinburgh Postnatal Depression Scale. The intervention group will be compared with the control group using intention-to-treat analyses. ORs and 95% CIs will be estimated and adjustments made if key participant characteristics differ between trial arms.

Ethics and dissemination

The study was approved by the Regional Ethical Review Board in Stockholm (approval number: 2018/12 - 31/2).

Trial registration number

NCT03461640; Pre-results.
Use of the nominal group technique to identify UK stakeholder views of the measures and domains used in the assessment of therapeutic exercise adherence for patients with musculoskeletal disorders
Authors: Mallett Ross , McLean Sionnadh , Holden Melanie A , Potia Tanzila , Gee Melanie , Haywood Kirstie
Published: February 2020

Objectives

The objective was to the undertake nominal group technique (NGT) to evaluate current exercise adherence measures and isolated domains to develop stakeholder consensus on the domains to include in the measurement of therapeutic exercise adherence for patients with musculoskeletal disorders.

Design

A 1-day NGT workshop was convened. Six exercise adherence measures were presented to the group that were identified in our recent systematic review. Discussions considered these measures and isolated domains of exercise adherence. Following discussions, consensus voting identified stakeholder agreement on the suitability of the six offered adherence measures and the inclusion of isolated domains of exercise adherence in future measurement.

Setting

One stakeholder NGT workshop held in Sheffield, UK.

Participants

Key stakeholders from the UK were invited to participate from four identified populations. 14 participants represented patients, clinicians, researchers and service managers.

Results

All six exercise adherence measures were deemed not appropriate for use in clinical research or routine practice with no measure reaching 70% group agreement for suitability, relevance, acceptability or appropriateness. Three measures were deemed feasible to use in clinical practice. 25 constructs of exercise adherence did reach consensus threshold and were supported to be included as domains in the future measurement of exercise adherence.

Conclusion

A mixed UK-based stakeholder group felt these six measures of exercise adherence were unacceptable. Differences in opinion within the stakeholder group highlighted the lack of consensus as to what should be measured, the type of assessment that is required and whose perspective should be sought when assessing exercise adherence. Previously unused domains may be needed alongside current ones, from both a clinician's and patient’s perspective, to gain understanding and to inform future measurement development. Further conceptualisation of exercise adherence is required from similar mixed stakeholder groups in various socioeconomic and cultural populations.
‘I’ve always done what I was told by the medical people’: a qualitative study of the reasons why older adults attend multifactorial falls risk assessments mapped to the Theoretical Domains Framework
Authors: Racine Emmy , Soye Anna , Barry Patrick , Cronin Finola , Hosford Orla , Moriarty Eileen , O’Connor Kieran A , Turvey Spencer , Timmons Suzanne , Kearney Patricia M , McHugh Sheena M
Published: February 2020

Objectives

Multifactorial falls risk assessments reduce the rate of falls in older people and are recommended by international guidelines. Despite their effectiveness, their potential impact is often constrained by barriers to implementation. Attendance is an issue. The aim of this study was to explore why older people attend community-based multifactorial falls risk assessment clinics, and to map these reasons to a theoretical framework.

Design

This is a qualitative study. Semi-structured interviews were conducted and analysed thematically. Each theme and subtheme were then mapped onto the Theoretical Domains Framework (TDF) to identify the determinants of behaviour.

Participants

Older adults (aged 60 and over) who attended community-based multifactorial falls risk assessments.

Results

Sixteen interviews were conducted. Three main themes explained participants’ reasons for attending the multifactorial risk assessment; being that ‘type of person’, being ‘linked in’ with health and community services and having ‘strong social support’. Six other themes were identified, but these themes were not as prominent during interviews. These were knowing what to expect, being physically able, having confidence in and being positive towards health services, imagining the benefits given previous positive experiences, determination to maintain or regain independence, and being ‘crippled’ by the fear of falling. These themes mapped on to nine TDF domains: ‘knowledge’, ‘skills’, ‘social role and identity’, ‘optimism’, ‘beliefs about consequences’, ‘goals’, ‘environmental context and resources’, ‘social influences’ and ‘emotion’. There were five TDF domains that were not relevant to the reasons for attending.

Conclusions

These findings provide theoretically based factors that influence attendance which can be used to inform the development of interventions to improve attendance to falls prevention programmes.
Evaluation of clarity of the STOPP/START criteria for clinical applicability in prescribing for older people: a quality appraisal study
Authors: Sallevelt Bastiaan Theodoor Gerard Marie , Huibers Corlina Johanna Alida , Knol Wilma , Puijenbroek Eugene van , Egberts Toine , Wilting Ingeborg
Published: February 2020

Objectives

Appropriate prescribing in older people continues to be challenging. Studies still report a high prevalence of inappropriate prescribing in older people. To reduce the problem of underprescribing and overprescribing in this population, explicit drug optimisation tools like Screening Tool of Older Persons’ potentially inappropriate Prescriptions/Screening Tool to Alert to Right Treatment (STOPP/START) have been developed. The aim of this study was to evaluate the clinical applicability of STOPP/START criteria in daily patient care by assessing the clarity of singular criteria.

Design

Quality appraisal study.

Methods

For each of the 114 STOPP/START criteria V.2, elements describing the action (what/howto do), condition (whento do) and explanation (whyto do) were identified. Next, the clarity of these three elements was quantified on a 7-point Likert scale using tools provided by the Appraisal of Guidelines for Research and Evaluation (AGREE) Consortium.

Primary and secondary outcomes

The primary outcome measure was the clarity rating per element, categorised into high (>67.7%), moderate (33.3%–67.7%) or low (<33.3%). Secondary, factors that positively or negatively affected clarity most were identified. Additionally, the nature of the conditions was further classified into five descriptive components: disease, sign, symptom, laboratory finding and medication.

Results

STOPP recommendations had an average clarity rating of 64%, 60% and 69% for actions, conditions and explanations, respectively. The average clarity rating in START recommendations was 60% and 57% for actions and conditions, respectively. There were no statements present to substantiate the prescription of potential omissions for the 34 START criteria.

Conclusions

Our results show that the clarity of the STOPP/START criteria can be improved. For future development of explicit drug optimisation tools, such as STOPP/START, our findings identified facilitators (high clarity) and barriers (low clarity) that can be used to improve the clarity of clinical practice guidelines on a language level and therefore enhance clinical applicability.
Pramipexole in peritoneal dialysis patients with restless legs syndrome (RLS): a protocol for a multicentre double-blind randomised controlled trial
Authors: Ma Tian-tian , Yang Zhikai , Zhu Sainan , Zhao Jing-hong , Li Yi , Sun Fu-yun , Zhao Nan , Xiong Zu-ying , Xiong Zi-bo , Dong Jie
Published: February 2020

Introduction

Restless legs syndrome (RLS) is a common neurological sensorimotor disorder among patients with end stage renal disease. This clinical trial aimed to provide evidence on the efficacy and safety of pramipexole in patients with uremic RLS receiving peritoneal dialysis (PD).

Methods and analysis

This is a 12-week, multicentre, randomised, double-blind, placebo-controlled clinical trial. In total, 104 patients with uremic RLS receiving PD will be enrolled from four hospitals and randomly assigned in a 1:1 ratio to either placebo or pramipexole. We will determine the efficacy of pramipexole in the improvement of International RLS Study Group Rating Scale as the primary outcome, while responder rates for other RLS scales at week 12, change from baseline to week 12 for psychological status, sleep disorder and quality of life and blood pressure represent the secondary outcomes.

Ethics and dissemination

The study was approved by the ethics committees of Peking University First Hospital, Xinqiao hospital of Army Medical University, Cangzhou Center Hospital and Peking University Shenzhen Hospital. The results will be disseminated in peer-reviewed journals.

Trial registration number

NCT03817554
Latent tuberculosis infection screening and treatment in congregate settings (TB FREE COREA): protocol for a prospective observational study in Korea
Authors: Min Jinsoo , Kim Hyung Woo , Stagg Helen R , Lipman Marc , Rangaka Molebogeng X , Myong Jun-Pyo , Yim Hyeon Woo , Lim Jeong Uk , Lee Yunhee , Koo Hyeon-Kyoung , Lee Sung-Soon , Park Jae Seuk , Cho Kyung Sook , Kim Ju Sang
Published: February 2020

Introduction

South Korea regards tuberculosis (TB) incidence in congregate settings as a serious problem. To this end, systematic latent TB infection (LTBI) diagnosis and treatment were provided to approximately 1.2 million individuals in high-risk congregate settings.

Methods and analysis

We designed a prospective cohort study of individuals tested for LTBI, based on the data collected on all persons screened for LTBI as part of the 2017 congregate settings programme in South Korea. Four types of databases are kept: LTBI screening database (personal information and LTBI test results), national health information (NHI) database (socio-demographic data and comorbidities), public healthcare information system (PHIS) database, and the Korean national TB surveillance system database (TB outcomes). Information regarding LTBI treatment at private hospitals and public health centres is collected from NHI and PHIS databases, respectively. The screening data are cleaned, duplicates are removed, and, where appropriate, re-coded to analyse specific exposures and outcomes. The primary objective is to compare the number of active TB cases prevented within 2 years between participants undergoing treatment and not undergoing treatment in the LTBI screening programme in congregate settings. Cascade of care for LTBI diagnosis and treatment will be evaluated among those with a positive LTBI test result. A Cox proportional hazards model will be applied to determine the risk factors for developing active TB.

Ethics and dissemination

The protocol is approved by the institutional review boards of Incheon St. Mary’s Hospital, the Catholic University of Korea. Study results will be disseminated through peer-reviewed journals and conference presentations.

Trial registration number

KCT0003905
High-flow nasal oxygenation versus standard oxygenation for gastrointestinal endoscopy with sedation. The prospective multicentre randomised controlled ODEPHI study protocol
Authors: Eugene Axelle , Fromont Lucie , Auvet Adrien , Baert Olivier , Mfam Willy-Serge , Remerand Francis , Boulain Thierry , Nay Mai-Anh
Published: February 2020

Introduction

Hypoxaemia is a major complication during gastrointestinal endoscopy (GIE) procedures (upper/lower) when performed under deep sedation in the procedure room. Standard oxygen therapy (SOT) is used to prevent hypoxaemia. Data suggest that risk factors for hypoxaemia under deep sedation during GIE are obstructive sleep apnoea syndrome, a body mass index above 30 kg/m², high blood pressure, diabetes, heart disease, age over 60 years old, high American Society of Anesthesiologists physical status class and the association of upper and lower GIE. High-flow nasal oxygenation (HFNO) may potentially improve oxygenation during GIE under deep sedation. We hypothesised that HFNO could decrease the incidence of hypoxaemia in comparison with SOT.

Methods and analysis

The ODEPHI (High-flow nasaloxygenation versus standardoxygenation for gastrointestinalendoscopy withsedation. The prospective multicentre randomised controlled) study is a multicentre randomised controlled trial comparing HFNO to SOT during GIE (upper and/or lower) under deep sedation administered by anaesthesiologists in the procedure room. Three hundred and eighty patients will be randomised with a 1:1 ratio in two parallel groups.

The primary outcome is the occurrence of hypoxaemia, defined by a pulse oximetry measurement of peripheral capillary oxygen saturation (SpO2) below or equal to 92% during the GIE procedure. Secondary outcomes include prolonged hypoxaemia, severe hypoxaemia, need for manoeuvres to maintain upper airway patency and other adverse events.

Ethics and dissemination

This study has been approved by the ethics committee (CPP Sud Est Paris V, France), and patients are included after informed consent. The results will be submitted for publication in peer-reviewed journals. As provided for by French law, patients participating in the study are informed that they have the possibility to ask the investigators, once the study is completed, to be informed of the overall results of the study. Thus, a summary of the results will be sent by post to the participants on request.

Trial registration number

ClinicalTrials.gov Registry (NCT03829293).
Analysing actual prices of medical products: a cross-sectional survey of Dutch hospitals
Authors: den Ambtman Anouk , Knoben Joris , van den Hurk Dana , Van Houdenhoven Mark
Published: February 2020

Objectives

To assess whether there is a difference between the net prices of medical products used by Dutch hospitals and, if there is, how this difference can be explained.

Design

Cross-sectional self-administered electronic survey.

Setting

We surveyed the prices paid for 17 commonly used medical products, such as pacemakers, gloves and stents in 38 Dutch hospitals (including general, specialised and academic hospitals) in 2017. Hospitals voluntarily and anonymously provided these data and received a personalised free benchmark tool in return. This tool provides information about the variance in prices of the medical products they buy.

Participants

38 out of 79 hospitals entered and completed the study.

Primary and secondary outcome measures

Actual price paid excluding Value Added Tax (VAT) per item, the order size per year, total spending for an assortment group and total spending for all products purchased from a specific supplier were measured.

Results

We found large price variations for the medical products surveyed (average coefficient of variation of 71%). In general, these differences were hard to explain (average R2of 26%). Only purchasing volume (for 8 out of 17 products) was significantly associated with the net price paid by a hospital. Total spending for an assortment group (in euros with a specific supplier) and total spending (for all products in euros with a specific supplier) were not related to the net price paid.

Conclusions

We conclude that only purchasing volume is associated with lower prices paid. Total spending for an assortment group and total spending for all products purchased from a specific supplier are not. These results are in stark contrast to expectations based on economic theory. Other sources of differences in bargaining power might explain these findings. Further research might involve comparing prices across countries.
Using telemedicine to improve access, cost and quality of secondary care for people in prison in England: a hybrid type 2 implementation effectiveness study
Authors: Edge Chantal , George Julie , Black Georgia , Gallagher Michelle , Ala Aftab , Patel Shamir , Edwards Simon , Hayward Andrew
Published: February 2020

Introduction

People in prison tend to experience poorer health, access to healthcare services and health outcomes than the general population. Use of video consultations (telemedicine) has been proven effective at improving the access, cost and quality of secondary care for prisoners in the USA and Australia. Implementation and use in English prison settings has been limited to date despite political drivers for change. We plan to research the implementation of a new prison-hospital telemedicine model in an English county to understand what factors drive or hinder implementation and whether the model can improve healthcare outcomes as demonstrated in other contextual settings.

Methods and analysis

We will undertake a hybrid type 2 implementation effectiveness study to gather evidence on both clinical and implementation outcomes. Data collection will be guided by the theoretical constructs of Normalisation Process Theory. We will prospectively collect data through: (1) prisoner/patient focus groups, interviews and questionnaires, (2) prison healthcare, hospital and wider prison staff interviews and questionnaires, (3) routine quality improvement and service evaluation data. Up to four prisons and three hospital settings in Surrey (England) will be included in the telemedicine research, dependent on their telemedicine readiness during the study period. Prisons proposed include male and female prisoners, remand (not yet sentenced) and sentenced individuals and different security categorisations. In addition, focus groups in five telemedicine naïve prisons will provide information on patient preconceptions and concerns surrounding telemedicine.

Ethics and dissemination

This study has received National Health Service Research Ethics Committee, Her Majesty’s Prison and Probation Service National Research Committee and Health Research Authority approval. Dissemination of results will take place through peer-reviewed journals, conferences and existing health and justice networks.
A comparative analysis of Donald Bradman and Steven Smith: what are their secrets?
Authors: Noorbhai Habib
Published: February 2020

There has been growing evidence on the batting backlift technique in cricket at varying levels of cricket ability and the way in which batsmen direct or manoeuvre their bat in various ways. Most recently, there has been elevated awareness and discussion around the technique of Steven Smith. To an extent, there has been some comparison and reference been made to Sir Donald Bradman. Both Donald Bradman and Steven Smith have exhibited techniques and movements at the crease which many regard as ‘unorthodox’ or ‘unnatural’. This paper compares each of the batting technique components of both batsmen. The paper describes that both Bradman and Smith held their bat with an open grip which allowed them to hit the ball in most scoring areas of the field. The most common element that both batsmen demonstrate is a backlift that is directed towards the gulley or point region, otherwise known as the rotary method of batting, which is contrary to most of the coaching literature. Future research would require objective measures on Steven Smith to fully understand the kinetics and kinematics associated with his batting technique. The variances of performance averages across other formats (one-day internationals and 20-20 cricket) must be noted.
Associations of appetite sensations and metabolic characteristics with weight retention in postpartum women
Authors: Pereira Leticia C.R. , Elliott Sarah A. , McCargar Linda J. , Bell Rhonda C. , Robson Paula J. , Prado Carla M. ,   the ENRICH Study Team
Published: February 2020

Postpartum weight retention (PPWR) is an important risk factor for long-term obesity. Appetite may be a key factor regulating PPWR. The objectives of this study were to determine the associations between (i) PPWR and appetite; and (ii) appetite, lactation, and metabolic characteristics. Data from 49 women at 9 months postpartum contributed to this cross-sectional analysis. Energy expenditure was assessed in a whole-body calorimetry unit for 24 h. Appetite sensations were rated using visual analogue scales. Lactation (min/day) was measured using a 3-day breastfeeding diary. PPWR was negatively associated with fullness (β ± SE; R2 = –2.97 ± 0.72; 0.661; P < 0.001), and satiety (–2.75 ± 0.81; 0.617; P = 0.002), and was positively associated with hunger (2.19 ± 1.02; 0.548; P = 0.039), prospective food consumption (PFC; 2.19 ± 0.91; 0.562; P = 0.021), and composite appetite score (CAS; 0.34 ± 0.09; 0.632; P = 0.001). Lactation was associated with higher CAS (39.68 ± 15.56; 0.365; P = 0.015), hunger (3.56 ± 1.61; 0.308; P = 0.033), and PFC (4.22 ± 1.78; 0.314; P = 0.023), and with reduced sensations of fullness (–4.18 ± 1.94; 0.358; P = 0.038) and satiety (–3.83 ± 1.87; 0.295; P = 0.048). Lactation was associated with appetite, which in turn was related to PPWR. Appetite control should be explored to support postpartum weight management strategies.

Novelty Postpartum weight retention was associated with appetite sensations, which were assessed throughout the day under conditions in which energy intake and expenditure were precisely matched. Lactation and other maternal metabolic factors, including carbohydrate oxidation and physical activity level may play a role in controlling appetite during the postpartum period.
Effect of microbially induced cementation on the instability and critical state behaviours of Fraser River sand
Authors: Riveros Guillermo Alexander , Sadrekarimi Abouzar
Published: February 2020

Microbially induced calcite precipitation (MICP) is a naturally driven biological process that harnesses the natural metabolic action of bacteria to induce the precipitation of calcium carbonate and alter soil engineering properties. This paper presents the results of using MICP to improve the monotonic undrained yield and critical strengths of Fraser River sand specimens. Bacteria called “Sporosarcina ureae” are employed as a ureolytic organism to achieve MICP. The formation of calcite cementation among sand particles is confirmed using scanning electron microscopic images and X-ray compositional analysis of cemented sand clusters. The progress of MICP cementation is assessed by measuring the velocity of a shear wave (VS) traveling through the specimen. The results show that VS starts to increase just as the calcium solution is introduced into each specimen after soaking the samples with the bacterial solution. Improvement in monotonic strength of sand samples is subsequently measured in a series of direct simple shear tests. Due to the combined effects of particle cementation and densification, the sand’s undrained and drained monotonic shearing strengths are significantly enhanced.
On the deconfinement phase transition in neutron-star mergers
Authors: Most Elias R. , Jens Papenfort L. , Dexheimer Veronica , Hanauske Matthias , Stoecker Horst , Rezzolla Luciano
Published: February 2020

We study in detail the nuclear aspects of a neutron-star merger in which deconfinement to quark matter takes place. For this purpose, we make use of the Chiral Mean Field (CMF) model, an effective relativistic model that includes self-consistent chiral symmetry restoration and deconfinement to quark matter and, for this reason, predicts the existence of different degrees of freedom depending on the local density/chemical potential and temperature. We then use the out-of-chemical-equilibrium finite-temperature CMF equation of state in full general-relativistic simulations to analyze which regions of different QCD phase diagrams are probed and which conditions, such as strangeness and entropy, are generated when a strong first-order phase transition appears. We also investigate the amount of electrons present in different stages of the merger and discuss how far from chemical equilibrium they can be and, finally, draw some comparisons with matter created in supernova explosions and heavy-ion collisions.
Jeans analysis in energy–momentum-squared gravity
Authors: Kazemi Ali , Roshan Mahmood , De Martino Ivan , De Laurentis Mariafelicia
Published: February 2020

In this paper, we study the Jeans analysis in the context of energy–momentum-squared gravity (EMSG). More specifically we find the new Jeans mass for non-rotating infinite mediums as the smallest mass scale for local perturbations that can be stable against its own gravity. Furthermore, for rotating mediums, specifically for rotating thin disks in the context of EMSG, we find a new Toomre-like criterion for the local gravitational stability. Finally, the results are applied to a hyper-massive neutron star, as an astrophysical system. Using a simplified toy model we have shown that, for a positive (negative) value of the EMSG parameter $$\alpha $$α, the system is stable (unstable) in a wide range of $$\alpha $$α. On the other hand, no observational evidence has been reported on the existence of local fragmentation in HMNS. Naturally, this means that EMSG with positive $$\alpha $$α is more acceptable from the physical point of view.
Dynamics of holomorphic correspondences on Riemann surfaces
Authors: Dinh Tien-Cuong , Kaufmann Lucas , Wu Hao
Published: February 2020

We study the global dynamics of holomorphic correspondences [Formula: see text] on a compact Riemann surface [Formula: see text] in the case, so far not well understood, where [Formula: see text] and [Formula: see text] have the same topological degree. In the absence of a mild and necessary obstruction that we call weak modularity, [Formula: see text] admits two canonical probability measures [Formula: see text] and [Formula: see text] which are invariant by [Formula: see text] and [Formula: see text] respectively. If the critical values of [Formula: see text] (respectively, [Formula: see text]) are not periodic, the backward (respectively, forward) orbit of any point [Formula: see text] equidistributes towards [Formula: see text] (respectively, [Formula: see text]), uniformly in [Formula: see text] and exponentially fast.
Dynamical analysis of Brans–Dicke universe with inverse power-law effective potential
Authors: Sim Jonghyun , Park Jiwon , Lee Tae Hoon
Published: February 2020

We study Brans–Dicke cosmology with an inverse power-law effective potential. By using dynamical analyses, we search for fixed points corresponding to the radiation-like matter and dark energy-dominated era of our Universe, and the stability of fixed points is also investigated. We find phase space trajectories which are attracted to the stable point of the dark energy-dominated era from unstable fixed points like matter-dominated era of the Universe. The dark energy comes from effective potentials of the Brans–Dicke field, whose variation (related to the time-variation of the gravitational coupling constant) is shown to be in good agreement with observational data.
Charged anisotropic compact stars in Logarithmic-Corrected R2 gravity
Authors: Shamir M. Farasat , Fayyaz I.
Published: February 2020

We consider [Formula: see text] corrected model, i.e. [Formula: see text], where [Formula: see text] is the Ricci scalar and [Formula: see text], [Formula: see text] are arbitrary constant values, to investigate some of the interior configurations of static anisotropic spherical charged stellar structures. The existence of electric charge and a strong electric field confirms due to the higher values of pressure distribution and energy density of the matter inside the stars. Furthermore, for compact star configurations, we also consider the simplified MIT bag model equation of state (EoS) given by [Formula: see text], where [Formula: see text] is radial pressure, [Formula: see text] is energy density and [Formula: see text] is bag constant. This approach allows to find electric charge from the Einstein–Maxwell field equations. We have extensively discussed the behavior of the electric charge and anisotropic fluid distribution factor for five different values of [Formula: see text]. Interestingly, it is noticed during this study, for smaller values of [Formula: see text] we get intensity in electric charge. The Tolman–Oppenheimer–Volkoff equation (TOV), is modified in order to carry electric charge. In particular, we model the compact star candidates SAXJ 1808.4–3658 and Vela X-1 and give graphical representation of some important properties such as equilibrium condition, mass-radius ratio and surface redshift. In the end, our calculated solutions provide strong evidences for more realistic and viable charged stellar model.
Microstructure evolution and mechanical properties of W/MA956 joints by brazing
Authors: Chen Yuanting , Li Xianfen , Hua Peng , Chen Boyan , Wu Yucheng , Zhou Wei
Published: February 2020

Brazing experiments between tungsten and MA956 ODS steel were conducted at [Formula: see text] with different holding time to investigate the interface microstructure evolution and mechanical properties of the brazed joints. The interface microstructures were analyzed by the scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and X-ray diffraction (XRD), and the mechanical properties of the joints were measured to find the optimal brazing parameter. The results show that tungsten and MA956 steel has been successfully joined by brazing. The intermetallic compound of Ni–W formed at the W/BNi-2 interface, which was detrimental to the strength of the joint. Due to the excellent mutual solubility between Fe and Ni, no new formed intermetallic compound was found at MA956-brazing filler interface. The shear strength of the brazed joints with BNi-2 filler reached 246 MPa at the optimal brazing parameter [Formula: see text].
Impact of resistive switching parameters on resistive random access memory crossbar arrays
Authors: Fu Liping , Chen Sikai , Wu Zewei , Li Xiaoyan , You Mingyang , Fan Xiaolong , Gao Xiaoping , Li Yingtao
Published: February 2020

Sneak current issue of RRAM-based crossbar array is one of the biggest hindrances for high-density memory application. The integration of an addition selector to each cell is one of the most familiar solutions to avoid this undesired cross-talk issue, and resistive switching parameters would affect on the storage density. This paper investigates the potential impact of different resistive switching parameters on crossbar arrays with one-diode one-resistor (1D1R) and one-selector one-resistor (1S1R) architectures. Results indicate that 1S1R architecture is a more scalable technology for high-density crossbar array than 1D1R, and the storage density of 1D1R- and 1S1R-based crossbar array shows little dependence on resistance values of high-resistance state and low-resistance state, which gives a guideline for choosing appropriate selectors for RRAM crossbar array with specific parameters.
The knot Floer cube of resolutions and the composition product
Authors: Dowlin Nathan
Published: February 2020

We examine the relationship between the oriented cube of resolutions for knot Floer homology and HOMFLY-PT homology. By using a filtration induced by additional basepoints on the Heegaard diagram for a knot [Formula: see text], we see that the filtered complex decomposes as a direct sum of HOMFLY-PT complexes of various subdiagrams. Applying Jaeger’s composition product formula for knot polynomials, we deduce that the graded Euler characteristic of this direct sum is the HOMFLY-PT polynomial of [Formula: see text].
Vibration Analysis of Coupled Multilayer Structures with Discrete Connections for Noise Prediction
Authors: Lu Zheng , Li Junzuo , Li Qi
Published: February 2020

It is often necessary to calculate the vibration of noise from multilayer structures comprising several substructures coupled with discrete connections. A dynamic flexibility method (DFM) is adopted to decouple the multilayer substructures, which allows the interface forces among the substructures to be directly solved using a linear equation of deformation compatibility. The structural vibrations and power flows into each substructure can then be calculated. To illustrate the use of the DFM, a coupled train–track–bridge system for urban rail transit traffic is investigated as a case study. Two infinite plate models are used to model the U-shaped bridge substructure to improve the computing efficiency compared with the finite element models in calculating high-frequency vibration. The applicability of the infinite plate models is discussed in terms of various rail positions on the bridge, the thickness of the rail support blocks, and multiple wheels that interface with the rail. The results show that the Mindlin plate model has similar accuracy but much greater computing efficiency than the finite element models. With the vibration results from the DFM, the associated wheel–rail noise and structure-borne noise from the bridge are then calculated together with a 2D acoustic model. Good agreement is observed between the predicted noises and the measured data.